Erschienen in:
01.02.2012 | Case Report
Sympathetic noradrenergic before striatal dopaminergic denervation: relevance to Braak staging of synucleinopathy
verfasst von:
David S. Goldstein, Courtney Holmes, LaToya Sewell, Mee Yeong Park, Yehonatan Sharabi
Erschienen in:
Clinical Autonomic Research
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Ausgabe 1/2012
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Abstract
Braak’s staging concept of Lewy body disease pathogenesis is based on a spatiotemporal sequence of alpha-synuclein deposition, with autonomic nervous system involvement before synucleinopathy in substantia nigra neurons. A patient with primary chronic autonomic failure underwent biennial brain 6-[18F]DOPA and myocardial 6-[18F]dopamine scanning over 4 years. Low myocardial radioactivity indicated cardiac noradrenergic denervation that persisted. Striatal 6-[18F]DOPA-derived radioactivity initially was normal, 2 years later was decreased subtly, and by 4 years was clearly decreased, accompanied by dementia and parkinsonism. In this case, neuroimaging evidence of cardiac noradrenergic denervation and subsequent progressive striatal dopaminergic denervation fit with Braak staging.