This article requires a subscription to view the full text. If you have a subscription you may use the login form below to view the article. Access to this article can also be purchased.
Differential diagnosis between PD and multiple-system atrophy (MSA) is often difficult, especially in early disease stages. Recent studies have shown that [123I]metaiodobenzylguanidine (MIBG) myocardial scintigraphy is useful to separate PD from MSA; MIBG uptake in PD is significantly lower than in MSA.1-3⇓⇓ However, a pathophysiologic mechanism for the decrease in myocardial MIBG uptake in PD and MSA remains to be elucidated. We describe a patient with PD and a patient with MSA. Postmortem examination revealed a severe loss of myocardial sympathetic nerve fibers in the former but not in the latter.
Case reports.
Patient 1.
An 80-year-old woman developed bradykinesia and gait disturbance, followed by right dominant resting hand tremor and rigidity, postural instability, severe constipation, and orthostatic hypotension. Dopaminergic therapy such as levodopa/carbidopa was given and effective for bradykinesia, rigidity, and tremor. She was diagnosed as having PD at the age of 82 years. Her condition deteriorated; she occasionally experienced syncope. She died of bronchopneumonia at 84 years old. MIBG myocardial scintigraphy, at the age of 83 years, showed …
AAN Members
We have changed the login procedure to improve access between AAN.com and the Neurology journals. If you are experiencing issues, please log out of AAN.com and clear history and cookies. (For instructions by browser, please click the instruction pages below). After clearing, choose preferred Journal and select login for AAN Members. You will be redirected to a login page where you can log in with your AAN ID number and password. When you are returned to the Journal, your name should appear at the top right of the page.
AAN Non-Member Subscribers
Purchase access
Letters: Rapid online correspondence
REQUIREMENTS
You must ensure that your Disclosures have been updated within the previous six months. Please go to our Submission Site to add or update your Disclosure information.
Your co-authors must send a completed Publishing Agreement Form to Neurology Staff (not necessary for the lead/corresponding author as the form below will suffice) before you upload your comment.
If you are responding to a comment that was written about an article you originally authored:
You (and co-authors) do not need to fill out forms or check disclosures as author forms are still valid
and apply to letter.
Submission specifications:
- Submissions must be < 200 words with < 5 references. Reference 1 must be the article on which you are commenting.
- Submissions should not have more than 5 authors. (Exception: original author replies can include all original authors of the article)
- Submit only on articles published within 6 months of issue date.
- Do not be redundant. Read any comments already posted on the article prior to submission.
- Submitted comments are subject to editing and editor review prior to posting.
You May Also be Interested in
Topics Discussed
Alert Me
Recommended articles
α-SYNUCLEIN ACCUMULATION IN SKIN NERVE FIBERS REVEALED BY SKIN BIOPSY IN PURE AUTONOMIC FAILURE
The Parkinson chimera
Lewy body–type degeneration in cardiac plexus in Parkinson’s and incidental Lewy body diseases
What Is the Clinical Correlation of Cardiac Noradrenergic Denervation in Parkinson Disease?