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Neurology 2003;60:1036-1039
© 2003 American Academy of Neurology
Brief Communications

Neurotransmitter specificity of sympathetic denervation in Parkinson’s disease

Y. Sharabi, MD, S.-T. Li, MD PhD, R. Dendi, MD, C. Holmes, CMT and D.S. Goldstein, MD PhD

From the Clinical Neurocardiology Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD.

Address correspondence and reprint requests to Dr. David S. Goldstein, Clinical Neurocardiology Section, NINDS, NIH, Building 10 Room 6N252, 10 Center Drive, MSC-1620, Bethesda, MD 20892-1620; e-mail: goldsteind{at}ninds.nih.gov

In PD, orthostatic hypotension reflects sympathetic noradrenergic denervation. The authors assessed sympathetic cholinergic innervation by the quantitative sudomotor axon reflex test (QSART) in 12 patients who had sympathetic neurocirculatory failure, markedly decreased cardiac 6-[18F] fluorodopamine-derived radioactivity, and subnormal plasma norepinephrine increments during standing. All 12 had normal QSART results. The sympathetic nervous system lesion in PD involves loss of postganglionic catecholaminergic but not cholinergic nerves.




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