PMID- 27539837
OWN - NLM
STAT- MEDLINE
DCOM- 20170501
LR  - 20181113
IS  - 1535-5667 (Electronic)
IS  - 0161-5505 (Print)
IS  - 0161-5505 (Linking)
VI  - 58
IP  - 2
DP  - 2017 Feb
TI  - 2-Year Natural Decline of Cardiac Sympathetic Innervation in Idiopathic Parkinson 
      Disease Studied with 11C-Hydroxyephedrine PET.
PG  - 326-331
LID - 10.2967/jnumed.116.176891 [doi]
AB  - The objective of this study was to detect regional patterns of cardiac 
      sympathetic denervation in idiopathic Parkinson disease (IPD) using 
      (11)C-hydroxyephedrine ((11)C-HED) PET and determine the denervation rate over 2 
      y. METHODS: We obtained 62 cardiac (11)C-HED PET scans in 39 patients (30 men and 
      9 women; mean age +/- SD, 61.9 +/- 5.9 y), including 23 patients with follow-up scans 
      at 2 y. We derived (11)C-HED retention indices (RIs; mL of blood/min/mL of 
      tissue) reflecting nerve density and integrity for 480 left ventricular (LV) 
      sectors. We compared IPD patients with 33 healthy controls using z score 
      analysis; RI values </= 2.5 SDs were considered abnormal. We expressed global and 
      regional LV denervation as the percentage extent of z score severity and 
      severity-extent product (SEP) on 9-segment bullseye maps and decline in cardiac 
      sympathetic innervation as the 2-y difference in SEP (diff-SEP). RESULTS: 
      Baseline (11)C-HED PET in the 39 IPD patients revealed an RI mean of 0.052 +/- 
      0.022 mL of blood/min/mL of tissue. In comparison with data from normal controls, 
      12 patients had normal (11)C-HED PET, 5 showed mild denervation (percentage 
      extent < 30%), and 22 had moderate to severe denervation (percentage extent > 
      30%, z score </= 2.5 SD). In the 23 paired PET scans, worsening cardiac denervation 
      (global diff-SEP > 9) occurred in 14 of 23 (60.9%) patients over 2 y, including 
      percentage LV abnormality (59% increasing to 66%), z-severity (-2.4 down to 
      -2.5), and SEP (-195 to -227) (P = 0.0062). We found a mean annual decline of 
      4.6% +/- 5.6 (maximum, 13%) in (11)C-HED retention from a baseline global RI mean 
      of 0.0481 +/- 0.0218 to 0.0432 +/- 0.0220 (P = 0.0009). At baseline, 5 patients with 
      normal uptake had no interval change; 3 with mild denervation developed interval 
      decline in lateral and inferior segments (diff-SEP -82 to -99) compared with 
      anterior and septal segments (-65 to -79), whereas the reverse pattern occurred 
      in 15 patients with severe baseline denervation. CONCLUSION: Progressive decline 
      in cardiac sympathetic neural integrity in IPD patients occurs at a modest rate 
      over 2 y on (11)C-HED scans with marked heterogeneity and a regional pattern of 
      involvement and decline.
CI  - (c) 2017 by the Society of Nuclear Medicine and Molecular Imaging.
FAU - Wong, Ka Kit
AU  - Wong KK
AD  - Division of Nuclear Medicine, Department of Radiology, University of Michigan, 
      Ann Arbor, Michigan kakit@med.umich.edu.
AD  - VA Ann Arbor Healthcare System, GRECC, Ann Arbor, Michigan.
FAU - Raffel, David M
AU  - Raffel DM
AD  - Division of Nuclear Medicine, Department of Radiology, University of Michigan, 
      Ann Arbor, Michigan.
FAU - Bohnen, Nicolaas I
AU  - Bohnen NI
AD  - Division of Nuclear Medicine, Department of Radiology, University of Michigan, 
      Ann Arbor, Michigan.
AD  - VA Ann Arbor Healthcare System, GRECC, Ann Arbor, Michigan.
AD  - Functional Neuroimaging, Cognitive and Mobility Laboratory, Departments of 
      Radiology and Neurology, University of Michigan, Ann Arbor, Michigan.
AD  - University of Michigan Morris K. Udall Center of Excellence for Parkinson's 
      Disease Research, Ann Arbor, Michigan.
FAU - Altinok, Gulcin
AU  - Altinok G
AD  - Division of Nuclear Medicine, Department of Radiology, University of Michigan, 
      Ann Arbor, Michigan.
FAU - Gilman, Sid
AU  - Gilman S
AD  - Department of Neurology, University of Michigan (retired), Ann Arbor, Michigan; 
      and.
FAU - Frey, Kirk A
AU  - Frey KA
AD  - Division of Nuclear Medicine, Department of Radiology, University of Michigan, 
      Ann Arbor, Michigan.
AD  - Department of Neurology, University of Michigan, Ann Arbor, Michigan.
LA  - eng
GR  - P50 NS091856/NS/NINDS NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
DEP - 20160818
PL  - United States
TA  - J Nucl Med
JT  - Journal of nuclear medicine : official publication, Society of Nuclear Medicine
JID - 0217410
RN  - 0 (Radiopharmaceuticals)
RN  - 3002-40-2 (3-hydroxyephedrine)
RN  - GN83C131XS (Ephedrine)
SB  - IM
MH  - Aged
MH  - Autonomic Nervous System Diseases/*diagnostic imaging/etiology
MH  - Disease Progression
MH  - Ephedrine/*analogs & derivatives
MH  - Female
MH  - Heart/*diagnostic imaging/*innervation
MH  - Humans
MH  - Longitudinal Studies
MH  - Male
MH  - Middle Aged
MH  - Parkinson Disease/complications/*diagnostic imaging
MH  - Positron-Emission Tomography/*methods
MH  - Radiopharmaceuticals
MH  - Reproducibility of Results
MH  - Sensitivity and Specificity
PMC - PMC5288743
OTO - NOTNLM
OT  - 11C-hydroxyephedrine PET
OT  - Parkinson disease
OT  - autonomic nervous system
OT  - cardiac sympathetic denervation
EDAT- 2016/08/20 06:00
MHDA- 2017/05/02 06:00
PMCR- 2017/08/01
CRDT- 2016/08/20 06:00
PHST- 2016/04/15 00:00 [received]
PHST- 2016/07/21 00:00 [accepted]
PHST- 2016/08/20 06:00 [pubmed]
PHST- 2017/05/02 06:00 [medline]
PHST- 2016/08/20 06:00 [entrez]
PHST- 2017/08/01 00:00 [pmc-release]
AID - jnumed.116.176891 [pii]
AID - 176891 [pii]
AID - 10.2967/jnumed.116.176891 [doi]
PST - ppublish
SO  - J Nucl Med. 2017 Feb;58(2):326-331. doi: 10.2967/jnumed.116.176891. Epub 2016 Aug 
      18.