Rapid Communication| Volume 216, P59-62, January 2019

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Association of autonomic symptoms with presynaptic striatal dopamine depletion in drug-naive Parkinson's disease: An analysis of the PPMI data

  • Ryul Kim
    Department of Neurology, Aerospace Medical Center, Republic of Korea Air Force, Cheongju, Republic of Korea
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  • Jin-Sun Jun
    Corresponding author at: Department of Neurology, Kyungpook National University, Kyungpook National University Chilgok Hospital, 807 Hoguk-ro, Buk-gu, Daegu 41404, Republic of Korea.
    Department of Neurology, School of Medicine, Kyungpook National University, Kyungpook National University Chilgok Hospital, Daegu, Republic of Korea
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Published:September 15, 2018DOI:


      • Association of striatal dopamine depletion with autonomic symptoms was assessed in untreated PD.
      • Autonomic symptoms were evaluated using the SCOPA-AUT.
      • Lower DAT activity in the putamen but not in the caudate was related to urinary symptoms.
      • Striatal DAT activities were not associated with other autonomic symptoms.


      While the involvement of the central and peripheral autonomic networks is thought to play an integral role in the development of autonomic symptoms in Parkinson's disease (PD), there is little evidence for an association between autonomic symptoms and striatal dopaminergic depletion. We compared dopamine transporter activity in striatal subregions with various autonomic symptoms covered by the SCOPA-AUT domains including gastrointestinal, urinary, cardiovascular, thermoregulatory, pupillomotor, and sexual symptoms in 418 untreated patients with PD. We found evidence for a dopaminergic association with only urinary symptoms. Moreover, dopaminergic denervation in the putamen but not in the caudate may underlie these symptoms.


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        • Coon E.A.
        • Cutsforth-Gregory J.K.
        • Benarroch E.E.
        Neuropathology of autonomic dysfunction in synucleinopathies.
        Mov. Disord. 2018; 33: 349-358
        • Dayan E.
        • Sklerov M.
        • Browner N.
        Disrupted hypothalamic functional connectivity in patients with PD and autonomic dysfunction.
        Neurology. 2018; 90: e2051-e2058
        • Forjaz M.J.
        • Ayala A.
        • Rodriguez-Blazquez C.
        • Frades-Payo B.
        • Martinez-Martin P.
        Assessing autonomic symptoms of Parkinson's disease with the SCOPA-AUT: a new perspective from Rasch analysis.
        Eur. J. Neurol. 2010; 17: 273-279
        • Kim R.
        • Jeon B.
        Nonmotor effects of conventional and transdermal dopaminergic therapies in Parkinson's disease.
        Int. Rev. Neurobiol. 2017; 134: 989-1018
        • Kim R.
        • Lee J.
        • Kim Y.
        • Kim A.
        • Jang M.
        • Kim H.J.
        • et al.
        Presynaptic striatal dopaminergic depletion predicts the later development of freezing of gait in de novo Parkinson's disease: an analysis of the PPMI cohort.
        Parkinsonism Relat. Disord. 2018; 51: 49-54
        • Kitta T.
        • Kakizaki H.
        • Furuno T.
        • Moriya K.
        • Tanaka H.
        • Shiga T.
        • et al.
        Brain activation during detrusor overactivity in patients with Parkinson's disease: a positron emission tomography study.
        J. Urol. 2006; 175: 994-998
        • Matsuura S.
        • Kakizaki H.
        • Mitsui T.
        • Shiga T.
        • Tamaki N.
        • Koyanagi T.
        Human brain region response to distention or cold stimulation of the bladder: a positron emission tomography study.
        J. Urol. 2002; 168: 2035-2039
        • Merola A.
        • Romagnolo A.
        • Rosso M.
        • Suri R.
        • Berndt Z.
        • Maule S.
        • et al.
        Autonomic dysfunction in Parkinson's disease: a prospective cohort study.
        Mov. Disord. 2018; 33: 391-397
        • Muller B.
        • Larsen J.P.
        • Wentzel-Larsen T.
        • Skeie G.O.
        • Tysnes O.B.
        Autonomic and sensory symptoms and signs in incident, untreated Parkinson's disease: frequent but mild.
        Mov. Disord. 2011; 26: 65-72
        • Panicker J.N.
        • Fowler C.J.
        • Kessler T.M.
        Lower urinary tract dysfunction in the neurological patient: clinical assessment and management.
        Lancet Neurol. 2015; 14: 720-732
        • Sakakibara R.
        • Shinotoh H.
        • Uchiyama T.
        • Yoshiyama M.
        • Hattori T.
        • Yamanishi T.
        SPECT imaging of the dopamine transporter with [(123)I]-beta-CIT reveals marked decline of nigrostriatal dopaminergic function in Parkinson's disease with urinary dysfunction.
        J. Neurol. Sci. 2001; 187: 55-59
        • Winge K.
        • Friberg L.
        • Werdelin L.
        • Nielsen K.K.
        • Stimpel H.
        Relationship between nigrostriatal dopaminergic degeneration, urinary symptoms, and bladder control in Parkinson's disease.
        Eur. J. Neurol. 2005; 12: 842-850