Decreased intestinal acetylcholinesterase in early Parkinson disease
An 11C-donepezil PET study
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Abstract
Objective: To investigate systemic levels of acetylcholinesterase in early Parkinson disease (PD) with 11C-donepezil PET, a potential marker of parasympathetic innervation.
Methods: This was a cross-sectional study with 19 patients with early-stage PD (disease duration 1.5 ± 0.6 years) and 16 age-matched controls who had clinical assessments, olfaction tests, and 11C-donepezil PET to measure acetylcholinesterase density in peripheral organs.
Results: The patients with PD showed significantly reduced 11C-donepezil uptake in the small intestine (−14%, p = 0.018), colon (−22%, p < 0.001), and kidneys (−14%, p = 0.028). No difference in myocardial or pancreatic acetylcholinesterase levels was seen.
Conclusion: We found significantly decreased 11C-donepezil signal in the intestine and kidneys of patients with early PD, suggesting that parasympathetic denervation is present early in the disease course.
GLOSSARY
- AUC=
- area under the curve;
- HU=
- Hounsfield units;
- MMSE=
- Mini-Mental State Examination;
- PD=
- Parkinson disease;
- PNS=
- parasympathetic nervous system;
- ROC=
- receiver-operating characteristic;
- SUV=
- standardized uptake value;
- UPDRS=
- Unified Parkinson's Disease Rating Scale;
- VOI=
- volume of interest
Footnotes
Go to Neurology.org for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.
Supplemental data at Neurology.org
- Received May 25, 2016.
- Accepted in final form November 29, 2016.
- © 2017 American Academy of Neurology
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