Cardiac sympathetic denervation could be associated with dysphagia in Parkinson's disease

Jinyoung Youn; George Umemoto; Eungseok Oh; Jinse Park; Wooyoung Jang; Yoon-Sang Oh; Hee-Tae Kim; Jin Whan Cho; Shinsuke Fujioka; Yoshio Tsuboi

doi:10.3389/fneur.2022.1010006

Cardiac sympathetic denervation could be associated with dysphagia in Parkinson's disease

Front Neurol. 2022 Oct 11:13:1010006. doi: 10.3389/fneur.2022.1010006. eCollection 2022.

Authors

Jinyoung Youn¹, George Umemoto², Eungseok Oh³, Jinse Park⁴, Wooyoung Jang⁵, Yoon-Sang Oh⁶, Hee-Tae Kim⁷, Jin Whan Cho¹, Shinsuke Fujioka⁸, Yoshio Tsuboi⁸

Affiliations

¹ Department of Neurology, Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul, South Korea.
² Swallowing Disorders Center, Fukuoka University Hospital, Fukuoka, Japan.
³ Department of Neurology, Chungnam National University College of Medicine, Chungnam National University Hospital, Daejeon, South Korea.
⁴ Department of Neurology, Inje University, Haeundae Paik Hospital, Busan, South Korea.
⁵ Department of Neurology, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, South Korea.
⁶ Department of Neurology, College of Medicine, The Catholic University of Korea, Seoul, South Korea.
⁷ Department of Neurology, Hanyang University College of Medicine, Seoul, South Korea.
⁸ Department of Neurology, Faculty of Medicine, Fukuoka University, Fukuoka, Japan.

Abstract

Background: Dysphagia is an important non-motor symptom that is closely associated with quality of living and mortality in Parkinson's disease (PD). However, the pathophysiology of dysphagia in PD remains inconclusive. We tried to confirm whether the occurrence of dysphagia could be related to sympathetic degeneration using cardiac ¹²³I-metaiodobenzylguanidine (MIBG) scintigraphy.

Methods: We prospectively recruited 27 PD patients and classified them into two groups (PD with dysphagia vs. PD without dysphagia) by Swallowing Disturbance Questionnaire (SDQ) score and compared the clinical characteristics, videofluoroscopic swallowing study (VFSS) findings and parameters from cardiac MIBG scintigraphy.

Results: The mean early and late H/M ratios were significantly lower in the PD with dysphagia group than those in the PD without dysphagia group (1.39 ± 0.21 vs. 1.86 ± 0.21, p < 0.01; 1.26 ± 0.18 vs. 1.82 ± 0.29, p < 0.01). In the correlation analysis, both the early and late H/M ratios were negatively correlated with the SDQ score and total VDS score (r = -0.65, p < 0.01; r = -0.53, p < 0.01; r = -0.65, p < 0.01, r = -0.58, p < 0.01).

Conclusion: We confirmed that cardiac sympathetic denervation might be associated with the presence and severity of dysphagia. This finding indicates that dysphagia in PD could be associated with a nondopaminergic mechanism.

Keywords: 123I-metaiodobenzylguanidine (MIBG); Parkinson's disease; VFSS; dysphagia; non-motor symptoms; swallowing.