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Patients with pure autonomic failure or parkinsonism and sympathetic neurocirculatory failure had no myocardial 6-[18F]fluorodopamine-derived radioactivity or cardiac norepinephrine spillover,indicating loss of myocardial sympathetic-nerve terminals,whereas patients with the Shy- Drager syndrome had increased levels of 6-[18F]fluorodopamine-derived radioactivity,indicating intact sympathetic terminals and absent nerve traffic.Patients with dysautonomia who did not have sympathetic neurocirculatory failure had normal levels of 6[18]fluorodopamine-derived radioactivity in myocardium and normal rates of cardiac norepinephrine spillover.The results of 6-[18]fluorodopamine positron-emission tomography and neurochemical analyses support a new clinical pathophysiologic classification of dysautonomias,based on the occurrence of sympathetic neurocirculatory failure,signs of central neurodegeneration,and responsiveness to levodopa-carbidopa. |
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autonomic dysfunction
autonomic dysfunction,evaluation of
autonomic nervous system
CAT scan,emission
CAT scan,emission,abnormal
L-dopa
multiple system atrophy
neurologic disease,diagnoses of
parasympathetic nervous system
Parkinson disease
Parkinsonism multiple-system atrophy
pure autonomic failure
review article
Shy-Drager syndrome
sinemet
sympathetic nervous system
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