Cardiac sympathetic denervation and synucleinopathy in Alzheimer’s disease with brain Lewy body disease

• DOI: 10.1093/braincomms/fcaa004
• Publication Date: 2020-01-28T14:26:36Z
• Authors: Geidy E Serrano; David Shprecher; Michael Callan; Brett Cutler; Michael Glass; Nan Zhang; Jessica Walker; Anthony Intorcia; Charles H Adler; Holly A Shill; Erika Driver-Dunc...; Shyamal H Mehta; Christine M Belden; Edward Zamrini; Lucia I Sue; Daisy Vargas; Thomas G Beach
• Keywords: Lewy body; Lewy body disease; Sympathetic Denervation

Comorbid Lewy body pathology is very common in Alzheimer's disease and may confound clinical trial design, yet there no vivo test to identify patients with this. Tissue (and/or radioligand imaging) studies have shown cardiac sympathetic denervation Parkinson's dementia bodies, but this has not been explored subjects bodies meeting clinicopathological criteria. To determine if show denervation, we analysed epicardial myocardial tissue from autopsy-confirmed cases using tyrosine hydroxylase neurofilament immunostaining. Comparison of fibre density 19 disease/dementia 20 12 without disease, 30 incidental 22 cognitively normal or indicated a significant group difference (P < 0.01; Kruskal-Wallis analysis variance) subsequent pair-wise Mann-Whitney U tests showed that 0.05) 0.01) subjects, had significantly reduced as compared normal. Both also losses protein-immunoreactive nerve densities within the bundles both groups high pathologic alpha-synuclein 0.0001). Cardiac correlated brain 0.001), while immunoreactive were negatively alpha-synuclein, well Unified Disease Rating Scale scores 0.05). The clear separation normal, based on density, first report statistically between these groups. Our data do strongly confirm nuclear imaging noradrenergic worthy further study potential means separate during life.