RT Journal Article SR Electronic T1 Cardiac sympathetic denervation preceding motor signs in Parkinson disease JF Cleveland Clinic Journal of Medicine JO Cleve Clin J Med FD Cleveland Clinic SP S47 OP S50 DO 10.3949/ccjm.76.s2.10 VO 76 IS 4 suppl 2 A1 Goldstein, David S. A1 Sharabi, Yehonatan A1 Karp, Barbara I. A1 Bentho, Oladi A1 Saleem, Ahmed A1 Pacak, Karel A1 Eisenhofer, Graeme YR 2009 UL http://www.ccjm.org/content/76/4_suppl_2/S47.abstract AB There is substantial interest in identifying biomarkers to detect early Parkinson disease (PD). Cardiac noradrenergic denervation and attenuated baroreflex-cardiovagal function occur in de novo PD, but whether these abnormalities can precede PD has been unknown. Here we report the case of a patient who had profoundly decreased left ventricular myocardial 6-[18F]fluorodopamine-derived radioactivity and low baroreflex-cardiovagal gain, 4 years before the onset of symptoms and signs of PD. The results lead us to hypothesize that cardiac noradrenergic denervation and decreased baroreflex-cardiovagal function may occur early in the pathogenesis of PD.