Decreased intestinal acetylcholinesterase in early Parkinson disease: An 11C-donepezil PET study

Neurology. 2017 Feb 21;88(8):775-781. doi: 10.1212/WNL.0000000000003633. Epub 2017 Jan 18.

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.

MeSH terms

  • Acetylcholinesterase / metabolism*
  • Aged
  • Area Under Curve
  • Carbon Radioisotopes
  • Cross-Sectional Studies
  • Donepezil
  • Female
  • Heart / diagnostic imaging
  • Humans
  • Indans
  • Intestines / diagnostic imaging*
  • Intestines / enzymology*
  • Kidney / diagnostic imaging
  • Kidney / enzymology
  • Male
  • Middle Aged
  • Myocardium / enzymology
  • Pancreas / diagnostic imaging
  • Pancreas / enzymology
  • Parkinson Disease / diagnostic imaging*
  • Parkinson Disease / enzymology*
  • Piperidines
  • Positron-Emission Tomography*
  • ROC Curve
  • Radiopharmaceuticals
  • Time Factors

Substances

  • Carbon Radioisotopes
  • Indans
  • Piperidines
  • Radiopharmaceuticals
  • Donepezil
  • Acetylcholinesterase