Autonomic dysfunction in Lewy body disease

Satoshi Orimo

Department of Neurology, Kanto Central Hospital

The neuropathological hallmark of Lewy body disease including Parkinson’s disease (PD) and dementia with Lewy bodies (DLB) is the presence of Lewy bodies in not only the central nervous system but also the peripheral autonomic nervous system.　α-Synuclein is a presynaptic protein and is a major constituent of Lewy bodies.　The peripheral autonomic nervous system innervates various organs such as the gastrointestinal tract, the heart, the urinary bladder, and the skin.　Thus various kinds of symptoms, signs, and abnormal findings of the autonomic tests and images are found in people with Lewy body disease.　Reduced cardiac MIBG uptake on MIBG myocardial scintigraphy has been adopted into the supportive criteria of Movement Disorder Society Diagnostic Criteria for PD in 2015 and the indicative biomarkers in the revised criteria of the clinical diagnosis for DLB in 2017.

Key words: Lewy body disease, orthostatic hypotension, MIBG myocardial scintigraphy, skin biopsy, α-synuclein

Address correspondence to Dr. Satoshi Orimo, Department of Neurology, Kanto Central Hospital（6-25-1 Kami-Yoga, Setagaya-ku, Tokyo 158-8531, Japan）