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Thyroid hormone level is associated with motor symptoms in de novo Parkinson’s disease

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Abstract

Sympathetic denervation has been observed not only in the myocardium but also in the thyroid of patients with Parkinson’s disease (PD). We investigated whether sympathetic denervation as indicated by decreased cardiac 123I-meta-iodobenzylguanidine uptake is associated with the levels of thyroid hormones and whether the levels of thyroid hormones affect clinical manifestations in patients with PD. The subjects were 75 patients with de novo PD and 20 age-matched healthy controls. We examined the levels of thyroid-stimulating hormone, free triiodothyronine, and free thyroxine, and evaluated the associations of these levels with cardiac 123I-meta-iodobenzylguanidine uptake and motor symptoms. The results showed that the free triiodothyronine level was below the normal range in 29 patients (approximately 40 %) and was significantly lower in the patients with PD than in the controls. The decreased free triiodothyronine level was associated with akinetic-rigid motor subtype and washout ratio of cardiac 123I-meta-iodobenzylguanidine scintigraphy. The free triiodothyronine level negatively correlated with disease severity. Thyroid-stimulating hormone level was within normal range. However, its level was lower in patients with tremor-dominant type or mixed type than in those with akinetic-rigid type. All correlations of these variables with the levels of thyroid hormones remained statistically significant on multiple regression analysis. Our results suggest that the thyroid hormone level, especially the free triiodothyronine level, is closely related to motor symptoms in patients with de novo PD. Further studies are needed to clarify whether the decreased hormone levels have functional roles in motor and non-motor symptoms.

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References

  1. Goldstein DS, Holmes CS, Dendi R, Bruce SR, Li ST (2002) Orthostatic hypotension from sympathetic denervation in Parkinson’s disease. Neurology 58:1247–1255

    Article  CAS  PubMed  Google Scholar 

  2. Matsui H, Udaka F, Oda M et al (2005) Metaiodobenzylguanidine (MIBG) uptake in Parkinson’s disease also decreases at thyroid. Ann Nucl Med 19:225–229

    Article  CAS  PubMed  Google Scholar 

  3. Jang W, Kim JS, Cho JW, Ahn JY, Choi YY, Kim HT (2013) Thyroid MIBG uptake in Parkinson’s disease with diabetes mellitus. Clin Auton Res 23:221–224

    Article  PubMed  Google Scholar 

  4. Tipre DN, Goldstein DS (2005) Cardiac and extracardiac sympathetic denervation in Parkinson’s disease with orthostatic hypotension and in pure autonomic failure. J Nucl Med 46:1775–1781

    CAS  PubMed  Google Scholar 

  5. Melander A, Ericson LE, Sundler F, Ingbar SH (1974) Sympathetic innervation of the mouse thyroid and its significance in thyroid hormone secretion. Endocrinology 94:959–966

    Article  CAS  PubMed  Google Scholar 

  6. Silva JE, Bianco SD (2008) Thyroid-adrenergic interactions: physiological and clinical implications. Thyroid 18:157–165

    Article  CAS  PubMed  Google Scholar 

  7. Caradoc-Davies TH (1986) Resolution of dyskinesia and the “on–off” phenomenon in thyrotoxic patients with Parkinson’s disease after antithyroid treatment. Br Med J (Clin Res Ed) 293:38–39

    Article  CAS  Google Scholar 

  8. Kim HT, Edwards MJ, Lakshmi Narsimhan R, Bhatia KP (2005) Hyperthyroidism exaggerating parkinsonian tremor: a clinical lesson. Parkinsonism Relat Disord 11:331–332

    Article  PubMed  Google Scholar 

  9. Guerin V, Guyot C, Hartemann P (1990) Dysthyroidism and Parkinson’s disease. Ann Endocrinol (Paris) 51:43–45

    CAS  Google Scholar 

  10. Prakash KM (2010) Hyperthyroidism “masked” the levodopa response in newly diagnosed Parkinson’s disease patients. Parkinsonism Relat Disord 16:691–692

    Article  PubMed  Google Scholar 

  11. Flotats A, Carrio I, Agostini D, Le Guludec D, Marcassa C, Schafers M et al (2010) Proposal for standardization of 123I-metaiodobenzylguanidine (MIBG) cardiac sympathetic imaging by the EANM Cardiovascular Committee and the European Council of Nuclear Cardiology. Eur J Nucl Med Mol Imaging 37:1802–1812

    Article  PubMed  Google Scholar 

  12. Hughes AJ, Daniel SE, Kilford L, Lees AJ (1992) Accuracy of clinical diagnosis of idiopathic Parkinson’s disease. A clinico-pathological study of 100 cases. J Neurol Neurosurg Psychiatry 55:181–184

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  13. Spiegel J, Hellwig D, Samnick S et al (2007) Striatal FP-CIT uptake differs in the subtypes of early Parkinson’s disease. J Neural Transm 114:331–335

    Article  CAS  PubMed  Google Scholar 

  14. Sapin R, Schlienger JL (2003) Thyroxine (T4) and tri-iodothyronine (T3) determinations: techniques and value in the assessment of thyroid function. Ann Biol Clin (Paris) 61:411–420

    CAS  Google Scholar 

  15. Wingert TD, Hershman JM (1997) Sinemet and thyroid function in Parkinson’s disease. Neurology 29:1073–1074

    Article  Google Scholar 

  16. Mannisto P, Mattila J, Kaakkola S (1981) Possible involvement of nigrostriatal dopamine system in the inhibition of thyrotropin secretion in the rat. Eur J Pharmacol 76:403–409

    Article  CAS  PubMed  Google Scholar 

  17. Schilling JC, Adamus WS, Palluk R (1992) Neuroendocrine and side effect profile of pramipexole, a new dopamine receptor agonist, in humans. Clin Pharmacol Ther 51:541–548

    Article  CAS  PubMed  Google Scholar 

  18. Berger JR, Kelly RE (1981) Thyroid function in Parkinson’s disease. Neurology 31:93–95

    Article  CAS  PubMed  Google Scholar 

  19. Munhoz RP, Teive HA, Troiano AR et al (2004) Parkinson’s disease and thyroid dysfunction. Parkinsonism Relat Disord 10:381–383

    Article  PubMed  Google Scholar 

  20. Bonuccelli U, D’Avino C, Caraccio N et al (1999) Thyroid function and autoimmunity in Parkinson’s disease: a study of 101 patients. Parkinsonsim Relat Disord 5:49–53

    Article  CAS  Google Scholar 

  21. Tandeter H, Levy A, Gutman G, Shvartzman P (2001) Subclinical thyroid disease in patients with Parkinson’s disease. Arch Gerontol Geriatr 33:295–300

    Article  CAS  PubMed  Google Scholar 

  22. Falaschi P, Martocchia A, Proietti A et al (2004) The hypothalamic-pituitary-thyroid axis in subjects with subclinical thyroid diseases: the impact of the negative feedback mechanism. Neuro Endocrinol Lett 25:292–296

    PubMed  Google Scholar 

  23. Orimo S, Ozawa E, Nakade S, Sugimoto T, Mizusawa H (1999) (123)I-metaiodobenzylguanidine myocardial scintigraphy in Parkinson’s disease. J Neurol Neurosurgery Psychiatry 67(2):189–194

    Article  CAS  Google Scholar 

  24. Oka H, Toyoda C, Yogo M, Mochio S (2011) Cardiovascular dysautonomia in de novo Parkinson’s disease without orthostatic hypotension. Eur J Neurol 18:286–292

    Article  CAS  PubMed  Google Scholar 

  25. Orimo S, Uchihara T, Nakamura A et al (2008) Axonal alpha-synuclein aggregates herald centripetal degeneration of cardiac sympathetic nerve in Parkinson’s disease. Brain 131:642–650

    Article  PubMed  Google Scholar 

  26. Cardinali DP, Vacas MI, Gejman PV (1981) The sympathetic superior cervical ganglia as peripheral neuroendocrine centers. J Neural Transm 52:1–21

    Article  CAS  PubMed  Google Scholar 

  27. Del Tredici K, Hawkes CH, Ghebremedhin E, Braak H (2010) Lewy pathology in the submandibular gland of individuals with incidental Lewy body disease and sporadic Parkinson’s disease. Acta Neuropathol 119:703–713

    Article  PubMed  Google Scholar 

  28. Imamura Y, Ando H, Ashihara T et al (1996) Myocardial adrenergic nervous activity is intensified in patients with heart failure without left ventricular volume or pressure overload. J Am Coll Cardiol 28:371–375

    Article  CAS  PubMed  Google Scholar 

  29. Sisson JC, Shapiro B, Meyers L et al (1987) Metaiodobenzylguanidine to map scintigraphically the adrenergic nervous system in man. J Nucl Med 28:1625–1636

    CAS  PubMed  Google Scholar 

  30. Tandeter HB, Shvartzman P (1993) Parkinson’s disease camouflaging early signs of hypothyroidism. Postgrad Med 94:187–190

    CAS  PubMed  Google Scholar 

  31. Garcia-Moreno JM, Chacon J (2002) Hypothyroidism concealed by Parkinson’s disease. Rev Neurol 35:741–742

    CAS  PubMed  Google Scholar 

  32. Garcia-Moreno JM, Chacon-Pena J (2003) Hypothyroidism and Parkinson’s disease and the issue of diagnostic confusion. Mov Disord 18:1058–1059

    Article  PubMed  Google Scholar 

  33. Samuels MH, Henry P, Ridqway EC (1992) Effects of dopamine and somatostatin on pulsatile pituitary glycoprotein secretion. J Clin Endocrinol Metab 74:217–222

    CAS  PubMed  Google Scholar 

  34. Rossi C, Frosini D, Volterrani D, De Feo P, Unti E, Nicoletti V et al (2010) Differences in nigro-striatal impairment in clinical variants of early Parkinson’s disease: evidence from a FP-CIT SPECT study. Eur J Neurol 17:626–630

    Article  CAS  PubMed  Google Scholar 

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Conflicts of interest

There is no conflict of interest.

Ethical standard statement

This study has been approved by the Ethics Committee of Jikei University School of Medicine, and has, therefore, been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. All subjects gave written informed consent before enrollment.

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Authors and Affiliations

  1. Department of Neurology, Daisan Hospital, The Jikei University School of Medicine, 4-11-1 Izumihoncho, Komae-shi, Tokyo, 201-8601, Japan

    Tadashi Umehara, Hiromasa Matsuno & Hisayoshi Oka

  2. Department of Neurology, The Jikei University School of Medicine, Tokyo, Japan

    Chizuko Toyoda

Authors
  1. Tadashi Umehara
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  2. Hiromasa Matsuno
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  3. Chizuko Toyoda
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  4. Hisayoshi Oka
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Correspondence to Tadashi Umehara.

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Umehara, T., Matsuno, H., Toyoda, C. et al. Thyroid hormone level is associated with motor symptoms in de novo Parkinson’s disease. J Neurol 262, 1762–1768 (2015). https://doi.org/10.1007/s00415-015-7780-x

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  • DOI: https://doi.org/10.1007/s00415-015-7780-x

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