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The status of sympathetic noradrenergic innervation at other extracranial sites has been unclear. Although in vivo neuroimaging studies have indicated a cardioselective noradrenergic lesion, no previous study has surveyed peripheral organs for norepinephrine contents in LB diseases. We reviewed\n                      <jats:sup>18<\/jats:sup>\n                      F\u2010dopamine (\n                      <jats:sup>18<\/jats:sup>\n                      F\u2010DA) positron emission tomographic images and postmortem neurochemical data across several body organs of controls and patients with the LB synucleinopathies PD and pure autonomic failure (PAF) and the non\u2010LB synucleinopathy multiple system atrophy (MSA).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      <jats:sup>18<\/jats:sup>\n                      F\u2010DA\u2013derived radioactivity in the heart, liver, spleen, pancreas, stomach, kidneys, thyroid, and submandibular glands were analyzed from 145 patients with LB synucleinopathies (112 PD, 33 PAF), 74 controls, and 85 MSA patients. In largely separate cohorts, postmortem tissue norepinephrine data were reviewed for heart, liver, spleen, pancreas, kidney, thyroid, submandibular gland, and sympathetic ganglion tissue from 38 PD, 2 PAF, and 5 MSA patients and 35 controls.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Interventricular septal\n                      <jats:sup>18<\/jats:sup>\n                      F\u2010DA\u2013derived radioactivity was decreased in the LB synucleinopathy group compared to the control and MSA groups (P\u00a0&lt;\u00a00.0001 each). The LB and non\u2010LB groups did not differ in liver, spleen, pancreas, stomach, or kidney\n                      <jats:sup>18<\/jats:sup>\n                      F\u2010DA\u2013derived radioactivity. The LB synucleinopathy group had markedly decreased apical myocardial norepinephrine, but normal tissue norepinephrine in other organs. The MSA group had normal tissue norepinephrine in all examined organs.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interpretation<\/jats:title>\n                    <jats:p>By in vivo sympathetic neuroimaging and postmortem neurochemistry peripheral noradrenergic deficiency in LB synucleinopathies is cardioselective. MSA does not involve peripheral noradrenergic deficiency.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/acn3.51243","type":"journal-article","created":{"date-parts":[[2020,11,20]],"date-time":"2020-11-20T18:07:34Z","timestamp":1605895654000},"page":"2450-2460","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":30,"title":["Cardioselective peripheral noradrenergic deficiency in Lewy body synucleinopathies"],"prefix":"10.1002","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4048-6095","authenticated-orcid":false,"given":"Guillaume","family":"Lamotte","sequence":"first","affiliation":[{"name":"Clinical Neurosciences Program (CNP) Division of Intramural Research (DIR) National Institute of Neurological Disorders and Stroke (NINDS) National Institutes of Health (NIH) Bethesda Maryland USA"},{"name":"Autonomic Medicine Section CNP\/DIR\/NINDS\/NIH Bethesda Maryland 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