{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T23:15:47Z","timestamp":1787008547811,"version":"build-2736575974"},"reference-count":84,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2023,11,17]],"date-time":"2023-11-17T00:00:00Z","timestamp":1700179200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/501100004587","name":"Instituto de Salud Carlos III-Fondo Europeo de Desarrollo Regional","doi-asserted-by":"publisher","award":["PI20\/00613"],"award-info":[{"award-number":["PI20\/00613"]}],"id":[{"id":"10.13039\/501100004587","id-type":"DOI","asserted-by":"publisher"}]},{"name":"\u2018Miguel Servet\u2019 program","award":["CP19\/00031"],"award-info":[{"award-number":["CP19\/00031"]}]},{"DOI":"10.13039\/501100003035","name":"Aase og Ejnar Danielsens fond","doi-asserted-by":"publisher","award":["36456"],"award-info":[{"award-number":["36456"]}],"id":[{"id":"10.13039\/501100003035","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000864","name":"Michael J Fox Foundation","doi-asserted-by":"publisher","award":["MJFF-022856"],"award-info":[{"award-number":["MJFF-022856"]}],"id":[{"id":"10.13039\/100000864","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003554","name":"Lundbeck foundation","doi-asserted-by":"publisher","award":["R-359-2020-2533"],"award-info":[{"award-number":["R-359-2020-2533"]}],"id":[{"id":"10.13039\/501100003554","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,1,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Dementia with Lewy bodies is characterized by a high burden of autonomic dysfunction and Lewy pathology in peripheral organs and components of the sympathetic and parasympathetic nervous system. Parasympathetic terminals may be quantified with 18F-fluoroetoxybenzovesamicol, a PET tracer that binds to the vesicular acetylcholine transporter in cholinergic presynaptic terminals. Parasympathetic imaging may be useful for diagnostics, improving our understanding of autonomic dysfunction and for clarifying the spatiotemporal relationship of neuronal degeneration in prodromal disease. Therefore, we aimed to investigate the cholinergic parasympathetic integrity in peripheral organs and central autonomic regions of subjects with dementia with Lewy bodies and its association with subjective and objective measures of autonomic dysfunction. We hypothesized that organs with known parasympathetic innervation, especially the pancreas and colon, would have impaired cholinergic integrity.<\/jats:p>\n                  <jats:p>To achieve these aims, we conducted a cross-sectional comparison study including 23 newly diagnosed non-diabetic subjects with dementia with Lewy bodies (74 \u00b1 6 years, 83% male) and 21 elderly control subjects (74 \u00b1 6 years, 67% male). We obtained whole-body images to quantify PET uptake in peripheral organs and brain images to quantify PET uptake in regions of the brainstem and hypothalamus. Autonomic dysfunction was assessed with questionnaires and measurements of orthostatic blood pressure.<\/jats:p>\n                  <jats:p>Subjects with dementia with Lewy bodies displayed reduced cholinergic tracer uptake in the pancreas (32% reduction, P = 0.0003) and colon (19% reduction, P = 0.0048), but not in organs with little or no parasympathetic innervation. Tracer uptake in a region of the medulla oblongata overlapping the dorsal motor nucleus of the vagus correlated with autonomic symptoms (rs = \u22120.54, P = 0.0077) and changes in orthostatic blood pressure (rs = 0.76, P &amp;lt; 0.0001). Tracer uptake in the pedunculopontine region correlated with autonomic symptoms (rs = \u22120.52, P = 0.0104) and a measure of non-motor symptoms (rs = \u22120.47, P = 0.0230).<\/jats:p>\n                  <jats:p>In conclusion, our findings provide the first imaging-based evidence of impaired cholinergic integrity of the pancreas and colon in dementia with Lewy bodies. The observed changes may reflect parasympathetic denervation, implying that this process is initiated well before the point of diagnosis. The findings also support that cholinergic denervation in the brainstem contributes to dysautonomia.<\/jats:p>","DOI":"10.1093\/brain\/awad391","type":"journal-article","created":{"date-parts":[[2023,11,17]],"date-time":"2023-11-17T13:24:29Z","timestamp":1700227469000},"page":"255-266","source":"Crossref","is-referenced-by-count":14,"title":["Impaired cholinergic integrity of the colon and pancreas in dementia with Lewy bodies"],"prefix":"10.1093","volume":"147","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6483-9505","authenticated-orcid":false,"given":"Niels","family":"Okkels","sequence":"first","affiliation":[{"name":"Department of Nuclear Medicine and PET, Aarhus University Hospital , 8200 Aarhus N , Denmark"},{"name":"Department of Clinical Medicine, Aarhus University , 8000 Aarhus C , Denmark"},{"name":"Department of Neurology, Aarhus University Hospital , 8200 Aarhus N , Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6098-0045","authenticated-orcid":false,"given":"Jacob","family":"Horsager","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine and PET, Aarhus University Hospital , 8200 Aarhus N , Denmark"},{"name":"Department of Clinical Medicine, Aarhus University , 8000 Aarhus C , Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tatyana D","family":"Fedorova","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine and PET, Aarhus University Hospital , 8200 Aarhus N , Denmark"},{"name":"Department of Clinical Medicine, Aarhus University , 8000 Aarhus C , Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karoline","family":"Knudsen","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine and PET, Aarhus University Hospital , 8200 Aarhus N , 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Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Roc\u00edo\/CSIC\/Universidad de Sevilla , 41013 Seville , Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red Sobre Enfermedades Neurodegenerativas (CIBERNED), Instituto de Salud Carlos III , 28029 Madrid , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karsten","family":"Vestergaard","sequence":"additional","affiliation":[{"name":"Department of Neurology, Aalborg University Hospital , 9000 Aalborg , Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janne K","family":"Mortensen","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine, Aarhus University , 8000 Aarhus C , Denmark"},{"name":"Department of Neurology, Aarhus University Hospital , 8200 Aarhus N , Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henriette","family":"Klit","sequence":"additional","affiliation":[{"name":"Department of 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