Thermoregulatory effects of female hormones mediated by peripheral cold receptors

Abstract

Parkinson’s disease (PD) has traditionally been regarded as a central nervous system disorder characterized predominantly by motor symptoms. However, recent advances have led to the recognition of PD as a multisystem disease involving widespread non-motor symptoms, notably autonomic dysfunction. According to Braak’s hypothesis, abnormal α-synuclein aggregates initially appear in the dorsal motor nucleus of the vagus nerve and the olfactory bulb, subsequently spreading in an ascending manner throughout the central nervous system. This suggests that peripheral autonomic nervous system involvement may precede the onset of motor symptoms. This review outlines the significance of autonomic dysfunction in PD, focusing particularly on the clinical utility of ¹²³I–MIBG myocardial scintigraphy. As the only currently available non-invasive marker capable of quantitatively evaluating non-motor symptoms, MIBG myocardial scintigraphy plays a crucial role in early diagnosis and differential diagnosis of PD. Furthermore, it holds promise as a tool for detecting prodromal PD．