Objective: To compare the correlation with some assessments of DAT scan and myocardial MIBG scintigraphy between depression and anhedonia in drug naive Parkinson’s Disease (PD) patients.

Background: Anhedonia is an element of depression, however both symptoms can emerge independently in PD. On the other hand, various symptoms in PD emerge depending on the distribution of pathological findings in nervous systems. DAT scan and myocardial MIBG scintigraphy are imaging biomarkers reflecting pathological findings of PD.

Method: Assessments of depression (Self-rating Depression Scale; SDS), anhedonia (Snaith-Hamilton Pleasure Scale; SHAPS), DAT scan (specific binding ratio for the striatum; SBR, and visual assessment grade of the shape of the lesion with striatal uptake) and myocardial MIBG scintigraphy (H/M ratio and washout rate) were performed in 23 drug naïve PD patients. In addition to myocardial MIBG scintigraphy which assesses cardiac sympathetic nervous function, head-up tilt test up to 60° was also performed to assess cardiovascular autonomic nervous function and maximum percent decrease in systolic blood pressure within 3 minutes from tilt up was calculated. Spearman’s correlation coefficients among each assessment scores were compared.

Results: There was no significant correlation between SDS and SHAPS (r=0.276, p=0.133). SDS and SHAPS did not correlate with any assessment of the DAT scan. SDS significantly correlated with H/M ratio of early image (r=-0.550, p=0.007), that of delayed image (r=-0.546, p=0.007) and maximum percent decrease in systolic blood pressure (r=0.456, p=0.022). SHAPS correlated with no assessment of the myocardial MIBG scintigraphy nor the percent decrease in systolic blood pressure. Multiple regression considering SDS as the dependent variable and patient background factors (above mentioned parameters, age, disease duration, Hoehn and Yahr scale, Unified Parkinson’s Disease Rating Scale; UPDRS, Mini-Mental State Examination; MMSE, Montreal Cognitive Assessment; MoCA) as the independent variables showed no factor directly correlated with SDS.

Conclusion: Depression, but not anhedonia, indirectly correlate with cardiac sympathetic dysfunction. Depression and anhedonia may have different pathophysiological background in drug naïve PD patients.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/differences-in-correlation-with-cardiac-sympathetic-denervation-between-depression-and-anhedonia-in-drug-naive-parkinson-disease-patients/