However, up to 50% of de novo and early-stage IPD patients may show preserved cardiac sympathetic innervation, and reduced cardiac tracer uptake has been reported in one third of patients with MSA, consistent with a reduced number of postganglionic tyrosine hydroxylase immunoreactive axons and alpha-synuclein-positive inclusions in sympathetic ganglia of patients with MSA [17, 21–27]. Here, TH is linked to multiple system atrophy.