Association Analyses of Autonomic Dysfunction and Sympathetic Skin Response in Motor Subtypes of Parkinson's Disease

Wang, Jianyong; Wang, Meng-Yan; Liu, Rong-Pei; Li, Yan; Zhang, Wenyuan; Ovlyakulov, Begench; Zhang, Xiong; Zhu, Jian-Hong

doi:10.3389/fneur.2020.577128

Cited by 11 publications

(9 citation statements)

References 34 publications

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“…Autonomic dysfunction, including bladder and bowel symptoms and orthostatic hypotension, have been shown to occur more frequently in individuals with PIGD. 84 been associated with FoG. 85 The caveat behind all these findings is that these associations may simply arise simultaneously due to advancing disease stage, where both autonomic symptoms and gait dysfunction tend to be more common.…”

Section: Correlation With Nonmotor Symptomsmentioning

confidence: 99%

Current Perspectives on the Assessment and Management of Gait Disorders in Parkinson’s Disease

Smith¹,

Brazier²,

Henderson³

2021

NDT

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Gait dysfunction is a key defining feature of Parkinson’s disease (PD), and is associated with symptoms of freezing and an increased risk of falls. In this narrative review, we cover the putative mechanisms of gait dysfunction in PD, the assessment of gait abnormalities, and the management of symptoms caused by the inherent difficulty in walking. Our understanding of the causes of gait problems in PD has progressed in recent times, moving from neurocognitive theory to correlates of affected neuronal pathways. In particular, this can be shown to correspond with abnormalities in responses to dual-task paradigms and dysfunction in cholinergic signaling. Great progress has been made in the sophistication and precision of gait assessment; however, it has firmly remained in the research domain. There is significant momentum behind wearable technologies that can be used by patients in their own environment, acting as digital biomarkers that can not only reflect progression but also independently discriminate PD from non-PD individuals. The treatment of gait dysfunction has historically relied on physical therapies and training combined with a view to mitigating the impact of such consequences as falls. Pharmacological therapies that are the mainstay of treatment in PD have tended to address symptoms like bradykinesia; however, optimization of dopaminergic therapies likely has a positive effect on quality of gait. Other targets have been assessed with the goal of improving gait, of which medications that improve cholinergic signaling appear most promising. Neuromodulation techniques are increasingly used in the form of deep-brain stimulation; however, standard targets, such as the globus pallidus interna, have a modest effect on gait. Considerable benefit has been seen through targeting the pedunculopontine nucleus, and a dual-target approach may be warranted. Stimulation of the spinal cord and brain through direct or magnetic approaches has been assessed, but requires further evidence.

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Section: Correlation With Nonmotor Symptomsmentioning

confidence: 99%

Current Perspectives on the Assessment and Management of Gait Disorders in Parkinson’s Disease

Smith¹,

Brazier²,

Henderson³

2021

NDT

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“…The interictal R-R interval and BP changes of PwE of this study indicate ANS (parasympathetic and sympathetic) dysregulation. Such changes denote an interrelationship between the brain and the heart in PwE [4,14,29,30]. These epilepsy-related cardiac manifestations can occur ictally, but also in the interictal period [11,31].…”

Section: Discussionmentioning

confidence: 99%

“…So, it is rational for the SSR to reflect the effects of central influences on autonomic function. Many studies documented prolonged SSR latencies in diseases where the ANS is extensively involved such as Parkinson's disease, complex regional pain syndrome, and amyotrophic lateral sclerosis, and ischemic strokes [30,[40][41][42].…”

Section: Discussionmentioning

confidence: 99%

Interictal autonomic dysfunction in patients with epilepsy

Shaker¹,

Mahdawi

Hamdan

2021

Egypt J Neurol Psychiatry Neurosurg

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Background Autonomic nervous system (ANS) symptoms are frequently present in people with epilepsy (PwE). They are generally more prominent when they originate from the temporal lobe. We aim to investigate the alterations of autonomic functions during the interictal period in patient with temporal lobe epilepsy (TLE) and idiopathic generalized epilepsy (IGE) using heart-based tests, blood pressure (BP)-based tests and sympathetic skin response (SSR). Forty-eight PwE with disease duration ranging from 2 to 15 years and 51 healthy individuals were studied. Long-term electroencephalography (EEG) monitoring, the heart rate variability (HRV) during normal breathing, deep breathing, Valsalva maneuver and standing, BP responses during standing, to isometric hand grip and to mental arithmetic, and the SSR was recorded for all participants. Results 31 patients with TLE and 17 with IGE showed lower RR-IV values during deep breathing, Valsalva maneuver and standing, but not during rest, impaired BP responses during standing, isometric hand grip, and mental arithmetic. Also, prolonged SSR latencies. Within PwE group, no difference was noticed between males and females, nor between the left and right temporal lobes. Conclusion Abnormal autonomic (sympathetic and parasympathetic) regulatory functions suggest that epilepsy may alter the autonomic function and this is not only in TLE but rather in IGE too. These autonomic changes are irrespective of the localization of epilepsy between the two hemispheres. The ANS changes in epileptic patients, particularly those with autonomic symptoms, confirm that electrophysiologic measures of autonomic function may be of value in preventing sudden unexpected death in epilepsy.

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“…PD is heterogeneous in clinical presentation, treatment responsiveness, and underlying pathology ( Mestre et al, 2021 ). PD subtypes, including postural instability gait disorder (PIGD), tremor dominant (TD), and intermediate, are significantly different in motor and non-motor symptoms ( Jankovic et al, 1990 ; Wang et al, 2020 ). In this study, we aimed to understand whether and how DNMT1 genetic variant, individually or in form of haplotype, are significantly associated with risk for PD and PD subtypes by analyzing tag-single nucleotide polymorphisms (tag-SNPs) in a large Chinese cohort.…”

Section: Introductionmentioning

confidence: 99%

Gene-wide significant association analyses of DNMT1 genetic variants with Parkinson’s disease

et al. 2023

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Background: DNA methylation plays an important role in Parkinson’s disease (PD) pathogenesis. DNA methyltransferase 1 (DNMT1) is critical for maintaining DNA methylation in mammals. The link between DNMT1 polymorphisms and PD remains elusive.Methods: The DNMT1 gene contained a total of 28 single nucleotide polymorphisms (SNPs). Four representing tag-SNPs (rs16999593, rs2162560, rs11880553, and rs9305012) were identified and genotyped in a Han Chinese population comprising 712 PD patients and 696 controls. Association analyses were performed at gene-wide significance (p < 1.8 × 10−3).Results: Rs9305012, but not the other 3 tag-SNPs, was gene-wide significantly associated with PD risk (p = 0.8 × 10−3). The rs9305012/C was a protective allele against PD (p = 1.5 × 10−3, OR 0.786, 95% CI 0.677–0.912). No significant association was observed in individual genders or PD subtypes. Haplotypes of the 4 tag-SNPs showed a significant overall distribution difference between PD patients and controls (p < 1 × 10−4). The 3-allele ACC module in the order of rs2162560, rs11880553, and rs9305012 was the highest-risk haplotype associated with PD (p < 1 × 10−4, OR 2.439, 95% CI 1.563–3.704). Rs9305012 displayed certain probability to affect transcription factor binding and target gene expression based on functional annotation analyses.Conclusion: The DNMT1 variant rs9305012 together with its haplotypes may gene-wide significantly modulate PD susceptibility. Our results support a role of DNMT1 in PD pathogenesis and provide novel insights into the genetic connection in between.

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Association Analyses of Autonomic Dysfunction and Sympathetic Skin Response in Motor Subtypes of Parkinson's Disease

Cited by 11 publications

References 34 publications

Current Perspectives on the Assessment and Management of Gait Disorders in Parkinson’s Disease

Current Perspectives on the Assessment and Management of Gait Disorders in Parkinson’s Disease

Interictal autonomic dysfunction in patients with epilepsy

Gene-wide significant association analyses of DNMT1 genetic variants with Parkinson’s disease

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