Baroreflex sensitivity and power spectral analysis in different extrapyramidal syndromes

Friedrich, C.; Rüdiger, Heinz; Schmidt, Claudia; Herting, Birgit; Prieur, Silke; Junghanns, Susann; Schweitzer, Katherine J.; Globas, Christoph; Schöls, Lüdger; Berg, Daniela; Reichmann, Heinz; Ziemssen, Tjalf

doi:10.1007/s00702-008-0127-3

Cited by 47 publications

(59 citation statements)

References 39 publications

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“…This is further supported by Barbic et al 10 finding that BRS was lower in PDOH patients than in PD patients without OH. The results of our study differed from those of Friedrich et al 8 because we had excluded confounding factors by recruiting a group of PD patients who were homogeneous with respect to the severity of the disease and the presence of OH. The presence of OH and the similarity of the disease severity in the PD patients could explain why the spontaneous BRS was similar in the PD and MSA-P patients in our study.…”

Section: Discussionmentioning

confidence: 63%

“…Friedrich et al 8 reported that BRS was lower in MSA than in PD. That study grouped the PD patients together irrespective of the disease severity and the presence or absence of OH, and found an inverse correlation between the spontaneous BRS and disease severity.…”

Section: Discussionmentioning

confidence: 97%

“…It is well documented that MSA-C patients (MSA of the cerebellar type) and MSA-P patients show differences in both the severity and onset of OH 9 and it is noteworthy that several studies combined these patients in their analyses. 7,8 It has also been demonstrated that BRS is lower in Parkinson's disease patients with orthostatic hypotension (PDOH) than in those without OH 5,10 and that a lower BRS is correlated with a higher score on the Hoehn and Yahr scale of severity. 8 BRS has also been shown to differ between males and females.…”

Section: Jcnmentioning

confidence: 99%

“…7,8 It has also been demonstrated that BRS is lower in Parkinson's disease patients with orthostatic hypotension (PDOH) than in those without OH 5,10 and that a lower BRS is correlated with a higher score on the Hoehn and Yahr scale of severity. 8 BRS has also been shown to differ between males and females. 11,12 However, the groups included in all of the previous studies were heterogeneous in nature and the confounding factors were not taken into consideration.…”

Section: Jcnmentioning

confidence: 99%

“…[5][6][7] while others have shown it to be significantly smaller in MSA. 8 These previous studies are subject to a few important caveats. Some of them assessed the BRS using a spontaneous method while others used a reflexive method, with no compari- …”

Section: Introductionmentioning

confidence: 97%

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Cardiovagal Baroreflex Sensitivity in Parkinson's Disease and Multiple-System Atrophy

et al. 2016

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Background and PurposezzParkinson's disease (PD) and multiple-system atrophy of the parkinsonian type (MSA-P) are progressive neurodegenerative disorders that in addition to dysfunction of the motor system also present with features of dysautonomia, frequently manifesting as orthostatic hypotension (OH). The pathophysiology of OH has been proposed to differ between these two disorders. This study investigated the spontaneous and cardiovagal baroreflex sensitivity (BRS) in Parkinson's disease patients with orthostatic hypotension (PDOH) and multiple system atrophy of Parkinsonian type with orthostatic hypotension in an attempt to differentiate the two disorders.MethodszzTwo methods were used for determining the BRS: a spontaneous method (spontaneous BRS) and the reflexive baroreflex gain (cardiovagal BRS) from phases II and IV of the Valsalva maneuver (VM) in PDOH and MSA-POH. ConclusionszzThe cardiovagal BRS from phase IV of the VM has potential for differentiating PDOH and MSA-POH, indicating a difference in the pathophysiological mechanisms underlying the autonomic dysfunction in the two disorders. Key Wordszz baroreflex sensitivity, valsalva maneuver, Parkinson's disease, multiple system atrophy.

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Section: Discussionmentioning

confidence: 63%

Section: Discussionmentioning

confidence: 97%

Section: Jcnmentioning

confidence: 99%

Section: Jcnmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 97%

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Cardiovagal Baroreflex Sensitivity in Parkinson's Disease and Multiple-System Atrophy

et al. 2016

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Loss of nocturnal blood pressure fall in various extrapyramidal syndromes

et al. 2009

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Cardiovascular autonomic dysfunction has frequently been reported in some patients with extrapyramidal syndromes, especially multiple system atrophy (MSA) but also Parkinson's disease (PD). However, there are only few reports on the prevalence of cardiovascular autonomic dysfunction progressive in supranuclear palsy (PSP). Moreover, the relation of detailed cardiovascular testing and easy to assess 24-hour ambulatory blood pressure (BP) is not known. Our study evaluates 24-hour ambulatory BP monitoring in patients with PD, PSP, MSA, and corresponding controls (Con) and relates the findings to the results of comprehensive cardiovascular autonomic testing. Twenty-three patients with PD, 25 patients with PSP, 25 patients with MSA, and 26 corresponding controls were studied by 24-hour ambulatory BP monitoring (ABPM) in comparison to cardiovascular autonomic testing. Patients with PD, PSP, and MSA presented frequently with a pathological nocturnal BP regulation (no decrease or even an increase of nocturnal BP) in comparison to the control group (PD 48%, PSP 40%, MSA 68% vs. Con 8%). In MSA and PD patients, the frequent pathological BP increase during night was closely correlated to orthostatic hypotension. Since loss of nocturnal BP fall is frequent in patients with extrapyramidal syndromes, even if they are free of subjective autonomic dysfunction, we recommend 24-hour ABPM as an easy to perform screening test, especially if detailed autonomic testing is not available. Pathological loss of nocturnal BP fall may account for increased cardiovascular mortality in extrapyramidal syndromes.

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Baroreflex sensitivity and power spectral analysis during autonomic testing in different extrapyramidal syndromes

et al. 2010

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Autonomic dysfunction has been frequently demonstrated in patients with extrapyramidal diseases by cardiovascular autonomic testing. In addition to classical testing, we applied the more detailed baroreflex and spectral analysis on three traditional cardiovascular tests in this study to get additional information on autonomic outflow. We recorded continuously blood pressure, electrocardiogram, and respiration in 35 patients with multiple system atrophy, 32 patients with progressive supranuclear palsy, 46 patients with idiopathic Parkinson's disease and in 27 corresponding healthy subjects during cardiovascular autonomic testing (metronomic breathing, Valsalva manoeuvre, head-up tilt). Baroreflex and spectral analyses were performed by using trigonometric regressive spectral analysis between and during the manoeuvres. Consistent with previous interpretations, our data showed an increase of sympathetic activity in head-up tilt and Valsalva test in healthy controls. This sympathetic activity was significantly decreased in patients with typical and atypical Parkinson syndromes. Significant modulation of baroreflex activity could be observed especially during metronomic breathing; again it was significantly lower in all patient groups. Baroreflex and spectral parameters could not only differentiate between patients and healthy controls, but also differentiate between clinically symptomatic (with autonomic dysfunction as eg. orthostatic hypotension) and asymptomatic patients. In conclusion, our approach allows the evaluation of autonomic variability during short and nonstationary periods of time and may constitute a useful advance in the assessment of autonomic function in both physiological and pathological conditions.

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Baroreflex sensitivity and power spectral analysis in different extrapyramidal syndromes

Cited by 47 publications

References 39 publications

Cardiovagal Baroreflex Sensitivity in Parkinson's Disease and Multiple-System Atrophy

Cardiovagal Baroreflex Sensitivity in Parkinson's Disease and Multiple-System Atrophy

Loss of nocturnal blood pressure fall in various extrapyramidal syndromes

Baroreflex sensitivity and power spectral analysis during autonomic testing in different extrapyramidal syndromes

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