Cardiac parasympathetic dysfunction concurrent with cardiac sympathetic denervation in Parkinson's disease

Shibata, Mamoru; Morita, Yoko; Shimizu, Toshihiko; Takahashi, Katsumi; Suzuki, Noriyuki

doi:10.1016/j.jns.2008.09.005

Cited by 72 publications

(60 citation statements)

References 32 publications

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“…HRV was automatically calculated as a percentage of the standard deviation of the RR intervals divided by their mean. HRV at rest while the subject breathed normally was considered an index of parasympathetic activity [50,54,59]. For the autonomic tests, most subjects were studied in the morning in a fasting state or at least 3 h after a light meal to exclude the possibility of postprandial hypotension.…”

Section: Cardiac 123 I-mibg Scintigraphymentioning

confidence: 99%

Olfactory dysfunction and cardiovascular dysautonomia in Parkinson’s disease

Oka¹,

Toyoda²,

Yogo³

et al. 2010

J Neurol

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Several studies have reported that olfactory dysfunction is an early neuropathological manifestation of Parkinson's disease (PD). Reduced cardiac meta-iodobenzylguanidine ((123)I-MIBG) uptake may be one of the earliest signs of PD. We studied the relation of olfactory dysfunction to cardiovascular dysautonomia in patients with PD. The study group comprised 66 patients with PD (70.5 years) and 26 controls (70.3 years) for olfactory assessment, 21 controls (72.1 years) for cardiac (123)I-MIBG scintigraphy and heart rate variability (HRV), assessed using the coefficient of variation for RR intervals (HRV), and 23 controls (69.2 years) for orthostatic blood pressure response. Olfactory function was assessed by the odor stick identification test Japan (OSIT-J), and cardiovascular autonomic function was evaluated by (123)I-MIBG scintigraphy of the heart, the fall in orthostatic blood pressure, and HRV. Patients with PD had a significantly lower OSIT-J score than did the controls (4.1 +/- 3.0 vs. 9.9 +/- 1.7, p = 0.001). The OSIT-J score was unrelated to variables other than gender, including age, disease duration, motor score on the unified Parkinson's disease rating scale, score on the mini-mental state examination, motor phenotype, visual hallucinations, and dopaminergic medication on multiple regression and logistic regression analyses. The OSIT-J score was related to the heart/mediastinum ratio of cardiac (123)I-MIBG uptake, the fall in orthostatic blood pressure, and HRV, after adjustment for other clinical variables. Olfactory dysfunction in PD was, thus, significantly related to both cardiac sympathetic and parasympathetic dysfunction, as well as vascular sympathetic dysfunction. As non-motor symptoms of PD, olfactory dysfunction and autonomic network failure appear to be closely related in PD.

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Section: Cardiac 123 I-mibg Scintigraphymentioning

confidence: 99%

Olfactory dysfunction and cardiovascular dysautonomia in Parkinson’s disease

Oka¹,

Toyoda²,

Yogo³

et al. 2010

J Neurol

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“…The study of Scigliano et al (2006) suggested that the reduced risk for vascular disorders in untreated PD patients could stem from a reduced autonomic activity in PD. While sympathetic hyperactivity is known to exacerbate high blood pressure, diabetes and dyslipidemia, PD patients present with cardiac sympathetic denervation and parasympathetic dysfunction (Buob et al, 2010;Shibata et al, 2009), thus possibly reducing HT and other VRF related to it. In addition, the reduction in sympathetic activity may be relevant for postural hypotension reported in 70% of PD patients (Appenzeller & Goss, 1971;Shindo et al, 2003).…”

Section: Diabetes Mellitus Hypertension Hypercholesterolemia Alcohmentioning

confidence: 99%

Idiopathic Parkinson's Disease, Vascular Risk Factors and Cognition: A Critical Review

Doiron¹,

Simard²

2012

Neurodegeneration

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“…Likewise, existing reports indicate that autonomic dysfunction occurs before any medical intervention and often precedes motor disturbances 5 . All three branches of the autonomic nerve system (ANS) are affected in PD 6 . Sympathetic cardioneuropathy was first described about 15 years ago using 6-[18F]fluorodopamine positron-emission tomography and later confirmed by neuropathological and neuroimaging findings 7 .…”

mentioning

confidence: 99%

“…Sympathetic cardioneuropathy was first described about 15 years ago using 6-[18F]fluorodopamine positron-emission tomography and later confirmed by neuropathological and neuroimaging findings 7 . Furthermore, Shibata et al demonstrated that in the early stages of PD, cardiovagal dysfunction occurs concurrently with cardiosympathetic denervation 6 , but possibly the latter is incom-plete and the remaining fibers are sufficient for the maintenance of sympathetic control 8 . Neuropathological studies have demonstrated the presence of Lewy bodies (LB) in both tyrosine hydroxylase-positive and -negative nerve processes of the cardiac plexus, and also in Auerbach's and Meissner's plexuses 5,6 .…”

mentioning

confidence: 99%

“…Furthermore, Shibata et al demonstrated that in the early stages of PD, cardiovagal dysfunction occurs concurrently with cardiosympathetic denervation 6 , but possibly the latter is incom-plete and the remaining fibers are sufficient for the maintenance of sympathetic control 8 . Neuropathological studies have demonstrated the presence of Lewy bodies (LB) in both tyrosine hydroxylase-positive and -negative nerve processes of the cardiac plexus, and also in Auerbach's and Meissner's plexuses 5,6 . The occurrence of prodromal symptoms appears to correspond to the neuropathological staging of PD-associated LB pathology as proposed by Braak et al and later modified by Przuntek et al 3 .…”

mentioning

confidence: 99%

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Cardiovascular variability in Mexican patients with Parkinson's disease

Delgado

Estañol

Rodríguez-Violante

et al. 2014

Arq. Neuro-Psiquiatr.

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Cardiovascular variability (CVV) has been evaluated in patients with Parkinson's disease (PD) in other countries and exhibit ethnic differences. Objective: We investigated heart rate variability (HRV) and blood pressure variability (BPV) in Mexican patients with PD. Method: We further compared HRV and BPV between this group and young healthy controls (YHC) in order to estimate, for the first time in our country, the magnitude of the difference. Twenty patients were examined. Time-and frequency-domain CVV parameters were studied during supine rest (SR), active standing (AS) and controlled breathing. These measurements were compared to those of 20 YHC. Results: In the three conditions tested, our study showed a decrease in almost all HRV parameters in PD patients; on the contrary, decreased BPV parameters were found less frequently and only during SR and AS. Conclusion: Our results indicate that HRV is impaired in PD. Some BPV parameters are also diminished.Keywords: Parkinson's disease, autonomic nervous system, heart rate variability, blood pressure variability, dysautonomia. RESUMOA variabilidade cardiovascular (VCV) tem sido avaliada em doentes parkinsonianos em vários países e apresenta diferenças étnicas. Objetivo: Investigar a variabilidade da frequência cardíaca (VFC) e a variabilidade da pressão arterial (VPA) em doentes parkinsonianos mexicanos. Método: Comparamos VFC e VPA entre o grupo de estudo e controles jovens (CJ), a fim de estimar a magnitude da diferença. CVV foi estudada no domínio do tempo e da frequência durante repouso supino (RS), ortostase ativa (OA) e respiração controlada. Estas medições foram comparadas com aquelas de 20 CJ. Resultados: Nosso estudo mostrou diminuição em quase todos os parâmetros da VFC em doentes parkinsonianos. A diminuição dos parâmetros da VPA foi encontrada com menos frequência. Conclusão: Nossos resultados indicam que a VFC é prejudicada na doença de Parkinson. Alguns parâmetros do VPA também são reduzidos.Palavras-chave: doença de Parkinson, sistema nervoso autônomo, variabilidade da frequência cardíaca, variabilidade da pressão arterial, disreflexia autonômica.The clinical features of Parkinson's disease (PD) are not restricted to the classical triad of resting tremor, rigidity, and bradykinesia, but also include autonomic disturbances 1 , which were first noted by James Parkinson in his original description. Concretely, the prevalence of clinically relevant dysautonomia in PD exceeds 50% 2 . The period between the onset of neurodegeneration and appearance of the cardinal motor signs is referred to as premotor or prodromal phase of PD and its duration has been estimated to be from years to decades 3 . During this phase patients later diagnosed with PD have more autonomic symptoms than control subjects 3,4 . Likewise, existing reports indicate that autonomic dysfunction occurs before any medical intervention and often precedes motor disturbances 5 .All three branches of the autonomic nerve system (ANS) are affected in PD 6 . Sympathetic cardioneuropathy ...

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Cardiac parasympathetic dysfunction concurrent with cardiac sympathetic denervation in Parkinson's disease

Cited by 72 publications

References 32 publications

Olfactory dysfunction and cardiovascular dysautonomia in Parkinson’s disease

Olfactory dysfunction and cardiovascular dysautonomia in Parkinson’s disease

Idiopathic Parkinson's Disease, Vascular Risk Factors and Cognition: A Critical Review

Cardiovascular variability in Mexican patients with Parkinson's disease

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