Cardiovascular Autonomic Dysfunction in Mild and Advanced Parkinson’s Disease

Kim, Joong‐Seok; Lee, Si Hoon; Oh, Yoon‐Sang; Park, Jeong Wook; An, Jae Young; Park, Sung Kyung; Han, Si Ryung; Lee, Kwang Soo

doi:10.14802/jmd.16001

Cited by 44 publications

(39 citation statements)

References 25 publications

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“…Tilt testing was performed after 20 min of supine rest. Orthostatic hypotension was defined as a fall in blood pressure (BP) of at least 20 mmHg systolic BP and/or 10 mmHg diastolic BP, measured from the mean supine baseline 2–5 min after the tilt . Constipation: defined as a blockage of the bowel, in which there is a bowel movement no more than twice per week . Urinary dysfunction: complaints of urinary incontinence (i.e. frequency, urgency or nocturia) or >100 mL of residual urine on post‐void residual sonography . Unexplained chronic joint and muscle pain: onset of unexplained chronic pain before the diagnosis of PD. Anosmia or hyposmia: defined by a Cross‐Cultural Smell Identification Test score <8. Dementia and mild cognitive impairment: cognitive status was assessed using the Seoul Neuropsychological Screening Battery, which includes attention, language, praxis, the four elements of Gerstmann syndrome, visuospatial function, verbal and visual memory, and frontal/executive functions.…”

Section: Methodsmentioning

confidence: 99%

Normal ‘heart’ in Parkinson's disease: is this a distinct clinical phenotype?

Kim

Park

et al. 2016

Euro J of Neurology

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Section: Methodsmentioning

confidence: 99%

Normal ‘heart’ in Parkinson's disease: is this a distinct clinical phenotype?

Kim

Park

et al. 2016

Euro J of Neurology

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“…[17] Our results are also consistent with earlier reports. [1,17,18] This blunted response in HR, DBP, and MAP to tilt-up in patients with PD as compared to healthy individuals may be correlated to the common origin of sympathetic nerve supply to the heart and blood vessels, which may be impaired in patients with PD. Autonomic failure in PD, therefore, seems to reflect a "triple whammy" of cardiac and extra-cardiac noradrenergic denervation and baroreflex failure.…”

Section: Discussionmentioning

confidence: 96%

Autonomic cardiovascular regulation in Parkinson's disease by head-up tilt test - A cross-sectional study

Jaipurkar¹,

Mohan²,

Tomar³

2018

Natl J Physiol Pharm Pharmacol

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Background: Autonomic failure is an integral component of Parkinson's disease (PD), and orthostatic hypotension (OH) is commonly observed in advanced cases of PD. OH may be the result of underlying cardiovascular autonomic dysfunction or adverse effect of antiparkinsonian drugs. Patients may be asymptomatic during the early stage of disease but may have underlying cardiovascular dysautonomia which becomes obvious on stress. Most of the earlier studies used morphological and functional methods to evaluate cardiovascular autonomic control but were unable to evaluate during dynamic conditions. Aims and Objectives: The aim of the study was to evaluate cardiovascular autonomic disturbances in patients with PD using head-up tilt table test (HUTT). The objective of the study was to compare the spectral profile of heart rate variability (HRV) and blood pressure (BP) to orthostatic challenges using HUTT in patients with PD with healthy individuals. Materials and Methods: In this cross-sectional study, we have recorded continuous lead II ECG along with BP every 2 min in patients with PD and control group during HUTT for 10 min in supine, 45 min in 70° tilt and again 10 min in supine position which were later analyzed using Biopac software for HRV. Results: Symptoms indicating autonomic nervous system dysfunction were present in 65% (20) patients with PD. Postural dizziness was present in 20% (6) patients. After 5 min of tilt-up, increase in HR in patients with PD was lower than in controls. There was no significant change in diastolic BP (DBP) on tilting-up in patients with PD while DBP significantly increased in controls on tilting-up from73 ± 9 mm Hg to 80±11 mm Hg (P < 0.00001). The low frequency (LF) was not significantly changed in patients with PD, and it increased significantly in controls from 3.05 (2.28 to 4.70) ms 2 to 3.73 (2.69-5.03) ms

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“…Cardiovascular autonomic dysfunction is relatively common in patients with PD, and can occur independently of levodopa treatment and early in the course of the disease 6. The manifestations of this dysfunction include orthostatic hypotension (OH), supine hypertension (SH), nocturnal hypertension (NH), and absence of a decrease in blood pressure (BP) during the night (nondipping) 67…”

Section: Introductionmentioning

confidence: 99%

“…The manifestations of this dysfunction include orthostatic hypotension (OH), supine hypertension (SH), nocturnal hypertension (NH), and absence of a decrease in blood pressure (BP) during the night (nondipping) 67…”

Section: Introductionmentioning

confidence: 99%

Cardiovascular Autonomic Dysfunction in Patients with Drug-Induced Parkinsonism

Kim

Ryu

et al. 2017

J Clin Neurol

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Background and PurposeRecent studies have shown that several nonmotor symptoms differ between Parkinson's disease (PD) and drug-induced parkinsonism (DIP). However, there have been no reports on cardiovascular autonomic function in DIP, and so this study investigated whether cardiovascular autonomic function differs between PD and DIP patients.MethodsThis study consecutively enrolled 20 DIP patients, 99 drug-naïve PD patients, and 25 age-matched healthy controls who underwent head-up tilt-table testing and 24-h ambulatory blood pressure monitoring.ResultsOrthostatic hypotension was more frequent in patients with PD or DIP than in healthy controls. In DIP, orthostatic hypotension was associated with the underlying psychiatric diseases and neuroleptics use, whereas prokinetics were not related to orthostatic hypotension. The supine blood pressure, nighttime blood pressure, and nocturnal blood pressure dipping did not differ significantly between the DIP and control groups. Supine hypertension and nocturnal hypertension were more frequent in PD patients than in controls.ConclusionsThe included DIP patients frequently exhibited orthostatic hypotension that was associated with the underlying diseases as well as the nature of and exposure time to the offending drugs. Clinicians should individualize the manifestations of DIP according to underlying diseases as well as the action mechanism of and exposure time to each offending drug.

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Cardiovascular Autonomic Dysfunction in Mild and Advanced Parkinson’s Disease

Cited by 44 publications

References 25 publications

Normal ‘heart’ in Parkinson's disease: is this a distinct clinical phenotype?

Normal ‘heart’ in Parkinson's disease: is this a distinct clinical phenotype?

Autonomic cardiovascular regulation in Parkinson's disease by head-up tilt test - A cross-sectional study

Cardiovascular Autonomic Dysfunction in Patients with Drug-Induced Parkinsonism

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