Cardiovascular dysautonomia and cognition in Parkinson’s Disease — a possible relationship

Introduction. Progressive supranuclear palsy (PSP) and corticobasal syndrome (CBS) are clinical manifestations of tauopathies. They are commonly associated with rapid motor and cognitive deterioration. Sleep disturbances are less frequently described as a feature of these diseases, though they are reported among 50-75% of PSP patients.State of the art. Apart from various clinical manifestations, sleep abnormalities in PSP and CBS seem to be a factor enhancing pathogenesis as well its consequences. Multiple researchers have looked into the issue of whether the complexity of sleep disturbances in PSP and CBS could be linked to atrophic changes within structures crucial for daytime regulation, coexisting pathologies, or other less explored mechanisms.Clinical significance. Among sleep abnormalities in PSP and CBS have been reported excessive daytime sleepiness, night-time insomnia, reduction of total sleep time, more pronounced sleep fragmentation, restless leg syndrome (RLS), agrypnia excitata, periodic limb movements, sleep respiratory disturbances, rapid-eye movement behaviour disorder, and others.Future directions. The aim of this review was to elaborate upon the significance of sleep abnormalities in tauopathic parkinsonian syndromes, and to determine their usefulness in differential diagnosis with synucleinopathic parkinsonian syndromes. Extended analyses of sleep disturbances may provide a different perspective on atypical parkinsonisms.

Section: Sleep Disturbances In Progressive Supranuclear Palsymentioning

confidence: 99%

Sleep disturbances in progressive supranuclear palsy syndrome (PSPS) and corticobasal syndrome (CBS)

Alster

Madetko

Migda

et al. 2023

“…In general, high HRV is regarded as an index of cardiovascular health [18]. Moreover, low HRV parameters are related to diverse psychiatric illnesses including major depressive disorder [19], bipolar disorder [20], anxiety disorder [21], schizophrenia [22] and Parkinson's Disease (PD) [23,24]. PLMS are frequently observed in individuals with PD, and are often accompanied by dysautonomia and cognitive impairment, which are among the non-motor symptoms associated with PD [24,25].…”

Section: Introductionmentioning

confidence: 99%

“…Moreover, low HRV parameters are related to diverse psychiatric illnesses including major depressive disorder [19], bipolar disorder [20], anxiety disorder [21], schizophrenia [22] and Parkinson's Disease (PD) [23,24]. PLMS are frequently observed in individuals with PD, and are often accompanied by dysautonomia and cognitive impairment, which are among the non-motor symptoms associated with PD [24,25]. Cardiovascular ANS dysautonomia in PD involve abnormalities such as decreased HRV and impaired baroreflex sensitivity which may contribute to the increased risk of cardiovascular events in individuals with PD [24].…”

Section: Introductionmentioning

confidence: 99%

“…PLMS are frequently observed in individuals with PD, and are often accompanied by dysautonomia and cognitive impairment, which are among the non-motor symptoms associated with PD [24,25]. Cardiovascular ANS dysautonomia in PD involve abnormalities such as decreased HRV and impaired baroreflex sensitivity which may contribute to the increased risk of cardiovascular events in individuals with PD [24]. It is possible that the dysregulation of autonomic cardiovascular control in PD could impact upon cerebral blood flow and oxygenation, and contribute to neuroinflammation and neurodegeneration, thus affecting cognitive function [24].…”

Section: Introductionmentioning

confidence: 99%

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Effect of series of periodic limb movements in sleep on blood pressure, heart rate and high frequency heart rate variability

Malkiewicz,

Grzywinska,

Malinowski

et al. 2024

Introduction. The phenomenon known as periodic limb movements in sleep (PLMS) has been linked to a change in autonomic nervous system (ANS) activity and its effect on circulatory regulation. Autonomic dysfunction or dysregulation in patients with PLMS has been described in some domains; however, any relationship between heart rate variability (HRV) and PLMS has not been clearly established. HRV analysis is a recognised, non-invasive research method that describes the influence of the ANS on heart rate (HR). The aim of our study was to further investigate the dysregulation of autonomic HR control in patients with PLMS. Material and methods.We undertook a retrospective analysis of the polysomnographic (PSG), demographic and medical data of five patients with a total number of 1,348 PLMS. We analysed HR, HRV HF, systolic blood pressure (SBP), and diastolic blood pressure (DBP) for 10 heartbeats before the series of PLMS and 10 consecutive heartbeats as beat-to-beat measurements. The presented method of using successive, short, 10 RR interval segments refers to the time-frequency measurement, which is very clear and useful for presenting changes in the calculated parameters over time and thereby illustrating their dynamics. This method allowed us to assess dynamic changes in HRV HF during successive PLMS series. Statistical analysis was performed using IBM SPSS Statistics (v. 28.0.0.0). The Kruskal-Wallis test was performed to find statistically significant changes from baseline. Results. No statistically significant changes in HR, SBP, or DBP were found in our group, although an increase in the value of the HRV HF was noted, suggesting an increase in intracardiac parasympathetic activity during the subsequent series of PLMS. Conclusions.Our study indicates an increase in parasympathetic activity during the appearance of successive PLMS, which, with the simultaneous lack of changes in HR, may suggest an increase in sympathetic activity, and therefore the appearance of so-called 'autonomic co-activation' resulting in the possibility of life-threatening cardiac events. Clinical implications. Our findings add to the literature information regarding HRV in PLMS, and highlight the need for further studies to elucidate the effects of these conditions on the ANS, and on cardiovascular health.

“…Disrupted insulin signalling in the brain, apart from the loss of its physiological neuroprotective action, is supposed to decrease synaptic plasticity and affect cognition [1,26]. Since orthostatic hypotension is one of the factors thought to contribute to cognitive decline in PD [27], a possible deleterious effect of DM is easy to predict: autonomic dysfunction, resulting from α-synuclein pathology in both peripheral and central autonomic nervous system in the course of PD, may be further aggravated by autonomic neuropathy, a common but underdiagnosed complication of DM [28].…”

Section: Introductionmentioning

confidence: 99%

Carbohydrate metabolism and lipid profile in patients with Parkinson’s disease with subthalamic deep brain stimulation

Samborska-Ćwik

Szlufik

Migda

et al. 2022

Aim of the study. Assessment of potential effect of subthalamic nucleus deep brain stimulation (STN-DBS) on glucose metabolism in patients with Parkinson's disease (PD).Clinical rationale for the study. Although a valuable alternative to pharmacotherapy in advanced PD, STN-DBS is thought to negatively affect the cardiometabolic profile of patients (including body mass, lipid profile). Exacerbation of glucose metabolism dysregulation after DBS could therefore be assumed. Material and methods.Two groups of patients with Parkinson's disease were included: 20 treated pharmacologically (PHT) and 20 newly qualified for STN-DBS (DBS) -with the first assessment prior to surgery, and the second 11 months after surgery on average. Body mass index (BMI), plasma concentrations of total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol (HDL-C), triglycerides (TG) and glucose levels during a three-point oral glucose tolerance test were measured three times (median intervals between visits 12 and 14 months respectively).Results. Significant differences between the two groups were noted with respect to changes in BMI, and serum concentration of TG and HDL-C over the course of the study. In the DBS group, a significant increase in BMI (26.42 vs. 27.24 kg/m 2 , p = 0.03) and TG level (103.8 vs. 142.8 mg/dL, p < 0.001) with a simultaneous decrease in HDL-C level (54.4 vs. 46 mg/dL, p < 0.01) was observed. Mean glucose level after oral glucose administration was lower in the DBS than in the PHT group (147.4 vs. 120.2 mg/dL, p = 0.03 after one hour and 109.9 vs. 82.3 mg/dL, p < 0.01 after two hours) during the second visit. Also inter-visit changes in fasting glucose levels (8.4 mg/dL in the PHT group and -5.8 mg/dL in the DBS group, p = 0.02) differed over the study duration. Conclusions.Our observations are similar to previous ones indicating less favourable changes in BMI and some lipid fractions in patients treated surgically. Interestingly, such a trend was not observed for glucose metabolism parameters, suggesting that mechanisms other than simple body mass changes are involved in early biochemical changes after STN-DBS in PD patients.Clinical implications. The metabolic consequences of DBS require further investigation as an additional factor potentially affecting the outcome of therapy, and routine patient follow-up should not be limited to neurological and psychological assessments.