Cardiovascular dysautonomia in de novo Parkinson’s disease without orthostatic hypotension

Oka, Hiroyuki; Toyoda, Chizuko; Yogo, Makiko; Mochio, Soichiro

doi:10.1111/j.1468-1331.2010.03135.x

Cited by 54 publications

(41 citation statements)

References 65 publications

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“…In both groups, LF (ms 2 ) values were considerably increased in magnitude but different from each other during CB, a condition known to augment cardiovagal control 21 . Nevertheless this finding does not reflect sympathetic dominance but rather an effect of low respiratory frequency (,0.2 Hz), which causes an overlap of the LF and HF components of CVV signals 22,26 .…”

Section: Hrvmentioning

confidence: 95%

“…LF (mmHg 2 ) was comparatively lower in PD during AS, this reduction in the so-called Mayer waves reflects an impairment in the vasosympathetic outflow 5,25 . Meanwhile, during SR, a similar though statistically not significant trend was noticed as shown in Figure. Vasosympathetic dysfunction in PD has been already reported 25,26 . The coincidence of LF (mmHg 2 ) comparatively decreased in PD and MSBP similar between groups after orthostatic challenge (i. e., AS) is consistent with a previously proposed hypothesis that initial alterations of vasosympathetic control may primarily affect BPV and only subsequently induce changes in MSBP values leading to orthostatic hypotension 25 .…”

Section: Bpvmentioning

confidence: 97%

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Cardiovascular variability in Mexican patients with Parkinson's disease

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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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Section: Hrvmentioning

confidence: 95%

Section: Bpvmentioning

confidence: 97%

Cardiovascular variability in Mexican patients with Parkinson's disease

Delgado

Estañol

Rodríguez-Violante

et al. 2014

Arq. Neuro-Psiquiatr.

View full text Add to dashboard Cite

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“…Another autonomic disturbance is the postganglionic sympathetic denervation of the heart, which can be measured by iodine-123-metaiodobenzylguanidine SPECT. 5 Patients with idiopathic RBD may also show a significant reduction of heart rate variability. RBD is characterized by a loss of atony during REM sleep, 6 and patients with RBD physically and verbally act out their dreams.…”

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confidence: 99%

Treatment Strategies in Early and Advanced Parkinson Disease

Ossig¹,

Reichmann²

2015

Neurologic Clinics

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“…Recently, it has been reported that PD patients with TOH (PD+TOH) have a lower basal leg vascular resistance, which might suggest that sympathetic denervation is more pronounced in PD+TOH than in PD patients without TOH (PD-TOH) 8 . Yet, Oka et al documented that latent cardiac and vasomotor sympathetic dysfunction occurs in PD-TOH patients 9 . While the hemodynamic response to orthostatic stress has been already evaluated in PD-TOH 8 , IOH can be documented only by continuous beat-to-beat BP monitoring during AS 1 .…”

mentioning

confidence: 99%

Initial circulatory response to active standing in Parkinson's disease without typical orthostatic hypotension

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Estañol

Rodríguez-Violante

et al. 2014

Arq. Neuro-Psiquiatr.

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While the circulatory response to orthostatic stress has been already evaluated in Parkinson's disease patients without typical orthostatic hypotension (PD-TOH), there is an initial response to the upright position which is uniquely associated with active standing (AS). We sought to assess this response and to compare it to that seen in young healthy controls (YHC). Method: In 10 PD-TOH patients (8 males, 60±7 years, Hoehn and Yahr #3) the changes in systolic blood pressure (SBP) and heart rate that occur in the first 30 seconds (sec) of standing were examined. Both parameters were non-invasively and continuously monitored using the volume-clamp method by Peñáz and the Physiocal criteria by Wesseling. The choice of sample points was prompted by the results of previous studies. These sample points were compared to those of 10 YHC (8 males, 32±8 years). Results: The main finding of the present investigation was an increased time between the AS onset and SBP overshoot in PD-TOH group (24±4 vs. 19±3 sec; p,0.05). Conclusion: This delay might reflect a prolonged latency in the baroreflex-mediated vascular resistance response, but more studies are needed to confirm this preliminary hypothesis.Keywords: Parkinson's disease, autonomic nervous system, orthostatic hypotension, hemodynamics, cardiovascular physiological Phenomena. RESUMOApesar da resposta circulatória ao estresse ortostático já foi estudada em pacientes com doença de Parkinson sem hipotensão ortostática típica (PD-TOH), não há uma resposta inicial que é exclusivamente associada com o ortostase ativa (AS). Portanto, buscou-se avaliar esta resposta e compará-la à observada em jovens saudáveis (YHC). Método: Em 10 PD-TOH pacientes (8 homens, 60±7 anos, Hoehn e Yahr #3) as mudanças na pressão arterial sistólica (PAS) e da frequência cardíaca que ocorrem nos primeiros 30 segundos (seg) de pé foram examinados. Ambos parâmetros foram monitorizados continuamente através do método Penõáz e os critérios de Wesseling. Os pontos de amostragem foram escolhidos com base em estudos anteriores. Estes pontos foram comparados com os de 10 YHC (32±8 anos). Resultados: O principal achado deste estudo foi o aumento do tempo entre o início de AS e rebote sistólica no grupo p,0,05). Conclusão: Este atraso pode refletir uma latência prolongada na resposta da resistência vascular mediado pelo barorreflexo, mas outros estudos são necessários para confirmar esta hipótese preliminar.Palavras-chave: doença de Parkinson, sistema nervoso autônomo, hipotensão ortostática, hemodinâmica, fenômenos fisiológicos cardiovasculares.

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Cardiovascular dysautonomia in de novo Parkinson’s disease without orthostatic hypotension

Abstract: These results show that latent cardiac and vasomotor sympathetic dysfunction but not parasympathetic dysfunction is already present in early stage de novo PD, even without orthostatic hypotension.

Cited by 54 publications

References 65 publications

Cardiovascular variability in Mexican patients with Parkinson's disease

Cardiovascular variability in Mexican patients with Parkinson's disease

Treatment Strategies in Early and Advanced Parkinson Disease

Initial circulatory response to active standing in Parkinson's disease without typical orthostatic hypotension

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