Cardiovascular Reflexes in Parkinson’s Disease

Abstract

The autonomic nervous system (ANS) function of patients with Parkinson’s disease (PD) was investigated in 30 patients with PD, and in 21 healthy subjects of similar age by utilizing cardiovascular reflex measurements as indicators. In deep breathing, in the Valsalva manoeuvre, and in the tilting test the heart rate variability (R-R variation) differed significantly between the patients and the controls: the beat-to-beat variation was clearly decreased in patients with PD. Responses in diastolic pressure to isometric work were also clearly diminished. However, no significant differences in any measured ANS indices were found between the patients who were treated with levodopa and those who were not. Similarly, anticholinergics did not seem to affect the results.

Autonomic dysfunctions in idiopathic Parkinson's disease

“…There is no area within the autonomic nervous system that goes unaffected in the course of parkinsonism [5]. Data on the incidence of autonomic incompetence in idiopathic parkinsonian syndrome (iPS) vary between 14 and 80 % depending on the collective studied and the method used [5,[8][9][10]. Subjective handicaps in everyday life related to disturbances of the autonomic nervous system are described in more than 50 % of the patients suffering from idiopathic Parkinson's syndrome [5].…”

Hypotensive Effect of Long-Term Levodopa in Patients with Parkinson’s Disease

“…It is known that most patients with Parkinson's dis ease have a normal or low blood pressure [1], In the 1960s, when levodopa was introduced for the treatment of Parkinson's disease, and also in the early 1970s, hypo tension was reported among the side effects of levodopa therapy of less than 1 year duration [2][3][4], Early in the treatment with levodopa, hypotension was considered a transient phenomenon [5], Little attention was paid thereafter to the effect of levodopa on resting blood pres sure, although extensive studies were done of reflex changes in blood pressure in response to standing, tilting and isometric exercise, as an index of cardiovascular reflexes, and also of the effect of levodopa on these reflex changes in blood pressure [6][7][8][9][10][11]. In fact, it is still unknown whether any hypotensive effect remains in patients on long-term levodopa.…”

Design and implementation of a PC-based data acquisition system for measuring ECG and respiratory signals

“…Measurement of cardiovascular reflexes has gained the position of the' golden standard'. In this test R-R variation in the electrocardiogram associated with cardiovascular responses is a sensitive noninvasive test for the detection of autonomic dysfunctions as also seen in our clinical studies [2,3,5]. Although these parameters can be measured manually, the use of a computer-based automatic method increases the accuracy and speed of the tests.…”

“…The 30 : 15 ratio was calculated as the ratio of the longest R-R interval around beat 30 (beats 20 to 40) to the shortest R-R interval around beat 15 (beats 10 to 20) after tilting. More detailed information about the experimental protocol and the results relative to physiological and clinical cases may be found in [5]. In all tests a plot of R-R interval versus time for a period of one minute was displayed on the computer screen after visual inspecting the obtained QRS complexes or phases of respiration ( Figure 6).…”

“…Primary diseases of ANS are rare but ANS is affected in conjunction with other diseases such as diabetes, Parkinson's disease, stroke and sleep apneas [2][3][4][5]. Since signs of ANS abnormalities are so frequent and they concern almost all organs, many different tests have been tried.…”