Heart rate variability in patients with untreated Parkinson’s disease

Kallio, Mika; Haapaniemi, Tarja H.; Turkka, Jukka; Suominen, Kalervo; Tolonen, U.; Sotaniemi, K. A.; Heikkilä, Vesa-Pekka; Myllylä, Vilho V.

doi:10.1046/j.1468-1331.2000.00127.x

Cited by 93 publications

(73 citation statements)

References 24 publications

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“…In keeping with our results, a cardiac sympathetic denervation has already been hypothesized in patients with severe orthostatic hypotension by means of MIBG myocardial scintigraphy 17 and on the basis of a reduced LF component in the power spectrum of RR variability both on short 16 and 24-hour periods. 34 Finally, immunohistochemical staining of postmortem specimens of cardiac tissue showed a decreased number of sympathetic axons innervating the left anterior ventricular wall of the heart of 4 patients suffering from Parkinson's disease.…”

Section: Cardiovascular and Autonomic Profile Of Parkinson's Disease supporting

confidence: 91%

“…A study based on spectral analysis of heart rate variability reported a reduction in absolute values of both the high-frequency (HF) and low-frequency (LF) spectral components in patients compared with age-matched controls. 16 Reduced uptake of meta-([123]I)iodobenzylguanedine (MIBG), suggestive of partial cardiac sympathetic denervation, has been observed in patients with Parkinson's disease by means of MIBG myocardial scintigraphy. 17 In a study based on cardiac norepinephrine spillover and positron emission tomography scan using radiolabeled interventricular fluorodopamine, a selective cardiac sympathetic denervation has also been described.…”

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confidence: 99%

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Early Abnormalities of Vascular and Cardiac Autonomic Control in Parkinson’s Disease Without Orthostatic Hypotension

et al. 2007

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Abstract-Cardiac autonomic abnormalities have been described in Parkinson's disease. Little is known about possible alterations of vascular sympathetic regulatory activity in patients without orthostatic hypotension or symptoms of orthostatic intolerance. Nineteen patients with Parkinson's disease without orthostatic hypotension (PD), 21 with orthostatic hypotension (PDOH), and 20 healthy controls underwent ECG, beat-to-beat arterial pressure, and respiration recordings while recumbent and during a 75°head-up tilt. Spectrum analysis of RR interval and systolic arterial pressure (SAP) variability provided indices of cardiac sympathovagal interaction (low frequency [LF]/high frequency [HF]) to the sinoatrial node and sympathetic vasomotor control (LF SAP ). Arterial baroreceptor mechanisms were assessed by the spontaneous sequences technique and bivariate spectrum analysis (␣ index). Plasma catecholamines provided the neurohormonal profile. At rest, hemodynamics and spectral markers of autonomic function were similar in PD and control subjects. Norepinephrine was lower in PD and PDOH than in control subjects. In PDOH, SAP was higher, whereas LF/HF ratio and LF SAP were lower compared with control subjects. During tilt, SAP was unchanged in PD; however, similar to PDOH, the increase of heart rate, LF/HF ratio, and LF SAP was blunted compared with control subjects. Baroreflex indices were unmodified in PD and PDOH compared with control subjects. Initial alterations in both cardiac and vascular sympathetic modulatory activity were found in PD and revealed by a gravitational stimulus. Prompt recognition of sympathetic abnormalities might result in earlier therapeutic intervention, reduced orthostatic intolerance, and increased quality of life.

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Section: Cardiovascular and Autonomic Profile Of Parkinson's Disease supporting

confidence: 91%

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confidence: 99%

Early Abnormalities of Vascular and Cardiac Autonomic Control in Parkinson’s Disease Without Orthostatic Hypotension

et al. 2007

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“…Parkinson patients develop several nonmotor symptoms with a diurnal component, suggesting circadian dysfunction (Kallio et al, 2000;Buijs et al, 2003;Willison et al, 2013). Orally administered levodopa is usually delivered throughout the day in several doses because the absorption of the drug was shown to be faster during the daytime (Nyholm et al, 2010).…”

Section: Discussionmentioning

confidence: 99%

The Molecular Mechanism of Intestinal Levodopa Absorption and Its Possible Implications for the Treatment of Parkinson’s Disease

Camargo

Vuille‐dit‐Bille

Mariotta

et al. 2014

J Pharmacol Exp Ther

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Levodopa (L-DOPA) is the naturally occurring precursor amino acid for dopamine and the main therapeutic agent for neurologic disorders due to dopamine depletion, such as Parkinson's disease. L-DOPA absorption in small intestine has been suggested to be mediated by the large neutral amino acids transport machinery, but the identity of the involved transporters is unknown. Clinically, coadministration of L-DOPA and dietary amino acids is avoided to decrease competition for transport in intestine and at the bloodbrain barrier. L-DOPA is routinely coadministered with levodopa metabolism inhibitors (dopa-decarboxylase and cathechol-O-methyl transferase inhibitors) that share structural similarity with levodopa. In this systematic study involving Xenopus laevis oocytes and Madin-Darby canine kidney epithelia expression systems and ex vivo preparations from wild-type and knockout mice, we identified the neutral and dibasic amino acids exchanger (antiporter) AT-rBAT substrates, whereas dopadecarboxylase and cathechol-O-methyl transferase inhibitors had no effect. The presence of amino acids in the basolateral compartment mimicking the postprandial phase increased transepithelial levodopa transport by stimulating basolateral efflux via the antiporter LAT2-4F2 (SLC7A8-SLC3A2). Additionally, the aromatic amino acid uniporter TAT1 (SLC16A10) was shown to play a major role in L-DOPA efflux from intestinal enterocytes. These results identify the molecular mechanisms mediating small intestinal levodopa absorption and suggest strategies for optimization of delivery and absorption of this important prodrug.

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“…Those findings describe autonomic responses, during only a limited period of time, with large individual variability, promoting a limited view of the autonomic mechanisms in control of cardiac activity [9,21,22].…”

Section: Discussionmentioning

confidence: 99%

Measures of Heart Rate Variability in Patients with Idiopathic Parkinson’s Disease

Soares¹

2013

J Alzheimers Dis Parkinsonism

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Heart rate variability in patients with untreated Parkinson’s disease

Cited by 93 publications

References 24 publications

Early Abnormalities of Vascular and Cardiac Autonomic Control in Parkinson’s Disease Without Orthostatic Hypotension

Early Abnormalities of Vascular and Cardiac Autonomic Control in Parkinson’s Disease Without Orthostatic Hypotension

The Molecular Mechanism of Intestinal Levodopa Absorption and Its Possible Implications for the Treatment of Parkinson’s Disease

Measures of Heart Rate Variability in Patients with Idiopathic Parkinson’s Disease

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