Respiratory changes in Parkinson's disease may be unrelated to dopaminergic dysfunction

Abstract

OBJECTIVE: To investigate the maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP) in patients with Parkinson's disease (PD) during the on and off periods of levodopa and to compare with healthy controls. METHODS: Twenty-six patients were analyzed with Hoehn and Yahr scores (2-3) and 26 age and gender matched-controls. Statistical analysis was performed with Student's t-test for paired and independent samples. RESULTS: MIP and MEP values in patients were significantly lower than the values obtained in controls both for off and on stages -excepted for MIP in women (p=0.28). For patients with PD, the studied parameters did not differ between stages on and off, with the exception of MEP in women (p=0.00). CONCLUSIONS: Patients with PD have respiratory pressure lower than controls, even in early stages of the disease, and dopamine replacement has little impact over these respiratory pressures. These findings suggest that respiratory changes in PD may be unrelated to dopaminergic dysfunction.

Neurodegenerative Disorders Increase Decline in Respiratory Muscle Strength in Older Adults

“…We chose to maintain this delimitation, as previous studies show that medication based on dopamine (for PD) does not exercise any influence on the subjects' parameters of P Imax and P Emax , just like medication based on acetylcholinesterase inhibitors and N-methyl-D-aspartate antagonists (for AD), which have a neuro-psycho-behavioral action. 23,35 Limitations Although we believe this study does have merits, the limitations should be pointed out. One limitation is that we used cross-sectional data that do not allow us to assess causal relationships.…”

“…23 Mehanna and Jankovic 24 hypothesized that the respiratory dysfunctions in PD may be the result of muscle dystonia causing abnormal rhythmic oscillations in the supraglottic structures. In addition to this, rigidity, freezing, and bradykinesia exacerbate the restrictive pulmonary dynamic, which, associated with the inefficacy of the cough reflex, predisposes the subject to an elevated risk of aspiration pneumonia.…”

“…In addition to this, rigidity, freezing, and bradykinesia exacerbate the restrictive pulmonary dynamic, which, associated with the inefficacy of the cough reflex, predisposes the subject to an elevated risk of aspiration pneumonia. 23,24 In spite of the most striking pathological modification in PD being the degeneration of the mesencephalic substantia nigra, recent studies prove that apoptotic processes suffered in the illness involve neuronal lesions adjacent to the basal nuclei that affect brainstem, locus coeruleus, and upper cerebral regions. 25 Because of their compromised connective pathways, this study's clinical findings, which proved there were shortcomings in the patients' maximal respiratory strength (P Imax and P Emax ), are substantiated.…”

Serotonergic system in hypoxic ventilatory response in unilateral rat model of Parkinson’s disease

“…Apart from the motor deficits patients with PD frequently exhibit non-motor symptoms, which although significant are still often undiagnosed and untreated [3]. Among the latter are respiratory disturbances: restrictive pulmonary function, respiratory dysrhythmias and upper airway dysfunction [4, 5]. Ventilatory response to hypoxia (HVR) has been examined in very few human studies, which showed quite divergent results: enhanced response [6], diminished [7, 8] and unchanged [9].…”

Alterações Funcionais Respiratórias Na Doença De Parkinson

“…Credita--se essa melhora à reversão parcial da deficiência motora, resultando em diminuição do tremor e rigidez muscular, melhora na coordenação dos mús-culos e facilitação do movimento. (19) Guedes, (24) ao investigarem a PImáx e a PEmáx no período on e off da medicação, comparando a um grupo controle, encontraram valores menores em ambos os perío-dos, estando essa disfunção respiratória presente independente do estadiamento da doença. Os resultados de outra pesquisa indicaram que apenas indivíduos que apresentavam obstrução das vias aéreas superiores obtiveram resultados significativos após a utilização da levodopa.…”