Sudomotor and cardiovascular dysfunction in patients with early untreated Parkinson's disease.
J Parkinsons Dis
; 4(3): 385-93, 2014.
Article
en En
| MEDLINE
| ID: mdl-24577504
ABSTRACT
BACKGROUND:
According to Braak staging of Parkinson's disease (PD), detection of autonomic dysfunction would help with early diagnosis of PD.OBJECTIVE:
To determine whether the autonomic nervous system is involved in the early stage of PD, we evaluated cardiovascular and sudomotor function in early untreated PD patients.METHODS:
Orthostatic blood pressure regulation, heart rate variability, skin vasomotor function, and palmar sympathetic sweat responses were examined in 50 early untreated PD patients and 20 healthy control subjects.RESULTS:
The mean decrease in systolic blood pressure during head-up tilt in PD patients was mildly but significantly larger than in controls (p = 0.0001). There were no differences between the 2 groups in heart rate variability, with analysis of low frequency (LF; mediated by baroreflex feedback), and high frequency (HF; mainly reflecting parasympathetic vagal) modulation. However, LF/HF, an index of sympatho-parasympathetic balance, was lower in the PD group than in controls (p = 0.02). Amplitudes of palmar sweat responses to deep inspiration (p = 0.004), mental arithmetic (p = 0.01), and exercise (p = 0.01) in PD patients were lower than in controls, with negative correlations with motor severity. Amplitudes of palmar skin vasomotor reflexes in PD patients did not differ from controls.CONCLUSIONS:
Our study indicates impairment of sympathetic cardiovascular and sudomotor function with orthostatic dysregulation of blood pressure control, reduced LF/HF and reduction in palm sweat responses even in early untreated PD patients.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Enfermedad de Parkinson
/
Enfermedades del Sistema Nervioso Autónomo
/
Enfermedades Cardiovasculares
Tipo de estudio:
Screening_studies
Límite:
Aged
/
Female
/
Humans
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Male
/
Middle aged
Idioma:
En
Revista:
J Parkinsons Dis
Año:
2014
Tipo del documento:
Article
País de afiliación:
Japón