Sympathetic cardiovascular dysfunction in long-standing idiopathic Parkinson's disease
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Standard autonomic tests (heart rate response to deep breathing-HR db , heart rate and systolic blood pressure response to tilt-ΔHR and ΔSBP) and spectral analysis of heart rate and arterial blood pressure and their transfer function (for the mid-frequency band a measure of baroreflex sensitivity) were performed in 20 patients with idiopathic Parkinson's disease (IPD) and 20 age-matched controls. Patients showed significantly diminished ΔSBP, and reduced sympathetic vasomotor and cardiomotor outflow (diminished Mayer waves), consistent with an alteration of the efferent arc of the baroreflex. These results were only significant in long-standing IPD (IPD-1, >5 years), whereas patients with short disease duration (IPD-s, <5 years) showed values comparable to controls. Respiratory-related heart rate variability was slightly reduced in IPD-1 but this was mainly due to diminished respiratory effort, indicated by low respiratoryrelated blood pressure variability. We conclude that autonomic abnormalities are only present in long-standing IPD and consist in reduced sympathetic vasomotor and cardiomotor outflow.
- Aminoff MJ. Other extrapyramidal disorders. In: Low PA, ed.Clinical Autonomic Disorders. Boston: Little, Brown and Company, 1992;527–535.
- Goldstein DS, Holmes C, Cannon RO, Eisenhofer G, Kopin IJ, Sympathetic cardioneuropathy in dysautonomias.N Engl J Med 1997;336:696–702.
- Mathias CJ. Autonomic disorders and their recognition (editorial).N Engl J Med 1997;336:721–723.
- Gross M, Bannister R, Godwin-Austen R. Orthostatic hypotension in Parkinson's disease.Lancet 1972;i:174–176.
- Sachs C, Berglund B, Kaijser L. Autonomic cardiovascular responses in parkinsonism: effect of levodopa with dopa-decarboxylase inhibition.Acta Neurol Scand 1985;71:37–42.
- Ludin SM, Steiger UH, Ludin HP. Autonomic disturbances and cardiovascular reflexes in idiopathic Parkinson's disease.J Neurol 1987;235:10–15.
- Turkka JT, Tolonen U, Myllyla VV. Cardiovascular reflexes in Parkinson's disease.Eur Neurol 1987;26:104–112.
- Piha SJ, Rinne JO, Rinne UK, Seppanen A. Autonomic dysfunction in recent onset and advanced Parkinson's disease.Clin Neurol Neurosurg 1988;90:221–226.
- van Dijk JG, Haan J, Zwinderman K, Kremer B, van Hilten BJ, Roos RAC. Autonomic nervous system dysfunction in Parkinson's disease: relationship with age, medication, duration and severity.J Neurol Neurosurg Psychiatry 1993;56:1090–1095.
- Meco G, Pratesi L, Bonifati V. Cardiovascular reflexes and autonomic dysfunction in Parkinson's disease.J Neurol 1991;238:195–199.
- Diehl RR, Linden D, Berlit P. Determinants of heart rate variability during deep breathing: basic findings and clinical applications.Clin Auton Res 1997;7:131–135.
- Camerlingho M, Aillon C, Bottacchi E et al. Parasympathetic assessment in Parkinson's disease.Adv Neurol 1986;45:267–269.
- DeBoer RW, Karemaker JM, Strackee J. Hemodynamic fluctuations and baroreflex sensitivity in humans: a beat-to-beat model.Am J Physiol 1987;253:680–689.
- Karemaker JM. Analysis of blood pressure and heart rate variability: theoretical considerations and clinical applicability. In: Low PA, ed.Clinical Autonomic Disorders. Boston: Little, Brown and Company, 1992;315–329.
- Saul JP, Berger RD, Albrecht P, Stein SP, Chen MH, Cohen RJ. Transfer function analysis of the circulation: unique insights into cardiovascular regulation.Am J Physiol 1991;261:H1231–1245.
- Robbe HWJ, Mulder MJL, Rüddel H, Langewitz WA, Veldman JBP, Mulder G. Assessment of baroreceptor reflex sensitivity by means of spectral analysis.Hypertension 1987;10:538–543.
- Linden D, Diehl RR. Estimation of baroreflex sensitivity using transfer function analysis: normal values and theoretical considerations.Clin Auton Res 1996;6:157–161.
- Linden D, Diehl RR, Kretzschmar A, Berlit P. Autonomic evaluation by means of standard tests and power spectral analysis in multiple sclerosis.Muscle Nerve 1997;20:809–813.
- Hoehn MM, Yahr MD. Parkinsonism: onset, progression and mortality.Neurology (Minn) 1967;17:427–442.
- Linden D, Diehl RR. Comparison of standard autonomic tests and power spectral analysis in normal adults.Muscle Nerve 1996;19:556–562.
- Taha BH, Simon PM, Dempsey JA, Skatrud JB, Iber C. Respiratory sinus arrhythmia in humans: an obligatory role for vagal feedback from the lungs.J Appl Physiol 1995;78:638–645.
- Cacioppo JT, Berntson GG, Binkley PF, Quigley KS, Uchino BN, Fieldstone A. Autonomic cardiac control. II. Noninvasive indices and basal response as revealed by autonomic blockades.Psychophysiology 1994;31:586–598.
- Pagani M, Lombardi F, Guzzetti S et al. Power spectral analysis of heart rate and arterial pressure variabilities as a marker of sympatho-vagal interaction in man and conscious dog.Circ Res 1986;59:178–193.
- Weise F, Heydenreich F, Runge U. Contributions of sympathetic and vagal mechanisms to the genesis of heart rate fluctuations during orthostatic load: a spectral analysis.J Auton Nerv Syst 1987;21:127–134.
- Andersen EB, Boesen F. Sympathetic vasoconstrictor reflexes in Parkinson's disease with autonomic dysfunction.Clin Auton Res 1997;7:5–11.
- Sympathetic cardiovascular dysfunction in long-standing idiopathic Parkinson's disease
Clinical Autonomic Research
Volume 7, Issue 6 , pp 311-314
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- idiopathic Parkinson's disease
- sympathetic dysfunction
- autonomic evaluation
- spectral analysis
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