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Non-dipping nocturnal blood pressure and psychosis parameters in Parkinson disease

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Abstract

Background

Non-motor symptoms are increasingly recognized in Parkinson disease (PD) and include physical as well as psychological symptoms. A psychological condition that has been well studied in PD is psychosis. Cardiovascular autonomic dysfunction in PD can include a reversed or loss of blood pressure (BP) circadian rhythm, referred to as nocturnal non-dipping. The aim of this study was to determine the relationship between 24 h ambulatory blood pressure measurements (ABPM), i.e., absence or presence of nocturnal dipping, and psychosis scores in PD.

Methods

Twenty-one patiens with PD underwent 24 h ABPM using an autonomic protocol. A decrease in nocturnal mean arterial blood pressure of less than 10 % was defined as non-dipping. Patients were interviewed (including the brief psychiatric rating scale; BPRS) for the assessment of psychosis.

Results

Eleven patients were dippers and 10 were non-dippers. BPRS scores were higher in non-dippers, who, on average, met the criteria for psychosis (mean non-dipper BPRS: 34.3 ± 7.3 vs mean dipper BPRS: 27.5 ± 5.3; cutoff for “mildly ill” 31). There was a correlation between BPRS scores and non-dipping, indicating that those patients who had a blunted nocturnal fall in BP were more prone to psychotic symptoms (Pearson’s Correlation = 0.554, p = 0.009).

Conclusion

These results suggest that, among PD patients, a non-dipping circadian rhythm is associated with more severe symptoms of psychosis than is a dipping circadian rhythm. This association warrants further investigation.

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Acknowledgments

CAH conceived the initial idea to the project, CAH, ES, DAL and CJM managed the ethics committee application, ES, EV, DAL and CAH contributed to the Conception, Organization and Execution of the Research project, ES and EV performed all testing, CAH, CJM, DAL and SI supervised the project. ES, EV, DAL and CAH contributed to the Review and Critique of the Statistical Analysis, ES drafted the original version of the manuscript, DAL, EV, CJM, SI and CAH contributed the Review and Critique of the Manuscript. All authors contributed extensively to the work presented in this paper.

Conflict of interest

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

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Authors and Affiliations

  1. Autonomic Laboratory, Department of Neurology and Clinical Neurophysiology, Faculty of Health, University of Witten/Herdecke, HELIOS-Klinikum Wuppertal, Wuppertal, Germany

    E. Stuebner & S. Isenmann

  2. Autonomic and Neurovascular Medicine Unit, Division of Brain Sciences, Faculty of Medicine, Imperial College London at St Mary’s Hospital, London, UK

    E. Vichayanrat & C. J. Mathias

  3. Autonomic Unit, Queen Square/Division of Clinical Neurology, National Hospital for Neurology and Neurosurgery, Institute of Neurology, University College London, London, UK

    E. Vichayanrat & C. J. Mathias

  4. Kliniken Maria Hilf Mönchengladbach, Autonomic Laboratory, Department of Neurology, Faculty of Health, University of Witten/Herdecke, Viersenerstr. 450, 41063, Mönchengladbach, Germany

    C. A. Haensch

  5. Research Institute of Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK

    D. A. Low

  6. Faculty of Science, Department of Medicine, Imperial College London, London, UK

    D. A. Low

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  1. E. Stuebner
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  5. S. Isenmann
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  6. C. A. Haensch
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Correspondence to C. A. Haensch.

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Stuebner, E., Vichayanrat, E., Low, D.A. et al. Non-dipping nocturnal blood pressure and psychosis parameters in Parkinson disease. Clin Auton Res 25, 109–116 (2015). https://doi.org/10.1007/s10286-015-0270-5

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  • DOI: https://doi.org/10.1007/s10286-015-0270-5

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