Clinical Autonomic Research

, Volume 9, Issue 3, pp 139–144

Clinical and physiological characteristics of autonomic failure with Parkinson's disease

  • Yuki Niimi
  • Toshiaki Ieda
  • Masaaki Hirayama
  • Yasuo Koike
  • Gen Sobue
  • Yasuhiro Hasegawa
  • Akira Takahashi
Research Paper

DOI: 10.1007/BF02281627

Cite this article as:
Niimi, Y., Ieda, T., Hirayama, M. et al. Clinical Autonomic Research (1999) 9: 139. doi:10.1007/BF02281627

Abstract

We analyzed the clinical and physiological features of autonomic failure with Parkinson's disease (AF-PD) in seven patients and compared them with those of autonomic failure with multiple system atrophy (AF-MSA). In AF-PD, parkinsonism was more gradually progressive than in AF-MSA, and symptoms were responsive to L-dopa. All seven patients with AF-PD had orthostatic hypotension, postprandial hypotension, and constipation, but no urinary retention. Of these, three had hypohidrosis and five had frequent urination; five patients had subnormal plasma norepinephrine (NE) concentrations. Supersensitivity to NE infusion was observed in all patients. Head-up tilting (HUT) test resulted in no increase of plasma NE concentrations in both groups, but a significant increase of the plasma arginine vasopressin (AVP) concentrations in the patients with AF-PD. Urodynamic studies revealed that urinary bladder function was relatively well preserved in AF-PD in contrast to AF-MSA. In conclusion, there exists some clinical and physiological differences in autonomic features between AF-PD and AF-MSA, and postganglionic involvement predominates in AF-PD.

Keywords

autonomic failure Parkinson's disease multiple system atrophy pure autonomic failure 

Copyright information

© Lippincott Williams & Wilkins 1999

Authors and Affiliations

  • Yuki Niimi
    • 1
  • Toshiaki Ieda
    • 1
  • Masaaki Hirayama
    • 1
  • Yasuo Koike
    • 2
  • Gen Sobue
    • 1
  • Yasuhiro Hasegawa
    • 3
  • Akira Takahashi
    • 4
  1. 1.Department of NeurologyNagoya University School of MedicineNagoyaJapan
  2. 2.Nagoya University College of Medical TechnologyNagoyaJapan
  3. 3.Department of NeurologyHigashi Municipal Hospital of NagoyaNagoyaJapan
  4. 4.Tokal Central HospitalKakamigaharaJapan
  5. 5.Department of Autonomic Neuroscience, Division of Higher Nervous Control, the Research Institute of Environmental MedicineNagoya UniversityNagoyaJapan

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