Clinical Autonomic Research

, Volume 15, Issue 2, pp 76–82 | Cite as

Symptoms of autonomic failure in Parkinson’s disease: prevalence and impact on daily life

  • Christiane Magerkurth
  • Rita Schnitzer
  • Stefan Braune
RESEARCH ARTICLE

Abstract

Frequency and clinical importance of autonomic failure in idiopathic Parkinson’s disease (PD) are discussed controversially. 141 patients with PD and 50 healthy age-matched control subjects were interviewed for symptoms of autonomic failure and their influence on daily life using a questionnaire. In PD patients, the prevalence of orthostatic dizziness, bladder dysfunction, erectile dysfunction and hyperhidrosis was significantly higher compared with controls. About 50% of PD patients rated the impact of the symptoms of autonomic failure on their daily lives as “a lot” or “very much” due to orthostatic dizziness, bladder dysfunction and constipation, which were more statistically significant than in age-matched controls. Prevalence and number of autonomic symptoms were not correlated with duration and severity of PD. In 32% of patients, impaired cardiovascular regulation was found by standardized cardiovascular function tests. If testing showed abnormal findings, orthostatic dizziness, bladder dysfunction, constipation and erectile dysfunction were significantly more frequent than in patients with normal regulation, but the impact on daily life due to these symptoms differed significantly only for bladder dysfunction between groups. It is concluded that autonomic failure is a clinically relevant, pervasive problem in PD and compromise patients’ daily life activities in all stages of the disease. This underlines the necessity to adequately search for and treat these non-dopaminergic symptoms during the whole course of the disease.

Key words

autonomic failure Parkinson’s disease quality of life cardiovascular function tests 

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References

  1. 1.
    Appenzeller O, Goss JE (1971) Autonomic deficits in Parkinson’s syndrome. Arch Neurol 24:50–57PubMedGoogle Scholar
  2. 2.
    Awerbuch GI, Sandyk R (1994) Autonomic functions in the early stages of Parkinson’s disease. Int J Neurosci 74:9–16PubMedCrossRefGoogle Scholar
  3. 3.
    Bennarroch EE, Opfer-Gehrking TL, Low PA (1991) Use of the photoplethysmographic technique to analyze the Valsalva-maneuver in normal man. Muscle Nerve 14:1165–1172Google Scholar
  4. 4.
    Braune S, Auer A, Schulte-Mönting J, Schwerbrock S, Lücking CH (1996) Cardiovascular parameters: sensitivity to detect autonomic dysfunction and influence of age and sex in normal subjects. Clin Auton Res 6:3–15PubMedGoogle Scholar
  5. 5.
    Braune S, Reinhardt M, Schnitzer R, Riedel A, Lücking CH (1999) Cardiac uptake of (123I) MIBG separates Parkinson’s disease from multiple system atrophy. Neurology 53:1020–1025PubMedGoogle Scholar
  6. 6.
    Calna DB, Snow BJ, Lee C (1992) Criteria for diagnosing Parkinson’s disease. Ann Neurol 32:S125–S127Google Scholar
  7. 7.
    Galloway NTM (1983) Urethral sphincter abnormalities in parkinsonism. Br J Urol 55:691–693PubMedGoogle Scholar
  8. 8.
    Goetz CG, Lutge W, Tanner CM (1986) Autonomic dysfunction in Parkinson’s disease. Neurology 36:73–75PubMedGoogle Scholar
  9. 9.
    Hartog Jager Den WA, Bethlem J (1960) The distribution of Lewy bodies in the central and the autonomic nervous system in idiopathic paralysis agitans. J Neurol Neurosurg Psychiatry 23:283–290Google Scholar
  10. 10.
    Ludin SM, Steiger UH, Ludin HP (1987) Autonomic disturbances and cardiovascular reflexes in idiopathic Parkinson’s disease. J Neurol 235:10–15PubMedGoogle Scholar
  11. 11.
    Meco G, Pratesi L, Bonifati V (1991) Cardiovascular reflexes and autonomic dysfunction in Parkinson’s disease. J Neurol 238:195–199PubMedGoogle Scholar
  12. 12.
    Mesec A, Sega S, Kiauta T (1993) The influence of the type, duration, severity and levodopa treatment of Parkinson’s disease on cardiovascular autonomic response. Clin Auton Res 3:339–344PubMedGoogle Scholar
  13. 13.
    Netten PM, de Vos K, Horstink MWIM, Hoefnagels WHL (1995) Autonomic dysfunction in Parkinson’s disease, tested with a computerized method using a Finapres device. Clin Auton Res 5:85–89PubMedGoogle Scholar
  14. 14.
    Orimo S, Ozawa E, Nakade S, Sugimoto T, Mizusawa H (1999) (123)I-metaiodobenzylguanidine myocardial scintigraphy in Parkinson’s disease. J Neurol Neurosurg Psychiatry 67(2):189–194PubMedCrossRefGoogle Scholar
  15. 15.
    Parkinson J (1817) An essay on the shaking palsy. London. Sherwood, Neely, and JonesGoogle Scholar
  16. 16.
    Pavlakis AJ, Siroky MB, Goldstein I, Krane RJ (1983) Neurourological findings in Parkinson’s disease. J Urol 129:80–83PubMedGoogle Scholar
  17. 17.
    Sachs C, Berlund B, Kaijser L (1985) Autonomic cardiovascular responses in parkinsonism: effect of levodopa with dopa-decarboxylase inhibition. Acta Neurol Scand 71:37–42PubMedCrossRefGoogle Scholar
  18. 18.
    Senard JM, Rai S, Lapeyre-Mestre M, Brefel C, Rascol O, Rascol A, Montastruc JL (1997) Prevalence of orthostatic hypotension in Parkinson’s disease. J Neurol Neurosurg Psychiatry 63:584–589CrossRefPubMedGoogle Scholar
  19. 19.
    Siddiqui MF, Rast S, Lynn MJ, Auchus AP, Pfeiffer RF (2002) Autonomic dysfunction in Parkinson’s disease: a comprehensive symptom survey. Parkinsonism and related Disorders 8:277–284PubMedGoogle Scholar
  20. 20.
    Singer C, Weiner WJ, Sanchez-Ramos JR (1992) Autonomic dysfunction in men with Parkinson’s disease. Eur Neurol 32:134–140PubMedGoogle Scholar
  21. 21.
    Takahashi A (1991) Autonomic nervous system disorders in Parkinson’s disease. Eur Neurol 31(Suppl 1):41–47PubMedGoogle Scholar
  22. 22.
    Takatsu H, Nagashima K, Murase M, Fujiwara H, Nishida H, Matsuo H, Watanabe S, Satomi K (2000) Differentiating Parkinson disease from multiple-system atrophy by measuring cardiac iodine-123 metaiodobenzylguanidine accumulation. JAMA 284(1):44–45PubMedGoogle Scholar
  23. 23.
    Taki J, Nakajima K, Hwang E-H, Matsunari I, Komai K, Yoshita M, Sakajiri K, Tonami N (2000) Peripheral sympathetic dysfunction in patients with Parkinson’s disease without autonomic failure is heart selective and disease specific. Eur J Nucl Med 27(5):566–573PubMedGoogle Scholar
  24. 24.
    Turkka J, Tolonen U, Myllyla VV (1987) Cardiovascular reflexes in Parkinson’s disease. Eur Neurol 26:104–112PubMedGoogle Scholar
  25. 25.
    Wakabayashi K, Takahashi H, Ohama E, Takeda S, Ikuta F (1993) Lewy bodies in the visceral autonomic nervous system in Parkinson’s disease. Adv Neurol 60:609–612PubMedGoogle Scholar
  26. 26.
    Wakabayashi K, Takahashi H (1997) Neuropathology of autonomic nervous system in Parkinson’s disease. Eur Neurol 38(Suppl 2):2–7PubMedGoogle Scholar

Copyright information

© Steinkopff Verlag 2005

Authors and Affiliations

  • Christiane Magerkurth
    • 1
  • Rita Schnitzer
    • 1
  • Stefan Braune
    • 2
  1. 1.Dept. of NeurologyUniversity of FreiburgFreiburgGermany
  2. 2.Neurozentrum PrienPrienGermany

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