Abstract
Centrally and locally elicited sympathetic vasoconstrictor responses were examined in 12 patients with symptoms and signs of cardiovascular autonomic dysfunction due to Parkinson's disease. The sympathetic reflex mechanisms were measured in skeletal muscle and subcutaneous tissue of the arm and leg using the 133-Xenon washout technique. This method allows differentiation between local and central sympathetic reflexes in different tissues. The results indicate an abolished centrally mediated vasoconstrictor response in skeletal muscle in the arm and a decreased response in skeletal muscle in the leg and in subcutaneous tissue. This is in agreement with an autonomic dysfunction located in the central nervous system. A possible spinal sympathetic reflex controlling blood flow in subcutaneous tissue and leg muscles is considered. The sympathetic vasoconstrictor responses in parkinsonian patients without autonomic failure were of normal magnitude and the responses were not affected by long-term levodopa treatment.
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Parkinson J. An essay on the shaking palsy. London, 1817. Reprinted in: Chritchley M, ed.James Parkinson (1755–1824). London: Macmillan, 1955.
Porter RW, Bors E, Hyman W. Distortion of extrapyramidal visceral interrelationships in Parkinson's syndrome. In: Gillingham FJ, Donaldson IML, eds.Third Symposium on Parkinson's Disease. Edinburgh and London: Livingstone, 1969; 124–128.
Spiegel EA, Wycis HT, Schor S, Schwartz HA, Fabiani FR. The incidence of vegetative symptoms in Parkinson patients with and without bradykinesia. In: Gillingham FJ, Donaldson IML, eds.Third Symposium on Parkinson's Disease. Edinburgh and London: Livingstone, 1969; 200–203.
Aminoff MJ, Wilcox CS. Assessment of autonomic function in patients with a parkinsonian syndrome.Br Med J 1971;4: 80–84.
Appenzeller O, Goss JE. Autonomic deficits in Parkinson's syndrome.Arch Neurol 1971;24: 50–57.
Reid JL, Calne DB, George CF et al. Cardiovascular reflexes in parkinsonism.Clin Sci 1971;41: 63–67.
Gross M, Bannister R, Godwin-Austen R. Orthostatic hypotension in Parkinson's disease.Lancet 1972;i: 174–176.
Elliot K, Gote LJ, Frewin DB, Downey JA. Vascular responses in the hands of Parkinson's disease patients.Neurology 1974;24: 857–862.
Rajput AH, Rozdilsky B. Dysautonomia in Parkinsonism: a clinicopathological study.J Neurol Neurosurg Psychiatr 1976;39: 1092–1100.
Sachs C, Berglund B, Kaijser L. Autonomic cardiovascular responses in Parkinsonism: effect of levodopa with dopadecarboxylase-inhibition.Acta Neurol Scand 1985;71: 37–42.
Goetz CG, Lutge W, Tanner CM. Autonomic dysfunction in Parkinson's disease.Neurology 1986;36: 73–75.
Turrka J. Autonomic dysfunction in Parkinson's disease.Acta Universitatis Ouluensis 1986; D142: 15–66.
Kuroiwa Y, Wada T, Tohgi H. Measurement of blood pressure and heart-rate variation while resting supine and standing for the evaluation of autonomic dysfunction.J Neurol 1987;235: 65–68.
Ørskov L, Jakobsen J, Dupont E, Olivarius BdF, Christensen NJ. Autonomic function in parkinsonian patients relates to duration of disease.Neurology 1987;37: 1173–1178.
Turkka JT, Tolonen U, Myllylä VV. Cardiovascular reflexes in Parkinson's disease.Eur Neurol 1987;26: 104–112.
Piha SJ, Rinne JO, Rinne UK, Seppänen A. Autonomic dysfunction in recent onset and advanced Parkinson's disease.Clin Neurol Neurosurg 1988;90: 221–226.
Mesec A, Sega S, Kiauta T. The influence of the type, duration, severity and levodopa treatment of Parkinson's disease on cardiovascular autonomic responses.Clin Aut Res 1993;3: 339–344.
van Dijk JG, Haan J, Zwinderman K, Kremer B, van Hilten BJ, Roos RAC. Autonomic nervous system dysfunction in Parkinson's disease: relationships with age, medication, duration, and severity.J Neurol Neurosurg Psychiat 1993;56: 1090–1095.
Henning M, Rubanson A. Evidence for a centrally mediated hypotensive effect of L-dopa in the rat.J Pharm Pharmac 1970;22: 241–243.
Calne DB, Brennan J, Spiers ASD, Stern GM. Hypotension caused by L-dopa.Br Med J 1970;1: 474–475.
Reid JL, Greenacre JK, Teychenne PF. Cardiovascular actions of L-dopa and dopaminergic agonists in Parkinsonism. Vth International Symposium on Parkinson's Disease.Editiones Roche 1976: 566–573.
Ziegler MG, Kennedy B, Holland OB, Murphy D, Lake CR. The effect of dopamine agonists on human cardiovascular and sympathetic nervous systems.Int J Clin Pharm Ther Toxicol 1985;23: 175–179.
Camerlingo, M, Ferraro B, Gazzaniga GC, Casto L, Cesana BM, Mamoli A. Cardiovascular reflexes in Parkinson's disease: longterm effects of levodopa treatment on de novo patients.Acta Neurol Scand 1990;81: 346–348.
Iwasaki S, Hamaguchi K, Iwasaki A, Takakusagi M, Narabayashi Y. Hypotensive effect of long-term levodopa in patients with Parkinson's disease.Eur Neurol 1990;30: 194–199.
Barbeau A. L-dopa therapy in Parkinson's disease. A critical review of nine years experience.Canad Med Ass J 1969;101: 791–800.
Ballantyne JP. Early and late effects of levodopa on the cardiovascular system in Parkinson's disease.J Neurol Sci 1973;19: 97–103.
Gauer OH, Thron HL. Postural changes in the circulation. In:Handbook of Physiology, Circulation. Washington: American Physiological Society, 1965; section 2, III: 2409–2439.
Skagen K. Sympathetic reflex control of blood flow in human subcutaneous tissue during orthostatic maneuvres.Laegeforeningens forlag 1983: 7–43.
Andersen EB, Boesen F, Henriksen O, Sonne M. Blood flow in skeletal muscle of tetraplegic man during postural changes.Clin Sci 1986;70: 321–325.
Henriksen O, Seirsen P. Local reflex in microcirculation in human cutaneous tissue.Acta Physiol Scand 1976;98: 227–231.
Henriksen O, Sejrsen P. Local reflex in microcirculation in human skeletal muscle.Acta Physiol Scand 1977;99: 19–26.
Skagen K, Jensen KI, Henriksen O, Knudsen L. Sympathetic control of subcutaneous blood flow in tetraplegic man during postural changes.Clin Sci 1982;62: 605–609.
Hilsted J. Decreased sympathetic vasomotor tone in diabetic orthostatic hypotension.Diabetes 1979;28: 970–973.
Jensen K, Andersen K, Smith T, Henriksen O, Melgaard B. Sympathetic vasoconstrictor nerve function in alcoholic neuropathy.Clin Physiol 1984;4: 253–263.
Hoehn MM, Yahr MD. Parkinsonism: onset, progression and mortality.Neurology 1967;17: 427–442.
Nielsen SL, Adipose tissue blood flow determined by the washout of locally injected 133-XenonScand J Clin Lab Invest 1972;29: 31–36.
Henriksen O. Local sympathetic reflex mechanism in regulation of blood flow in human subcutaneous adipose tissue.Acta Physiol Scand 1977; suppl. 450: 7–48.
Skagen K. Contribution of local blood flow regulation mechanism during head-up tilt in human subcutaneous tissue.,Acta Physiol Scand 1982;116: 331–334.
Andersen EB, Boesen F, Henriksen O. Local and central sympathetic reflex control of blood flow in skeletal muscle and subcutaneous tissue in normal man.Clin Physiol 1991;11: 451–458.
Bannister R, Ardill L, Fentum P. Detective autonomic control of blood vessels in idiopathic orthostatic hypotension.Brain 1967;90: 725–746.
Ludin SM, Steiger UH, Ludin HP. Autonomic disturbances and cardiovascular reflexes in idiopathic Parkinson's disease.J Neurol 1987;235: 10–15.
Ishida G, Nakashima K, Takahashi K. Skin nerve sympathetic activity reflex latency in Parkinson's disease.Acta Neurol Scand 1990;81: 121–124.
Den Hartog Jager WA, Bethlem J. The distribution of Lewy bodies in the central and autonomic nervous systems in idiopathic paralysis agitans.J Neurol Neurosurg Psychiat, 1960;23: 283–290.
Langston JW, Fomo LS. The hypothalamus in Parkinson's disease.Ann Neurol 1978;3: 129–133.
Gai WP, Geffen LB, Denoroy L, Blessing WW. Loss of C1 and C3 epinephrine-synthesizing neurons in the medulla oblongata in Parkinson's disease.Ann Neurol 1993;33: 357–367.
Kaplan HR, Barker JW, La Sala SA. Direct evidence for a centrallymediated hypotensive action of L-dopa in anesthetized dogs.Eur J Pharmacol 1972;17: 273–278.
Reid JL, Calne DB. Cardiovascular effect of levodopa in Parkinsonism.Advances in Neurology 1973;3: 223–232.
Mc Dowell FH, Lee JE, Levodopa, Parkinson's disease and hypotension.Ann Int Med 1970;5: 751–752.
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Andersen, E.B., Boesen, F. Sympathetic vasoconstrictor reflexes in Parkinson's disease with autonomic dysfunction. Clinical Autonomic Research 7, 5–11 (1997). https://doi.org/10.1007/BF02267620
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DOI: https://doi.org/10.1007/BF02267620