Abstract
We have investigated the autonomic function of 95 patients with Parkinson disease (PD) by testing their cardiovascular reflexes and compared the results with those of 53 healthy volunteers. 51.1% of the patients were on antiparkinsonian therapy. The patients showed a smaller heart rate response to deep breathing with a mean exhalation-inspiration difference of 87.73±7 (p: 0.0005), a smaller heart rate response to standing with a mean 30 ∶ 15 index of 1.18±0.25 (p∶ 0.01), and a smaller blood pressure rise to handgrip with a mean rise of 9.53±8.76 mmHG (p∶ 0.005). We found a higher percentage of patients with established sympathetic lesion (41% vs 34%) or atypical patterns of global autonomic function involvement (33% vs 26%), but the percentage of subjects with parasympathetic lesion was similar in both, patients and controls (16% vs 15%). We found no significant difference on cardiovascular performance between treated and untreated patients. The patients with autonomic impairment were older than the patients with normal autonomic function. Our findings suggest that patients with PD have a true autonomic dysfunction.
Sommario
Abbiamo studiato la funzionalità del Sistema Nervoso Autonomo in 95 pazienti affetti da Malattia di Parkinson (PD), valutando i riflessi cardiovascolari e confrontando i risultati con quelli ottenuti da 53 volontari sani.
Il 51.1% dei pazienti Parkinsoniani era in trattamento farmacologico. I pazienti hanno mostrato una ridotta risposta della frequenza cardiaca alla ventilazione profonda, alla stazione eretta e un ridotto aumento pressorio dopo esercizio isometrico. È stata riscontrata una più alta percentuale di pazienti con lesioni simpatiche stabilite (41% vs 34%) e con quadro atipico di coinvolgimento globale della funzione autonomica (33% vs 26%), ma la percentuale di soggetti con lesioni parasimpatiche era simile nei pazienti e nei soggetti di controllo (16% vs 15%). Non è stata riscontrata una significativa differenza alle performance cardiovascolari tra pazienti in trattamento farmacologico e non trattati. I pazienti con disturbi autonomici erano più anziani di quelli con normale funzione autonomica. I dati suggeriscono la presenza di una vera disfunzione autonomica nei pazienti affetti da PD.
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Martín, R., Manzanares, R., Moltó, J.M. et al. Cardiovascular reflexes in Parkinson disease. Ital J Neuro Sci 14, 437–442 (1993). https://doi.org/10.1007/BF02339173
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DOI: https://doi.org/10.1007/BF02339173