Jung Bin Kim1, Byung-Jo Kim1, Seong-Beom Koh1, Kun-Woo Park2. 1. Department of Neurology, Korea University Medical Center, Korea University College of Medicine, #126-1, Anam-Dong 5Ga, Seongbuk-Gu, Seoul 136-705, Republic of Korea. 2. Department of Neurology, Korea University Medical Center, Korea University College of Medicine, #126-1, Anam-Dong 5Ga, Seongbuk-Gu, Seoul 136-705, Republic of Korea. Electronic address: neuro_kim@naver.com.
Abstract
BACKGROUND: Although autonomic dysfunction is common in patients with Parkinson's disease (PD), few data are available regarding its pattern and quantitative severity with increasing Hoehn and Yahr (H&Y) stage. We conducted autonomic function tests to quantify autonomic dysfunction in PD patients and to elucidate its possible relationship with disease progression. METHODS: We performed autonomic function tests including Valsalva ratio, heart rate response to deep breathing, quantitative sudomotor axon reflex test, and head-up tilt test in 66 patients with PD. We compared clinical characteristics and results of autonomic function tests between stages, and correlated the proportion of abnormal patients in each test with their H&Y stage. In addition, logistic regression analyses were conducted to examine the contribution of increasing H&Y stage to impairments of each domain of the autonomic nervous system. RESULTS: We found that PD patients with higher disease stage tended to have impairments in cardiovagal and sudomotor domains of the autonomic nervous system. Cardiovagal function was the domain most influenced by disease progression. Our findings also demonstrated that the pattern of sudomotor impairment in PD was similar to that in patients with peripheral autonomic neuropathy. CONCLUSIONS: Our study demonstrates that autonomic dysfunction is not only common in early stage PD but it increases in severity with increasing disease stage. Given that the patterns of sudomotor impairments in PD are similar to those in peripheral neuropathy, our data support a previous hypothesis that pathophysiology of PD involves both the central and peripheral nervous systems.
BACKGROUND: Although autonomic dysfunction is common in patients with Parkinson's disease (PD), few data are available regarding its pattern and quantitative severity with increasing Hoehn and Yahr (H&Y) stage. We conducted autonomic function tests to quantify autonomic dysfunction in PDpatients and to elucidate its possible relationship with disease progression. METHODS: We performed autonomic function tests including Valsalva ratio, heart rate response to deep breathing, quantitative sudomotor axon reflex test, and head-up tilt test in 66 patients with PD. We compared clinical characteristics and results of autonomic function tests between stages, and correlated the proportion of abnormal patients in each test with their H&Y stage. In addition, logistic regression analyses were conducted to examine the contribution of increasing H&Y stage to impairments of each domain of the autonomic nervous system. RESULTS: We found that PDpatients with higher disease stage tended to have impairments in cardiovagal and sudomotor domains of the autonomic nervous system. Cardiovagal function was the domain most influenced by disease progression. Our findings also demonstrated that the pattern of sudomotor impairment in PD was similar to that in patients with peripheral autonomic neuropathy. CONCLUSIONS: Our study demonstrates that autonomic dysfunction is not only common in early stage PD but it increases in severity with increasing disease stage. Given that the patterns of sudomotor impairments in PD are similar to those in peripheral neuropathy, our data support a previous hypothesis that pathophysiology of PD involves both the central and peripheral nervous systems.
Authors: S Bostantjopoulou; Z Katsarou; I Danglis; H Karakasis; D Milioni; C Falup-Pecurariu Journal: Hippokratia Date: 2016 Apr-Jun Impact factor: 0.471
Authors: Diego Santos-García; Teresa de Deus; Carlos Cores; Hector Canfield; Jose M Paz González; Cristina Martínez Miró; Lorena Valdés Aymerich; Ester Suárez; Silvia Jesús; Miquel Aguilar; Pau Pastor; Lluis Planellas; Marina Cosgaya; Juan García Caldentey; Nuria Caballol; Ines Legarda; Jorge Hernández-Vara; Iria Cabo; Lydia López Manzanares; Isabel González Aramburu; Maria A Ávila Rivera; Maria J Catalán; Victor Nogueira; Victor Puente; Julio Dotor; Carmen Borrué; Berta Solano; Maria Álvarez Sauco; Lydia Vela; Sonia Escalante; Esther Cubo; Francisco Carrillo; Juan C Martínez Castrillo; Pilar Sánchez Alonso; Gemma Alonso; Nuria López Ariztegui; Itziar Gastón; Jaime Kulisevsky; Marta Blázquez; Manuel Seijo; Javier Rúiz Martínez; Caridad Valero; Monica Kurtis; Oriol de Fábregues; Jessica Ardura; Ruben Alonso; Carlos Ordás; Luis M López Díaz; Darrian McAfee; Pablo Martinez-Martin; Pablo Mir Journal: J Pers Med Date: 2021-06-30