Literature DB >> 26609462

Abnormal Cerebrovascular Reactivity in Parkinson's Disease.

Kiran Prakash1.   

Abstract

Entities:  

Year:  2015        PMID: 26609462      PMCID: PMC4644837          DOI: 10.1155/2015/464052

Source DB:  PubMed          Journal:  Parkinsons Dis        ISSN: 2042-0080


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We read with great interest the recent original article by Camargo et al. [1] titled “Abnormal Cerebrovascular Reactivity in Patients with Parkinson's Disease.” Authors observed that patients with Parkinson's disease (PD) have impaired cerebrovascular reactivity (CVR) as compared to those without orthostatic hypotension (OH) and to the control subjects. Also, authors have reported that there was not any significant difference between the Breath Holding Index (BHI) of control and patients with PD but without OH. This observation should be interpreted with caution because of important potential limitations of the study. First, a major flaw was in the assessment of CVR. As it is established and authors have also mentioned that there is impairment in the cerebral autoregulatory capacity of patients with PD, proper corrections [2, 3] should be applied during CVR assessment. Hypercapnia per se can increase the systemic arterial blood pressure which can result in increased cerebral blood flow velocity and pseudo-high results of BHI. This may be the reason behind nonsignificant difference in the BHI values of control subjects and the subjects with PD without OH. Also, 54.5% of PD subjects and 27.3% of control subjects were found to have abnormal BHI. The cut-off value of BHI beyond which it is said to be abnormal has not been mentioned. A second concern was regarding selection of control subjects. Controls were selected from healthy individuals recruited among the hospital staff and patient's relatives. Therefore, selection bias may be present in control selection as health concern may have influenced their participation. The third flaw, also mentioned by the authors, was the small sample size. Therefore, nonsignificant associations reported in this study have to be interpreted with caution. We congratulate Camargo et al. on this meticulous study exploring the cerebrovascular reactivity status in the patients with PD. However, clinicians and researchers should interpret this study with caution because of its shortcomings.
  3 in total

1.  Transcranial Doppler estimation of cerebral blood flow and cerebrovascular conductance during modified rebreathing.

Authors:  Jurgen A H R Claassen; Rong Zhang; Qi Fu; Sarah Witkowski; Benjamin D Levine
Journal:  J Appl Physiol (1985)       Date:  2006-11-16

2.  Correction for blood pressure improves correlation between cerebrovascular reactivity assessed by breath holding and 6% CO(2) breathing.

Authors:  Kiran Prakash; Dinu S Chandran; Rajesh Khadgawat; Ashok Kumar Jaryal; Kishore Kumar Deepak
Journal:  J Stroke Cerebrovasc Dis       Date:  2013-07-04       Impact factor: 2.136

3.  Abnormal Cerebrovascular Reactivity in Patients with Parkinson's Disease.

Authors:  Carlos Henrique Ferreira Camargo; Eduardo Antunes Martins; Marcos Christiano Lange; Henrique Alvaro Hoffmann; Jissa Jeanete Luciano; Marcelo Rezende Young Blood; Marcelo Derbli Schafranski; Marcelo Machado Ferro; Edmar Miyoshi
Journal:  Parkinsons Dis       Date:  2015-06-16
  3 in total

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