Literature DB >> 34099524

Association of Orthostatic Hypotension With Cerebral Atrophy in Patients With Lewy Body Disorders.

Andrea Pilotto1, Alberto Romagnolo2, Andrea Scalvini2, Mario Masellis2, Yasushi Shimo2, Laura Bonanni2, Richard Camicioli2, Lily L Wang2, Alok K Dwivedi2, Katherine Longardner2, Federico Rodriguez-Porcel2, Mark DiFrancesco2, Joaquin A Vizcarra2, Elisa Montanaro2, Simona Maule2, Alessandro Lupini2, Carmen Ojeda-López2, Sandra E Black2, Stefano Delli Pizzi2, Myrlene Gee2, Ryota Tanaka2, Kazuo Yamashiro2, Taku Hatano2, Barbara Borroni2, Roberto Gasparotti2, Maria C Rizzetti2, Nobutaka Hattori2, Leonardo Lopiano2, Irene Litvan2, Alberto J Espay2, Alessandro Padovani2, Aristide Merola2.   

Abstract

OBJECTIVE: To evaluate whether orthostatic hypotension (OH) or supine hypertension (SH) is associated with brain atrophy and white matter hyperintensities (WMH), we analyzed clinical and radiologic data from a large multicenter consortium of patients with Parkinson disease (PD) and dementia with Lewy bodies (DLB).
METHODS: Supine and orthostatic blood pressure (BP) and structural MRI data were extracted from patients with PD and DLB evaluated at 8 tertiary-referral centers in the United States, Canada, Italy, and Japan. OH was defined as a systolic/diastolic BP fall ≥20/10 mm Hg within 3 minutes of standing from the supine position (severe ≥30/15 mm Hg) and SH as a BP ≥140/90 mm Hg with normal sitting BP. Diagnosis-, age-, sex-, and disease duration-adjusted differences in global and regional cerebral atrophy and WMH were appraised with validated semiquantitative rating scales.
RESULTS: A total of 384 patients (310 with PD, 74 with DLB) met eligibility criteria, of whom 44.3% (n = 170) had OH, including 24.7% (n = 42) with severe OH and 41.7% (n = 71) with SH. OH was associated with global brain atrophy (p = 0.004) and regional atrophy involving the anterior-temporal (p = 0.001) and mediotemporal (p = 0.001) regions, greater in severe vs nonsevere OH (p = 0.001). The WMH burden was similar in those with and without OH (p = 0.49). SH was not associated with brain atrophy (p = 0.59) or WMH (p = 0.72).
CONCLUSIONS: OH, but not SH, was associated with cerebral atrophy in Lewy body disorders, with prominent temporal region involvement. Neither OH nor SH was associated with WMH.
© 2021 American Academy of Neurology.

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Year:  2021        PMID: 34099524      PMCID: PMC8397588          DOI: 10.1212/WNL.0000000000012342

Source DB:  PubMed          Journal:  Neurology        ISSN: 0028-3878            Impact factor:   11.800


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