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Sudomotor and cardiovascular dysfunction in patients with early untreated Parkinson's disease.

Asahina, M and Mathias, CJ and Katagiri, A and Low, DA and Vichayanrat, E and Fujinuma, Y and Yamanaka, Y and Kuwabara, S (2014) Sudomotor and cardiovascular dysfunction in patients with early untreated Parkinson's disease. Journal of Parkinson's Disease, 4 (3). pp. 385-393. ISSN 1877-7171

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Abstract

BACKGROUND: According to Braak staging of Parkinson's disease (PD), detection of autonomic dysfunction would help with early diagnosis of PD. OBJECTIVE: To determine whether the autonomic nervous system is involved in the early stage of PD, we evaluated cardiovascular and sudomotor function in early untreated PD patients. METHODS: Orthostatic blood pressure regulation, heart rate variability, skin vasomotor function, and palmar sympathetic sweat responses were examined in 50 early untreated PD patients and 20 healthy control subjects. RESULTS: The mean decrease in systolic blood pressure during head-up tilt in PD patients was mildly but significantly larger than in controls (p = 0.0001). There were no differences between the 2 groups in heart rate variability, with analysis of low frequency (LF; mediated by baroreflex feedback), and high frequency (HF; mainly reflecting parasympathetic vagal) modulation. However, LF/HF, an index of sympatho-parasympathetic balance, was lower in the PD group than in controls (p = 0.02). Amplitudes of palmar sweat responses to deep inspiration (p = 0.004), mental arithmetic (p = 0.01), and exercise (p = 0.01) in PD patients were lower than in controls, with negative correlations with motor severity. Amplitudes of palmar skin vasomotor reflexes in PD patients did not differ from controls. CONCLUSIONS: Our study indicates impairment of sympathetic cardiovascular and sudomotor function with orthostatic dysregulation of blood pressure control, reduced LF/HF and reduction in palm sweat responses even in early untreated PD patients.

Item Type: Article
Uncontrolled Keywords: Parkinson's disease; autonomic nervous system; cardiovascular system; sudomotor function
Subjects: R Medicine > RC Internal medicine > RC0321 Neuroscience. Biological psychiatry. Neuropsychiatry
R Medicine > RC Internal medicine > RC1200 Sports Medicine
Divisions: Sport & Exercise Sciences
Publisher: IOS Press
Related URLs:
Date Deposited: 04 Feb 2015 14:12
Last Modified: 04 Feb 2015 14:12
DOI or Identification number: 10.3233/JPD-130326
URI: http://researchonline.ljmu.ac.uk/id/eprint/363

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