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23.04.2024 | Research Article

Sympathetic dysfunction as an early indicator of autonomic involvement in Parkinson’s disease

verfasst von: Jin-Woo Park, Luis E. Okamoto, Sung-Hwan Kim, Chan-Nyoung Lee, Kun Woo Park, Seol-Hee Baek, Joo Hye Sung, Namjoon Jeon, Seong-Beom Koh, Alfredo Gamboa, Cyndya A. Shibao, André Diedrich, Byung-Jo Kim, Italo Biaggioni

Erschienen in: Clinical Autonomic Research | Ausgabe 2/2024

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Abstract

Purpose

The specific characteristics of autonomic involvement in patients with early Parkinson’s disease (PD) are unclear. This study aimed to evaluate the characteristics of autonomic dysfunction in drug-naïve patients with early-stage PD without orthostatic hypotension (OH) by analyzing Valsalva maneuver (VM) parameters.

Methods

We retrospectively analyzed drug-naïve patients without orthostatic hypotension (n = 61) and controls (n = 20). The patients were subcategorized into early PD (n = 35) and mid-PD (n = 26) groups on the basis of the Hoehn and Yahr staging. VM parameters, including changes in systolic blood pressure at late phase 2 (∆SBP_VM2), ∆HR_VM3, Valsalva ratio (VR), pressure recovery time, adrenergic baroreflex sensitivity, and vagal baroreflex sensitivity, were assessed.

Results

In the early PD group, ∆SBP_VM2, a marker of sympathetic function, was significantly lower compared with that in controls (risk ratio = 0.95, P = 0.027). Receiver operating characteristic (ROC) curve analysis showed an optimal cut-off value of −10 mmHg for ∆SBP_VM2 [P = 0.002, area under the curve (AUC): 0.737]. VR exhibited an inverse relationship with Unified Parkinson’s Disease Rating Scale Part 3 scores in the multivariable regression analysis (VR: P = 0.038, β = −28.61), whereas age showed a positive relationship (age: P = 0.027, β = 0.35).

Conclusion

The ∆BP_VM2 parameter of the VM may help detect autonomic nervous system involvement in early-PD without OH. Our results suggest that sympathetic dysfunction is an early manifestation of autonomic dysfunction in patients with PD.

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Titel: Sympathetic dysfunction as an early indicator of autonomic involvement in Parkinson’s disease
verfasst von: Jin-Woo Park
Luis E. Okamoto
Sung-Hwan Kim
Chan-Nyoung Lee
Kun Woo Park
Seol-Hee Baek
Joo Hye Sung
Namjoon Jeon
Seong-Beom Koh
Alfredo Gamboa
Cyndya A. Shibao
André Diedrich
Byung-Jo Kim
Italo Biaggioni
Publikationsdatum: 23.04.2024
Verlag: Springer Berlin Heidelberg
Erschienen in: Clinical Autonomic Research / Ausgabe 2/2024
Print ISSN: 0959-9851
Elektronische ISSN: 1619-1560
DOI: https://doi.org/10.1007/s10286-024-01031-6

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Sympathetic dysfunction as an early indicator of autonomic involvement in Parkinson’s disease

Abstract

Purpose

Methods

Results

Conclusion

Neu in den Fachgebieten Neurologie und Psychiatrie

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Nicht Creutzfeldt Jakob, sondern Abführtee-Vergiftung

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Abstract

Purpose

Methods

Results

Conclusion

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