scholarly journals Orthostatic Hypotension in Drug-Naïve Patients with Parkinson’s Disease

2011 ◽  
Vol 4 (1) ◽  
pp. 33-37 ◽  
Author(s):  
Hyo-Jin Bae ◽  
Sang-Myung Cheon ◽  
Jae Woo Kim
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Orthostatic Hypotension ◽  
Drug Naïve

scholarly journals Delayed orthostatic hypotension in Parkinson’s disease

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Sang-Won Yoo ◽  
Joong-Seok Kim ◽  
Ji-Yeon Yoo ◽  
Eunkyeong Yun ◽  
Uicheul Yoon ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Orthostatic Hypotension ◽  
Disease Severity ◽  
Cortical Thickness ◽  
Early Stage ◽  
Brain Magnetic Resonance Imaging ◽  
Clinical Scales ◽  
Drug Naïve

AbstractOrthostatic hypotension (OH) is relatively common in the early stage of Parkinson’s disease (PD). It is divided into delayed OH and classical OH. Classical OH in PD has been investigated widely, however, the clinical implications of delayed OH in PD have seldom been studied. The purpose of this study is to characterize delayed OH in PD. A total of 285 patients with early drug-naïve PD were enrolled and divided into three groups according to orthostatic change: no-OH, delayed OH, and classical OH. The disease severity in terms of motor, non-motor, and cognitive functions was assessed. The cortical thickness of 82 patients was analyzed with brain magnetic resonance imaging. The differences among groups and linear tendency in the order of no-OH, delayed OH, and classical OH were investigated. Seventy-seven patients were re-evaluated. Initial and follow-up evaluations were explored to discern any temporal effects of orthostasis on disease severity. Sixty-four (22.5%) patients were defined as having delayed OH and 117 (41.1%) had classical OH. Between-group comparisons revealed that classical OH had the worst outcomes in motor, non-motor, cognitive, and cortical thickness, compared to the other groups. No-OH and delayed OH did not differ significantly. Linear trends across the pre-ordered OH subtypes found that clinical parameters worsened along with the orthostatic challenge. Clinical scales deteriorated and the linear gradient was maintained during the follow-up period. This study suggests that delayed OH is a mild form of classical OH in PD. PD with delayed OH has milder disease severity and progression.

Lower vascular tone and larger plasma volume in Parkinson's disease with orthostatic hypotension

2011 ◽  
Vol 111 (2) ◽  
pp. 443-448 ◽  
Author(s):  
J. T. Groothuis ◽  
R. A. J. Esselink ◽  
J. P. H. Seeger ◽  
M. J. H. van Aalst ◽  
M. T. E. Hopman ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Blood Flow ◽  
Orthostatic Hypotension ◽  
Vascular Resistance ◽  
Plasma Volume ◽  
Venous Pressure ◽  
Dilution Method ◽  
Significant Difference ◽  
Head Up Tilt

The pathophysiology of orthostatic hypotension in Parkinson's disease (PD) is incompletely understood. The primary focus has thus far been on failure of the baroreflex, a central mediated vasoconstrictor mechanism. Here, we test the role of two other possible factors: 1) a reduced peripheral vasoconstriction (which may contribute because PD includes a generalized sympathetic denervation); and 2) an inadequate plasma volume (which may explain why plasma volume expansion can manage orthostatic hypotension in PD). We included 11 PD patients with orthostatic hypotension (PD + OH), 14 PD patients without orthostatic hypotension (PD − OH), and 15 age-matched healthy controls. Leg blood flow was examined using duplex ultrasound during 60° head-up tilt. Leg vascular resistance was calculated as the arterial-venous pressure gradient divided by blood flow. In a subset of 9 PD + OH, 9 PD − OH, and 8 controls, plasma volume was determined by indicator dilution method with radiolabeled albumin (125I-HSA). The basal leg vascular resistance was significantly lower in PD + OH (0.7 ± 0.3 mmHg·ml−1·min) compared with PD − OH (1.3 ± 0.6 mmHg·ml−1·min, P < 0.01) and controls (1.3 ± 0.5 mmHg·ml−1·min, P < 0.01). Leg vascular resistance increased significantly during 60° head-up tilt with no significant difference between the groups. Plasma volume was significantly larger in PD + OH (3,869 ± 265 ml) compared with PD − OH (3,123 ± 377 ml, P < 0.01) and controls (3,204 ± 537 ml, P < 0.01). These results indicate that PD + OH have a lower basal leg vascular resistance in combination with a larger plasma volume compared with PD − OH and controls. Despite the increase in leg vascular resistance during 60° head-up tilt, PD + OH are unable to maintain their blood pressure.

2.282 FACTORS RELATED TO ORTHOSTATIC HYPOTENSION IN PARKINSON'S DISEASE

2012 ◽  
Vol 18 ◽  
pp. S136
Author(s):  
S. Perez-Lloret ◽  
M.V. Rey ◽  
N. Fabre ◽  
F. Ory ◽  
U. Spampinato, ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Orthostatic Hypotension

scholarly journals Initial circulatory response to active standing in Parkinson's disease without typical orthostatic hypotension

2014 ◽  
Vol 72 (3) ◽  
pp. 208-213
Author(s):  
Guillermo Delgado ◽  
Bruno Estañol ◽  
Mayela Rodríguez-Violante ◽  
Jesús Antonio González-Hermosillo ◽  
Óscar Infante-Vázquez
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Orthostatic Hypotension ◽  
Initial Response ◽  
Upright Position ◽  
Resistance Response ◽  
Circulatory Response ◽  
Volume Clamp Method ◽  
Sample Points ◽  
Prolonged Latency

While the circulatory response to orthostatic stress has been already evaluated in Parkinson's disease patients without typical orthostatic hypotension (PD-TOH), there is an initial response to the upright position which is uniquely associated with active standing (AS). We sought to assess this response and to compare it to that seen in young healthy controls (YHC). Method In 10 PD-TOH patients (8 males, 60±7 years, Hoehn and Yahr ≤3) the changes in systolic blood pressure (SBP) and heart rate that occur in the first 30 seconds (sec) of standing were examined. Both parameters were non-invasively and continuously monitored using the volume-clamp method by Peñáz and the Physiocal criteria by Wesseling. The choice of sample points was prompted by the results of previous studies. These sample points were compared to those of 10 YHC (8 males, 32±8 years). Results The main finding of the present investigation was an increased time between the AS onset and SBP overshoot in PD-TOH group (24±4 vs. 19±3 sec; p<0.05). Conclusion This delay might reflect a prolonged latency in the baroreflex-mediated vascular resistance response, but more studies are needed to confirm this preliminary hypothesis.

Striatal Dopamine Denervation Impairs Gait Automaticity in Drug‐Naïve Parkinson's Disease Patients

2020 ◽  
Vol 35 (6) ◽  
pp. 1037-1045
Author(s):  
Kosei Hirata ◽  
Takaaki Hattori ◽  
Satoko Kina ◽  
Qingmeng Chen ◽  
Masahiro Ohara ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Striatal Dopamine ◽  
Drug Naïve

Rapid eye movement behavior disorder in drug-naïve patients with Parkinson’s disease

2019 ◽  
Vol 59 ◽  
pp. 254-258 ◽  
Author(s):  
Hui Liu ◽  
Ruwei Ou ◽  
Qianqian Wei ◽  
Yanbing Hou ◽  
Bei Cao ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Eye Movement ◽  
Behavior Disorder ◽  
Movement Behavior ◽  
Rapid Eye Movement ◽  
Drug Naïve
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