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Reduced central sympathetic activity in Parkinson's disease

OBJECTIVE: With a combination of different sympathetic tests, we aimed to elucidate whether impairment of sympathetic function in Parkinson's disease (PD) is the consequence of a central or peripheral efferent dysfunction. METHODS: Thirty‐five patients with early‐to‐intermediate PD (median age:...

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Autores principales: Krämer, Heidrun H., Lautenschläger, Gothje, de Azevedo, Michael, Doppler, Kathrin, Schänzer, Anne, Best, Christoph, Oertel, Wolfgang H., Reuter, Iris, Sommer, Claudia, Birklein, Frank
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6908869/
https://www.ncbi.nlm.nih.gov/pubmed/31691543
http://dx.doi.org/10.1002/brb3.1463
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author Krämer, Heidrun H.
Lautenschläger, Gothje
de Azevedo, Michael
Doppler, Kathrin
Schänzer, Anne
Best, Christoph
Oertel, Wolfgang H.
Reuter, Iris
Sommer, Claudia
Birklein, Frank
author_facet Krämer, Heidrun H.
Lautenschläger, Gothje
de Azevedo, Michael
Doppler, Kathrin
Schänzer, Anne
Best, Christoph
Oertel, Wolfgang H.
Reuter, Iris
Sommer, Claudia
Birklein, Frank
author_sort Krämer, Heidrun H.
collection PubMed
description OBJECTIVE: With a combination of different sympathetic tests, we aimed to elucidate whether impairment of sympathetic function in Parkinson's disease (PD) is the consequence of a central or peripheral efferent dysfunction. METHODS: Thirty‐five patients with early‐to‐intermediate PD (median age: 63 years; IQR: 57–67 years; disease duration 1–9 years, 15 women) and 20 age‐ and sex‐matched healthy controls (median age: 64.5 years; IQR: 58–68 years; 10 women) were recruited. Autonomic testing was performed in two subgroups and included the assessment of resting cardiovascular parameters, postprandial hypotension (PPH), orthostatic hypotension (OH), and vasoconstriction induced by intradermal microdialysis with different concentrations of norepinephrine (NE; 10(–5); 10(–6); 10(–7); 10(–8)) and by cold through forehead cooling. We also used sympathetic multiunit microneurography (muscle sympathetic nerve activity; MSNA; burst frequency (BF): bursts per minute; burst incidence (BI): bursts per 100 heart beats) and evaluated the presence of phosphorylated α‐synuclein deposits in skin innervation in biopsies from the thighs by immunohistohemistry. RESULTS: Diastolic blood pressure was higher in the PD group at rest (p < .001) and during OH (F = 6.533; p = .022). Vasoconstriction induced by NE microdialysis and cold was unchanged in PD patients. MSNA was lower in PD patients than in controls (BF: p = .001; BI: p = .025). Phosphorylated α‐synuclein deposits could be found only in PD patients. CONCLUSION: We did not find indications for peripheral sympathetic nerve fiber dysfunction or adrenoreceptor sensitivity changes. The decreased MSNA argues in favor of central sympathetic impairment.
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spelling pubmed-69088692019-12-20 Reduced central sympathetic activity in Parkinson's disease Krämer, Heidrun H. Lautenschläger, Gothje de Azevedo, Michael Doppler, Kathrin Schänzer, Anne Best, Christoph Oertel, Wolfgang H. Reuter, Iris Sommer, Claudia Birklein, Frank Brain Behav Original Research OBJECTIVE: With a combination of different sympathetic tests, we aimed to elucidate whether impairment of sympathetic function in Parkinson's disease (PD) is the consequence of a central or peripheral efferent dysfunction. METHODS: Thirty‐five patients with early‐to‐intermediate PD (median age: 63 years; IQR: 57–67 years; disease duration 1–9 years, 15 women) and 20 age‐ and sex‐matched healthy controls (median age: 64.5 years; IQR: 58–68 years; 10 women) were recruited. Autonomic testing was performed in two subgroups and included the assessment of resting cardiovascular parameters, postprandial hypotension (PPH), orthostatic hypotension (OH), and vasoconstriction induced by intradermal microdialysis with different concentrations of norepinephrine (NE; 10(–5); 10(–6); 10(–7); 10(–8)) and by cold through forehead cooling. We also used sympathetic multiunit microneurography (muscle sympathetic nerve activity; MSNA; burst frequency (BF): bursts per minute; burst incidence (BI): bursts per 100 heart beats) and evaluated the presence of phosphorylated α‐synuclein deposits in skin innervation in biopsies from the thighs by immunohistohemistry. RESULTS: Diastolic blood pressure was higher in the PD group at rest (p < .001) and during OH (F = 6.533; p = .022). Vasoconstriction induced by NE microdialysis and cold was unchanged in PD patients. MSNA was lower in PD patients than in controls (BF: p = .001; BI: p = .025). Phosphorylated α‐synuclein deposits could be found only in PD patients. CONCLUSION: We did not find indications for peripheral sympathetic nerve fiber dysfunction or adrenoreceptor sensitivity changes. The decreased MSNA argues in favor of central sympathetic impairment. John Wiley and Sons Inc. 2019-11-05 /pmc/articles/PMC6908869/ /pubmed/31691543 http://dx.doi.org/10.1002/brb3.1463 Text en © 2019 The Authors. Brain and Behavior published by Wiley Periodicals, Inc. This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Research
Krämer, Heidrun H.
Lautenschläger, Gothje
de Azevedo, Michael
Doppler, Kathrin
Schänzer, Anne
Best, Christoph
Oertel, Wolfgang H.
Reuter, Iris
Sommer, Claudia
Birklein, Frank
Reduced central sympathetic activity in Parkinson's disease
title Reduced central sympathetic activity in Parkinson's disease
title_full Reduced central sympathetic activity in Parkinson's disease
title_fullStr Reduced central sympathetic activity in Parkinson's disease
title_full_unstemmed Reduced central sympathetic activity in Parkinson's disease
title_short Reduced central sympathetic activity in Parkinson's disease
title_sort reduced central sympathetic activity in parkinson's disease
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6908869/
https://www.ncbi.nlm.nih.gov/pubmed/31691543
http://dx.doi.org/10.1002/brb3.1463
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