Cargando…

Impaired Cerebral Autoregulation in Parkinson's Disease: An Orthostatic Hypotension Analysis

Orthostatic hypotension (OH) is an early non-motor manifestation of Parkinson's disease (PD). However, the underlying mechanism of hemodynamic changes in patients with PD and OH remains unclear. This study aimed to investigate the dynamic cerebral autoregulation changes in patients with PD with...

Descripción completa

Detalles Bibliográficos
Autores principales: Xing, Yingqi, Li, Qing, Xu, Erhe, Zeng, Jingrong, Li, Qiuping, Mei, Shanshan, Hua, Yang
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8971280/
https://www.ncbi.nlm.nih.gov/pubmed/35370873
http://dx.doi.org/10.3389/fneur.2022.811698
_version_ 1784679599984082944
author Xing, Yingqi
Li, Qing
Xu, Erhe
Zeng, Jingrong
Li, Qiuping
Mei, Shanshan
Hua, Yang
author_facet Xing, Yingqi
Li, Qing
Xu, Erhe
Zeng, Jingrong
Li, Qiuping
Mei, Shanshan
Hua, Yang
author_sort Xing, Yingqi
collection PubMed
description Orthostatic hypotension (OH) is an early non-motor manifestation of Parkinson's disease (PD). However, the underlying mechanism of hemodynamic changes in patients with PD and OH remains unclear. This study aimed to investigate the dynamic cerebral autoregulation changes in patients with PD with OH. Ninety patients with PD and 20 age- and sex-matched healthy controls (HCs) were recruited. The patients' non-invasive blood pressure (BP) and cerebral blood flow velocity were simultaneously recorded at supine and orthostatic positions during the active standing test (AST). Transfer function analysis was used to determine autoregulatory parameters including gain [i.e., damping effect of dynamic cerebral autoregulation (dCA) on the magnitude of BP oscillation] and phase difference (i.e., the time delay of the cerebral blood flow response to BP). Sixteen patients (17.8%) in the PD population were diagnosed with OH (PD-OH). The AST results were normal for 74 patients (82.2%) (PD-NOR). In the supine position, the PD-OH group had a lower phase degree than the PD-NOR group (50.3 ± 23.4 vs. 72.6 ± 32.2 vs. 68.9 ± 12.1, p = 0.020); however, no significant difference was found upon comparing with the HC group. In the orthostatic position, the normalized gain was significantly higher for the symptomatic OH group than for the asymptomatic OH group and HC group (1.50 ± 0.58 vs. 0.97 ± 0.29 vs. 1.10 ± 0.31, p = 0.019). A symptomatic OH in the PD population indicates an impaired cerebral autoregulation ability in the orthostatic position. Cerebral autoregulation tends to be impaired in the supine position in the OH population.
format Online
Article
Text
id pubmed-8971280
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher Frontiers Media S.A.
record_format MEDLINE/PubMed
spelling pubmed-89712802022-04-02 Impaired Cerebral Autoregulation in Parkinson's Disease: An Orthostatic Hypotension Analysis Xing, Yingqi Li, Qing Xu, Erhe Zeng, Jingrong Li, Qiuping Mei, Shanshan Hua, Yang Front Neurol Neurology Orthostatic hypotension (OH) is an early non-motor manifestation of Parkinson's disease (PD). However, the underlying mechanism of hemodynamic changes in patients with PD and OH remains unclear. This study aimed to investigate the dynamic cerebral autoregulation changes in patients with PD with OH. Ninety patients with PD and 20 age- and sex-matched healthy controls (HCs) were recruited. The patients' non-invasive blood pressure (BP) and cerebral blood flow velocity were simultaneously recorded at supine and orthostatic positions during the active standing test (AST). Transfer function analysis was used to determine autoregulatory parameters including gain [i.e., damping effect of dynamic cerebral autoregulation (dCA) on the magnitude of BP oscillation] and phase difference (i.e., the time delay of the cerebral blood flow response to BP). Sixteen patients (17.8%) in the PD population were diagnosed with OH (PD-OH). The AST results were normal for 74 patients (82.2%) (PD-NOR). In the supine position, the PD-OH group had a lower phase degree than the PD-NOR group (50.3 ± 23.4 vs. 72.6 ± 32.2 vs. 68.9 ± 12.1, p = 0.020); however, no significant difference was found upon comparing with the HC group. In the orthostatic position, the normalized gain was significantly higher for the symptomatic OH group than for the asymptomatic OH group and HC group (1.50 ± 0.58 vs. 0.97 ± 0.29 vs. 1.10 ± 0.31, p = 0.019). A symptomatic OH in the PD population indicates an impaired cerebral autoregulation ability in the orthostatic position. Cerebral autoregulation tends to be impaired in the supine position in the OH population. Frontiers Media S.A. 2022-03-18 /pmc/articles/PMC8971280/ /pubmed/35370873 http://dx.doi.org/10.3389/fneur.2022.811698 Text en Copyright © 2022 Xing, Li, Xu, Zeng, Li, Mei and Hua. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Neurology
Xing, Yingqi
Li, Qing
Xu, Erhe
Zeng, Jingrong
Li, Qiuping
Mei, Shanshan
Hua, Yang
Impaired Cerebral Autoregulation in Parkinson's Disease: An Orthostatic Hypotension Analysis
title Impaired Cerebral Autoregulation in Parkinson's Disease: An Orthostatic Hypotension Analysis
title_full Impaired Cerebral Autoregulation in Parkinson's Disease: An Orthostatic Hypotension Analysis
title_fullStr Impaired Cerebral Autoregulation in Parkinson's Disease: An Orthostatic Hypotension Analysis
title_full_unstemmed Impaired Cerebral Autoregulation in Parkinson's Disease: An Orthostatic Hypotension Analysis
title_short Impaired Cerebral Autoregulation in Parkinson's Disease: An Orthostatic Hypotension Analysis
title_sort impaired cerebral autoregulation in parkinson's disease: an orthostatic hypotension analysis
topic Neurology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8971280/
https://www.ncbi.nlm.nih.gov/pubmed/35370873
http://dx.doi.org/10.3389/fneur.2022.811698
work_keys_str_mv AT xingyingqi impairedcerebralautoregulationinparkinsonsdiseaseanorthostatichypotensionanalysis
AT liqing impairedcerebralautoregulationinparkinsonsdiseaseanorthostatichypotensionanalysis
AT xuerhe impairedcerebralautoregulationinparkinsonsdiseaseanorthostatichypotensionanalysis
AT zengjingrong impairedcerebralautoregulationinparkinsonsdiseaseanorthostatichypotensionanalysis
AT liqiuping impairedcerebralautoregulationinparkinsonsdiseaseanorthostatichypotensionanalysis
AT meishanshan impairedcerebralautoregulationinparkinsonsdiseaseanorthostatichypotensionanalysis
AT huayang impairedcerebralautoregulationinparkinsonsdiseaseanorthostatichypotensionanalysis