Premium
Orthostatic dizziness in Parkinson's disease is attributed to cerebral hypoperfusion: A transcranial doppler study
Author(s) -
Park Jinse,
Kim HeeTae,
Park Kang Min,
Ha Sam Yeol,
Kim Sung Eun,
Shin Kyong Jin,
Kim Si Eun,
Jang Wooyoung,
Kim Ji Sun,
Youn Jinyoung,
Oh Engsoek,
Park Suyeon
Publication year - 2017
Publication title -
journal of clinical ultrasound
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.272
H-Index - 61
eISSN - 1097-0096
pISSN - 0091-2751
DOI - 10.1002/jcu.22452
Subject(s) - medicine , transcranial doppler , orthostatic vital signs , cerebral blood flow , parkinson's disease , cerebral autoregulation , anesthesia , cerebral perfusion pressure , tilt table test , blood pressure , middle cerebral artery , cardiology , autoregulation , disease , heart rate , ischemia
Objectives Orthostatic hypotension (OH) is controversially regarded as the cause of orthostatic dizziness in Parkinson's disease (PD). We sought to evaluate whether cerebral autoregulation is an alternative cause for orthostatic dizziness in PD patients, using transcranial Doppler monitoring during head‐up tilting. Methods Forty‐five PD patients with dizziness, 13 PD patients without dizziness, and 10 age‐matched healthy controls were enrolled. Participants were divided into the following four groups: patients with dizziness and OH (group 1, n = 22), patients with dizziness but no OH (n = 23, group 2), patients without dizziness (n = 11, group 3), and age‐matched healthy controls (n = 10, group 4). All participants underwent transcranial Doppler and blood pressure monitoring for 10 minutes during the head‐up tilt test. Changes in the cerebral blood flow velocity (CBFV) in the middle cerebral artery and the mean blood pressure (mBP) within 3 minutes after head‐up tilting were compared between groups. Results Group 1 showed a significantly higher change in mBP (−16.3 ± 10.8 mmHg) than groups 2 (−2.6 ± 4.9), 3 (−2.2 ± 3.6), or 4 (1.8 ± 6.0) ( p < 0.001). However, groups 3 (4.6 ± 3.0 cm/s) and 4 (−4.2 ± 2.5) showed a significantly smaller change in CBFV than groups 1 (−9.0 ± 4.2) and 2 (−8.1 ± 5.1) ( p < 0.01). Conclusions Our results suggest that cerebral hypoperfusion contributes to dizziness in PD patients despite a lack of OH. Transcranial Doppler monitoring during head‐up tilting may be a useful tool for evaluating dizziness in PD patients with or without OH. © 2016 Wiley Periodicals, Inc. J Clin Ultrasound 45 :337–342, 2017;