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Impaired cardiovascular autonomic function in Parkinson's disease with visual hallucinations
Author(s) -
Oka Hisayoshi,
Yoshioka Masayuki,
Onouchi Kenji,
Morita Masayo,
Mochio Soichiro,
Suzuki Masahiko,
Hirai Toshiaki,
Urashima Mitsuyoshi,
Inoue Kiyoharu
Publication year - 2007
Publication title -
movement disorders
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.352
H-Index - 198
eISSN - 1531-8257
pISSN - 0885-3185
DOI - 10.1002/mds.21581
Subject(s) - medicine , hemodynamics , vasomotor , supine position , valsalva maneuver , cardiology , parkinson's disease , pure autonomic failure , tilt table test , blood pressure , orthostatic vital signs , autonomic nervous system , heart rate , norepinephrine , disease , dopamine
We assessed the relations of visual hallucinations (VH) to cardiovascular autonomic dysfunction in patients with Parkinson's disease (PD). The subjects were 37 patients without VH (VH(−)) and 31 with VH (VH(+)). Autonomic function was evaluated on the basis of cardiac 123‐radioiodinated metaiodobenzylguanidine ( 123 I‐MIBG) uptake and hemodynamic testing with Valsalva maneuver. Systolic blood pressure (SBP) and plasma norepinephrine concentrations (NE) were measured by tilt‐table testing. 123 I‐MIBG uptake was lower in VH(+) than VH(−). Hemodynamic studies showed that VH(−) had only cardiac sympathetic and parasympathetic dysfunction, while VH(+) additionally had reduced vasomotor sympathetic functions. The fall in SBP during tilt‐table testing was greater in VH(+) than VH(−). NE and its difference in the supine and upright positions were decreased in VH(+). We conclude that cardiac and vasomotor sympathetic dysfunction is more severe in VH(+) than in VH(−). Severe dysfunction in PD with VH is probably attributed to Lewy‐body lesions or neuronal loss in sympathetic ganglia, the central autonomic system, or both. © 2007 Movement Disorder Society