Cardiac parasympathetic dysfunction in the early phase of Parkinson’s disease
详细信息 查看全文
- 作者：Masashi Suzuki ; Tomohiko Nakamura ; Masaaki Hirayama ; Miki Ueda…
- 关键词：Parkinson’s disease ; Cardiac parasympathetic dysfunction ; Cardiac 123I ; metaiodobenzylguanidine scintigraphy ; Autonomic dysfunction ; Autonomic nervous system
- 刊名：Journal of Neurology
- 出版年：2017
- 出版时间：February 2017
- 年：2017
- 卷：264
- 期：2
- 页码：333-340
- 全文大小：
- 刊物类别：Medicine
- 刊物主题：Neurology; Neurosciences; Neuroradiology;
- 出版者：Springer Berlin Heidelberg
- ISSN：1432-1459
- 卷排序：264
文摘
Cardiac parasympathetic function is strongly affected by aging. Although sympathetic dysfunction has been well documented in Parkinson’s disease (PD), cardiac parasympathetic dysfunction has not been well studied. The objective of this study was to clarify the development of cardiac parasympathetic dysfunction in the early phase of PD and to explore the age-corrected correlation between cardiac parasympathetic dysfunction and cardiac sympathetic dysfunction. We reviewed 25 healthy controls and 56 patients with idiopathic PD of Hoehn and Yahr stages I–III. We evaluated cardiac parasympathetic function using the Valsalva ratio, the baroreflex sensitivity (BRS) and the coefficient of variation of RR intervals in the resting state (resting-CVRR) and during deep breathing (DB-CVRR). In addition, we measured cardiac 123I-metaiodobenzylguanidine (MIBG) uptake to investigate the relationship between cardiac sympathetic and parasympathetic dysfunction in PD. Compared with healthy controls, patients with PD showed significantly decreased cardiac parasympathetic parameters (resting-CVRR 2.8 ± 1.3 vs. 1.7 ± 0.6%, p < 0.001; DB-CVRR 5.8 ± 2.3 vs. 3.8 ± 1.7%, p < 0.001; Valsalva ratio 1.52 ± 0.26 vs. 1.34 ± 0.17, p < 0.01; BRS 10.6 ± 9.5 vs. 5.0 ± 5.4 ms/mmHg, p < 0.01). In particular, resting-CVRR and DB-CVRR were significantly decreased in the early phase of PD. In age-corrected analyses, none of the parasympathetic indices correlated with the delayed cardiac 123I-MIBG uptake. These observations indicate that cardiac parasympathetic dysfunction occurs in the early phase of PD, but not necessarily in parallel with cardiac sympathetic dysfunction.