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Orthostatic and Supine Blood Pressures Are Associated with White Matter Hyperintensities in Parkinson Disease
Yoon-Sang Oh, Joong-Seok Kim, Kwang-Soo Lee
J Mov Disord. 2013;6(2):23-27.   Published online October 30, 2013
DOI: https://doi.org/10.14802/jmd.13006
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  • 51 Crossref
AbstractAbstract PDF
Background and Purpose:

Several reports on the elderly population have suggested that orthostatic hypotension is associated with white matter hyperintensities (WMH); however, little information is available on patients with Parkinson’s disease (PD).

Methods:

We analyzed the association blood pressure profiles during tilt table testing with WMH scores in 117 patients with PD. WMH were rated using the semiquantitative visual rating system proposed by Scheltens et al.

Results:

The presence of orthostatic hypotension was associated with increasing tendency of WMH score and the blood pressure changes during tilting and supine blood pressure were positively correlated with increasing WMH score.

Conclusions:

This finding indicates that hemodynamic changes associated with orthostatic hypotension may be associated with white matter changes in patients with PD.

Citations

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Orthostatic Hypotension in Drug-Naïve Patients with Parkinson’s Disease
Hyo-Jin Bae, Sang-Myung Cheon, Jae Woo Kim
J Mov Disord. 2011;4(1):33-37.
DOI: https://doi.org/10.14802/jmd.11005
  • 9,590 View
  • 61 Download
  • 12 Crossref
AbstractAbstract PDF
Background and Purpose

Orthostatic hypotension (OH) is known to be present even in patients with early Parkinson’s disease (PD). To affirm the presence of OH and find correlation between OH and other dysautonomic symptoms in PD, this study has done in newly-diagnosed PD patients.

Methods

Forty-five non-demented patients with no prior history of treatment for PD were recruited (17 men, 63.8 ± 10.1 years of age). All the patients were evaluated for OH before starting medications. Autonomic symptoms were evaluated with structured questionnaires. Clinical characteristics of PD were evaluated (median Hoehn and Yahr stage 2.0 (1–3), 1.3 ± 1.1 years of disease duration), and comorbid medical conditions that could affect blood pressure were also recorded.

Results

OH was prevalent, and eighteen patients (40%) showed orthostatic hypotension, and twenty-seven (60%) did not (normotensive group). There was no significant difference in demographic and clinical characteristics between groups. The presence or severity of symptoms of autonomic dysfunction in the OH group also not differed from those of the normotensive group.

Conclusions

OH was prevalent even in the early stage of PD, and was not related to presence or severity of any other symptoms of autonomic dysfunction. Our findings suggest that clinicians should pay attention to OH from the early stage of disease.

Citations

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  • Pathophysiology of non-motor signs in Parkinson’s disease: some recent updating with brief presentation
    Khaled Radad, Rudolf Moldzio, Christopher Krewenka, Barbara Kranner, Wolf-Dieter Rausch
    Exploration of Neuroprotective Therapy.2023; : 24.     CrossRef
  • Central retinal microvasculature damage is associated with orthostatic hypotension in Parkinson’s disease
    Jong Hyeon Ahn, Min Chae Kang, Dongyoung Lee, Jin Whan Cho, Kyung-Ah Park, Jinyoung Youn
    npj Parkinson's Disease.2023;[Epub]     CrossRef
  • Pronounced Orthostatic Hypotension in GBA-Related Parkinson’s Disease
    Tatiana Usnich, Henrike Hanssen, Katja Lohmann, Christina Lohse, Christine Klein, Meike Kasten, Norbert Brüggemann
    Journal of Parkinson's Disease.2022; 12(5): 1539.     CrossRef
  • Could Small Heat Shock Protein HSP27 Be a First-Line Target for Preventing Protein Aggregation in Parkinson’s Disease?
    Javier Navarro-Zaragoza, Lorena Cuenca-Bermejo, Pilar Almela, María-Luisa Laorden, María-Trinidad Herrero
    International Journal of Molecular Sciences.2021; 22(6): 3038.     CrossRef
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    Sang-Won Yoo, Joong-Seok Kim, Ji-Yeon Yoo, Eunkyeong Yun, Uicheul Yoon, Na-Young Shin, Kwang-Soo Lee
    npj Parkinson's Disease.2021;[Epub]     CrossRef
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    Ylva Hivand Hiorth, Kenn Freddy Pedersen, Ingvild Dalen, Ole-Bjørn Tysnes, Guido Alves
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    Hyo-Jin Bae, Jun-Ho Lim, Sang-Myung Cheon
    Journal of Movement Disorders.2014; 7(2): 102.     CrossRef
Autonomic Dysfunctions in Parkinsonian Disorders
Hyo-Jin Bae, Sang-Myung Cheon, Jae Woo Kim
J Mov Disord. 2009;2(2):72-77.
DOI: https://doi.org/10.14802/jmd.09019
  • 33,263 View
  • 92 Download
  • 6 Crossref
AbstractAbstract PDF
Background and Purpose:

Symptoms of autonomic dysfunctions are common in the patients with parkinsonian disorders. Because clinical features of autonomic dysfunctions are diverse, the comprehensive evaluation is essential for the appropriate management. For the appreciation of autonomic dysfunctions and the identification of differences, patients with degenerative parkinsonisms are evaluated using structured questionnaire for autonomic dysfunction (ADQ).

Methods:

Total 259 patients, including 192 patients with [idiopathic Parkinson’s disease (IPD, age 64.6 ± 9.6 years)], 37 with [multiple system atrophy (MSA, 62.8 ± 9.1)], 9 with [dementia with Lewy body (DLB, 73.9 ± 4.3)], and 21 with [progressive supranuclear palsy (PSP, 69.4 ± 9.6)]. The ADQ was structured for evaluation of the presence of symptoms and its severity due to autonomic dysfunction, covering gastrointestinal, urinary, sexual, cardiovascular and thermoregulatory domains. Patients were also evaluated for the orthostatic hypotension.

Results:

Although dementia with Lewy body (DLB) patients were oldest and duration of disease was longest in IPD, total ADQ scores of MSA and PSP (23.9 ± 12.6 and 21.1 ± 7.8) were significantly increased than that of IPD (15.1 ± 10.6). Urinary and cardiovascular symptom scores of MSA and gastrointestinal symptom score of PSP were significantly worse than those of IPD. The ratio of patient with orthostatic hypotension in IPD was 31.2% and not differed between groups (35.1% in MSA, 33.3% in DLB and 33.3% in PSP). But the systolic blood pressure dropped drastically after standing in patients with MSA and DLB than in patients with IPD and PSP.

Conclusions:

Patients with degenerative parkinsonism showed widespread symptoms of autonomic dysfunctions. The severity of those symptoms in patients with PSP were comparing to that of MSA patients and worse than that of IPD.

Citations

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JMD : Journal of Movement Disorders