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Standing worsens cognitive functions in patients with neurogenic orthostatic hypotension

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Abstract

In previous studies, addressing the association between orthostatic hypotension and cognitive decline, patients underwent neuropsychological evaluation in sitting position, and blood pressure values and cognition were not measured concurrently. Furthermore, no studies assessed the acute effects of orthostatic hypotension on cognitive performances. The aim of our study was to evaluate the effect of a documented fall in systolic blood pressure (SBP) of at least 20 mmHg on a battery of cognitive tests in patients with neurogenic orthostatic hypotension. Ten consecutive patients with neurogenic orthostatic hypotension, normal brain imaging, and a normal Mini Mental State Examination in supine position were enrolled in the study. Patients underwent a detailed neuropsychological assessment (Brief Mental Deterioration battery and computerized tests) over two test sessions: the first while tilted to an angle able to cause a fall of at least 20 mmHg in SBP; the second while supine, after 30 min of rest. Parallel forms of the tests were presented on each testing session. Patients scored significantly worse in the visual search test, analogies test, immediate visual memory, and the measure of global cognitive functioning of Brief Mental Deterioration battery during the orthostatic challenge compared to the supine position. Orthostatic hypotension was associated with a significant worsening of cognitive performances, affecting both global cognitive functioning and specific tasks, mainly exploring executive functions. The assessment of cognitive function in patients with neurogenic orthostatic hypotension should be performed considering the body’s position of the subject.

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References

  1. (1996) Consensus statement on the definition of orthostatic hypotension, pure autonomic failure, and multiple system atrophy. The Consensus Committee of the American Autonomic Society and the American Academy of Neurology. Neurology 46(5):1470

  2. Mathias CJ, Bannister R (1999) Investigation of autonomic disorders. In: Mathias CJ, Bannister R (eds) Autonomic failure : a textbook of clinical disorders of the autonomic nervous system, 4th edn. Oxford University Press, Oxford, pp 169–195

    Google Scholar 

  3. Matsubayashi K, Okumiya K, Wada T, Osaki Y, Fujisawa M, Doi Y, Ozawa T (1997) Postural dysregulation in systolic blood pressure is associated with worsened scoring on neurobehavioral function tests and leukoaraiosis in the older elderly living in a community. Stroke 28(11):2169–2173

    Article  PubMed  CAS  Google Scholar 

  4. Perlmuter LC, Greenberg JJ (1996) Do you mind standing?: cognitive changes in orthostasis. Exp Aging Res 22(4):325–341

    Article  PubMed  CAS  Google Scholar 

  5. Czajkowska J, Ozhog S, Smith E, Perlmuter LC (2010) Cognition and hopelessness in association with subsyndromal orthostatic hypotension. J Gerontol A Biol Sci Med Sci 65(8):873–879

    Article  PubMed  Google Scholar 

  6. Mehrabian S, Duron E, Labouree F, Rollot F, Bune A, Traykov L, Hanon O (2010) Relationship between orthostatic hypotension and cognitive impairment in the elderly. J Neurol Sci 299(1–2):45–48

    Article  PubMed  Google Scholar 

  7. Elmstahl S, Rosen I (1997) Postural hypotension and EEG variables predict cognitive decline: results from a 5-year follow-up of healthy elderly women. Dement Geriatr Cogn Disord 8(3):180–187

    Article  PubMed  CAS  Google Scholar 

  8. Rose KM, Couper D, Eigenbrodt ML, Mosley TH, Sharrett AR, Gottesman RF (2010) Orthostatic hypotension and cognitive function: the atherosclerosis risk in communities study. Neuroepidemiology 34(1):1–7

    Article  PubMed  Google Scholar 

  9. Viramo P, Luukinen H, Koski K, Laippala P, Sulkava R, Kivela SL (1999) Orthostatic hypotension and cognitive decline in older people. J Am Geriatr Soc 47(5):600–604

    PubMed  CAS  Google Scholar 

  10. Magni E, Binetti G, Padovani A, Cappa SF, Bianchetti A, Trabucchi M (1996) The Mini-Mental State Examination in Alzheimer’s disease and multi-infarct dementia. Int Psychogeriatr 8(1):127–134

    Article  PubMed  CAS  Google Scholar 

  11. Gallassi R, Bisulli A, Oppi F, Poda R, di Felice C (2008) Subjective cognitive complaints, neuropsychological performance, affective and behavioural symptoms in non-demented patients. Int J Geriatr Psychiatry 23(1):95–101

    Article  PubMed  Google Scholar 

  12. Gallassi R, Morreale A, Montagna P, Gambetti P, Lugaresi E (1992) “Fatal familial insomnia”: neuropsychological study of a disease with thalamic degeneration. Cortex 28(2):175–187

    PubMed  CAS  Google Scholar 

  13. Bondar RL, Dunphy PT, Moradshahi P, Kassam MS, Blaber AP, Stein F, Freeman R (1997) Cerebrovascular and cardiovascular responses to graded tilt in patients with autonomic failure. Stroke 28(9):1677–1685

    Article  PubMed  CAS  Google Scholar 

  14. Harms MP, Colier WN, Wieling W, Lenders JW, Secher NH, van Lieshout JJ (2000) Orthostatic tolerance, cerebral oxygenation, and blood velocity in humans with sympathetic failure. Stroke 31(7):1608–1614

    Article  PubMed  CAS  Google Scholar 

  15. Fukuoka S, Hayashida K, Nishiooeda Y, Hirose Y, Miyashita K, Kawano S, Shimotsu Y, Ishida Y, Nishimura T (1996) Cerebral hypoperfusion in orthostatic hypotension with globally denervated myocardium. J Nucl Med 37(11):1824–1826

    PubMed  CAS  Google Scholar 

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The authors have no financial interest to disclose.

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Authors and Affiliations

  1. Neurological Sciences Department, University of Bologna, Bologna, Italy

    R. Poda, P. Guaraldi, L. Solieri, G. Calandra-Buonaura, R. Gallassi & P. Cortelli

  2. Department of Clinical Nutrition, USSL no. 18, Rovigo, RO, Italy

    G. Marano

  3. Dipartimento di Scienze Neurologiche, Clinica Neurologica, via U. Foscolo no. 7, 40123, Bologna, BO, Italy

    R. Poda

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  1. R. Poda
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  2. P. Guaraldi
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  3. L. Solieri
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  4. G. Calandra-Buonaura
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  5. G. Marano
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  6. R. Gallassi
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  7. P. Cortelli
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Correspondence to R. Poda.

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Poda, R., Guaraldi, P., Solieri, L. et al. Standing worsens cognitive functions in patients with neurogenic orthostatic hypotension. Neurol Sci 33, 469–473 (2012). https://doi.org/10.1007/s10072-011-0746-6

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  • DOI: https://doi.org/10.1007/s10072-011-0746-6

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