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Erschienen in: Journal of Neurology 12/2015

01.12.2015 | Original Communication

Autonomic dysfunction in subjects at high risk for Parkinson’s disease

verfasst von: Inga Liepelt-Scarfone, Andrea Pilotto, Katharina Müller, Christian Bormann, Katharina Gauss, Isabel Wurster, Johannes Streffer, Daniela Berg

Erschienen in: Journal of Neurology | Ausgabe 12/2015

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Abstract

Aim of this project was to evaluate autonomic dysfunction in subjects proposed to be at high risk to develop Parkinson’s disease (PD) compared to control subjects and PD patients at different disease stages. Combinations of substantia nigra hyperechogenicity (SN+) assessed by transcranial ultrasound (TCS), hyposmia, lifetime prevalence of depression and mild PD-specific motor signs were used to identify subjects at high risk for motor Parkinson’s disease (HR-PD). Supine and standing blood pressure (BP), hearth rate (HR), orthostatic, urinary, sexual and bowel symptoms were evaluated in HR-PD, healthy control subjects and PD patients, divided into mild and advanced stages. The study group consisted of 113 PD patients (mild PD n = 71, advanced PD, n = 42), 40 HR-PD individuals and 50 controls. Compared to controls, HR-PD subjects complained more often about urinary (p = 0.002) and bowel dysfunction (p = 0.001) and had a higher diastolic BP drop after standing (p = 0.01). The cumulative number of autonomic symptoms differentiated PD as well as HR-PD significantly from controls (p < 0.001). Advanced PD patients presented often and severe orthostatic symptoms, not significantly different from mild PD after concomitant medication correction. Our results support the presence of urinary and bowel dysfunction in subjects at high risk for motor PD. Presence and severity of orthostatic symptoms was higher during stages and increase in advanced stages, at least partly due to increase in dopaminergic and conflicting medication. Understanding the progression of non-motor aspects in PD might offer the possibility to use them as targets for disease-modifying therapies.
Literatur
3.
5.
Zurück zum Zitat Müller B, Larsen JP, Wentzel-Larsen T et al (2011) Autonomic and sensory symptoms and signs in incident, untreated Parkinson’s disease: frequent but mild. Mov Disord 26:65–72. doi:10.1002/mds.23387 CrossRefPubMed Müller B, Larsen JP, Wentzel-Larsen T et al (2011) Autonomic and sensory symptoms and signs in incident, untreated Parkinson’s disease: frequent but mild. Mov Disord 26:65–72. doi:10.​1002/​mds.​23387 CrossRefPubMed
7.
Zurück zum Zitat Van Dijk JG, Haan J, Zwinderman K et al (1993) Autonomic nervous system dysfunction in Parkinson’s disease: relationships with age, medication, duration, and severity. J Neurol Neurosurg Psychiatry 56:1090–1095PubMedCentralCrossRefPubMed Van Dijk JG, Haan J, Zwinderman K et al (1993) Autonomic nervous system dysfunction in Parkinson’s disease: relationships with age, medication, duration, and severity. J Neurol Neurosurg Psychiatry 56:1090–1095PubMedCentralCrossRefPubMed
8.
Zurück zum Zitat Martinez-Martin P, Rodriguez-Blazquez C, Kurtis MM, Chaudhuri KR (2011) The impact of non-motor symptoms on health-related quality of life of patients with Parkinson’s disease. Mov Disord 26:399–406. doi:10.1002/mds.23462 CrossRefPubMed Martinez-Martin P, Rodriguez-Blazquez C, Kurtis MM, Chaudhuri KR (2011) The impact of non-motor symptoms on health-related quality of life of patients with Parkinson’s disease. Mov Disord 26:399–406. doi:10.​1002/​mds.​23462 CrossRefPubMed
12.
Zurück zum Zitat Lang AE (2011) A critical appraisal of the premotor symptoms of Parkinson’s disease: potential usefulness in early diagnosis and design of neuroprotective trials. Mov Disord 26:775–783. doi:10.1002/mds.23609 CrossRefPubMed Lang AE (2011) A critical appraisal of the premotor symptoms of Parkinson’s disease: potential usefulness in early diagnosis and design of neuroprotective trials. Mov Disord 26:775–783. doi:10.​1002/​mds.​23609 CrossRefPubMed
16.
Zurück zum Zitat Braak H, Del Tredici K, Rüb U et al (2003) Staging of brain pathology related to sporadic Parkinson’s disease. Neurobiol Aging 24:197–211CrossRefPubMed Braak H, Del Tredici K, Rüb U et al (2003) Staging of brain pathology related to sporadic Parkinson’s disease. Neurobiol Aging 24:197–211CrossRefPubMed
18.
Zurück zum Zitat Liepelt-Scarfone I, Gauss K, Maetzler W et al (2013) Evaluation of progression markers in the premotor phase of Parkinson’s disease: the progression markers in the premotor phase study. Neuroepidemiology 41:174–182. doi:10.1159/000353560 CrossRefPubMed Liepelt-Scarfone I, Gauss K, Maetzler W et al (2013) Evaluation of progression markers in the premotor phase of Parkinson’s disease: the progression markers in the premotor phase study. Neuroepidemiology 41:174–182. doi:10.​1159/​000353560 CrossRefPubMed
21.
22.
Zurück zum Zitat Hummel T, Konnerth CG, Rosenheim K, Kobal G (2001) Screening of olfactory function with a four-minute odor identification test: reliability, normative data, and investigations in patients with olfactory loss. Ann Otol Rhinol Laryngol 110:976–981CrossRefPubMed Hummel T, Konnerth CG, Rosenheim K, Kobal G (2001) Screening of olfactory function with a four-minute odor identification test: reliability, normative data, and investigations in patients with olfactory loss. Ann Otol Rhinol Laryngol 110:976–981CrossRefPubMed
23.
Zurück zum Zitat World Health Organization (1992) The ICD-10 classification of mental and behavioural disorders; clinical descriptions and diagnostic guidelines. World Health Organization, Geneva World Health Organization (1992) The ICD-10 classification of mental and behavioural disorders; clinical descriptions and diagnostic guidelines. World Health Organization, Geneva
24.
Zurück zum Zitat Marder K, Tang MX, Mejia H et al (1996) Risk of Parkinson’s disease among first-degree relatives: a community-based study. Neurology 47:155–160CrossRefPubMed Marder K, Tang MX, Mejia H et al (1996) Risk of Parkinson’s disease among first-degree relatives: a community-based study. Neurology 47:155–160CrossRefPubMed
26.
Zurück zum Zitat Folstein MF, Folstein SE, McHugh PR (1975) “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 12:189–198CrossRefPubMed Folstein MF, Folstein SE, McHugh PR (1975) “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 12:189–198CrossRefPubMed
31.
33.
Zurück zum Zitat Postuma RB, Gagnon J-F, Vendette M et al (2011) Olfaction and color vision identify impending neurodegeneration in rapid eye movement sleep behavior disorder. Ann Neurol 69:811–818. doi:10.1002/ana.22282 CrossRefPubMed Postuma RB, Gagnon J-F, Vendette M et al (2011) Olfaction and color vision identify impending neurodegeneration in rapid eye movement sleep behavior disorder. Ann Neurol 69:811–818. doi:10.​1002/​ana.​22282 CrossRefPubMed
34.
Zurück zum Zitat Köllensperger M, Geser F, Ndayisaba J-P et al (2010) Presentation, diagnosis, and management of multiple system atrophy in Europe: final analysis of the European multiple system atrophy registry. Mov Disord 25:2604–2612. doi:10.1002/mds.23192 CrossRefPubMed Köllensperger M, Geser F, Ndayisaba J-P et al (2010) Presentation, diagnosis, and management of multiple system atrophy in Europe: final analysis of the European multiple system atrophy registry. Mov Disord 25:2604–2612. doi:10.​1002/​mds.​23192 CrossRefPubMed
36.
Zurück zum Zitat Postuma RB, Gagnon J-F, Pelletier A, Montplaisir J (2013) Prodromal autonomic symptoms and signs in Parkinson’s disease and dementia with Lewy bodies. Mov Disord 28:597–604. doi:10.1002/mds.25445 CrossRefPubMed Postuma RB, Gagnon J-F, Pelletier A, Montplaisir J (2013) Prodromal autonomic symptoms and signs in Parkinson’s disease and dementia with Lewy bodies. Mov Disord 28:597–604. doi:10.​1002/​mds.​25445 CrossRefPubMed
38.
Zurück zum Zitat Abbott RD, Petrovitch H, White LR et al (2001) Frequency of bowel movements and the future risk of Parkinson’s disease. Neurology 57:456–462CrossRefPubMed Abbott RD, Petrovitch H, White LR et al (2001) Frequency of bowel movements and the future risk of Parkinson’s disease. Neurology 57:456–462CrossRefPubMed
43.
Zurück zum Zitat Postuma RB, Iranzo A, Hogl B et al (2015) Risk factors for neurodegeneration in idiopathic rapid eye movement sleep behavior disorder: a multicenter study. Ann Neurol 77:830–839. doi:10.1002/ana.24385 CrossRefPubMed Postuma RB, Iranzo A, Hogl B et al (2015) Risk factors for neurodegeneration in idiopathic rapid eye movement sleep behavior disorder: a multicenter study. Ann Neurol 77:830–839. doi:10.​1002/​ana.​24385 CrossRefPubMed
45.
48.
Zurück zum Zitat Fereshtehnejad S-M, Romenets SR, Anang JBM et al (2015) New clinical subtypes of Parkinson disease and their longitudinal progression: a prospective cohort comparison with other phenotypes. JAMA Neurol. doi:10.1001/jamaneurol.2015.0703 PubMed Fereshtehnejad S-M, Romenets SR, Anang JBM et al (2015) New clinical subtypes of Parkinson disease and their longitudinal progression: a prospective cohort comparison with other phenotypes. JAMA Neurol. doi:10.​1001/​jamaneurol.​2015.​0703 PubMed
49.
Zurück zum Zitat Mahlknecht P, Seppi K, Stockner H et al (2013) Substantia nigra hyperechogenicity as a marker for Parkinson’s disease: a population-based study. Neurodegener Dis 12:212–218. doi:10.1159/000348595 CrossRefPubMed Mahlknecht P, Seppi K, Stockner H et al (2013) Substantia nigra hyperechogenicity as a marker for Parkinson’s disease: a population-based study. Neurodegener Dis 12:212–218. doi:10.​1159/​000348595 CrossRefPubMed
51.
Metadaten
Titel
Autonomic dysfunction in subjects at high risk for Parkinson’s disease
verfasst von
Inga Liepelt-Scarfone
Andrea Pilotto
Katharina Müller
Christian Bormann
Katharina Gauss
Isabel Wurster
Johannes Streffer
Daniela Berg
Publikationsdatum
01.12.2015
Verlag
Springer Berlin Heidelberg
Erschienen in
Journal of Neurology / Ausgabe 12/2015
Print ISSN: 0340-5354
Elektronische ISSN: 1432-1459
DOI
https://doi.org/10.1007/s00415-015-7888-z

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