Autonomic Dysfunction in Parkinson's Disease

Pfeiffer, Ronald F.

doi:10.1007/s13311-020-00897-4

Cited by 43 publications

(24 citation statements)

References 207 publications

(244 reference statements)

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“…It can induce degeneration and loss of dopaminergic cells in the substantia nigra compacta, eventually leading to motor symptoms (Ubeda-Bañon et al, 2014). It has been confirmed that LP occurs not only in the central nervous system (CNS), but also in peripheral tissues (Malek et al, 2014), such as the gut (Pfeiffer, 2020). Moreover, the pathological changes of LP in the peripheral nervous system also affect the function of the normal enteric nervous system (ENS), even before the CNS is affected by the pathological changes (Bridi and Hirth, 2018).…”

Section: Introductionmentioning

confidence: 99%

Association of Parkinson’s Disease With Microbes and Microbiological Therapy

Chen

Liang

Yang

et al. 2021

Front. Cell. Infect. Microbiol.

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Parkinson’s disease (PD) is the most common movement disorder in the world, affecting 1–2 per 1,000 of the population. The main pathological changes of PD are damage of dopaminergic neurons in substantia nigra of the central nervous system and formation of Lewy bodies. These pathological changes also occur in the intestinal tract and are strongly associated with changes in intestinal flora. By reviewing the research progress in PD and its association with intestinal flora in recent years, this review expounded the mechanism of action between intestinal flora and PD as well as the transmission mode of α - synuclein in neurons. In clinical studies, β diversity of intestinal flora in PD patients was found to change significantly, with Lactobacillusaceae and Verrucomicrobiaceae being significantly increased and Lachnospiraceae and Prevotellaceae being significantly decreased. In addition, a longer PD course was associated with fewer bacteria and probiotics producing short chain fatty acids, but more pathogenic bacteria. Moreover, the motor symptoms of PD patients may be related to Enterobacteriaceae and bacteria. Most importantly, catechol-O-methyltransferase inhibitors and anticholinergic drugs could change the intestinal flora of PD patients and increase the harmful flora, whereas other anti-PD drugs such as levodopa, dopamine agonist, monoamine oxidase inhibitors, and amantadine did not have these effects. Probiotics, prebiotics, and synbiotics treatment had some potential values in improving the constipation of PD patients, promoting the growth of probiotics, and improving the level of intestinal inflammation. At present, there were only a few case studies and small sample studies which have found certain clinical efficacy of fecal microbiome transplants. Further studies are necessary to elaborate the relationship of PD with microbes.

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Section: Introductionmentioning

confidence: 99%

Association of Parkinson’s Disease With Microbes and Microbiological Therapy

Chen

Liang

Yang

et al. 2021

Front. Cell. Infect. Microbiol.

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“…The loss of dopaminergic neurons in the substantia nigra pars compacta is known to lead to the disinhibition of the micturition reflex in the pons, thus resulting in an overactive bladder in patients with PD ( Jost, 2012 ; Pfeiffer, 2020 ). The role of the diaphragm in reducing urinary incontinence has been demonstrated in a randomized clinical trial which assigned patients with radical prostatectomy to diaphragm training or pelvic floor muscle training, and researchers observed comparable effects between groups ( Zachovajeviene et al, 2019 ).…”

Section: Discussionmentioning

confidence: 99%

“…Patients with postural instability are more likely to fall, leading to reduced mobility and life expectancy ( Fasano et al, 2017 ). PD involves the accumulation of α-synuclein in multiple visceral systems which play essential roles in the non-motor symptoms ( Pfeiffer, 2020 ), including dysarthria ( Schalling et al, 2017 ), delayed gastric emptying and constipation ( Fasano et al, 2015 ), urinary urgency, and nocturia ( Jia et al, 2020 ). If not treated appropriately, the combination of motor and non-motor symptoms can significantly reduce the quality of life (QoL; Schapira et al, 2017 ).…”

Section: Introductionmentioning

confidence: 99%

The Role of the Diaphragm in Postural Stability and Visceral Function in Parkinson’s Disease

Jiang

Zhang

et al. 2021

Front. Aging Neurosci.

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Background: In normal subjects, the diaphragm plays a key functional role in postural stability, articulation, respiration, defecation, and urination.Objectives: The aim of this study was to investigate the role of the diaphragm in postural stability and visceral function in patients with Parkinson’s disease (PD) and to compare the diaphragm function by gender, Hoehn and Yahr (H&Y) staging, and motor subtypes.Methods: In total, 79 patients were enrolled in this cross-sectional study. The severity of the disease was assessed by the Movement Disorder Society-Unified Parkinson’s Disease Rating Scale III and by H&Y staging. Postural stability was quantitatively recorded, and respiratory function was evaluated by spirometry. Several scales were used to evaluate visceral function in patients with PD. In addition, diaphragm ultrasound was used to measure the excursion, contraction velocity, and thickness of the diaphragm during quiet breathing, deep breathing, and the sniff test. Significant features were selected by the least absolute shrinkage and selection operator (LASSO) regression and fitted in the multivariate linear regression and Pearson’s correlation analysis.Results: Diaphragm thickness and excursion during quiet breathing were significantly different between men and women and between H&Y stage 1–2 and stage 2.5–3, whereas the diaphragm function was not influenced by motor subtypes. It was shown that the diaphragmatic function was significantly correlated with postural stability, voice function, respiratory function, constipation, and urological function to varying degrees in patients with PD.Conclusion: The diaphragmatic function is associated with dysfunction in PD although it remains unclear as to whether the observed changes in the diaphragm are primary or secondary.

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“…Autonomic dysfunction is a common and disabling symptom in PD patients. It increases the risk of falls, exacerbates motor dysfunction, and decreases quality of life [ 30 ]. Among types of autonomic dysfunction, OH affects nearly half of PD patients, representing a major non-motor symptom burden of PD [ 3 , 31 ].…”

Section: Discussionmentioning

confidence: 99%

Validation of the Korean version of the composite autonomic symptom scale 31 in patients with Parkinson’s disease

et al. 2021

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Purpose The composite autonomic symptom scale-31 (COMPASS-31) is a self-rated questionnaire that evaluates diverse autonomic symptoms. In the present study, we developed the Korean version of the COMPASS-31 (K-COMPASS-31) with appropriate translation, and verified its reliability and internal and external validity in patients with Parkinson’s disease (PD). Methods The original COMPASS-31 was translated independently into Korean by two bilingual neurologists. Test-retest reliability was evaluated at a 2-week interval. We investigated the correlations between the K-COMPASS-31, the scale for outcomes in PD-autonomic (SCOPA-AUT), and the results of an autonomic function test (AFT), respectively. Results A total of 90 patients with PD (47 females; mean age, 63.4 ± 10.8 years) were enrolled. The K-COMPASS-31 showed excellent test-retest reliability (intra-class correlation coefficient = 0.874, p < 0.001) and internal validity (Cronbach’s α-coefficient = 0.878). The COMPASS-31 was positively correlated with SCOPA-AUT (r = 0.609, p < 0.001) and the results of the AFT. Conclusions In conclusion, the K-COMPASS-31 showed excellent reliability and validity for the assessment of autonomic symptoms in PD patients. The K-COMPASS-31 is an easy-to-repeat and widely used tool for investigating autonomic dysfunction in various neurologic disorders and enables comparison of autonomic dysfunction among neurologic disorders. We recommend the K-COMPASS-31 as a valid instrument for use in clinical practice for patients with PD.

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Autonomic Dysfunction in Parkinson's Disease

Cited by 43 publications

References 207 publications

Association of Parkinson’s Disease With Microbes and Microbiological Therapy

Association of Parkinson’s Disease With Microbes and Microbiological Therapy

The Role of the Diaphragm in Postural Stability and Visceral Function in Parkinson’s Disease

Validation of the Korean version of the composite autonomic symptom scale 31 in patients with Parkinson’s disease

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