Autonomic dysfunction is associated with neuropsychological impairment in Lewy body disease

Pino, Rocío Del; Murueta‐Goyena, Ane; Acera, Marian; Carmona-Abellán, Mar; Tijero, Beatriz; Lucas‐Jiménez, Olaia; Ojeda, Natalia; Ibarretxe‐Bilbao, Naroa; Peña, Javier; Gabilondo, Iñigo; Gómez‐Esteban, Juan Carlos

doi:10.1007/s00415-020-09783-7

Cited by 19 publications

(10 citation statements)

References 61 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Additionally, thermoregulatory dysfunction emerged as a unique predictor of both anxiety and depression, which is in line with at least 2 prior studies finding similar relationships. 33,34 Finally, we found that urinary symptoms were associated with increased depression, as were cardiovascular symptoms (corresponding to non-PD literature demonstrating cardiac autonomic imbalance in depression). 24 Overall, we found a greater number of unique autonomic predictors of depression than anxiety, with similar amount of variance explained in both mood variables.…”

Section: Discussionsupporting

confidence: 72%

“…24,25 In PD, studies using both self-report measures of autonomic symptoms as well as physiological probes (e.g., heart rate variability, baroreflex-cardio-vagal indicators) have found that autonomic insufficiency is associated with depression/anxiety. [26][27][28][29][30][31][32][33][34] There are several potential mechanisms for the relationship between autonomic dysfunction and mood in PD. One possibility would be an overlap in the limbic system and central autonomic network brain structures (e.g., pathology in areas such as the hypothalamus and anterior cingulate cortex could give rise to both mood and autonomic symptoms).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The Relationship Between Autonomic Dysfunction and Mood Symptoms in De Novo Parkinson’s Disease Patients Over Time

Ratajska,

Etheridge,

Lopez

et al. 2023

J Geriatr Psychiatry Neurol

View full text Add to dashboard Cite

Background Autonomic dysfunction is prevalent in Parkinson’s disease (PD) and can worsen quality of life. We examined: (a) whether specific autonomic symptoms were more strongly associated with anxiety or depression in PD and (b) whether overall autonomic dysfunction predicted mood trajectories over a 5-year period. Methods Newly diagnosed individuals with PD ( N = 414) from the Parkinson’s Progression Markers Initiative completed self-report measures of depression, anxiety, and autonomic symptoms annually. Cross-sectional linear regressions examined relationships between specific autonomic subdomains (gastrointestinal, cardiovascular, thermoregulatory, etc.) and mood. Multilevel modeling examined longitudinal relationships with total autonomic load. Results Gastrointestinal symptoms were associated with both higher anxiety ( b = 1.04, 95% CI [.55, 1.53], P < .001) and depression ( b = .24, 95% CI [.11, .37], P = .012), as were thermoregulatory symptoms (anxiety: b = 1.06, 95% CI [.46, 1.65], P = .004; depression: b = .25, 95% CI [.09, .42], P = .013), while cardiovascular ( b = .36, 95% CI [.10, .62], P = .012) and urinary symptoms ( b = .10, 95% CI [.01, .20], P = .037) were associated only with depression. Longitudinally, higher total autonomic load was associated with increases in both depression ( b = .01, 95% CI [.00, .02], P = .015) and anxiety ( b = .04, 95% CI [.01, .06], P < .001) over time, as well as occasion-to-occasion fluctuations (depression: b = .08, 95% CI [.05, .10], P < .001; anxiety: b = .24, 95% CI [.15, .32], P < .001). Conclusion Findings suggest autonomic dysfunction, particularly gastrointestinal and thermoregulatory symptoms, may be an indicator for elevated anxiety/depression and a potential treatment target early on in PD.

show abstract

Section: Discussionsupporting

confidence: 72%

Section: Introductionmentioning

confidence: 99%

The Relationship Between Autonomic Dysfunction and Mood Symptoms in De Novo Parkinson’s Disease Patients Over Time

Ratajska,

Etheridge,

Lopez

et al. 2023

J Geriatr Psychiatry Neurol

View full text Add to dashboard Cite

show abstract

“…Bipolar disorder (BD) is a recrudescent mood disorder with episodes of depression and mania [ 1 , 2 ]. It is often associated with significant impairment in cognitive functioning, circadian rhythm abnormalities, decreased quality of life, and reduced life expectancy [ 3 , 4 ].…”

Section: Introductionmentioning

confidence: 99%

Short- and Long-Term Influences of Benzodiazepine and Z-Drug Use in Patients with Bipolar Disorder Combined Sleep Disturbance during Affective Period: A Nine-Month Follow-Up Analysis

et al. 2022

View full text Add to dashboard Cite

Background. Sleep disturbances and benzodiazepine (BZD)/Z-drug use are common in patients with bipolar disorder (BD). Objective. To investigate the short- and long-term effects of BZD/Z-drug use during acute affective episode. Methods. Participants diagnosed with BD as well as sleep disturbance chose BZDs/Z-drugs or not at will. Manic and depressive symptoms were assessed by Mental Disorders Questionnaire (MDQ) and Quick Inventory of Depressive Symptoms (QIDS) as self-reporting surveys. The participants were assessed by trained evaluators at baseline and months 1, 3, 6, and 9. Results. 61 patients with BD combined sleep disturbances were studied. At baseline, patients who used BZDs/Z-drugs had more amount of mood stabilizers ( p = 0.038 ), other psychotropic medications ( p = 0.040 ), and more risk of suicide attempt ( p = 0.019 ). The BZD/Z-drug group had a significantly higher QIDS reductive ratio as compared with the no BZD/Z-drug group at month 1; no significant differences in the variability of MDQ, QIDS reductive ratio, or recurrence rate were found between these two groups at baseline, month 1, month 3, month 6, or month 9. Conclusions. During acute affective episode, patients with BD combined sleep disturbance who took BZDs/Z-drugs tended to use more amount of mood stabilizers. Polytherapy of BZDs/Z-drugs or other psychiatric drugs could increase suicide attempt during an acute affective episode. BZD/Z-drug use, however, had a significant effect on helping depressive symptoms alleviate during affective period.

show abstract

“…Del Pino [ 37 ] has already mentioned that cardiovascular autonomic dysfunction was associated with cognitive and neuropsychiatric impairment in Lewy body disease, using a number of tests to assess autonomic function such as hemodynamic parameters during deep breathing, the Valsalva maneuver, and head up tilt test. Several pathogeneses have been suggested for the association of cognitive dysfunction and BP abnormality, but the underlying mechanism is still unclear.…”

Section: Discussionmentioning

confidence: 99%

Comparisons of cardiovascular dysautonomia and cognitive impairment between de novo Parkinson’s disease and de novo dementia with Lewy bodies

et al. 2020

View full text Add to dashboard Cite

Background Cognitive impairment may be correlated with cardiovascular dysautonomia, including blood pressure (BP) dysregulation, in Parkinson’s disease (PD), but the association between these factors in dementia with Lewy bodies (DLB) is uncertain. This study aimed to clarify whether cardiovascular dysautonomia had an influence on cognitive function in Lewy body disease or not. Methods Ninty-nine patients with de novo PD (n = 75) and DLB (n = 24) were evaluated using the Mini-Mental State Examination (MMSE) and Frontal Assessment Battery (FAB). Cardiac 123I-metaiodobenzylguanidine (MIBG) scintigraphy, orthostatic hypotension (OH), supine hypertension (SH), postprandial hypotension (PPH), nocturnal BP fall in 24-h ambulatory blood pressure monitoring (ABPM) and constipation were estimated. Associations of these factors with cognitive and executive dysfunction were examined. Results In DLB, MIBG uptake was reduced and OH, PPH and SH were severely disturbed, compared to PD. The nocturnal BP fall in ABPM was lower in DLB, and the failure of nocturnal BP fall in PD was associated with MMSE, after adjustment for other clinical features. FAB was significantly associated nocturnal BP fall, age and SH in PD, but no significant correlations among factors were found for DLB. Conclusion The significant association between nocturnal BP dysregulation and cognitive or executive decline in PD might be due to impaired microvascular circulation or invasion of α-synuclein in the CNS. The lack of a correlation of BP insufficiency with cognitive impairment in DLB suggests initial involvement of Lewy body pathology in the neocortex, regardless of Lewy body invasion of the autonomic nervous system.

show abstract

Autonomic dysfunction is associated with neuropsychological impairment in Lewy body disease

Cited by 19 publications

References 61 publications

The Relationship Between Autonomic Dysfunction and Mood Symptoms in De Novo Parkinson’s Disease Patients Over Time

The Relationship Between Autonomic Dysfunction and Mood Symptoms in De Novo Parkinson’s Disease Patients Over Time

Short- and Long-Term Influences of Benzodiazepine and Z-Drug Use in Patients with Bipolar Disorder Combined Sleep Disturbance during Affective Period: A Nine-Month Follow-Up Analysis

Comparisons of cardiovascular dysautonomia and cognitive impairment between de novo Parkinson’s disease and de novo dementia with Lewy bodies

Contact Info

Product

Resources

About