Orthostatic hypotension and cardiac sympathetic denervation in Parkinson disease patients with REM sleep behavioral disorder

Kim, Joong‐Seok; Park, Hyung-Eun; Oh, Yoon‐Sang; Lee, Sihoon; Park, Jeong‐Wook; Son, Byung-chul; Lee, Kwang Soo

doi:10.1016/j.jns.2016.01.020

Cited by 54 publications

(25 citation statements)

References 36 publications

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“…The association between OH and RBD was examined in four longitudinal,12–14 25 nine cross-sectional studies26–30 32–35 and one autopsy series in PD 36. The OH-RBD cluster correlated with cognitive impairment and postural instability in a cohort of drug-naïve patients with PD followed-up for a mean of 4.5 years,14 and in analysis of the PPMI (Parkinson's Progression Markers Initiative) cohort,12 36 which also demonstrated an association between OH-RBD and greater cerebral atrophy, lower dopamine uptake and lower β-amyloid levels in the cerebrospinal fluid (table 2).…”

Section: Resultsmentioning

confidence: 99%

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Orthostatic hypotension and REM sleep behaviour disorder: impact on clinical outcomes in α-synucleinopathies

Padovani

Romagnolo

Tuazon

et al. 2019

J Neurol Neurosurg Psychiatry

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ObjectiveReview the effect of orthostatic hypotension (OH) and rapid-eye-movement sleep behavioural disorder (RBD) on survival, cognitive impairment and postural stability, and discuss pathogenic mechanisms involved in the association of these two common non-motor features with relevant clinical outcomes in α-synucleinopathies.MethodsWe searched PubMed (January 2007–February 2019) for human studies of OH and RBD evaluating cognitive impairment, postural instability, and survival in Parkinson’s disease (PD), dementia with Lewy bodies (DLB), multiple system atrophy (MSA) and pure autonomic failure (PAF). Included studies were analysed for design, key results and limitations as per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.ResultsOH and RBD showed a positive association with cognitive impairment in PD and DLB, conflicting association in PAF, and no association in MSA. OH was correlated with incident falls and postural instability in PD and DLB but not in MSA. The association between RBD and postural instability was inconclusive; positive in five studies, negative in seven. OH, but not RBD, correlated with reduced survival in PD, DLB and MSA. The combination of OH and RBD was associated with cognitive impairment and more rapid progression of postural instability.ConclusionsOH and RBD yielded individual and combined negative effects on disability in α-synucleinopathies, reflecting a ‘malignant’ phenotype of PD with early cognitive impairment and postural instability. Underlying mechanisms may include involvement of selected brainstem cholinergic and noradrenergic nuclei.

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Section: Resultsmentioning

confidence: 99%

“…Out of the 2601 records derived from the initial search strategy, 101 studies met full eligibility criteria and underwent data extraction10–14 18–36 [s10-s86] : 41 focused on OH; 43 on RBD; three on both OH and RBD and 14 on the association between OH and RBD (online supplementary figures 1-3).…”

Section: Resultsmentioning

confidence: 99%

Orthostatic hypotension and REM sleep behaviour disorder: impact on clinical outcomes in α-synucleinopathies

Padovani

Romagnolo

Tuazon

et al. 2019

J Neurol Neurosurg Psychiatry

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“…Previous studies have shown that age at onset, symptom severity and short symptom duration are negatively correlated with MIBG uptake . Other independent reports found that patients with PD with low MIBG uptake also have associated cognitive impairment, dementia, RBD, hyposmia, constipation and orthostatic hypotension . Recent research regarding the chronological change in MIBG uptakes in patients with PD revealed that there is heterogeneity in the MIBG uptake that may be associated with the evolution of Lewy body pathology in the myocardium .…”

Section: Discussionmentioning

confidence: 99%

Normal ‘heart’ in Parkinson's disease: is this a distinct clinical phenotype?

Kim

Park

et al. 2016

Euro J of Neurology

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“…The cardiac sympathoneural lesion in these diseases probably is important clinically. Thus, neuroimaging evidence of cardiac noradrenergic deficiency in PD is associated with cognitive impairment (4), exercise intolerance (5), olfactory dysfunction (6), rapid eye movement behavior disorder (7), visual hallucinations (8), falls from neurogenic orthostatic hypotension (9), fatigue (10), and shortened survival (11).…”

Section: Introductionmentioning

confidence: 99%

Computational modeling reveals multiple abnormalities of myocardial noradrenergic function in Lewy body diseases

Goldstein¹,

Pekker²,

Eisenhofer³

et al. 2019

JCI Insight

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IntroductionThe movement disorder in Parkinson disease (PD) results from depletion of the catecholamine dopamine in the brain's nigrostriatal system (1). PD also entails profound deficiency of the closely related catecholamine norepinephrine (NE) in the heart (2). Other Lewy body diseases -pure autonomic failure (PAF) and dementia with Lewy bodies -also involve severely decreased myocardial NE contents (3).The cardiac sympathoneural lesion in these diseases probably is important clinically. Thus, neuroimaging evidence of cardiac noradrenergic deficiency in PD is associated with cognitive impairment (4), exercise intolerance (5), olfactory dysfunction (6), rapid eye movement behavior disorder (7), visual hallucinations (8), falls from neurogenic orthostatic hypotension (9), fatigue (10), and shortened survival (11).One might presume that the myocardial NE depletion in these disorders directly and solely reflects loss BACKGROUND. Lewy body diseases, a family of aging-related neurodegenerative disorders, entail loss of the catecholamine dopamine in the nigrostriatal system and equally severe deficiency of the closely related catecholamine norepinephrine in the heart. The myocardial noradrenergic lesion is associated with major nonmotor symptoms and decreased survival. Numerous mechanisms determine norepinephrine stores, and which of these are altered in Lewy body diseases has not been examined in an integrated way. We used a computational modeling approach to assess comprehensively pathways of cardiac norepinephrine synthesis, storage, release, reuptake, and metabolism in Lewy body diseases. Application of a potentially novel kinetic model identified a pattern of dysfunctional steps contributing to norepinephrine deficiency. We then tested predictions from the model in a new cohort of Parkinson disease patients.

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Orthostatic hypotension and cardiac sympathetic denervation in Parkinson disease patients with REM sleep behavioral disorder

Cited by 54 publications

References 36 publications

Orthostatic hypotension and REM sleep behaviour disorder: impact on clinical outcomes in α-synucleinopathies

Orthostatic hypotension and REM sleep behaviour disorder: impact on clinical outcomes in α-synucleinopathies

Normal ‘heart’ in Parkinson's disease: is this a distinct clinical phenotype?

Computational modeling reveals multiple abnormalities of myocardial noradrenergic function in Lewy body diseases

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