期刊
JOURNAL OF THE NEUROLOGICAL SCIENCES
卷 276, 期 1-2, 页码 79-83出版社
ELSEVIER
DOI: 10.1016/j.jns.2008.09.005
关键词
Parkinson's disease; I-123-meta-iodobenzylguanidine; Coefficient variation of RR intervals; Parasympathetic dysfunction; Orthostatic hypotension
We aimed to characterize the relationship between cardiac sympathetic and parasympathetic dysfunction employing cardiac I-123-meta-iodobenzylguanidine (MIBG) uptake and other autonomic function parameters in Parkinson's disease (PD). 79 PD patients were studied. We performed I-123-MIBG myocardial scintigraphy to assess the extent of cardiac sympathetic denervation. Electrocardiogram readings at rest and postural change in blood pressure were also examined. Coefficient variation of RR intervals (CVR-R) Was used as ail index for cardiac parasympathetic activity. Cardiac I-123-MIBG uptake did not vary significantly among the Hoehn-Yahr (H-Y) stages. There was a significant correlation between cardiac I-123-MIBG uptake and CVR-R (early, r=0.457, p=0.001; late, r=0.442, p<0.001). While the correlation was present among the patients who had had the disease less than two years (early, r=0.558, p<0.001; late, r=0.530, p<0.001), the patients with the disease duration longer than two years did not have Such a significant correlation. Age, disease duration, corrected QT interval, or Postural blood pressure change did not correlate with cardiac I-123-MIBG uptake. Orthostatic hypotension was observed in 13 out of 72 subjects, and reduced CVR-R was a major determinant for the development of orthostatic hypotension. We conclude that cardiac parasympathetic dysfunction occurs concurrent with sympathetic denervation as revealed by I-123-MIBG myocardial scintigraphy in PD and contributes to the development of orthostatic hypotension. (C) 2008 Elsevier B.V. All rights reserved.
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