Impaired cardiovascular autonomic function in Parkinson's disease with visual hallucinations
Hisayoshi Oka1, Masayuki Yoshioka1, Kenji Onouchi2
1Department of Neurology, Jikei University School of Medicine, Tokyo, Japan.
Summary
Parkinson's disease patients with visual hallucinations exhibit more severe cardiac and vasomotor sympathetic dysfunction. This autonomic dysfunction may stem from Lewy-body pathology affecting the nervous system.
Area of Science:
- Neurology
- Cardiology
- Autonomic Neuroscience
Background:
- Parkinson's disease (PD) is a neurodegenerative disorder.
- Visual hallucinations (VH) are a common non-motor symptom in PD.
- Autonomic dysfunction is prevalent in PD, but its relation to VH is not fully understood.
Purpose of the Study:
- To investigate the association between visual hallucinations and cardiovascular autonomic dysfunction in Parkinson's disease patients.
- To compare autonomic function in PD patients with and without visual hallucinations.
Main Methods:
- Cardiac autonomic function assessed using 123-radioiodinated metaiodobenzylguanidine (123I-MIBG) uptake.
- Hemodynamic testing included Valsalva maneuver and tilt-table testing.
- Systolic blood pressure (SBP) and plasma norepinephrine concentrations (NE) were measured.
Main Results:
- Lower 123I-MIBG uptake was observed in PD patients with VH (VH(+)) compared to those without (VH(-)).
- VH(+) patients demonstrated reduced vasomotor sympathetic function, in addition to cardiac sympathetic and parasympathetic dysfunction seen in VH(-) patients.
- Greater SBP drop during tilt-table testing and decreased NE levels were noted in VH(+) patients.
Conclusions:
- Cardiovascular autonomic dysfunction, particularly involving cardiac and vasomotor sympathetic systems, is more severe in Parkinson's disease patients experiencing visual hallucinations.
- This enhanced autonomic dysfunction in PD with VH may be linked to Lewy-body pathology or neuronal loss in sympathetic ganglia and/or the central autonomic system.
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