Cardiovascular autonomic dysfunction in patients with movement disorders

Autonomic dysfunction is common in parkinsonian syndromes, particularly those involving dysregulation of alpha-synuclein, and may result from neurodegeneration in autonomic regulatory regions of the brain or peripherial autonomic ganglia. The most limiting cardiovascular autonomic dysfunction in these diseases is orthostatic hypotension, which is particularly prominent in multiple system atrophy. Postprandial hypotension and supine hypertension, as well as dopaminergic therapy, often complicate the management of orthostatic hypotension in patients with parkinsonian syndromes.