[Autonomic features in Parkinson disease]
Toshimasa Yamamoto1, Naotoshi Tamura
1Department of Neurology, Faculty of Medicine, Saitama Medical University, Iruma-gun, Saitama, Japan.
Brain and Nerve = Shinkei Kenkyu No Shinpo
|April 7, 2012
Summary
Parkinson disease (PD) often involves early autonomic nervous system dysfunction, affecting the heart and gut. This review explores various autonomic symptoms in PD and their underlying peripheral and central nervous system changes.
Area of Science:
- Neurology
- Autonomic Neuroscience
Context:
- Parkinson disease (PD) is characterized by both motor and nonmotor symptoms.
- Nonmotor symptoms, including autonomic dysfunction, are increasingly recognized as early indicators of PD.
- Cardiac sympathetic denervation and gastrointestinal issues like constipation are prevalent even in early PD stages.
Purpose:
- To review the diverse symptoms and pathophysiology of autonomic dysfunction in Parkinson disease.
- To discuss the proposed "Braak theory" regarding the progression of PD neuropathology from peripheral to central autonomic pathways.
- To explore organ-specific patterns of autonomic dysfunction in PD patients.
Summary:
- Autonomic dysfunction is a common and early feature of Parkinson disease, manifesting as gastrointestinal, urinary, sexual, sweating, pupillary, and cardiovascular issues.
- Neuropathological evidence suggests PD may originate in peripheral autonomic nerves before affecting central pathways, aligning with the Braak staging hypothesis.
- This review details specific autonomic disturbances in PD, including cardiac sympathetic denervation and constipation, and examines why certain organs are selectively affected.
Impact:
- Highlights the significance of nonmotor symptoms in early PD diagnosis and management.
- Provides insights into the progression of Parkinson disease pathology, potentially informing therapeutic strategies.
- Enhances understanding of the complex interplay between the peripheral and central nervous systems in PD-related autonomic failure.
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