Autonomic dysfunctions in parkinsonian disorders
Hyo-Jin Bae1, Sang-Myung Cheon1, Jae Woo Kim1
1Department of Neurology, Dong-A University College of Medicine, Busan, Korea.
Journal of Movement Disorders
|May 29, 2014
Summary
Autonomic dysfunction symptoms are common in parkinsonian disorders. Multiple System Atrophy and Progressive Supranuclear Palsy patients exhibit more severe autonomic symptoms than Idiopathic Parkinson's Disease patients.
Area of Science:
- Neurology
- Autonomic Nervous System Disorders
Background:
- Autonomic dysfunction is prevalent in parkinsonian disorders, presenting diverse clinical features.
- Comprehensive evaluation is crucial for managing these diverse symptoms effectively.
Purpose of the Study:
- To evaluate autonomic dysfunction in degenerative parkinsonisms.
- To identify differences in autonomic dysfunction severity among patient groups.
Main Methods:
- 259 patients with Idiopathic Parkinson's Disease (IPD), Multiple System Atrophy (MSA), Dementia with Lewy Body (DLB), and Progressive Supranuclear Palsy (PSP) were assessed.
- A structured questionnaire for autonomic dysfunction (ADQ) evaluated symptom presence and severity across multiple domains.
- Orthostatic hypotension was also assessed.
Main Results:
- MSA and PSP patients had significantly higher total ADQ scores compared to IPD patients.
- MSA showed worse urinary and cardiovascular symptoms, while PSP had worse gastrointestinal symptoms than IPD.
- Orthostatic hypotension prevalence was similar across groups, but MSA and DLB patients experienced a more drastic systolic blood pressure drop upon standing.
Conclusions:
- Degenerative parkinsonism is associated with widespread autonomic dysfunction.
- Autonomic dysfunction severity in PSP is comparable to MSA and greater than in IPD.
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