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Cerebral microbleeds and blood pressure abnormalities in Parkinson's disease

Kazuo Yamashiro1, Ryota Tanaka1, Yasushi Shimo1

  • 1Department of Neurology, Juntendo University School of Medicine, Tokyo, Japan.

Eneurologicalsci
|May 9, 2018
PubMed

Insights

Blood pressure abnormalities like orthostatic hypotension and supine hypertension in Parkinson's disease (PD) patients are linked to deep cerebral microbleeds (CMBs). This finding highlights a potential connection between specific blood pressure patterns and small vessel disease in PD.

Area of Science:

  • Neurology
  • Cardiology
  • Cerebrovascular Disease

Background:

  • Blood pressure abnormalities are common in Parkinson's disease (PD).
  • These abnormalities are associated with cerebrovascular conditions like white matter hyperintensities and carotid atherosclerosis.
  • Cerebral microbleeds (CMBs) are indicators of cerebral small vessel disease.

Purpose of the Study:

  • To investigate the association between blood pressure abnormalities and CMBs in PD patients.
  • To determine if specific blood pressure patterns (orthostatic hypotension, supine hypertension, nocturnal hypertension, non-dipping) correlate with CMB presence and location.

Main Methods:

  • 128 PD patients were assessed for supine and orthostatic blood pressures.
  • 24-hour ambulatory blood pressure monitoring was used to identify orthostatic hypotension (OH), supine hypertension (SH), nocturnal hypertension (NH), and non-dipping.
  • CMBs were detected and analyzed for location (deep/infratentorial, lobar, mixed).

Main Results:

  • CMBs were present in 10.2% of PD patients, with a median of 1 CMB.
  • The presence of both OH and SH was independently associated with a higher number of deep or infratentorial CMBs.
  • No association was found between NH or non-dipping and deep/infratentorial CMBs, nor between any blood pressure pattern and lobar CMBs.

Conclusions:

  • The combination of orthostatic hypotension and supine hypertension may be linked to deep or infratentorial CMBs in Parkinson's disease.
  • These findings suggest a specific relationship between certain blood pressure dysregulations and small vessel disease in the deep brain regions of PD patients.
Keywords:
Autonomic dysfunctionCerebral microbleedsOrthostatic hypotensionParkinson's diseaseSupine hypertension

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