Cerebral hemodynamic changes and their effects on cognitive function in patients with Parkinson's disease complicated...

This article explores the relationship between OH and cerebral hemodynamics in PD patients, and clarifies the correlation between OH and cognitive function in PD patients.

The included PD cases were divided into OH positive and OH negative groups according to Active standing test (AST). In the supine position test, cerebral blood flow velocity (CBFv) and pulsitility index (PI) were continuously monitored by TCD, and blood pressure and heart rate in the supine position and standing position for 1st, 3rd and 5th minute were recorded.

In the chi-square test, 87.5% of patients with Parkinson's disease with orthostatic hypotension (PD-OH) had poor W spike correction, while only 12.2% of patients in Parkinson's disease with non-orthostatic hypotension (PD-NOH) group had OH symptoms, and 14.6% of patients had poor W spike correction. MoCA scores were significantly lower, and the prevalence of cognitive decline (CD) was significantly higher, in the OH with poor W spike callback group than in the W spike disappearance (WD) and normal response groups (P < 0.01). The results showed that mean cerebral blood flow velocity ratio (mCBFvR, % of baseline) was slightly positively correlated with MoCA score. Univariate regression analysis of disease duration, LEDD and OH were positively associated with CI in PD patients.

CBFv reduction was positively correlated with CD. This study points out that PD patients have poor W spike callback with OH, and then reduces the cerebral blood perfusion in the prolonged upright state, which may explain the impaired cognitive function in PD patients with OH. OH may serve as a "marker" of the overall burden of the disease, rather than being the sole direct cause of cognitive impairment.