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Autonomic dysfunction in Parkinson's disease

Y Koike1, A Takahashi

  • 1Nagoya University College of Medical Technology, Japan.

European Neurology
|January 1, 1997
PubMed
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Autonomic dysfunction is common in idiopathic Parkinson's disease (iPD). Autonomic failure with PD presents unique symptoms, suggesting distinct neurological pathways.

Area of Science:

  • Neurology
  • Autonomic Nervous System Research

Background:

  • Autonomic dysfunction is a recognized complication of idiopathic Parkinson's disease (iPD).
  • The clinical spectrum and severity of autonomic dysfunction in iPD have evolved in definition and understanding.
  • Autonomic failure (AF) with PD represents a specific subtype requiring detailed characterization.

Purpose of the Study:

  • To review autonomic dysfunction in iPD.
  • To delineate the clinical features of AF with PD.
  • To analyze recent study findings on autonomic dysfunction in iPD.

Main Methods:

  • Review of existing literature and recent research findings.
  • Clinical characterization of autonomic failure with Parkinson's disease.
  • Analysis of diagnostic markers including scintigraphy and PET imaging.

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Main Results:

  • Autonomic dysfunction in iPD ranges from infrequent and mild to significant but less severe than in Shy-Drager syndrome.
  • AF with PD exhibits severe orthostatic and postprandial hypotension, noradrenaline supersensitivity, and reduced limb MIBG uptake.
  • Preserved vasopressin response and reduced cortical metabolism suggest postganglionic sympathetic lesions and diffuse nervous system involvement.

Conclusions:

  • Autonomic failure with Parkinson's disease presents with a distinct profile of autonomic and neurological symptoms.
  • Findings suggest a postganglionic sympathetic lesion, potentially overlapping with pure autonomic failure.
  • Evidence points towards diffuse nervous system lesions, similar to diffuse Lewy body disease, in AF with PD.