Reduced central sympathetic activity in Parkinson's disease

Brain and Behavior

Heidrun H. Krämer¹  Iris Reuter¹  Gothje Lautenschläger¹  Michael deAzevedo¹  Wolfgang H. Oertel²  Christoph Best²  Kathrin Doppler³  Claudia Sommer³  Frank Birklein⁴  Anne Schänzer⁵ 

[1] Department of Neurology Justus‐Liebig‐University Giessen Germany;Department of Neurology Philipps‐University Marburg Germany;Department of Neurology University Hospital Würzburg Würzburg Germany;Department of Neurology University Medical Center Johannes Gutenberg‐University Mainz Germany;Institute of Neuropathology Justus‐Liebig‐University Giessen Germany;

关键词: autonomic failure;    MSNA;    Parkinson's disease;    phosphorylated α‐synuclein deposits;   

DOI  :  10.1002/brb3.1463

来源: DOAJ

【 摘 要 】

Abstract Objective With a combination of different sympathetic tests, we aimed to elucidate whether impairment of sympathetic function in Parkinson's disease (PD) is the consequence of a central or peripheral efferent dysfunction. Methods Thirty‐five patients with early‐to‐intermediate PD (median age: 63 years; IQR: 57–67 years; disease duration 1–9 years, 15 women) and 20 age‐ and sex‐matched healthy controls (median age: 64.5 years; IQR: 58–68 years; 10 women) were recruited. Autonomic testing was performed in two subgroups and included the assessment of resting cardiovascular parameters, postprandial hypotension (PPH), orthostatic hypotension (OH), and vasoconstriction induced by intradermal microdialysis with different concentrations of norepinephrine (NE; 10–5; 10–6; 10–7; 10–8) and by cold through forehead cooling. We also used sympathetic multiunit microneurography (muscle sympathetic nerve activity; MSNA; burst frequency (BF): bursts per minute; burst incidence (BI): bursts per 100 heart beats) and evaluated the presence of phosphorylated α‐synuclein deposits in skin innervation in biopsies from the thighs by immunohistohemistry. Results Diastolic blood pressure was higher in the PD group at rest (p < .001) and during OH (F = 6.533; p = .022). Vasoconstriction induced by NE microdialysis and cold was unchanged in PD patients. MSNA was lower in PD patients than in controls (BF: p = .001; BI: p = .025). Phosphorylated α‐synuclein deposits could be found only in PD patients. Conclusion We did not find indications for peripheral sympathetic nerve fiber dysfunction or adrenoreceptor sensitivity changes. The decreased MSNA argues in favor of central sympathetic impairment.

【 授权许可】

Unknown