Initial circulatory response to active standing in Parkinson's disease without typical orthostatic hypotension
While the circulatory response to orthostatic stress has been already evaluated in Parkinson's disease patients without typical orthostatic hypotension (PD-TOH), there is an initial response to the upright position which is uniquely associated with active standing (AS). We sought to assess this...
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| Published in | Arquivos de neuro-psiquiatria Vol. 72; no. 3; pp. 208 - 213 |
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| Main Authors | , , , , |
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| Language | English Portuguese |
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Academia Brasileira de Neurologia - ABNEURO
01.03.2014
Academia Brasileira de Neurologia (ABNEURO) |
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| Abstract | While the circulatory response to orthostatic stress has been already evaluated in Parkinson's disease patients without typical orthostatic hypotension (PD-TOH), there is an initial response to the upright position which is uniquely associated with active standing (AS). We sought to assess this response and to compare it to that seen in young healthy controls (YHC).
In 10 PD-TOH patients (8 males, 60 ± 7 years, Hoehn and Yahr ≤ 3) the changes in systolic blood pressure (SBP) and heart rate that occur in the first 30 seconds (sec) of standing were examined. Both parameters were non-invasively and continuously monitored using the volume-clamp method by Peñáz and the Physiocal criteria by Wesseling. The choice of sample points was prompted by the results of previous studies. These sample points were compared to those of 10 YHC (8 males, 32 ± 8 years).
The main finding of the present investigation was an increased time between the AS onset and SBP overshoot in PD-TOH group (24 ± 4 vs. 19 ± 3 sec; p<0.05).
This delay might reflect a prolonged latency in the baroreflex-mediated vascular resistance response, but more studies are needed to confirm this preliminary hypothesis. |
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| AbstractList | While the circulatory response to orthostatic stress has been already evaluated in Parkinson's disease patients without typical orthostatic hypotension (PD-TOH), there is an initial response to the upright position which is uniquely associated with active standing (AS). We sought to assess this response and to compare it to that seen in young healthy controls (YHC). Method In 10 PD-TOH patients (8 males, 60+ or -7 years, Hoehn and Yahr [< or =]3) the changes in systolic blood pressure (SBP) and heart rate that occur in the first 30 seconds (sec) of standing were examined. Both parameters were non-invasively and continuously monitored using the volume-clamp method by Penaz and the Physiocal criteria by Wesseling. The choice of sample points was prompted by the results of previous studies. These sample points were compared to those of 10 YHC (8 males, 32+ or -8 years). Results The main finding of the present investigation was an increased time between the AS onset and SBP overshoot in PD-TOH group (24+ or -4 vs. 19+ or -3 sec; p<0.05). Conclusion This delay might reflect a prolonged latency in the baroreflex-mediated vascular resistance response, but more studies are needed to confirm this preliminary hypothesis. While the circulatory response to orthostatic stress has been already evaluated in Parkinson's disease patients without typical orthostatic hypotension (PD-TOH), there is an initial response to the upright position which is uniquely associated with active standing (AS). We sought to assess this response and to compare it to that seen in young healthy controls (YHC). Method In 10 PD-TOH patients (8 males, 60±7 years, Hoehn and Yahr ≤3) the changes in systolic blood pressure (SBP) and heart rate that occur in the first 30 seconds (sec) of standing were examined. Both parameters were non-invasively and continuously monitored using the volume-clamp method by Peñáz and the Physiocal criteria by Wesseling. The choice of sample points was prompted by the results of previous studies. These sample points were compared to those of 10 YHC (8 males, 32±8 years). Results The main finding of the present investigation was an increased time between the AS onset and SBP overshoot in PD-TOH group (24±4 vs. 19±3 sec; p<0.05). Conclusion This delay might reflect a prolonged latency in the baroreflex-mediated vascular resistance response, but more studies are needed to confirm this preliminary hypothesis. UNLABELLEDWhile the circulatory response to orthostatic stress has been already evaluated in Parkinson's disease patients without typical orthostatic hypotension (PD-TOH), there is an initial response to the upright position which is uniquely associated with active standing (AS). We sought to assess this response and to compare it to that seen in young healthy controls (YHC). METHODIn 10 PD-TOH patients (8 males, 60 ± 7 years, Hoehn and Yahr ≤ 3) the changes in systolic blood pressure (SBP) and heart rate that occur in the first 30 seconds (sec) of standing were examined. Both parameters were non-invasively and continuously monitored using the volume-clamp method by Peñáz and the Physiocal criteria by Wesseling. The choice of sample points was prompted by the results of previous studies. These sample points were compared to those of 10 YHC (8 males, 32 ± 8 years). RESULTSThe main finding of the present investigation was an increased time between the AS onset and SBP overshoot in PD-TOH group (24 ± 4 vs. 19 ± 3 sec; p<0.05). CONCLUSIONThis delay might reflect a prolonged latency in the baroreflex-mediated vascular resistance response, but more studies are needed to confirm this preliminary hypothesis. While the circulatory response to orthostatic stress has been already evaluated in Parkinson's disease patients without typical orthostatic hypotension (PD-TOH), there is an initial response to the upright position which is uniquely associated with active standing (AS). We sought to assess this response and to compare it to that seen in young healthy controls (YHC). In 10 PD-TOH patients (8 males, 60 ± 7 years, Hoehn and Yahr ≤ 3) the changes in systolic blood pressure (SBP) and heart rate that occur in the first 30 seconds (sec) of standing were examined. Both parameters were non-invasively and continuously monitored using the volume-clamp method by Peñáz and the Physiocal criteria by Wesseling. The choice of sample points was prompted by the results of previous studies. These sample points were compared to those of 10 YHC (8 males, 32 ± 8 years). The main finding of the present investigation was an increased time between the AS onset and SBP overshoot in PD-TOH group (24 ± 4 vs. 19 ± 3 sec; p<0.05). This delay might reflect a prolonged latency in the baroreflex-mediated vascular resistance response, but more studies are needed to confirm this preliminary hypothesis. While the circulatory response to orthostatic stress has been already evaluated in Parkinson's disease patients without typical orthostatic hypotension (PD-TOH), there is an initial response to the upright position which is uniquely associated with active standing (AS). We sought to assess this response and to compare it to that seen in young healthy controls (YHC). Method In 10 PD-TOH patients (8 males, 60±7 years, Hoehn and Yahr ≤3) the changes in systolic blood pressure (SBP) and heart rate that occur in the first 30 seconds (sec) of standing were examined. Both parameters were non-invasively and continuously monitored using the volume-clamp method by Peñáz and the Physiocal criteria by Wesseling. The choice of sample points was prompted by the results of previous studies. These sample points were compared to those of 10 YHC (8 males, 32±8 years). Results The main finding of the present investigation was an increased time between the AS onset and SBP overshoot in PD-TOH group (24±4 vs. 19±3 sec; p<0.05). Conclusion This delay might reflect a prolonged latency in the baroreflex-mediated vascular resistance response, but more studies are needed to confirm this preliminary hypothesis. Apesar da resposta circulatória ao estresse ortostático já foi estudada em pacientes com doença de Parkinson sem hipotensão ortostática típica (PD-TOH), não há uma resposta inicial que é exclusivamente associada com o ortostase ativa (AS). Portanto, buscou-se avaliar esta resposta e compará-la à observada em jovens saudáveis (YHC). Método Em 10 PD-TOH pacientes (8 homens, 60±7 anos, Hoehn e Yahr ≤3) as mudanças na pressão arterial sistólica (PAS) e da frequência cardíaca que ocorrem nos primeiros 30 segundos (seg) de pé foram examinados. Ambos parâmetros foram monitorizados continuamente através do método Peňáz e os critérios de Wesseling. Os pontos de amostragem foram escolhidos com base em estudos anteriores. Estes pontos foram comparados com os de 10 YHC (32±8 anos). Resultados O principal achado deste estudo foi o aumento do tempo entre o início de AS e rebote sistólica no grupo PD-TOH (24±4 vs 19±3 seg, p<0,05). Conclusão Este atraso pode refletir uma latência prolongada na resposta da resistência vascular mediado pelo barorreflexo, mas outros estudos são necessários para confirmar esta hipótese preliminar. |
| Author | González-Hermosillo, Jesús Antonio Estañol, Bruno Rodríguez-Violante, Mayela Infante-Vázquez, Óscar Delgado, Guillermo |
| AuthorAffiliation | Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán Instituto Nacional de Neurología y Neurocirugía National Institute of Cardiology Ignacio Chávez |
| AuthorAffiliation_xml | – name: Instituto Nacional de Neurología y Neurocirugía – name: National Institute of Cardiology Ignacio Chávez – name: Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán |
| Author_xml | – sequence: 1 givenname: Guillermo surname: Delgado fullname: Delgado, Guillermo organization: Laboratory of Clinical Neurophysiology, Department of Neurology and Psychiatry, National Institute of Medical Sciences and Nutrition Salvador Zubiran – sequence: 2 givenname: Bruno surname: Estañol fullname: Estañol, Bruno organization: Laboratory of Clinical Neurophysiology, Department of Neurology and Psychiatry, National Institute of Medical Sciences and Nutrition Salvador Zubiran – sequence: 3 givenname: Mayela surname: Rodríguez-Violante fullname: Rodríguez-Violante, Mayela organization: Movement Disorders Clinic, National Institute of Neurology and Neurosurgery Manuel Velasco Suarez – sequence: 4 givenname: Jesús Antonio surname: González-Hermosillo fullname: González-Hermosillo, Jesús Antonio organization: Department of Electrocardiography and Electrophysiology, National Institute of Cardiology Ignacio Chavez – sequence: 5 givenname: Óscar surname: Infante-Vázquez fullname: Infante-Vázquez, Óscar organization: Department of Electromechanical Instrumentation, National Institute of Cardiology Ignacio Chavez |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/24676438$$D View this record in MEDLINE/PubMed |
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| Cites_doi | 10.1161/01.STR.29.1.104 10.1007/s10286-005-0273-8 10.1097/00002826-198812000-00004 10.1042/CS20060091 10.1016/S1353-8020(01)00014-1 10.2340/0001555574197200 10.1042/cs0670321 10.1093/cvr/24.3.214 10.1111/j.1651-2227.1996.tb14090.x 10.1113/jphysiol.2009.177998 10.1136/jnnp.55.3.181 10.1007/BF02267620 10.1152/japplphysiol.00069.2011 10.1016/S0165-1838(00)00078-3 10.1002/mds.20213 10.1097/00126097-200302000-00006 10.1002/mds.22537 10.1016/j.autneu.2011.02.004 10.1042/cs0830149 10.1111/j.1651-2227.1994.tb13133.x 10.1113/jphysiol.2001.013060 10.1016/S1566-0702(00)00267-8 10.1111/j.1468-1331.2010.03135.x 10.1016/j.nbd.2011.10.025 10.1111/j.1468-1331.2006.01512.x |
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publication-title: Mov Disord contributor: fullname: Jamnadas-Khoda, J; Koshy, S; Mathias, CJ; Muthane, UB; Ragothaman, M; Dodaballapur, SK – volume: 7 start-page: 5 year: 1997 end-page: 11 article-title: Sympathetic vasoconstrictor reflexes in Parkinson's disease with autonomic dysfunction publication-title: Clin Auton Res contributor: fullname: Andersen, EB; Boesen, F – volume: 87 year: 2001 end-page: 66 article-title: Venoarteriolar response in hemi Parkinson's disease publication-title: Auton Neurosci contributor: fullname: Fusina, S; Bongiovanni, LG; Cacciatori, V; Gemma, L; Nardelli,; Rizzuto, N – volume: 29 start-page: 104 year: 1998 end-page: 111 article-title: Autoregulation of cerebral blood flow in orthostatic hypotension publication-title: Stroke contributor: fullname: Novak, V; Novak, P; Spies, JM; Low, PA – volume: 55 start-page: 181 year: 1992 end-page: 184 article-title: Accuracy of clinical diagnosis of idiopathic Parkinson's disease: a clinico-pathological study of 100 cases publication-title: J Neurol Neurosurg Psychiatr contributor: fullname: Hughes, AJ; Daniel, SE; Kilford, L; Lees, AJ – volume: 243 start-page: 676 year: 1982 end-page: 681 article-title: Mechanisms of initial heart rate response to postural change publication-title: Am J Physiol contributor: fullname: Borst, C; Wieling, W; van Brederode, JF; Hond, A; de Rijk, LG; Dunning, AJ – volume: 85 start-page: 577 year: 1996 end-page: 583 article-title: Beat-to-beat blood pressure and heart rate responses to active standing in Japanese children publication-title: Acta Paediatr contributor: fullname: Yamaguchi, H; Tanaka, H; Adachi, K; Mino, M – volume: 11 start-page: 512 year: 1988 end-page: 519 article-title: The nighttime problems of Parkinson's disease publication-title: Clin Neuropharmacol contributor: fullname: Lees, AJ; Blackburn, NA; Campbell, VL – volume: 83 start-page: 149 year: 1992 end-page: 155 article-title: Disparities in circulatory adjustment to standing between young and elderly subjects explained by pulse contour analysis publication-title: Clin Sci contributor: fullname: Wieling, W; Veerman, DP; Dambrink, JH; Imholz, BP – volume: 24 start-page: 214 year: 1990 end-page: 221 article-title: Non-invasive continuous finger blood pressure measurement during orthostatic stress compared to intra-arterial pressure publication-title: Cardiovasc Res contributor: fullname: Imholz, BP; Settels, JJ; van der Meiracker, AH; Wesseling, KH; Wieling, W – volume: 8 start-page: 255 year: 2002 end-page: 259 article-title: Normal cerebral hemodynamic response to orthostasis in Parkinson's disease publication-title: Parkinsonism Relat Disord contributor: fullname: Niehaus, L; Böckeler, GC; Kupsch, A; Meyer, BU – volume: 310 year: 1984 end-page: 1189 article-title: Cardiovascular effects of arising suddenly publication-title: N Engl J Med contributor: fullname: Wieling, W; Dambrink, JH; Borst, C – volume: 112 start-page: 157 year: 2007 end-page: 165 article-title: Initial orthostatic hypotension: review of a forgotten condition publication-title: Clin Sci contributor: fullname: Wieling, W; Krediet, CT; van Dijk, N; Linzer, M; Tschakovsky, ME – volume: 18 start-page: 286 year: 2011 end-page: 292 article-title: Cardiovascular dysautonomia in de novo Parkinson's disease without orthostatic hypotension publication-title: Eur J Neurol contributor: fullname: Oka, H; Toyoda, C; Yogo, M; Mochio, S – volume: 80 start-page: 93 year: 2000 end-page: 100 article-title: Arterial blood pressure oscillation after active standing up in kidney transplant recipients publication-title: J Auton Nerv Syst contributor: fullname: Gerhardt, U; Schäfer, M; Hohage, H – volume: 74 start-page: 194 year: 1994 end-page: 196 article-title: Impairment of the postural venoarteriolar reflex in aged individuals publication-title: Acta Derm Venereol contributor: fullname: Gniadecka, M; Gniadecki, R; Serup, J; Søndergaard, J – volume: 19 start-page: 1020 year: 2004 end-page: 1028 article-title: Movement Disorder Society Task Force report on the Hoehn and Yahr staging scale: status and recommendations publication-title: Mov Disord contributor: fullname: Goetz, CG; Poewe, W; Rascol, O – volume: 538 start-page: 599 year: 2002 end-page: 605 article-title: Evidence that the human cutaneous venoarteriolar response is not mediated by adrenergic mechanisms publication-title: J Physiol contributor: fullname: Crandall, CG; Shibasaki, M; Yen, TC – volume: 83 start-page: 754 year: 1994 end-page: 761 article-title: Circulatory responses in children with unexplained syncope evaluated by continuous non-invasive finger blood pressure monitoring publication-title: Acta Paediatr contributor: fullname: Tanaka, H; Thulesius, O; Yamaguchi, H; Mino, M |
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| Title | Initial circulatory response to active standing in Parkinson's disease without typical orthostatic hypotension |
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