Parkinson病の自律神経障害と認知機能障害
Parkinson病（PD）では多彩な非運動症状を認め，進行例では起立性低血圧（OH）を約50%，認知機能障害を約80％の症例で認めるとされている．OHと認知機能障害はPD患者のADL・QOLに大きな影響を及ぼす．食事性低血圧（PPH）でも脳虚血病変が増悪し，臥位性高血圧（SH），夜間高血圧（NH）も認知機能障害と関連している．PPH，SHなどの血圧循環障害が引き起こす血圧日内変動はPDの認知機能障害の発症と進展に密接に関連している．PDにおける血圧循環障害による認知機能低下に対して，OHの是正に加えてSHやNHを惹起しないよう考慮した対策も必要と考えられる．...
Saved in:
| Published in | 自律神経 Vol. 57; no. 1; pp. 2 - 6 |
|---|---|
| Main Authors | , |
| Format | Journal Article |
| Language | Japanese |
| Published |
日本自律神経学会
2020
|
| Subjects | |
| Online Access | Get full text |
| ISSN | 0288-9250 2434-7035 |
| DOI | 10.32272/ans.57.1_002 |
Cover
| Abstract | Parkinson病（PD）では多彩な非運動症状を認め，進行例では起立性低血圧（OH）を約50%，認知機能障害を約80％の症例で認めるとされている．OHと認知機能障害はPD患者のADL・QOLに大きな影響を及ぼす．食事性低血圧（PPH）でも脳虚血病変が増悪し，臥位性高血圧（SH），夜間高血圧（NH）も認知機能障害と関連している．PPH，SHなどの血圧循環障害が引き起こす血圧日内変動はPDの認知機能障害の発症と進展に密接に関連している．PDにおける血圧循環障害による認知機能低下に対して，OHの是正に加えてSHやNHを惹起しないよう考慮した対策も必要と考えられる． |
|---|---|
| AbstractList | Parkinson病（PD）では多彩な非運動症状を認め，進行例では起立性低血圧（OH）を約50%，認知機能障害を約80％の症例で認めるとされている．OHと認知機能障害はPD患者のADL・QOLに大きな影響を及ぼす．食事性低血圧（PPH）でも脳虚血病変が増悪し，臥位性高血圧（SH），夜間高血圧（NH）も認知機能障害と関連している．PPH，SHなどの血圧循環障害が引き起こす血圧日内変動はPDの認知機能障害の発症と進展に密接に関連している．PDにおける血圧循環障害による認知機能低下に対して，OHの是正に加えてSHやNHを惹起しないよう考慮した対策も必要と考えられる． |
| Author | 岡, 尚省 梅原, 淳 |
| Author_xml | – sequence: 1 fullname: 岡, 尚省 organization: 東京慈恵会医科大学附属第三病院神経内科 – sequence: 1 fullname: 梅原, 淳 organization: 東京慈恵会医科大学神経内科 |
| BookMark | eNo9z79Lw0AcBfBDKhhrR_-MxO_d5XI5nKT4Cwo6dD_uehdNrKnkujgWEQd1FkTsVNAOXcRR_5lSE_8LIxWX9-AzPHjrqJEPcovQJoaAEsLJlspdwHiAJQBZQR4JaehzoKyBPCBx7AvCYA21nEs1hCEPa6Meio5VcZbmbpCXD9fz0ay6mS4-b8vJc_l-9_34tJi9zUcv1fS-HE--XsfV1ccSN9BqovrOtv66ibp7u932gd852j9s73T8DHOmfGNNQsEIHQOLqNLADZCIa2MwxdoSzY2IVe0MeExYEjMhtAYttAFlBW2i7eVs5obqxMqLIj1XxaVUxTDt9a2sP0vGJf4N8q-9U1XITNEf-ddkDw |
| ContentType | Journal Article |
| Copyright | 2020 日本自律神経学会 |
| Copyright_xml | – notice: 2020 日本自律神経学会 |
| DOI | 10.32272/ans.57.1_002 |
| DatabaseTitleList | |
| DeliveryMethod | fulltext_linktorsrc |
| EISSN | 2434-7035 |
| EndPage | 6 |
| ExternalDocumentID | article_ans_57_1_57_2_article_char_ja |
| GroupedDBID | ABJNI ALMA_UNASSIGNED_HOLDINGS JSF MOJWN RJT |
| ID | FETCH-LOGICAL-j175a-dedf30d9b80563ab07d0267bdd131be2b7d98aab0507825f8599bb0b9bd0ae93 |
| ISSN | 0288-9250 |
| IngestDate | Wed Sep 03 06:23:34 EDT 2025 |
| IsDoiOpenAccess | true |
| IsOpenAccess | true |
| IsPeerReviewed | false |
| IsScholarly | false |
| Issue | 1 |
| Language | Japanese |
| LinkModel | OpenURL |
| MergedId | FETCHMERGED-LOGICAL-j175a-dedf30d9b80563ab07d0267bdd131be2b7d98aab0507825f8599bb0b9bd0ae93 |
| OpenAccessLink | https://www.jstage.jst.go.jp/article/ans/57/1/57_2/_article/-char/ja |
| PageCount | 5 |
| ParticipantIDs | jstage_primary_article_ans_57_1_57_2_article_char_ja |
| PublicationCentury | 2000 |
| PublicationDate | 2020 |
| PublicationDateYYYYMMDD | 2020-01-01 |
| PublicationDate_xml | – year: 2020 text: 2020 |
| PublicationDecade | 2020 |
| PublicationTitle | 自律神経 |
| PublicationYear | 2020 |
| Publisher | 日本自律神経学会 |
| Publisher_xml | – name: 日本自律神経学会 |
| References | 20) Oka H, Nakahara A, Umehara T. Rotigotine improves abnormal circadian rhythm of blood pressure in Parkinson’s disease. Eur Neurol 2018; 79: 281-286. 27) Singer W, Sandroni P, Opfer-Gehrking TL, et al. Pyridostigmine treatment trial in neurogenic orthostatic hypotension. Arch Neurol 2006; 63: 513-518. 3) Berganzo K, Díez-Arrola B, Tijero B, et al. Nocturnal hypertension and dysautonomia in patients with Parkinson’s disease: are they related? J Neurol 2013; 260: 1752-1756. 21) 岡, 尚省．特集I 自律神経機能のみかた―心血管系のみかた―．神経内科 2018; 89: 333-341. 25) Rocchi C, Pierantozzi M, Pisani V, et al. The impact of rotigotine on cardiovascular autonomic function in early Parkinson’s disease. Eur Neurol 2012; 68: 187-192. 4) Cash R, Dennis T, L’Heureux R, et al. Parkinson’s disease and dementia: norepinephrine and dopamine in locus ceruleus. Neurology 1987; 37: 42-46. 5) Centi J, Freeman R, Gibbons CH, et al. Effects of orthostatic hypotension on cognition in Parkinson disease. Neurology 2017; 88: 17-24. 29) Tanaka R, Shimo Y, Yamashiro K, et al. Association between abnormal nocturnal blood pressure profile and dementia in Parkinson’s disease. Parkinsonism Relat Disord 2018; 46: 24-29. 19) McDonald C, Newton JL, Burn DJ. Orthostatic hypotension and cognitive impairment in Parkinson’s disease: Causation or association? Mov Disord 2016; 31: 937-946. 31) Umehara T, Matsuno H, Toyoda C, et al. Clinical characteristics of supine hypertension in de novo Parkinson disease. Clin Auton Res 2016; 26: 15-21. 17) Lim SY, Lang AE. The nonmotor symptoms of Parkinson’s disease—an overview. Mov Disord 2010; 25 (Suppl. 1): S123-S130. 1) Allcock LM, Kenny RA, Burn DJ. Clinical phenotype of subjects with Parkinson’s disease and orthostatic hypotension: autonomic symptom and demographic comparison. Mov Disord 2006; 21: 1851-1855. 13) Hely MA, Morris JG, Reid WG, et al. Sydney Multicenter Study of Parkinson’s disease: non-L-dopa-responsive problems dominate at 15 years. Mov Disord 2005; 20: 190-199. 2) Bédard MA, el Massioui F, Malapani C, et al. Attentional deficits in Parkinson’s disease: partial reversibility with naphtoxazine (SDZ NVI-085), a selective noradrenergic alpha 1 agonist. Clin Neuropharmacol 1998; 21: 108-117. 15) Kohara K, Jiang Y, Igase M, et al. Postprandial hypotension is associated with asymptomatic cerebrovascular damage in essential hypertensive patients. Hypertension 1999; 33: 565-568. 22) Palma JA, Gomez-Esteban JC, Norcliffe-Kaufmann L, et al. Orthostatic hypotension in Parkinson disease: how much you fall or how low you go? Mov Disord 2015; 30: 639-645. 7) Dayan P, Yu AJ. Phasic norepinephrine: a neural interrupt signal for unexpected events. Network 2006; 17: 335-350. 24) Robbins TW. From arousal to cognition: the integrative position of the prefrontal cortex. Prog Brain Res 2000; 126: 469-483. 10) Goldstein DS. Orthostatic hypotension as early finding in Parkinson’s disease. Clin Auton Res 2006; 16: 46-54. 18) Matsui H, Udaka F, Miyoshi T, et al. Three-dimensional stereotactic surface projection study of orthostatic hypotension and brain perfusion image in Parkinson’s disease. Acta Neurol Scand 2005; 112: 36-41. 30) Umehara T, Toyoda C, Oka H. Postprandial hypotension in de novo Parkinson’s disease: a comparison with orthostatic hypotension. Parkinsonism Relat Disord 2014; 20: 573-577. 26) Sara SJ. The locus coeruleus and noradrenergic modulation of cognition. Nat Rev Neurosci 2009; 10: 211-223. 11) Goldstein DS, Holmes C, Sharabi Y, et al. Survival in synucleinopathies: A prospective cohort study. Neurology 2015; 85: 1554-1561. 6) Chobanian AV, Bakris GL, Black HR, et al. Seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Hypertension 2003; 42: 1206-1252. 28) Sterpenich V, D’Argembeau A, Desseilles M, et al. The locus ceruleus is involved in the successful retrieval of emotional memories in humans. J Neurosci 2006; 26: 7416-7423. 8) Fanciulli A, Jordan J, Biaggioni I, et al. Consensus statement on the definition of neurogenic supine hypertension in cardiovascular autonomic failure by the American Autonomic Society (AAS) and the European Federation of Autonomic Societies (EFAS): Endorsed by the European Academy of Neurology (EAN) and the European Society of Hypertension (ESH). Clin Auton Res 2018; 28: 355-362. 9) Goldstein DS, Eldadah BA, Holmes C, et al. Neurocirculatory abnormalities in Parkinson disease with orthostatic hypotension: independence from levodopa treatment. Hypertension 2005; 46: 1333-1339. 16) Kövari E, Gold G, Herrmann FR, et al. Lewy body densities in the entorhinal and anterior cingulate cortex predict cognitive deficits in Parkinson’s disease. Acta Neuropathol 2003; 106: 83-88. 14) Hohler AD, Zuzuarregui JR, Katz DI, et al. Differences in motor and cognitive function in patients with Parkinson’s disease with and without orthostatic hypotension. Int J Neurosci 2012; 122: 233-236. 12) Haubrich C, Pies K, Dafotakis M, et al. Transcranial Doppler monitoring in Parkinson’s disease: cerebrovascular compensation of orthostatic hypotension. Ultrasound Med Biol 2010; 36: 1581-1587. 23) Rascol O, Perez-Lloret S, Damier P, et al. Falls in ambulatory non-demented patients with Parkinson’s disease. J Neural Transm 2015; 122: 1447-1455. |
| References_xml | – reference: 9) Goldstein DS, Eldadah BA, Holmes C, et al. Neurocirculatory abnormalities in Parkinson disease with orthostatic hypotension: independence from levodopa treatment. Hypertension 2005; 46: 1333-1339. – reference: 20) Oka H, Nakahara A, Umehara T. Rotigotine improves abnormal circadian rhythm of blood pressure in Parkinson’s disease. Eur Neurol 2018; 79: 281-286. – reference: 8) Fanciulli A, Jordan J, Biaggioni I, et al. Consensus statement on the definition of neurogenic supine hypertension in cardiovascular autonomic failure by the American Autonomic Society (AAS) and the European Federation of Autonomic Societies (EFAS): Endorsed by the European Academy of Neurology (EAN) and the European Society of Hypertension (ESH). Clin Auton Res 2018; 28: 355-362. – reference: 26) Sara SJ. The locus coeruleus and noradrenergic modulation of cognition. Nat Rev Neurosci 2009; 10: 211-223. – reference: 28) Sterpenich V, D’Argembeau A, Desseilles M, et al. The locus ceruleus is involved in the successful retrieval of emotional memories in humans. J Neurosci 2006; 26: 7416-7423. – reference: 23) Rascol O, Perez-Lloret S, Damier P, et al. Falls in ambulatory non-demented patients with Parkinson’s disease. J Neural Transm 2015; 122: 1447-1455. – reference: 25) Rocchi C, Pierantozzi M, Pisani V, et al. The impact of rotigotine on cardiovascular autonomic function in early Parkinson’s disease. Eur Neurol 2012; 68: 187-192. – reference: 21) 岡, 尚省．特集I 自律神経機能のみかた―心血管系のみかた―．神経内科 2018; 89: 333-341. – reference: 12) Haubrich C, Pies K, Dafotakis M, et al. Transcranial Doppler monitoring in Parkinson’s disease: cerebrovascular compensation of orthostatic hypotension. Ultrasound Med Biol 2010; 36: 1581-1587. – reference: 13) Hely MA, Morris JG, Reid WG, et al. Sydney Multicenter Study of Parkinson’s disease: non-L-dopa-responsive problems dominate at 15 years. Mov Disord 2005; 20: 190-199. – reference: 19) McDonald C, Newton JL, Burn DJ. Orthostatic hypotension and cognitive impairment in Parkinson’s disease: Causation or association? Mov Disord 2016; 31: 937-946. – reference: 24) Robbins TW. From arousal to cognition: the integrative position of the prefrontal cortex. Prog Brain Res 2000; 126: 469-483. – reference: 5) Centi J, Freeman R, Gibbons CH, et al. Effects of orthostatic hypotension on cognition in Parkinson disease. Neurology 2017; 88: 17-24. – reference: 15) Kohara K, Jiang Y, Igase M, et al. Postprandial hypotension is associated with asymptomatic cerebrovascular damage in essential hypertensive patients. Hypertension 1999; 33: 565-568. – reference: 16) Kövari E, Gold G, Herrmann FR, et al. Lewy body densities in the entorhinal and anterior cingulate cortex predict cognitive deficits in Parkinson’s disease. Acta Neuropathol 2003; 106: 83-88. – reference: 14) Hohler AD, Zuzuarregui JR, Katz DI, et al. Differences in motor and cognitive function in patients with Parkinson’s disease with and without orthostatic hypotension. Int J Neurosci 2012; 122: 233-236. – reference: 31) Umehara T, Matsuno H, Toyoda C, et al. Clinical characteristics of supine hypertension in de novo Parkinson disease. Clin Auton Res 2016; 26: 15-21. – reference: 4) Cash R, Dennis T, L’Heureux R, et al. Parkinson’s disease and dementia: norepinephrine and dopamine in locus ceruleus. Neurology 1987; 37: 42-46. – reference: 30) Umehara T, Toyoda C, Oka H. Postprandial hypotension in de novo Parkinson’s disease: a comparison with orthostatic hypotension. Parkinsonism Relat Disord 2014; 20: 573-577. – reference: 22) Palma JA, Gomez-Esteban JC, Norcliffe-Kaufmann L, et al. Orthostatic hypotension in Parkinson disease: how much you fall or how low you go? Mov Disord 2015; 30: 639-645. – reference: 10) Goldstein DS. Orthostatic hypotension as early finding in Parkinson’s disease. Clin Auton Res 2006; 16: 46-54. – reference: 18) Matsui H, Udaka F, Miyoshi T, et al. Three-dimensional stereotactic surface projection study of orthostatic hypotension and brain perfusion image in Parkinson’s disease. Acta Neurol Scand 2005; 112: 36-41. – reference: 17) Lim SY, Lang AE. The nonmotor symptoms of Parkinson’s disease—an overview. Mov Disord 2010; 25 (Suppl. 1): S123-S130. – reference: 1) Allcock LM, Kenny RA, Burn DJ. Clinical phenotype of subjects with Parkinson’s disease and orthostatic hypotension: autonomic symptom and demographic comparison. Mov Disord 2006; 21: 1851-1855. – reference: 7) Dayan P, Yu AJ. Phasic norepinephrine: a neural interrupt signal for unexpected events. Network 2006; 17: 335-350. – reference: 3) Berganzo K, Díez-Arrola B, Tijero B, et al. Nocturnal hypertension and dysautonomia in patients with Parkinson’s disease: are they related? J Neurol 2013; 260: 1752-1756. – reference: 6) Chobanian AV, Bakris GL, Black HR, et al. Seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Hypertension 2003; 42: 1206-1252. – reference: 29) Tanaka R, Shimo Y, Yamashiro K, et al. Association between abnormal nocturnal blood pressure profile and dementia in Parkinson’s disease. Parkinsonism Relat Disord 2018; 46: 24-29. – reference: 11) Goldstein DS, Holmes C, Sharabi Y, et al. Survival in synucleinopathies: A prospective cohort study. Neurology 2015; 85: 1554-1561. – reference: 2) Bédard MA, el Massioui F, Malapani C, et al. Attentional deficits in Parkinson’s disease: partial reversibility with naphtoxazine (SDZ NVI-085), a selective noradrenergic alpha 1 agonist. Clin Neuropharmacol 1998; 21: 108-117. – reference: 27) Singer W, Sandroni P, Opfer-Gehrking TL, et al. Pyridostigmine treatment trial in neurogenic orthostatic hypotension. Arch Neurol 2006; 63: 513-518. |
| SSID | ssib044742883 ssib057928700 ssib058493109 ssib000872198 ssj0003314381 |
| Score | 1.7857888 |
| Snippet | ... |
| SourceID | jstage |
| SourceType | Publisher |
| StartPage | 2 |
| SubjectTerms | Parkinson 臥位性高血圧 認知機能障害 起立性低血圧 食事性低血圧 |
| Title | Parkinson病の自律神経障害と認知機能障害 |
| URI | https://www.jstage.jst.go.jp/article/ans/57/1/57_2/_article/-char/ja |
| Volume | 57 |
| hasFullText | 1 |
| inHoldings | 1 |
| isFullTextHit | |
| isPrint | |
| ispartofPNX | 自律神経, 2020, Vol.57(1), pp.2-6 |
| link | http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwnV29b9QwFI9OZWFBIEB8qwMecyT-iO0xybmqkMp0SN2i-JwMNxQE14WhUoUQAzAjIUSnStChC2KEf6Yqd_wB7LyXrwuiw9HFct695zznPdm_57OfPe9-4EqpbBH43NLC5zrK_VwK6ocOwrjc6UnhcGlg61G0-Zg_3Bbbg8Hv3q6l3ZkdTl6cea7kPFYFGtgVT8n-h2W7RoEAdbAvlGBhKFeyMR5Zrk9vGUm0JEoQwwAbktgQowjE-XFMjCCJISpBnlgQbbCSCKJSYjTRMdEp8oBIwlpxheIgq0ZVyxsoaCISa6xjy4wko3_F-0h3FQVaa1cslMQhGrx6CLBlfHVKVLhkAxVo1UuQNqhLxR-RRLZvbxYwaNA5G_6uZdMDaC9OV_s20KcRiSNiOElSUKc3ZFLwEE3rVLbDoqJRzrgP45roj_l1Uuy_fLsZwHtIIDprioEBUNIqufLzoZDDMAsCupxLux2OjU9kwJYJmYVY0Kyl4om6bAqw_gKVMsSdqFt7pofKICxfRsGcS453QrfPQmr8d7obZgFCatYmzUcAwhjeaV_dFdl-jzq7bKX7g77mgLumEIW0OxgrUDW-7F1qoqH1uFb4ijeY5le9qHPr-ftXJ_vHi9dHpz_ezA8_zb-9_fXh4-nx15P9z4ujd_ODw59fDhYvv9fEa954w4zTTb-53sOfAmbNfVe4kgVOWwUgnOU2kA6vQ7POhSy0BbXSaZUDXSCMFaUSWlsbWG1dkBeaXffWdp7sFDe8dRsBc-4ULScRL22pJmVY8Fxpy_ISJvCbHq97mT2tU7hkK5nn1vnEbnsX0c3rdbo73trs2W5xF5DrzN6r7PwHBwmDGQ |
| linkProvider | ISSN International Centre |
| openUrl | ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=Parkinson%E7%97%85%E3%81%AE%E8%87%AA%E5%BE%8B%E7%A5%9E%E7%B5%8C%E9%9A%9C%E5%AE%B3%E3%81%A8%E8%AA%8D%E7%9F%A5%E6%A9%9F%E8%83%BD%E9%9A%9C%E5%AE%B3&rft.jtitle=%E8%87%AA%E5%BE%8B%E7%A5%9E%E7%B5%8C&rft.au=%E5%B2%A1%2C+%E5%B0%9A%E7%9C%81&rft.au=%E6%A2%85%E5%8E%9F%2C+%E6%B7%B3&rft.date=2020&rft.pub=%E6%97%A5%E6%9C%AC%E8%87%AA%E5%BE%8B%E7%A5%9E%E7%B5%8C%E5%AD%A6%E4%BC%9A&rft.issn=0288-9250&rft.eissn=2434-7035&rft.volume=57&rft.issue=1&rft.spage=2&rft.epage=6&rft_id=info:doi/10.32272%2Fans.57.1_002&rft.externalDocID=article_ans_57_1_57_2_article_char_ja |
| thumbnail_l | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/lc.gif&issn=0288-9250&client=summon |
| thumbnail_m | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/mc.gif&issn=0288-9250&client=summon |
| thumbnail_s | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/sc.gif&issn=0288-9250&client=summon |