Journal of Movement Disorders

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Orthostatic Hypotension and Cognitive Impairment in De Novo Patients with Parkinson’s Disease: Hyo-Jin Bae, Jun-Ho Lim, Sang-Myung Cheon; J Mov Disord. 2014;7(2):102-104. Published online October 30, 2014; DOI: https://doi.org/10.14802/jmd.14016

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Original Articles

Orthostatic Hypotension in Drug-Naïve Patients with Parkinson’s Disease: Hyo-Jin Bae, Sang-Myung Cheon, Jae Woo Kim; J Mov Disord. 2011;4(1):33-37.; DOI: https://doi.org/10.14802/jmd.11005

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Abstract PDF

Background and Purpose

Orthostatic hypotension (OH) is known to be present even in patients with early Parkinson’s disease (PD). To affirm the presence of OH and find correlation between OH and other dysautonomic symptoms in PD, this study has done in newly-diagnosed PD patients.

Methods

Forty-five non-demented patients with no prior history of treatment for PD were recruited (17 men, 63.8 ± 10.1 years of age). All the patients were evaluated for OH before starting medications. Autonomic symptoms were evaluated with structured questionnaires. Clinical characteristics of PD were evaluated (median Hoehn and Yahr stage 2.0 (1–3), 1.3 ± 1.1 years of disease duration), and comorbid medical conditions that could affect blood pressure were also recorded.

Results

OH was prevalent, and eighteen patients (40%) showed orthostatic hypotension, and twenty-seven (60%) did not (normotensive group). There was no significant difference in demographic and clinical characteristics between groups. The presence or severity of symptoms of autonomic dysfunction in the OH group also not differed from those of the normotensive group.

Conclusions

OH was prevalent even in the early stage of PD, and was not related to presence or severity of any other symptoms of autonomic dysfunction. Our findings suggest that clinicians should pay attention to OH from the early stage of disease.

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Central retinal microvasculature damage is associated with orthostatic hypotension in Parkinson’s disease
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Pronounced Orthostatic Hypotension in GBA-Related Parkinson’s Disease
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Delayed orthostatic hypotension in Parkinson’s disease
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Neurogenic orthostatic hypotension in early stage Parkinson's disease: New insights from the first 105 patients of the BoProPark study
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Prevalence and factors related to orthostatic syndromes in recently diagnosed, drug-naïve patients with Parkinson disease
Cecilia Quarracino, Matilde Otero-Losada, Francisco Capani, Santiago Pérez-Lloret
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Ylva Hivand Hiorth, Kenn Freddy Pedersen, Ingvild Dalen, Ole-Bjørn Tysnes, Guido Alves
Neurology.2019;[Epub] CrossRef
The range and nature of non-motor symptoms in drug-naive Parkinson’s disease patients: a state-of-the-art systematic review
Panagiotis Zis, Roberto Erro, Courtney C Walton, Anna Sauerbier, Kallol Ray Chaudhuri
npj Parkinson's Disease.2015;[Epub] CrossRef
Orthostatic Hypotension and Cognitive Impairment in <i>De Novo</i> Patients with Parkinson’s Disease
Hyo-Jin Bae, Jun-Ho Lim, Sang-Myung Cheon
Journal of Movement Disorders.2014; 7(2): 102. CrossRef

Autonomic Dysfunctions in Parkinsonian Disorders: Hyo-Jin Bae, Sang-Myung Cheon, Jae Woo Kim; J Mov Disord. 2009;2(2):72-77.; DOI: https://doi.org/10.14802/jmd.09019

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Abstract PDF

Background and Purpose:

Symptoms of autonomic dysfunctions are common in the patients with parkinsonian disorders. Because clinical features of autonomic dysfunctions are diverse, the comprehensive evaluation is essential for the appropriate management. For the appreciation of autonomic dysfunctions and the identification of differences, patients with degenerative parkinsonisms are evaluated using structured questionnaire for autonomic dysfunction (ADQ).

Methods:

Total 259 patients, including 192 patients with [idiopathic Parkinson’s disease (IPD, age 64.6 ± 9.6 years)], 37 with [multiple system atrophy (MSA, 62.8 ± 9.1)], 9 with [dementia with Lewy body (DLB, 73.9 ± 4.3)], and 21 with [progressive supranuclear palsy (PSP, 69.4 ± 9.6)]. The ADQ was structured for evaluation of the presence of symptoms and its severity due to autonomic dysfunction, covering gastrointestinal, urinary, sexual, cardiovascular and thermoregulatory domains. Patients were also evaluated for the orthostatic hypotension.

Results:

Although dementia with Lewy body (DLB) patients were oldest and duration of disease was longest in IPD, total ADQ scores of MSA and PSP (23.9 ± 12.6 and 21.1 ± 7.8) were significantly increased than that of IPD (15.1 ± 10.6). Urinary and cardiovascular symptom scores of MSA and gastrointestinal symptom score of PSP were significantly worse than those of IPD. The ratio of patient with orthostatic hypotension in IPD was 31.2% and not differed between groups (35.1% in MSA, 33.3% in DLB and 33.3% in PSP). But the systolic blood pressure dropped drastically after standing in patients with MSA and DLB than in patients with IPD and PSP.

Conclusions:

Patients with degenerative parkinsonism showed widespread symptoms of autonomic dysfunctions. The severity of those symptoms in patients with PSP were comparing to that of MSA patients and worse than that of IPD.

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