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BMC Neurology
Published in: BMC Neurology 1/2020

01-12-2020 | Constipation | Research article

Comparisons of cardiovascular dysautonomia and cognitive impairment between de novo Parkinson’s disease and de novo dementia with Lewy bodies

Authors: Hisayoshi Oka, Tadashi Umehara, Atsuo Nakahara, Hiromasa Matsuno

Published in: BMC Neurology | Issue 1/2020

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Abstract

Background

Cognitive impairment may be correlated with cardiovascular dysautonomia, including blood pressure (BP) dysregulation, in Parkinson’s disease (PD), but the association between these factors in dementia with Lewy bodies (DLB) is uncertain. This study aimed to clarify whether cardiovascular dysautonomia had an influence on cognitive function in Lewy body disease or not.

Methods

Ninty-nine patients with de novo PD (n = 75) and DLB (n = 24) were evaluated using the Mini-Mental State Examination (MMSE) and Frontal Assessment Battery (FAB). Cardiac 123I-metaiodobenzylguanidine (MIBG) scintigraphy, orthostatic hypotension (OH), supine hypertension (SH), postprandial hypotension (PPH), nocturnal BP fall in 24-h ambulatory blood pressure monitoring (ABPM) and constipation were estimated. Associations of these factors with cognitive and executive dysfunction were examined.

Results

In DLB, MIBG uptake was reduced and OH, PPH and SH were severely disturbed, compared to PD. The nocturnal BP fall in ABPM was lower in DLB, and the failure of nocturnal BP fall in PD was associated with MMSE, after adjustment for other clinical features. FAB was significantly associated nocturnal BP fall, age and SH in PD, but no significant correlations among factors were found for DLB.

Conclusion

The significant association between nocturnal BP dysregulation and cognitive or executive decline in PD might be due to impaired microvascular circulation or invasion of α-synuclein in the CNS. The lack of a correlation of BP insufficiency with cognitive impairment in DLB suggests initial involvement of Lewy body pathology in the neocortex, regardless of Lewy body invasion of the autonomic nervous system.
Literature
1.
Goldstein DS. Orthostatic hypotension as an early finding in Parkinson disease. Clin Auton Res. 2006;16:46–54.PubMedCrossRef
2.
3.
Perlmuter LC, Sarda G, Casavant V, Mosnaim AD. A review of orthostatic blood pressure regulation and its association with mood and cognition. Clin Auton Res. 2012;22:99–107.PubMedCrossRef
4.
De Pablo-Fernandez E, Tur C, Revesz T, Lees AJ, Holton JJ, Warner TT. Association of autonomic dysfunction with disease progression and survival in Parkinson disease. JAMA Neurol. 2017;74:970–6.PubMedPubMedCentralCrossRef
5.
Allcock LM, Kenny RA, Mosimann UP, Tordoff S, Wesnes KA, Hildreth AJ, Burn DJ. Orthostatic hypotension in Parkinson’s disease: association with cognitive decline? Int J Geriatr Psychiatry. 2006;21:778–83.PubMedCrossRef
6.
Hohler AD, Zuzuárregui JR, Katz DI, Depiero TJ, Hehl CL, Leonard A, Allen V, Dentino J, Gardner M, Phenix H, Saint-Hilaire M, Ellis T. Differences in motor and cognitive function in patients with Parkinson’s disease with and without orthostatic hypotension. Int J Neurosci. 2012;122:233–6.PubMedCrossRef
7.
McDonald C, Newton JL, Burn DJ. Orthostatic hypotension and cognitive impairment in Parkinson's disease: causation or association? Mov Disord. 2016;31:937–46.PubMedCrossRef
8.
Guo H, Tabara Y, Igase M, Yamamoto M, Ochi N, Kido T, Uetani E, Taguchi K, Miki T, Kohara K. Abnormal nocturnal blood pressure profile is associated with mild cognitive impairment in the elderly: the J-SHIPP study. Hypertens Res. 2010;33:32–6.PubMedCrossRef
9.
Komori T, Eguchi K, Saito T, Nishimura Y, Hoshide S, Kario K. Riser blood pressure pattern is associated with mild cognitive impairment in heart failure patients. Am J Hypertens. 2016;29:194–201.PubMedCrossRef
10.
Alpérovitch A, Blachier M, Soumaré A, Ritchie K, Dartigues JF, Richard-Harston S, Tzourio C. Blood pressure variability and risk of dementia in an elderly cohort, the Three-City study. Alzheimers Dement. 2014;10:S330–7.PubMedCrossRef
11.
Kim JS, Oh YS, Lee KS, Kim YI, Yang DW, Goldstein DS. Association of cognitive dysfunction with neurocirculatory abnormalities in early Parkinson disease. Neurology. 2012;79:1323–31.PubMedPubMedCentralCrossRef
12.
Svenningsson P, Westman E, Ballard C, Aarsland D. Cognitive impairment in patients with Parkinson's disease: diagnosis, biomarkers, and treatment. Lancet Neurol. 2012;11:697–707.PubMedCrossRef
13.
Tanaka R, Shimo Y, Yamashiro K, Ogawa T, Nishioka K, Oyama G, Umemura A, Hattori N. Association between abnormal nocturnal blood pressure profile and dementia in Parkinson's disease. Parkinsonism Relat Disord. 2018;46:24–9.PubMedCrossRef
14.
Akaogi Y, Asahina M, Yamanaka Y, Koyama Y, Hattori T. Sudomotor, skin vasomotor, and cardiovascular reflexes in 3 clinical forms of Lewy body disease. Neurology. 2009;73:59–65.PubMedCrossRef
15.
Benarroch EE, Schmeichel AM, Low PA, Boeve BF, Sandroni P, Parisi JE. Involvement of medullary regions controlling sympathetic output in Lewy body disease. Brain. 2005;128:338–44.PubMedCrossRef
16.
Hughes AJ, Daniel SE, Kilford L, Lees AJ. Accuracy of clinical diagnosis of idiopathic Parkinson’s disease. A clinicopathological study of 100 cases. J Neurol Neurosurg Psychiatry. 1992;55:181–4.PubMedPubMedCentralCrossRef
17.
McKeith IG, Boeve BF, Dickson DW, Halliday G, Taylor JP, Weintraub D, Aarsland D, et al. Diagnosis and management of dementia with Lewy bodies: fourth consensus report of the DLB consortium. Neurology. 2017;89:88–100.PubMedPubMedCentralCrossRef
18.
Spiegel J, Hellwig D, Samnick S, Jost W, Möllers MO, Fassbender K, Kirsch CM, Dillmann U. Striatal FP-CIT uptake differs in the subtypes of early Parkinson’s disease. J Neural Transm. 2007;114:331–5.PubMedCrossRef
19.
Oka H, Toyoda C, Yogo M, Mochio S. Cardiovascular dysautonomia in de novo Parkinson’s disease without orthostatic hypotension. Eur J Neurol. 2011;18:286–92.PubMedCrossRef
20.
Oka H, Toyoda C, Yogo M, Mochio S. Olfactory dysfunction and cardiovascular dysautonomia in Parkinson’s disease. J Neurol. 2010;257:969–76.PubMedCrossRef
21.
Ogihara H, Kobayashi M, Nishida K, Kitano M, Takeuchi K. Applicability of the cross-culturally modified University of Pennsylvania Smell Identification Test in a Japanese population. Am J Rhinol Allergy. 2011;25:404–10.PubMedCrossRef
22.
Hashimoto Y, Fukazawa K, Fujii M, Takayasu S, Muto T, Saito S, Takashima Y, Sakagami M. Usefulness of the odor stick identification test for Japanese patients with olfactory dysfunction. Chem Senses. 2004;29:565–71.PubMedCrossRef
23.
Umehara T, Toyoda C, Oka H. Postprandial hypotension in de novo Parkinson’s disease: a comparison with orthostatic hypotension. Parkinsonism Relat Disord. 2014;20:573–7.PubMedCrossRef
24.
Kaufmann H. Consensus statement on the definition of orthostatic hypotension, pure autonomic failure and multiple system atrophy. Clin Auton Res. 1996;6:125–6.PubMedCrossRef
25.
Umehara T, Matsuno H, Toyoda C, Oka H. Clinical characteristics of supine hypertension in de novo Parkinson disease. Clin Auton Res. 2016;26:15–21.PubMedCrossRef
26.
Fanciulli A, Jordan J, Biaggioni I, Calandra-Buonaura G, Cheshire WP, Cortelli P, Eschlboeck S, 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;28:355–62.PubMedPubMedCentralCrossRef
27.
Manabe Y, Fujii D, Kono S, Sakai Y, Tanaka T, Narai H, Omori N, Imai Y, Abe K. Systemic blood pressure profile correlates with cardiac 123I-MIBG uptake in patients with Parkinson's disease. J Neurol Sci. 2011;307:153–6.PubMedCrossRef
28.
Oka H, Nakahara A, Umehara T. Rotigotine improves abnormal circadian rhythm of blood pressure in Parkinson's disease. Eur Neurol. 2018;79:281–6.PubMedCrossRef
29.
Umehara T, Nakahara A, Matsuno H, Toyoda C, Oka H. Predictors of postprandial hypotension in elderly patients with de novo Parkinson's disease. J Neural Transm (Vienna). 2016;123:1331–9.CrossRef
30.
Umehara T, Oka H, Nakahara A, Matsuno H, Toyoda C. High norepinephrinergic orthostatic hypotension in early Parkinson's disease. Parkinsonism Relat Disord. 2018;55:97–102.PubMedCrossRef
31.
Marozzi M. The Lepage location-scale test revisited. Far East J Theor Stat. 2008;24:137–55.
32.
Bohnen NI, Müller ML, Kotagal V, Koeppe RA, Kilbourn MA, Albin RL, Frey KA. Olfactory dysfunction, central cholinergic integrity and cognitive impairment in Parkinson’s disease. Brain. 2010;133:1747–54.PubMedPubMedCentralCrossRef
33.
Nelson PT, Schmitt FA, Jicha GA, Kryscio RJ, Abner EL, Smith CD, Van Eldik LJ, et al. Association between male gender and cortical Lewy body pathology in large autopsy series. J Neurol. 2010;257:1875–81.PubMedPubMedCentralCrossRef
34.
Baba T, Kikuchi A, Hirayama K, Nishio Y, Hosokai Y, Kanno S, Hasegawa T, Sugeno N, Konno M, Suzuki K, Takahashi S, Fukuda H, Aoki M, Itoyama Y, Mori E, Takeda A. Severe olfactory dysfunction is a prodromal symptom of dementia associated with Parkinson’s disease: a 3 year longitudinal study. Brain. 2012;135:161–9.PubMedCrossRef
35.
Berganzo K, Diez-Arrola B, Tijero B, Somme J, Lezcano E, Llorens V, Ugarriza I, Ciordia R, Gómez-Esteban JC, Zarranz JJ. Nocturnal hypertension and dysautonomia in patients with Parkinson's disease: are they related? J Neurol. 2013;260:1752–6.PubMedCrossRef
36.
Milazzo V, Di Stefano C, Vallelonga F, Sobrero G, Zibetti M, Romagnolo A, Merola A, Milan A, Espay AJ, Lopiano L, Veglio F, Maule S. Reverse blood pressure dipping as marker of dysautonomia in Parkinson disease. Parkinsonism Relat Disord. 2018;56:82–7.PubMedCrossRef
37.
Del Pino R, Murueta-Goyena A, Acera M, Carmona-Abellan M, Tijero B, Lucas-Jiménez O, Ojeda N, et al. Autonomic dysfunction is associated with neuropsychological impairment in Lewy body disease. J Neurol. 2020;267:1941–1951.37.PubMedCrossRef
38.
Braak H, Tredici KD, Rüb U, de Vos RAI, Jansen Steur ENH, Braak E. Staging of brain pathology related to sporadic Parkinson’s disease. Neurobiol Aging. 2003;24:197–211.PubMedCrossRef
39.
Kövari E, Gold G, Herrmann F, Canuto A, Hof PR, Bouras C, Giannakopoulos P. Lewy body densities in the entorhinal and anterior cingulate cortex predict cognitive deficits in Parkinson’s disease. Acta Neuropathol. 2003;106:83–8.PubMedCrossRef
40.
Matsui H, Udaka F, Miyoshi T, Hara N, Tamura A, Oda M, Kubori T, Nishinaka K, Kameyama M. Three-dimensional stereotactic surface projection study of orthostatic hypotension and brain perfusion image in Parkinson’s disease. Acta Neurol Scand. 2005;112:36–41.PubMedCrossRef
41.
Del Tredici K, Braak H. Dysfunction of the locus coeruleus norepinephrine system and related circuitry in Parkinson’s disease related dementia. J Neurol Neurosurg Psychiatry. 2013;84:774–83.PubMedCrossRef
42.
43.
Gall AJ, Todd WD, Blumberg MS. Development of SCN connectivity and the circadian control of arousal: a diminishing role for humoral factors? PLoS One. 2012;7:e45338.PubMedPubMedCentralCrossRef
44.
Schmidt R, Ropele S, Enzinger C, Petrovic K, Smith S, Schmidt H, Matthews PM, Fazekas F. White matter lesion progression, brain atrophy, and cognitive decline: the Austrian stroke prevention study. Ann Neurol. 2005;58:610–6.PubMedCrossRef
45.
Van Den Heuvel DMJ, Ten Dam VH, De Craen AJM, Admiraal-Behloul F, Olofsen H, Bollen EL, Jolles J, Murray HM, Blauw GJ, Westendorp RG, van Buchem MA. Increase in periventricular white matter hyperintensities parallels decline in mental processing speed in a non-demented elderly population. J Neurol Neurosurg Psychiatry. 2006;77:149–53.PubMedPubMedCentralCrossRef
46.
Walker L, McAleese KE, Thomas AJ, Johnson M, Martin-Ruiz C, Parker C, et al. Neuropathologically mixed Alzheimer's and Lewy body disease: burden of pathological protein aggregates differs between clinical phenotypes. Acta Neuropathol. 2015;129:729–48.PubMedCrossRef
47.
Hepp DH, Vergoossen DL, Huisman E, Lemstra AW, Netherlands Brain Bank, Berendse HW, et al. Distribution and load of amyloid-β pathology in Parkinson disease and dementia with Lewy bodies. J Neuropathol Exp Neurol. 2016;75:936–45.PubMedCrossRef
48.
Walker L, Stefanis L, Attems J. Clinical and neuropathological differences between Parkinson's disease, Parkinson's disease dementia, and dementia with Lewy bodies - current issues and future directions. J Neurochem. 2019. https://​doi.​org/​10.​1111/​jnc.​14698 [Epub ahead of print].
49.
Kim JS, Park HE, Oh YS, Song IU, Yang DW, Park JW, et al. 123I-MIBG myocardial scintigraphy and neurocirculatory abnormalities in patients with dementia with Lewy bodies and Alzheimer's disease. J Neurol Sci. 2015;357:173–7.PubMedCrossRef
Metadata
Title
Comparisons of cardiovascular dysautonomia and cognitive impairment between de novo Parkinson’s disease and de novo dementia with Lewy bodies
Authors
Hisayoshi Oka
Tadashi Umehara
Atsuo Nakahara
Hiromasa Matsuno
Publication date
01-12-2020
Publisher
BioMed Central
Published in
BMC Neurology / Issue 1/2020
Electronic ISSN: 1471-2377
DOI
https://doi.org/10.1186/s12883-020-01928-5

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