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01-11-2008 | Parkinson's Disease and Allied Conditions - Original Article

Baroreflex sensitivity and power spectral analysis in different extrapyramidal syndromes

Authors: C. Friedrich, H. Rüdiger, C. Schmidt, B. Herting, S. Prieur, S. Junghanns, K. Schweitzer, C. Globas, L. Schöls, D. Berg, H. Reichmann, T. Ziemssen

Published in: Journal of Neural Transmission | Issue 11/2008

Abstract

Cardiac autonomic abnormalities have been described in Parkinson’s disease and other extrapyramidal syndromes. To investigate baroreflex sensitivity as an important risk marker of cardiovascular mortality in patients with Parkinson’s disease and other extrapyramidal syndromes. We recorded continuously blood pressure, ECG and respiration in 35 patients with multiple system atrophy (MSA), 32 patients with progressive supranuclear palsy (PSP), 46 patients with idiopathic Parkinson’s disease (PD) and in 27 corresponding healthy subjects (Con). Recordings of 2 min at rest were used to calculate baroreflex and spectral analysis of heart rate and systolic blood pressure. Resting baroreflex sensitivity (BRS) was significantly lower in the MSA and the PSP group but not in the PD group in comparison to the Con group. With increasing Hoehn & Yahr stage, BRS significantly decreased in all patient groups. In spectral analysis, all patient groups had a significantly lower relative low frequency (LF)-band power than the healthy controls. Patients with extrapyramidal disorders frequently demonstrate pathologically decreased BRS values and abnormalities of spectral analysis. This may have fundamental impact on the cardiovascular prognosis of patients with extrapyramidal disease.

Appenzeller O, Goss JE (1971) Autonomic deficits in Parkinson’s syndrome. Arch Neurol 24:50–57PubMed

Ben-Shlomo Y, Marmot MG (1995) Survival and cause of death in a cohort of patients with Parkinsonism: possible clues to aetiology? J Neurol Neurosurg Psychiatry 58:293–299PubMedCrossRef

Bennett DA, Beckett LA, Murray AM, Shannon KM, Goetz CG, Pilgrim DM, Evans DA (1996) Prevalence of parkinsonian signs and associated mortality in a community population of older people. N Engl J Med 334:71–76PubMedCrossRef

Bouhaddi M, Vuillier F, Fortrat JO, Cappelle S, Henriet MT, Rumbach L, Regnard J (2004) Impaired cardiovascular autonomic control in newly and long-term-treated patients with Parkinson’s disease: involvement of L-dopa therapy. Auton Neurosci 116:30–38PubMedCrossRef

Braak H, Ghebremedhin E, Rub U, Bratzke H, Del Tredici K (2004) Stages in the development of Parkinson’s disease-related pathology. Cell Tissue Res 318:121–134PubMedCrossRef

Carney RM, Freedland KE, Veith RC (2005) Depression, the autonomic nervous system, and coronary heart disease. Psychosom Med 67(Suppl 1):S29–S33CrossRef

De Ferrari GM, Sanzo A, Bertoletti A, Specchia G, Vanoli E, Schwartz PJ (2007) Baroreflex sensitivity predicts long-term cardiovascular mortality after myocardial infarction even in patients with preserved left ventricular function. J Am Coll Cardiol 50:2285–2290PubMedCrossRef

Gilman S, Low PA, Quinn N, Albanese A, Ben-Shlomo Y, Fowler CJ, Kaufmann H, Klockgether T, Lang AE, Lantos PL, Litvan I, Mathias CJ, Oliver E, Robertson D, Schatz I, Wenning GK (1999) Consensus statement on the diagnosis of multiple system atrophy. J Neurol Sci 163:94–98PubMedCrossRef

Goldstein DS (2003) Dysautonomia in Parkinson’s disease: neurocardiological abnormalities. Lancet Neurol 2:669–676PubMedCrossRef

Goldstein DS (2007) Cardiac denervation in patients with Parkinson disease. Cleve Clin J Med 74(Suppl 1):S91–S94

Goldstein DS, Pechnik S, Holmes C, Eldadah B, Sharabi Y (2003) Association between supine hypertension and orthostatic hypotension in autonomic failure. Hypertension 42:136–142PubMedCrossRef

Goldstein DS, Sharabi Y, Karp BI, Bentho O, Saleem A, Pacak K, Eisenhofer G (2007) Cardiac sympathetic denervation preceding motor signs in Parkinson disease. Clin Auton Res 17:118–121PubMedCrossRef

Halliday GM, Li YW, Blumbergs PC, Joh TH, Cotton RG, Howe PR, Blessing WW, Geffen LB (1990) Neuropathology of immunohistochemically identified brainstem neurons in Parkinson’s disease. Ann Neurol 27:373–385PubMedCrossRef

Hilz MJ, Dutsch M (2006) Quantitative studies of autonomic function. Muscle Nerve 33:6–20PubMedCrossRef

Hughes AJ, Ben-Shlomo Y, Daniel SE, Lees AJ (2001) What features improve the accuracy of clinical diagnosis in Parkinson’s disease: a clinicopathologic study 1992. Neurology 57:S34–S38PubMed

Karemaker JM, Wesseling KH (2008) Variability in cardiovascular control: the baroreflex reconsidered. Cardiovasc Eng 8:23–29PubMedCrossRef

Kaufmann H (1996) Consensus statement on the definition of orthostatic hypotension, pure autonomic failure and multiple system atrophy. Clin Auton Res 6:125–126PubMedCrossRef

La Rovere MT (2000) Baroreflex sensitivity as a new marker for risk stratification. Z Kardiol 89(Suppl 3):44–50

Laude D, Elghozi JL, Girard A, Bellard E, Bouhaddi M, Castiglioni P, Cerutti C, Cividjian A, Di Rienzo M, Fortrat JO, Janssen B, Karemaker JM, Leftheriotis G, Parati G, Persson PB, Porta A, Quintin L, Regnard J, Rüdiger H, Stauss HM (2004) Comparison of various techniques used to estimate spontaneous baroreflex sensitivity (the EuroBaVar study). Am J Physiol Regul Integr Comp Physiol 286:R226–R231PubMed

Litvan I, Agid Y, Calne D, Campbell G, Dubois B, Duvoisin RC, Goetz CG, Golbe LI, Grafman J, Growdon JH, Hallett M, Jankovic J, Quinn NP, Tolosa E, Zee DS (1996) Clinical research criteria for the diagnosis of progressive supranuclear palsy (Steele-Richardson-Olszewski syndrome): report of the NINDS–SPSP international workshop. Neurology 47:1–9PubMedCrossRef

Malliani A, Montano N (2002) Heart rate variability as a clinical tool. Ital Heart J 3:439–445PubMed

Mathias CJ (1998) Cardiovascular autonomic dysfunction in parkinsonian patients. Clin Neurosci 5:153–166PubMed

Mesec A, Sega S, Kiauta T (1993) The influence of the type, duration, severity and levodopa treatment of Parkinson’s disease on cardiovascular autonomic responses. Clin Auton Res 3:339–344PubMedCrossRef

Moak JP, Goldstein DS, Eldadah BA, Saleem A, Holmes C, Pechnik S, Sharabi Y (2007) Supine low-frequency power of heart rate variability reflects baroreflex function, not cardiac sympathetic innervation. Heart Rhythm 4:1523–1529PubMedCrossRef

Oka H, Mochio S, Onouchi K, Morita M, Yoshioka M, Inoue K (2006a) Cardiovascular dysautonomia in de novo Parkinson’s disease. J Neurol Sci 241:59–65PubMedCrossRef

Oka H, Mochio S, Yoshioka M, Morita M, Inoue K (2003) Evaluation of baroreflex sensitivity by the sequence method using blood pressure oscillations and R–R interval changes during deep respiration. Eur Neurol 50:230–243PubMedCrossRef

Oka H, Mochio S, Yoshioka M, Morita M, Onouchi K, Inoue K (2006b) Cardiovascular dysautonomia in Parkinson’s disease and multiple system atrophy. Acta Neurol Scand 113:221–227PubMedCrossRef

Parati G, Di Rienzo M, Mancia G (2000) How to measure baroreflex sensitivity: from the cardiovascular laboratory to daily life. J Hypertens 18:7–19PubMed

Robinson TG, Dawson SL, Eames PJ, Panerai RB, Potter JF (2003) Cardiac baroreceptor sensitivity predicts long-term outcome after acute ischemic stroke. Stroke 34:705–712PubMedCrossRef

Rodriguez M, Sabate M, Troncoso E (1996) Time and frequency domain analysis for the assessment of heart autonomic control in Parkinson’s disease. J Neural Transm 103:447–454PubMedCrossRef

Rub U, Del Tredici K, Schultz C, de Vos RA, Jansen Steur EN, Arai K, Braak H (2002) Progressive supranuclear palsy: neuronal and glial cytoskeletal pathology in the higher order processing autonomic nuclei of the lower brainstem. Neuropathol Appl Neurobiol 28:12–22PubMedCrossRef

Rüdiger H, Klinghammer L, Scheuch K (1999) The trigonometric regressive spectral analysis—a method for mapping of beat-to-beat recorded cardiovascular parameters on to frequency domain in comparison with Fourier transformation. Comput Methods Programs Biomed 58:1–15PubMedCrossRef

Schmidt C, Herting B, Prieur S, Junghanns S, Schweitzer K, Globas C, Schols L, Antoni S, Ferger D, Reichmann H, Wilhelm H, Berg D, Ziemssen T (2007) Pupil diameter in darkness differentiates progressive supranuclear palsy (PSP) from other extrapyramidal syndromes. Mov Disord 22:2123–2126PubMedCrossRef

Schmidt C, Herting B, Prieur S, Junghanns S, Schweitzer K, Globas C, Schöls L, Reichmann H, Berg D, Ziemssen T (2008a) Autonomic dysfunction in different subtypes of multiple system atrophy. Mov Disord (in press)

Schmidt C, Herting B, Prieur S, Junghanns S, Schweitzer K, Reichmann H, Berg D, Ziemssen T (2008b) Cardiovascular autonomic dysfunction in patients with progressive supranuclear palsy (PSP). Mov Disord (in press)

Schwartz PJ (1998) The autonomic nervous system and sudden death. Eur Heart J 19(Suppl F):F72–F80

Szili-Torok T, Kalman J, Paprika D, Dibo G, Rozsa Z, Rudas L (2001) Depressed baroreflex sensitivity in patients with Alzheimer’s and Parkinson’s disease. Neurobiol Aging 22:435–438PubMedCrossRef

Wakabayashi K, Takahashi H (2006) Cellular pathology in multiple system atrophy. Neuropathology 26:338–345PubMedCrossRef

Ziemssen T, Gasch J, Rüdiger H (2008) Influence of ECG sampling frequency on spectral analysis of RR intervals and Baroreflex sensitivity using the EUROBAVAR data set. J Clin Monit Comput 22:159–168PubMedCrossRef

Ziemssen T, Reichmann H (2007) Non-motor dysfunction in Parkinson’s disease. Parkinsonism Relat Disord 13:323–332PubMedCrossRef

Title: Baroreflex sensitivity and power spectral analysis in different extrapyramidal syndromes
Authors: C. Friedrich
H. Rüdiger
C. Schmidt
B. Herting
S. Prieur
S. Junghanns
K. Schweitzer
C. Globas
L. Schöls
D. Berg
H. Reichmann
T. Ziemssen
Publication date: 01-11-2008
Publisher: Springer Vienna
Published in: Journal of Neural Transmission / Issue 11/2008
Print ISSN: 0300-9564
Electronic ISSN: 1435-1463
DOI: https://doi.org/10.1007/s00702-008-0127-3

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