Impaired cardiovascular autonomic function in Parkinson's disease with visual hallucinations

✍ Scribed by Hisayoshi Oka; Masayuki Yoshioka; Kenji Onouchi; Masayo Morita; Soichiro Mochio; Masahiko Suzuki; Toshiaki Hirai; Mitsuyoshi Urashima; Kiyoharu Inoue

• Publisher: John Wiley and Sons
• Year: 2007
• Tongue: English
• Weight: 68 KB
• Volume: 22
• Category: Article
• ISSN: 0885-3185
• DOI: 10.1002/mds.21581

✦ Synopsis

Abstract

We assessed the relations of visual hallucinations (VH) to cardiovascular autonomic dysfunction in patients with Parkinson's disease (PD). The subjects were 37 patients without VH (VH(−)) and 31 with VH (VH(+)). Autonomic function was evaluated on the basis of cardiac 123‐radioiodinated metaiodobenzylguanidine (^123^I‐MIBG) uptake and hemodynamic testing with Valsalva maneuver. Systolic blood pressure (SBP) and plasma norepinephrine concentrations (NE) were measured by tilt‐table testing. ^123^I‐MIBG uptake was lower in VH(+) than VH(−). Hemodynamic studies showed that VH(−) had only cardiac sympathetic and parasympathetic dysfunction, while VH(+) additionally had reduced vasomotor sympathetic functions. The fall in SBP during tilt‐table testing was greater in VH(+) than VH(−). NE and its difference in the supine and upright positions were decreased in VH(+). We conclude that cardiac and vasomotor sympathetic dysfunction is more severe in VH(+) than in VH(−). Severe dysfunction in PD with VH is probably attributed to Lewy‐body lesions or neuronal loss in sympathetic ganglia, the central autonomic system, or both. © 2007 Movement Disorder Society