ParkinsonCanadaV1, Main, Exploration, bibRecord, 001489

The role of autonomic testing in the differentiation of Parkinson's disease from multiple system atrophy

Identifieur interne : 001489 ( Main/Exploration ); précédent : 001488; suivant : 001490

The role of autonomic testing in the differentiation of Parkinson's disease from multiple system atrophy

Auteurs : Kurt Kimpinski [Canada] ; Valeria Iodice [Royaume-Uni] ; Duane D. Burton [États-Unis] ; Michael Camilleri [États-Unis] ; Brian P. Mullan [États-Unis] ; Axel Lipp [Allemagne] ; Paola Sandroni [États-Unis] ; Tonette L. Gehrking [États-Unis] ; David M. Sletten [États-Unis] ; J. E. Ahlskog [États-Unis] ; Robert D. Fealey [États-Unis] ; Wolfgang Singer [États-Unis] ; Phillip A. Low [États-Unis]

Source :

Journal of the neurological sciences [ 0022-510X ] ; 2012.

RBID : Pascal:12-0205015

Descripteurs français

Pascal (Inist)
- Maladie de Parkinson, Atrophie multisystématisée, Pathologie du système nerveux, Scintigraphie, Réflexe, Dépistage.

English descriptors

KwdEn :
- Adult, Aged, Aged, 80 and over, Autonomic Nervous System Diseases (diagnosis), Autonomic Nervous System Diseases (physiopathology), Body Temperature Regulation (physiology), Diagnostic Techniques, Neurological (standards), Female, Humans, Male, Medical screening, Middle Aged, Multiple System Atrophy (diagnosis), Multiple System Atrophy (physiopathology), Multiple system atrophy, Nervous system diseases, Parkinson Disease (diagnosis), Parkinson Disease (physiopathology), Parkinson disease, Prospective Studies, Reflex, Reflex (physiology), Scintigraphy, Sweating (physiology).
MESH :
- diagnosis : Autonomic Nervous System Diseases, Multiple System Atrophy, Parkinson Disease.
- physiology : Body Temperature Regulation, Reflex, Sweating.
- physiopathology : Autonomic Nervous System Diseases, Multiple System Atrophy, Parkinson Disease.
- standards : Diagnostic Techniques, Neurological.
- Adult, Aged, Aged, 80 and over, Female, Humans, Male, Middle Aged, Prospective Studies.

Abstract

Differentiation of idiopathic Parkinson's disease (PD) from multiple system atrophy (MSA) can be difficult Methods devised to help distinguish the two disorders include standardized autonomic testing and cardiac imaging with iodine-123 meta-iodobenzylguanidine myocardial scintigraphy. MSA patients had more severe adrenergic and overall autonomic dysfunction when compared to control and PD patients. Area of anhidrosis on thermoregulatory sweat test was greater in MSA (67.4±12.42, p<0.001) versus PD patients (area of anhidrosis, 1.7±2.96). Postganglionic cardiac sympathetic innervation (iodine-123 meta-iodobenzylguanidine) expressed as heart to mediastinal ratio was significantly lower in Parkinson's disease patients (1.4 ± 0.40, p= 0.025) compared to controls (2.0 ± 0.29), but not in multiple system atrophy (2.0 ± 0.76). These findings indicate that autonomic dysfunction is generalized and predominantly preganglionic in multiple system atrophy, and postganglionic in Parkinson's disease. In our hands the thermoregulatory sweat test provides the best distinction between MSA and PD. However further confirmatory studies using larger patient numbers are required. Currently a combination of clinical judgment and autonomic testing is recommended to help differentiate MSA and PD.

Url:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3340456

Affiliations:

Allemagne, Canada, Royaume-Uni, États-Unis
Angleterre, Berlin, Grand Londres
Berlin, Londres

Le document en format XML

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<term>Autonomic Nervous System Diseases (diagnosis)</term>
<term>Autonomic Nervous System Diseases (physiopathology)</term>
<term>Body Temperature Regulation (physiology)</term>
<term>Diagnostic Techniques, Neurological (standards)</term>
<term>Female</term>
<term>Humans</term>
<term>Male</term>
<term>Medical screening</term>
<term>Middle Aged</term>
<term>Multiple System Atrophy (diagnosis)</term>
<term>Multiple System Atrophy (physiopathology)</term>
<term>Multiple system atrophy</term>
<term>Nervous system diseases</term>
<term>Parkinson Disease (diagnosis)</term>
<term>Parkinson Disease (physiopathology)</term>
<term>Parkinson disease</term>
<term>Prospective Studies</term>
<term>Reflex</term>
<term>Reflex (physiology)</term>
<term>Scintigraphy</term>
<term>Sweating (physiology)</term>
</keywords>
<keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>Autonomic Nervous System Diseases</term>
<term>Multiple System Atrophy</term>
<term>Parkinson Disease</term>
</keywords>
<keywords scheme="MESH" qualifier="physiology" xml:lang="en"><term>Body Temperature Regulation</term>
<term>Reflex</term>
<term>Sweating</term>
</keywords>
<keywords scheme="MESH" qualifier="physiopathology" xml:lang="en"><term>Autonomic Nervous System Diseases</term>
<term>Multiple System Atrophy</term>
<term>Parkinson Disease</term>
</keywords>
<keywords scheme="MESH" qualifier="standards" xml:lang="en"><term>Diagnostic Techniques, Neurological</term>
</keywords>
<keywords scheme="MESH" xml:lang="en"><term>Adult</term>
<term>Aged</term>
<term>Aged, 80 and over</term>
<term>Female</term>
<term>Humans</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Prospective Studies</term>
</keywords>
<keywords scheme="Pascal" xml:lang="fr"><term>Maladie de Parkinson</term>
<term>Atrophie multisystématisée</term>
<term>Pathologie du   système nerveux</term>
<term>Scintigraphie</term>
<term>Réflexe</term>
<term>Dépistage</term>
</keywords>
</textClass>
</profileDesc>
</teiHeader>
<front><div type="abstract" xml:lang="en">Differentiation of idiopathic Parkinson's disease (PD) from multiple system atrophy (MSA) can be difficult Methods devised to help distinguish the two disorders include standardized autonomic testing and cardiac imaging with iodine-123 meta-iodobenzylguanidine myocardial scintigraphy. MSA patients had more severe adrenergic and overall autonomic dysfunction when compared to control and PD patients. Area of anhidrosis on thermoregulatory sweat test was greater in MSA (67.4±12.42, p<0.001) versus PD patients (area of anhidrosis, 1.7±2.96). Postganglionic cardiac sympathetic innervation (iodine-123 meta-iodobenzylguanidine) expressed as heart to mediastinal ratio was significantly lower in Parkinson's disease patients (1.4 ± 0.40, p= 0.025) compared to controls (2.0 ± 0.29), but not in multiple system atrophy (2.0 ± 0.76). These findings indicate that autonomic dysfunction is generalized and predominantly preganglionic in multiple system atrophy, and postganglionic in Parkinson's disease. In our hands the thermoregulatory sweat test provides the best distinction between MSA and PD. However further confirmatory studies using larger patient numbers are required. Currently a combination of clinical judgment and autonomic testing is recommended to help differentiate MSA and PD.</div>
</front>
</TEI>
<affiliations><list><country><li>Allemagne</li>
<li>Canada</li>
<li>Royaume-Uni</li>
<li>États-Unis</li>
</country>
<region><li>Angleterre</li>
<li>Berlin</li>
<li>Grand Londres</li>
</region>
<settlement><li>Berlin</li>
<li>Londres</li>
</settlement>
</list>
<tree><country name="Canada"><noRegion><name sortKey="Kimpinski, Kurt" sort="Kimpinski, Kurt" uniqKey="Kimpinski K" first="Kurt" last="Kimpinski">Kurt Kimpinski</name>
</noRegion>
</country>
<country name="Royaume-Uni"><region name="Angleterre"><name sortKey="Iodice, Valeria" sort="Iodice, Valeria" uniqKey="Iodice V" first="Valeria" last="Iodice">Valeria Iodice</name>
</region>
</country>
<country name="États-Unis"><noRegion><name sortKey="Burton, Duane D" sort="Burton, Duane D" uniqKey="Burton D" first="Duane D." last="Burton">Duane D. Burton</name>
</noRegion>
<name sortKey="Ahlskog, J E" sort="Ahlskog, J E" uniqKey="Ahlskog J" first="J. E." last="Ahlskog">J. E. Ahlskog</name>
<name sortKey="Camilleri, Michael" sort="Camilleri, Michael" uniqKey="Camilleri M" first="Michael" last="Camilleri">Michael Camilleri</name>
<name sortKey="Fealey, Robert D" sort="Fealey, Robert D" uniqKey="Fealey R" first="Robert D." last="Fealey">Robert D. Fealey</name>
<name sortKey="Gehrking, Tonette L" sort="Gehrking, Tonette L" uniqKey="Gehrking T" first="Tonette L." last="Gehrking">Tonette L. Gehrking</name>
<name sortKey="Low, Phillip A" sort="Low, Phillip A" uniqKey="Low P" first="Phillip A." last="Low">Phillip A. Low</name>
<name sortKey="Mullan, Brian P" sort="Mullan, Brian P" uniqKey="Mullan B" first="Brian P." last="Mullan">Brian P. Mullan</name>
<name sortKey="Sandroni, Paola" sort="Sandroni, Paola" uniqKey="Sandroni P" first="Paola" last="Sandroni">Paola Sandroni</name>
<name sortKey="Singer, Wolfgang" sort="Singer, Wolfgang" uniqKey="Singer W" first="Wolfgang" last="Singer">Wolfgang Singer</name>
<name sortKey="Sletten, David M" sort="Sletten, David M" uniqKey="Sletten D" first="David M." last="Sletten">David M. Sletten</name>
</country>
<country name="Allemagne"><region name="Berlin"><name sortKey="Lipp, Axel" sort="Lipp, Axel" uniqKey="Lipp A" first="Axel" last="Lipp">Axel Lipp</name>
</region>
</country>
</tree>
</affiliations>
</record>

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La maladie de Parkinson au Canada (serveur d'exploration)

The role of autonomic testing in the differentiation of Parkinson's disease from multiple system atrophy

The role of autonomic testing in the differentiation of Parkinson's disease from multiple system atrophy

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	La maladie de Parkinson au Canada (serveur d'exploration)
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