Loss of nocturnal blood pressure fall in various extrapyramidal syndromes
Identifieur interne : 000E26 ( Istex/Checkpoint ); précédent : 000E25; suivant : 000E27Loss of nocturnal blood pressure fall in various extrapyramidal syndromes
Auteurs : Claudia Schmidt [Allemagne] ; Daniela Berg [Allemagne] ; Herting [Allemagne] ; Silke Prieur [Allemagne] ; Susann Junghanns [Allemagne] ; Katherine Schweitzer [Allemagne] ; Christoph Globas [Allemagne] ; Ludger Schöls [Allemagne] ; Heinz Reichmann [Allemagne] ; Tjalf Ziemssen [Allemagne]Source :
- Movement Disorders [ 0885-3185 ] ; 2009-10-30.
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Abstract
Cardiovascular autonomic dysfunction has frequently been reported in some patients with extrapyramidal syndromes, especially multiple system atrophy (MSA) but also Parkinson's disease (PD). However, there are only few reports on the prevalence of cardiovascular autonomic dysfunction progressive in supranuclear palsy (PSP). Moreover, the relation of detailed cardiovascular testing and easy to assess 24‐hour ambulatory blood pressure (BP) is not known. Our study evaluates 24‐hour ambulatory BP monitoring in patients with PD, PSP, MSA, and corresponding controls (Con) and relates the findings to the results of comprehensive cardiovascular autonomic testing. Twenty‐three patients with PD, 25 patients with PSP, 25 patients with MSA, and 26 corresponding controls were studied by 24‐hour ambulatory BP monitoring (ABPM) in comparison to cardiovascular autonomic testing. Patients with PD, PSP, and MSA presented frequently with a pathological nocturnal BP regulation (no decrease or even an increase of nocturnal BP) in comparison to the control group (PD 48%, PSP 40%, MSA 68% vs. Con 8%). In MSA and PD patients, the frequent pathological BP increase during night was closely correlated to orthostatic hypotension. Since loss of nocturnal BP fall is frequent in patients with extrapyramidal syndromes, even if they are free of subjective autonomic dysfunction, we recommend 24‐hour ABPM as an easy to perform screening test, especially if detailed autonomic testing is not available. Pathological loss of nocturnal BP fall may account for increased cardiovascular mortality in extrapyramidal syndromes. © 2009 Movement Disorder Society
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DOI: 10.1002/mds.22767
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nuts="2">District de Dresde</region><settlement type="city">Dresde</settlement></placeName></affiliation></author><author><name sortKey="Schweitzer, Katherine" sort="Schweitzer, Katherine" uniqKey="Schweitzer K" first="Katherine" last="Schweitzer">Katherine Schweitzer</name><affiliation wicri:level="3"><country xml:lang="fr">Allemagne</country><wicri:regionArea>Department of Neurodegeneration, Center of Neurology, Hertie‐Institute for Clinical Brain Research University of Tübingen, Tübingen</wicri:regionArea><placeName><region type="land" nuts="1">Bade-Wurtemberg</region><region type="district" nuts="2">District de Tübingen</region><settlement type="city">Tübingen</settlement></placeName></affiliation></author><author><name sortKey="Globas, Christoph" sort="Globas, Christoph" uniqKey="Globas C" first="Christoph" last="Globas">Christoph Globas</name><affiliation wicri:level="3"><country xml:lang="fr">Allemagne</country><wicri:regionArea>Department of Neurodegeneration, Center of 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type="city">Dresde</settlement></placeName></affiliation></author></analytic><monogr></monogr><series><title level="j">Movement Disorders</title><title level="j" type="sub">Official Journal of the Movement Disorder Society</title><title level="j" type="abbrev">Mov. Disord.</title><idno type="ISSN">0885-3185</idno><idno type="eISSN">1531-8257</idno><imprint><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><pubPlace>Hoboken</pubPlace><date type="published" when="2009-10-30">2009-10-30</date><biblScope unit="vol">24</biblScope><biblScope unit="issue">14</biblScope><biblScope unit="page" from="2136">2136</biblScope><biblScope unit="page" to="2142">2142</biblScope></imprint><idno type="ISSN">0885-3185</idno></series><idno type="istex">0C3662277CB91A1295A3DF862EC493C8D5E559FC</idno><idno type="DOI">10.1002/mds.22767</idno><idno type="ArticleID">MDS22767</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0885-3185</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Parkinson's disease</term><term>ambulatory blood pressure</term><term>autonomic dysfunction</term><term>multiple system atrophy</term><term>progressive supranuclear palsy</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Cardiovascular autonomic dysfunction has frequently been reported in some patients with extrapyramidal syndromes, especially multiple system atrophy (MSA) but also Parkinson's disease (PD). However, there are only few reports on the prevalence of cardiovascular autonomic dysfunction progressive in supranuclear palsy (PSP). Moreover, the relation of detailed cardiovascular testing and easy to assess 24‐hour ambulatory blood pressure (BP) is not known. Our study evaluates 24‐hour ambulatory BP monitoring in patients with PD, PSP, MSA, and corresponding controls (Con) and relates the findings to the results of comprehensive cardiovascular autonomic testing. Twenty‐three patients with PD, 25 patients with PSP, 25 patients with MSA, and 26 corresponding controls were studied by 24‐hour ambulatory BP monitoring (ABPM) in comparison to cardiovascular autonomic testing. Patients with PD, PSP, and MSA presented frequently with a pathological nocturnal BP regulation (no decrease or even an increase of nocturnal BP) in comparison to the control group (PD 48%, PSP 40%, MSA 68% vs. Con 8%). In MSA and PD patients, the frequent pathological BP increase during night was closely correlated to orthostatic hypotension. Since loss of nocturnal BP fall is frequent in patients with extrapyramidal syndromes, even if they are free of subjective autonomic dysfunction, we recommend 24‐hour ABPM as an easy to perform screening test, especially if detailed autonomic testing is not available. Pathological loss of nocturnal BP fall may account for increased cardiovascular mortality in extrapyramidal syndromes. © 2009 Movement Disorder Society</div></front></TEI><affiliations><list><country><li>Allemagne</li></country><region><li>Bade-Wurtemberg</li><li>District de Dresde</li><li>District de Tübingen</li><li>Saxe (Land)</li></region><settlement><li>Dresde</li><li>Tübingen</li></settlement></list><tree><country name="Allemagne"><region name="Saxe (Land)"><name sortKey="Schmidt, Claudia" sort="Schmidt, Claudia" uniqKey="Schmidt C" first="Claudia" last="Schmidt">Claudia Schmidt</name></region><name sortKey="Berg, Daniela" sort="Berg, Daniela" uniqKey="Berg D" first="Daniela" last="Berg">Daniela Berg</name><name sortKey="Globas, Christoph" sort="Globas, Christoph" uniqKey="Globas C" first="Christoph" last="Globas">Christoph Globas</name><name sortKey="Herting" sort="Herting" uniqKey="Herting" last="Herting">Herting</name><name sortKey="Junghanns, Susann" sort="Junghanns, Susann" uniqKey="Junghanns S" first="Susann" last="Junghanns">Susann Junghanns</name><name sortKey="Prieur, Silke" sort="Prieur, Silke" uniqKey="Prieur S" first="Silke" last="Prieur">Silke Prieur</name><name sortKey="Reichmann, Heinz" sort="Reichmann, Heinz" uniqKey="Reichmann H" first="Heinz" last="Reichmann">Heinz Reichmann</name><name sortKey="Schols, Ludger" sort="Schols, Ludger" uniqKey="Schols L" first="Ludger" last="Schöls">Ludger Schöls</name><name sortKey="Schweitzer, Katherine" sort="Schweitzer, Katherine" uniqKey="Schweitzer K" first="Katherine" last="Schweitzer">Katherine Schweitzer</name><name sortKey="Ziemssen, Tjalf" sort="Ziemssen, Tjalf" uniqKey="Ziemssen T" first="Tjalf" last="Ziemssen">Tjalf Ziemssen</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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