Postprandial hypotension and parkinsonian state in Parkinson's disease.
Identifieur interne : 004E14 ( Ncbi/Curation ); précédent : 004E13; suivant : 004E15Postprandial hypotension and parkinsonian state in Parkinson's disease.
Auteurs : K R Chaudhuri [Royaume-Uni] ; C. Ellis ; S. Love-Jones ; T. Thomaides ; S. Clift ; C J Mathias ; J D ParkesSource :
- Movement disorders : official journal of the Movement Disorder Society [ 0885-3185 ] ; 1997.
English descriptors
- KwdEn :
- Adult, Aged, Autonomic Nervous System Diseases (complications), Autonomic Nervous System Diseases (physiopathology), Blood Glucose, Energy Intake, Humans, Hypotension (complications), Hypotension (diagnosis), Insulin (blood), Male, Middle Aged, Motor Activity, Parkinson Disease (complications), Parkinson Disease (physiopathology), Parkinson Disease, Secondary (complications), Parkinson Disease, Secondary (physiopathology), Severity of Illness Index, Time Factors.
- MESH :
- chemical , blood : Insulin.
- chemical : Blood Glucose.
- complications : Autonomic Nervous System Diseases, Hypotension, Parkinson Disease, Parkinson Disease, Secondary.
- diagnosis : Hypotension.
- physiopathology : Autonomic Nervous System Diseases, Parkinson Disease, Parkinson Disease, Secondary.
- Adult, Aged, Energy Intake, Humans, Male, Middle Aged, Motor Activity, Severity of Illness Index, Time Factors.
Abstract
Abnormal postprandial cardiovascular responses such as postprandial hypotension (PPH) occur in primary autonomic failure and contribute significantly to morbidity. The extent and frequency of PPH and its relationship to the parkinsonian state in idiopathic Parkinson's disease (IPD) is unknown. By studying 20 patients with IPD (without autonomic failure) and 16 age-matched controls after both groups ingested a standard isocaloric balanced liquid meal, we have shown that supine PPH complicates IPD and is related to marked worsening of the parkinsonian state as measured by a cumulative score of tremor, rigidity, bradykinesia, posture, and gait. Furthermore, significant postural hypotension is unmasked that results in postural intolerance due to presyncopal symptoms. Our study indicates that, in patients with IPD, ingestion of a meal may lead to abnormal postprandial cardiovascular responses and aggravation of the parkinsonian stage. The underlying mechanisms are unclear, although vasodilatory gut peptides released in response to food ingestion may be contributory.
DOI: 10.1002/mds.870120608
PubMed: 9399210
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pubmed:9399210Le document en format XML
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<affiliation wicri:level="2"><nlm:affiliation>University Department of Neurology, Institute of Psychiatry, London, England.</nlm:affiliation>
<country>Royaume-Uni</country>
<placeName><region type="country">Angleterre</region>
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<wicri:cityArea>University Department of Neurology, Institute of Psychiatry, London</wicri:cityArea>
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<author><name sortKey="Ellis, C" sort="Ellis, C" uniqKey="Ellis C" first="C" last="Ellis">C. Ellis</name>
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<author><name sortKey="Love Jones, S" sort="Love Jones, S" uniqKey="Love Jones S" first="S" last="Love-Jones">S. Love-Jones</name>
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<author><name sortKey="Thomaides, T" sort="Thomaides, T" uniqKey="Thomaides T" first="T" last="Thomaides">T. Thomaides</name>
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<author><name sortKey="Clift, S" sort="Clift, S" uniqKey="Clift S" first="S" last="Clift">S. Clift</name>
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<author><name sortKey="Mathias, C J" sort="Mathias, C J" uniqKey="Mathias C" first="C J" last="Mathias">C J Mathias</name>
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<author><name sortKey="Parkes, J D" sort="Parkes, J D" uniqKey="Parkes J" first="J D" last="Parkes">J D Parkes</name>
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<author><name sortKey="Chaudhuri, K R" sort="Chaudhuri, K R" uniqKey="Chaudhuri K" first="K R" last="Chaudhuri">K R Chaudhuri</name>
<affiliation wicri:level="2"><nlm:affiliation>University Department of Neurology, Institute of Psychiatry, London, England.</nlm:affiliation>
<country>Royaume-Uni</country>
<placeName><region type="country">Angleterre</region>
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<author><name sortKey="Ellis, C" sort="Ellis, C" uniqKey="Ellis C" first="C" last="Ellis">C. Ellis</name>
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<author><name sortKey="Love Jones, S" sort="Love Jones, S" uniqKey="Love Jones S" first="S" last="Love-Jones">S. Love-Jones</name>
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<author><name sortKey="Thomaides, T" sort="Thomaides, T" uniqKey="Thomaides T" first="T" last="Thomaides">T. Thomaides</name>
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<author><name sortKey="Clift, S" sort="Clift, S" uniqKey="Clift S" first="S" last="Clift">S. Clift</name>
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<author><name sortKey="Mathias, C J" sort="Mathias, C J" uniqKey="Mathias C" first="C J" last="Mathias">C J Mathias</name>
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<series><title level="j">Movement disorders : official journal of the Movement Disorder Society</title>
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<imprint><date when="1997" type="published">1997</date>
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<term>Aged</term>
<term>Autonomic Nervous System Diseases (complications)</term>
<term>Autonomic Nervous System Diseases (physiopathology)</term>
<term>Blood Glucose</term>
<term>Energy Intake</term>
<term>Humans</term>
<term>Hypotension (complications)</term>
<term>Hypotension (diagnosis)</term>
<term>Insulin (blood)</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Motor Activity</term>
<term>Parkinson Disease (complications)</term>
<term>Parkinson Disease (physiopathology)</term>
<term>Parkinson Disease, Secondary (complications)</term>
<term>Parkinson Disease, Secondary (physiopathology)</term>
<term>Severity of Illness Index</term>
<term>Time Factors</term>
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<keywords scheme="MESH" type="chemical" qualifier="blood" xml:lang="en"><term>Insulin</term>
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<keywords scheme="MESH" type="chemical" xml:lang="en"><term>Blood Glucose</term>
</keywords>
<keywords scheme="MESH" qualifier="complications" xml:lang="en"><term>Autonomic Nervous System Diseases</term>
<term>Hypotension</term>
<term>Parkinson Disease</term>
<term>Parkinson Disease, Secondary</term>
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<term>Parkinson Disease</term>
<term>Parkinson Disease, Secondary</term>
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<term>Aged</term>
<term>Energy Intake</term>
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<term>Middle Aged</term>
<term>Motor Activity</term>
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<front><div type="abstract" xml:lang="en">Abnormal postprandial cardiovascular responses such as postprandial hypotension (PPH) occur in primary autonomic failure and contribute significantly to morbidity. The extent and frequency of PPH and its relationship to the parkinsonian state in idiopathic Parkinson's disease (IPD) is unknown. By studying 20 patients with IPD (without autonomic failure) and 16 age-matched controls after both groups ingested a standard isocaloric balanced liquid meal, we have shown that supine PPH complicates IPD and is related to marked worsening of the parkinsonian state as measured by a cumulative score of tremor, rigidity, bradykinesia, posture, and gait. Furthermore, significant postural hypotension is unmasked that results in postural intolerance due to presyncopal symptoms. Our study indicates that, in patients with IPD, ingestion of a meal may lead to abnormal postprandial cardiovascular responses and aggravation of the parkinsonian stage. The underlying mechanisms are unclear, although vasodilatory gut peptides released in response to food ingestion may be contributory.</div>
</front>
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