Cardiovascular reflex testing contributes to clinical evaluation and differential diagnosis of Parkinsonian syndromes
Identifieur interne : 001B03 ( Main/Exploration ); précédent : 001B02; suivant : 001B04Cardiovascular reflex testing contributes to clinical evaluation and differential diagnosis of Parkinsonian syndromes
Auteurs : Björn Holmberg [Suède] ; Mika Kallio [Finlande] ; Bo Johnels [Suède] ; Mikael Elam [Suède]Source :
- Movement Disorders [ 0885-3185 ] ; 2001-03.
English descriptors
- KwdEn :
Abstract
The differentiation between Parkinson's disease (PD), progressive supranuclear palsy (PSP), and multiple system atrophy (MSA) may be difficult but is important for prognostic and therapeutic purposes. Varying degrees of autonomic failure have been described in PD and MSA, whereas its involvement in PSP remains controversial. The aim of this study was to investigate autonomic function in patients fulfilling strict clinical diagnostic criteria for the disorders above, to evaluate the diagnostic capacity of laboratory autonomic tests. The study group was consecutively recruited among patients referred to a movement disorder unit. Thirty‐four patients with PD, 15 patients with PSP, and 47 patients with MSA were compared with 18 healthy age‐matched controls. Autonomic tests included analysis of heart rate variability (HRV) in temporal domain, at rest and during forced respiration, as well as blood pressure (BP) changes during 75° head‐up tilt. HRV did not differ between groups during quiet breathing but was significantly reduced during forced respiration in MSA (P < 0.01), while PD and PSP groups did not differ from controls. Hypotensive responses during orthostatic provocation were seen in PD (P < 0.01) and MSA (P < 0.001), whereas BP remained stable in most PSP patients, not differing from the healthy control group. On an individual basis, decreased HRV and severe hypotensive responses were seen in MSA patients regardless of age and disease duration, whereas PD patients showed this combination only at high age and long duration. In PSP, only a few cases with decreased HRV and limited hypotensive responses were found. We conclude that cardiovascular reflex tests can supplement the clinical differentiation of Parkinsonian syndromes. © 2001 Movement Disorder Society.
Url:
DOI: 10.1002/mds.1062
Affiliations:
Links toward previous steps (curation, corpus...)
Le document en format XML
<record><TEI wicri:istexFullTextTei="biblStruct"><teiHeader><fileDesc><titleStmt><title xml:lang="en">Cardiovascular reflex testing contributes to clinical evaluation and differential diagnosis of Parkinsonian syndromes</title><author><name sortKey="Holmberg, Bjorn" sort="Holmberg, Bjorn" uniqKey="Holmberg B" first="Björn" last="Holmberg">Björn Holmberg</name></author><author><name sortKey="Kallio, Mika" sort="Kallio, Mika" uniqKey="Kallio M" first="Mika" last="Kallio">Mika Kallio</name></author><author><name sortKey="Johnels, Bo" sort="Johnels, Bo" uniqKey="Johnels B" first="Bo" last="Johnels">Bo Johnels</name></author><author><name sortKey="Elam, Mikael" sort="Elam, Mikael" uniqKey="Elam M" first="Mikael" last="Elam">Mikael Elam</name></author></titleStmt><publicationStmt><idno type="wicri:source">ISTEX</idno><idno type="RBID">ISTEX:DEB2B602558F637DA161A54E3A7866623B444790</idno><date when="2001" year="2001">2001</date><idno type="doi">10.1002/mds.1062</idno><idno type="url">https://api.istex.fr/document/DEB2B602558F637DA161A54E3A7866623B444790/fulltext/pdf</idno><idno type="wicri:Area/Main/Corpus">001597</idno><idno type="wicri:Area/Main/Curation">001364</idno><idno type="wicri:Area/Main/Exploration">001B03</idno></publicationStmt><sourceDesc><biblStruct><analytic><title level="a" type="main" xml:lang="en">Cardiovascular reflex testing contributes to clinical evaluation and differential diagnosis of Parkinsonian syndromes</title><author><name sortKey="Holmberg, Bjorn" sort="Holmberg, Bjorn" uniqKey="Holmberg B" first="Björn" last="Holmberg">Björn Holmberg</name><affiliation wicri:level="1"><country xml:lang="fr">Suède</country><wicri:regionArea>Department of Neurology, Institute of Clinical Neuroscience, University of Göteborg, Sahlgren's Hospital</wicri:regionArea><wicri:noRegion>Sahlgren's Hospital</wicri:noRegion></affiliation></author><author><name sortKey="Kallio, Mika" sort="Kallio, Mika" uniqKey="Kallio M" first="Mika" last="Kallio">Mika Kallio</name><affiliation wicri:level="1"><country xml:lang="fr">Finlande</country><wicri:regionArea>Department of Clinical Neurophysiology, University of Oulu, Oulu</wicri:regionArea><wicri:noRegion>Oulu</wicri:noRegion></affiliation></author><author><name sortKey="Johnels, Bo" sort="Johnels, Bo" uniqKey="Johnels B" first="Bo" last="Johnels">Bo Johnels</name><affiliation wicri:level="1"><country xml:lang="fr">Suède</country><wicri:regionArea>Department of Neurology, Institute of Clinical Neuroscience, University of Göteborg, Sahlgren's Hospital</wicri:regionArea><wicri:noRegion>Sahlgren's Hospital</wicri:noRegion></affiliation></author><author><name sortKey="Elam, Mikael" sort="Elam, Mikael" uniqKey="Elam M" first="Mikael" last="Elam">Mikael Elam</name><affiliation wicri:level="1"><country xml:lang="fr">Suède</country><wicri:regionArea>Department of Clinical Neurophysiology, Institute of Clinical Neuroscience, University of Göteborg, Sahlgren's Hospital</wicri:regionArea><wicri:noRegion>Sahlgren's Hospital</wicri:noRegion></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>John Wiley & Sons, Inc.</publisher><pubPlace>New York</pubPlace><date type="published" when="2001-03">2001-03</date><biblScope unit="volume">16</biblScope><biblScope unit="issue">2</biblScope><biblScope unit="page" from="217">217</biblScope><biblScope unit="page" to="225">225</biblScope></imprint><idno type="ISSN">0885-3185</idno></series><idno type="istex">DEB2B602558F637DA161A54E3A7866623B444790</idno><idno type="DOI">10.1002/mds.1062</idno><idno type="ArticleID">MDS1062</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>autonomic tests</term><term>differential diagnosis</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">The differentiation between Parkinson's disease (PD), progressive supranuclear palsy (PSP), and multiple system atrophy (MSA) may be difficult but is important for prognostic and therapeutic purposes. Varying degrees of autonomic failure have been described in PD and MSA, whereas its involvement in PSP remains controversial. The aim of this study was to investigate autonomic function in patients fulfilling strict clinical diagnostic criteria for the disorders above, to evaluate the diagnostic capacity of laboratory autonomic tests. The study group was consecutively recruited among patients referred to a movement disorder unit. Thirty‐four patients with PD, 15 patients with PSP, and 47 patients with MSA were compared with 18 healthy age‐matched controls. Autonomic tests included analysis of heart rate variability (HRV) in temporal domain, at rest and during forced respiration, as well as blood pressure (BP) changes during 75° head‐up tilt. HRV did not differ between groups during quiet breathing but was significantly reduced during forced respiration in MSA (P < 0.01), while PD and PSP groups did not differ from controls. Hypotensive responses during orthostatic provocation were seen in PD (P < 0.01) and MSA (P < 0.001), whereas BP remained stable in most PSP patients, not differing from the healthy control group. On an individual basis, decreased HRV and severe hypotensive responses were seen in MSA patients regardless of age and disease duration, whereas PD patients showed this combination only at high age and long duration. In PSP, only a few cases with decreased HRV and limited hypotensive responses were found. We conclude that cardiovascular reflex tests can supplement the clinical differentiation of Parkinsonian syndromes. © 2001 Movement Disorder Society.</div></front></TEI><affiliations><list><country><li>Finlande</li><li>Suède</li></country></list><tree><country name="Suède"><noRegion><name sortKey="Holmberg, Bjorn" sort="Holmberg, Bjorn" uniqKey="Holmberg B" first="Björn" last="Holmberg">Björn Holmberg</name></noRegion><name sortKey="Elam, Mikael" sort="Elam, Mikael" uniqKey="Elam M" first="Mikael" last="Elam">Mikael Elam</name><name sortKey="Johnels, Bo" sort="Johnels, Bo" uniqKey="Johnels B" first="Bo" last="Johnels">Bo Johnels</name></country><country name="Finlande"><noRegion><name sortKey="Kallio, Mika" sort="Kallio, Mika" uniqKey="Kallio M" first="Mika" last="Kallio">Mika Kallio</name></noRegion></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
EXPLOR_STEP=$WICRI_ROOT/Wicri/Sante/explor/ParkinsonV1/Data/Main/Exploration
HfdSelect -h $EXPLOR_STEP/biblio.hfd -nk 001B03 | SxmlIndent | more
Ou
HfdSelect -h $EXPLOR_AREA/Data/Main/Exploration/biblio.hfd -nk 001B03 | SxmlIndent | more
Pour mettre un lien sur cette page dans le réseau Wicri
{{Explor lien
|wiki= Wicri/Sante
|area= ParkinsonV1
|flux= Main
|étape= Exploration
|type= RBID
|clé= ISTEX:DEB2B602558F637DA161A54E3A7866623B444790
|texte= Cardiovascular reflex testing contributes to clinical evaluation and differential diagnosis of Parkinsonian syndromes
}}
| This area was generated with Dilib version V0.6.23. |  |