Evaluation of cerebral vasomotor reactivity in Parkinson's disease: Is there any association with orthostatic hypotension?

• Published in: Clinical neurology and neurosurgery 2011-06, Vol.113 (5), p.368-372
• Main Authors: Zamani, Babak, Mehrabani, Mehrnoush, Fereshtehnejad, Seyed-Mohammad, Rohani, Mohammad
• Format: Article
• Language: English
• Subjects: Adult; Age of Onset; Aged; Aged, 80 and over; Antiparkinson Agents - adverse effects; Antiparkinson Agents - therapeutic use; Biological and medical sciences; Blood Pressure - physiology; Carbon dioxide; Carbon Dioxide - blood; Cerebrovascular Circulation - physiology; Dopamine; Family medical history; Female; Flow velocity; Humans; Hypertension; Hypotension, Orthostatic - diagnosis; Hypotension, Orthostatic - etiology; Hypotension, Orthostatic - physiopathology; Levodopa - adverse effects; Levodopa - therapeutic use; Magnetic Resonance Imaging; Male; Medical sciences; Middle Aged; Middle Cerebral Artery - physiopathology; Muscle, Smooth, Vascular - physiopathology; Neurology; Neurosurgery; Orthostatic hypotension; Parkinson Disease - complications; Parkinson Disease - diagnosis; Parkinson Disease - physiopathology; Parkinson's disease; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Teaching hospitals; Tomography, X-Ray Computed; Transcranial Doppler; Ultrasonography, Doppler, Transcranial; Vasodilation - physiology; Vasomotor reactivity; Veins & arteries
• ISSN: 0303-8467; 1872-6968
• DOI: 10.1016/j.clineuro.2010.12.014

Abstract Objective Our aim was to look for a probable relationship between cerebral vasomotor reactivity (VMR) and orthostatic hypotension (OH) in Parkinson's disease (PD). Materials and methods This study was conducted on 44 patients with PD. Assessment of cerebral VMR was performed by means of transcranial Doppler (TCD) of middle cerebral artery (MCA) before and after a vasodilatory stimulus, carbon dioxide test. Moreover, orthostatic hypotension was evaluated. Results OH was presented in 12 (27.3%) Parkinson's patients. The average resting blood flow velocity (BFV) in the MCA was 30.20 (SD = 9.58) cm s−1 which significantly increased to 46.25 (SD = 16.23) cm s−1 after carbon dioxide test ( P < 0.001). Impaired VMR was observed in 15 (34.1%) of the subjects, while it was not associated with the presence of OH ( P = 0.770). Conclusion Evaluation of VMR in patients affected by PD, could assist in early diagnosis of cerebral autonomic dysfunction and prevent its serious consequences prior and more valid to OH.