%0 Journal Article
%T Nondipping in Parkinson's Disease
%A Sita Sommer
%A Billur Aral-Becher
%A Wolfgang Jost
%J Parkinson's Disease
%D 2011
%I Hindawi Publishing Corporation
%R 10.4061/2011/897586
%X Objective. The aim of this study was to identify patients with Parkinson's disease who showed loss or decrease of nocturnal blood pressure fall (nondipper patients) as a marker of autonomic dysfunction. Presence or absence of orthostatic hypotension was considered to investigate whether alterations in circadian blood pressure pattern are associated with posture-related dysregulation of blood pressure. Methods. 40 patients with Parkinson's disease underwent 24-hour blood pressure monitoring. 21 patients were diagnosed with arterial hypertension and received anti-hypertensive drugs. Nondipper patients were defined as having nocturnal decrease of mean systolic and diastolic blood pressure less than 10%. Presence or absence of orthostatic hypotension was determined by Schellong's test. Results. We identified 35 nondipper patients (88%). Nondipping was detected in 20 patients with orthostatic hypotension (95%) and in 15 patients without orthostatic hypotension (79%). 18 patients with hypertensive and 22 patients with normal blood pressure values were detected. Conclusions. In conclusion 24-hour blood pressure monitoring showed a high prevalence of nondipping in 40 patients with Parkinson's disease with and without orthostatic hypotension independent of coexisting arterial hypertension and antihypertensive treatment. 24-hour blood pressure monitoring may be useful to identify non-dipping as a marker of autonomic dysfunction in patients with Parkinson's disease. 1. Introduction ParkinsonĄ¯s disease is a multisystem degeneration [1]. Beside motor symptoms, and psychiatric symptoms autonomic dysfunction is a common finding in ParkinsonĄ¯s disease [2]. Neuropathological studies showed the presence of Lewy bodies in central and peripheral structures involved in autonomic regulation [3¨C6]. Involvement of the autonomic nervous system (ANS) occurs in the early stages of the disease [2]. Cardiovascular dysautonomia, especially orthostatic hypotension, is frequently reported in ParkinsonĄ¯s disease [7]. Involvement of peripheral components of the ANS can be demonstrated by MIBG scintigraphy. MIBG scintigraphy shows reduced cardiac uptake of MIBG (meta-[123I]iodobenzylguanidine) representing loss of postganglionic myocardial sympathetic nerve fibers in patients with ParkinsonĄ¯s disease and autonomic failure [8]. However these findings are also seen in the early stages of the disease independent of symptoms of cardiovascular dysautonomia [9]. Further effects of autonomic cardiovascular dysfunction are demonstrated in earlier studies such as baroreceptor reflex dysfunction,
%U http://www.hindawi.com/journals/pd/2011/897586/