Hyposmia and cardiovascular dysautonomia correlatively appear in early-stage Parkinson's disease
Hyposmia and cardiovascular dysautonomia correlatively appear in early-stage Parkinson's disease
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DOI：
10.1016/j.parkreldis.2014.02.010
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发表时间：
2014-05-01
影响因子：
4.1
通讯作者：
Sobue, Gen
中科院分区：
文献类型：
--
作者：
Mizutani, Yasuaki;Nakamura, Tomohiko;Sobue, Gen
目的：嗅觉功能障碍被认为先于运动症状和帕金森病（PD）的早期标志，而PD中出现心血管自主神经障碍的相对时间尚不清楚。为了评估PD患者心血管自主神经异常的表现，我们评估了其与早期PD患者嗅觉功能障碍的关系。方法：入选23例出现运动症状2年内的非痴呆性PD患者。我们通过气味棒识别测试（OSIT-J）评估日本人的嗅觉功能障碍，并分析其与其他心血管自主测试和心脏I-123-metaiodobenzylguanidine （MIBG）扫描结果的关系。结果：在去甲肾上腺素（r = 0.75, p < 0.0001, n = 21）和多布他宁（r = 0.57, p = 0.0087, n = 20）输注试验和心脏MIBG摄取（r = 0.42, p = 0.049, n = 23）中，嗅觉评分与血压升高存在相关性。直立倾斜试验期间直立血压的下降与嗅觉评分无关，但Valsalva操作显示osti - j评分与III期至血压恢复至基线的时间相关（r = 0.54, p = 0.037, n = 15），与IV期血压超调的幅度相关（r = 0.67, p = 0.0016, n = 20）。结论：我们的研究结果表明，在帕金森病的早期，心血管交感系统的广泛组成部分和嗅觉系统相关受损，这表明在帕金森病的运动前期，心血管交感系统的广泛方面的变性与嗅觉系统变性同时发生。(C) 2014 Elsevier Ltd.版权所有。
Objective: Olfactory dysfunction is considered to precede motor symptoms and early markers of Parkinson's disease (PD), while the relative time at which cardiovascular dysautonomia appears in PD is not well understood. To assess the appearance of cardiovascular dysautonomia in PD, we evaluated its relation to olfactory dysfunction in early-stage PD patients.Methods: Twenty-three non-demented PD patients within 2 years from the onset of motor symptoms were enrolled. We evaluated olfactory dysfunction by the Odor Stick Identification Test for Japanese (OSIT-J) and analyzed its relationship to the results of other cardiovascular autonomic tests and cardiac I-123-metaiodobenzylguanidine (MIBG) scintigraphy.Results: There was a correlation between olfactory scores and increased blood pressure in both the norepinephrine (r = 0.75, p < 0.0001, n = 21) and dobutarnine (r = 0.57, p = 0.0087, n = 20) infusion tests and cardiac MIBG uptake (r = 0.42, p = 0.049, n = 23). The fall in orthostatic blood pressure during the head-up tilt test was not correlated with the olfactory scores, but the Valsalva maneuver revealed that OSIT-J scores correlated with the pressure recovery time from phase III to the return of blood pressure to baseline (r = 0.54, p = 0.037, n = 15) and with the magnitude of blood pressure overshoot during phase IV (r = 0.67, p = 0.0016, n = 20).Conclusion: Our results demonstrate that extensive components of the cardiovascular sympathetic system as well as the olfactory system are correlatively impaired in the early stage of PD, suggesting that degeneration of broad aspects of the cardiovascular sympathetic system occurs concurrently with olfactory system degeneration during the premotor phase of PD. (C) 2014 Elsevier Ltd. All rights reserved.