Cardiovascular dysautonomia and cognition in Parkinson's Disease - a possible relationship

被引:15
|
作者
Kwasniak-Butowska, Magdalena [1 ,2 ]
Dulski, Jaroslaw [1 ,2 ]
Pierzchlinska, Anna [3 ]
Bialecka, Monika [3 ]
Wieczorek, Dariusz [4 ]
Slawek, Jaroslaw [1 ,2 ]
机构
[1] Med Univ Gdansk, Fac Hlth Sci, Div Neurol & Psychiat Nursing, Gdansk, Poland
[2] St Adalbert Hosp, Dept Neurol, Al Jana Pawla II 50, PL-80462 Gdansk, Poland
[3] Pomeranian Med Univ, Dept Pharmacokinet & Therapeut Drug Monitoring, Szczecin, Poland
[4] Med Univ Gdansk, Fac Hlth Sci, Div Rehabil, Gdansk, Poland
关键词
cognitive impairment; dementia; orthostatic hypotension; Parkinson's Disease; supine hypertension; WHITE-MATTER HYPERINTENSITIES; NEUROGENIC ORTHOSTATIC HYPOTENSION; VASCULAR RISK-FACTORS; BLOOD-PRESSURE; SUPINE HYPERTENSION; AUTONOMIC DYSFUNCTION; SYMPATHETIC DENERVATION; DEMENTIA; IMPAIRMENT; DECLINE;
D O I
10.5603/PJNNS.a2021.0040
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Dementia in advanced Parkinson's Disease (PD) is a fatal milestone resulting in reduced life expectancy and nursing home placement. Cognitive impairment and cardiovascular dysautonomia are common and debilitating non-motor symptoms that frequently coexist in PD since the early stages and progress in subsequent years. In particular, blood pressure (BP) abnormalities, including orthostatic hypotension (OH), supine hypertension (SH) and the loss of nocturnal BP fall (non-dipping) in PD have been associated with cognitive deterioration. They usually have multifactorial aetiology, including neuronal (central and peripheral) mechanisms and concomitant intake of medications. BP abnormalities can influence cognition in many ways, including repeated cerebral hypoperfusion leading to cerebral ischaemic lesions, higher burden of white matter hyperintensities, and possible impact on neurodegenerative process in PD. They are often asymptomatic and remain unrecognised, hence 24-hour ambulatory BP monitoring is recommended in patients with clinical symptoms of dysautonomia. Management is challenging and should address the multifactorial nature of BP disturbances.The aim of this review was to present the state of current knowledge regarding the possible relationship between cardiovascular dysautonomia and cognition in PD, its diagnosis and treatment.
引用
收藏
页码:525 / 535
页数:11
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