Baroreflex Sensitivity and Power Spectral Analysis During Autonomic Testing in Different Extrapyramidal Syndromes

被引:41
|
作者
Friedrich, Constanze [1 ]
Ruediger, Heinz [1 ]
Schmidt, Claudia [1 ]
Herting, Birgit [2 ]
Prieur, Silke [1 ]
Junghanns, Susann [2 ]
Schweitzer, Katherine [3 ,4 ]
Globas, Christoph [3 ,4 ]
Schoels, Ludger [3 ,4 ]
Berg, Daniela [3 ,4 ]
Reichmann, Heinz [2 ]
Ziemssen, Tjalf [1 ]
机构
[1] Tech Univ Dresden, Univ Clin Carl Gustav Carus, Auton & Neuroendocrinol Lab, D-01307 Dresden, Germany
[2] Tech Univ Dresden, Univ Clin Carl Gustav Carus, Dept Neurol, Movement Disorders Res Grp, D-01307 Dresden, Germany
[3] Univ Tubingen, Ctr Neurol, Dept Neurodegenerat, D-72074 Tubingen, Germany
[4] Univ Tubingen, Hertie Inst Clin Brain Res, D-72074 Tubingen, Germany
关键词
autonomic dysfunction; baroreflex sensitivity; extrapyramidal disease; spectral analysis; autonomic testing; HEART-RATE; DYSFUNCTION; PARAMETERS; PRESSURE;
D O I
10.1002/mds.22844
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Autonomic dysfunction has been frequently demonstrated in patients with extrapyramidal diseases by cardiovascular autonomic testing. In addition to classical testing, we applied the more detailed baroreflex and spectral analysis on three traditional cardiovascular tests in this study to get additional information on autonomic outflow. We recorded continuously blood pressure, electrocardiogram, and respiration in 35 patients with multiple system atrophy, 32 patients with progressive supranuclear palsy, 46 patients with idiopathic Parkinson's disease and in 27 corresponding healthy subjects during cardiovascular autonomic testing (metronomic breathing, Valsalva manoeuvre, head-tip tilt). Baroreflex and spectral, analyses were performed by using trigonometric regressive spectral analysis between and during the manoeuvres. Consistent with previous interpretations, our data showed an increase of sympathetic activity in head-up tilt and Valsalva test in healthy controls. This sympathetic activity was significantly decreased in patients with typical and atypical Parkinson syndromes. Significant modulation of baroreflex activity could be observed especially during metronomic breathing; again it was significantly lower in all patient groups. Baroreflex and spectral parameters could not only differentiate between patients and healthy controls, but also differentiate between clinically symptomatic (with autonomic dysfunction as eg. orthostatic hypotension) and asymptomatic patients. In conclusion, our approach allows the evaluation of autonomic variability during short and nonstationary periods of time and may constitute a useful advance in the assessment of autonomic function in both physiological and pathological conditions. (C) 2009 Movement Disorder Society
引用
收藏
页码:315 / 324
页数:10
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