In:
Military Medical and Pharmaceutical Journal of Serbia, National Library of Serbia, Vol. 71, No. 4 ( 2014), p. 346-351
Abstract:
Background/Aim. Dysautonomia appears in almost all patients with Parkinson?s
disease (PD) in a certain stage of their condition. The aim of our study was
to detect the development and type of autonomic disorders, find out the
factors affecting their manifestation by analyzing the potential association
with demographic variables related to clinical presentation, as well as the
symptoms of the disease in a PD patient cohort. Methods. The patients with PD
treated at the Clinic of Neurology in Belgrade during a 2-year period,
divided into 3 groups were studied: 25 de novo patients, 25 patients already
treated and had no long-term levodopa therapy-related complications and 22
patients treated with levodopa who manifested levodopa-induced motor
complications. Simultaneously, 35 healthy control subjects, matched by age
and sex, were also analyzed. Results. Autonomic nervous system malfunction
was defined by Ewing diagnostic criteria. The tests, indicators of
sympathetic and parasympathetic nervous systems, were significantly different
in the PD patients as compared with the controls, suggesting the failure of
both systems. However, it was shown, in the selected groups of patients, that
the malfunction of both systems was present in two treated groups of PD
patients, while de novo group manifested only sympathetic dysfunction. For
this reason, the complete autonomic neuropathy was diagnosed only in the
treated PD patients, while de novo patients were defined as those with the
isolated sympathetic dysfunction. The patients with the complete autonomic
neuropathy differed from the subjects without such neuropathy in higher
cumulative and motor unified Parkinson?s disease rating score (UPDRS) (p 〈
0.01), activities of daily living scores (p 〈 0.05), Schwab-England scale (p
〈 0.001) and Hoehn-Yahr scale. There was no difference between the patients
in other clinical-demographic characteristics (sex, age at the time of
diagnosis, actual age, duration of disease, involved side of the body, pain
and freezing), but mini mental status (MMS) score and Hamilton depression and
anxiety rating scale were significantly lower (p 〈 0.05). Conclusion. Our
results confirm a high prevalence of autonomic nervous system disturbances
among PD patients from the near onset of disease, with a predominant
sympathetic nervous system involvement. The patients who developed complete
autonomic neuropathy (both sympathetic and parasympathetic) were individuals
with considerable level of functional failure, more severe clinical
presentation and the existing anxiety and depression.
Type of Medium:
Online Resource
ISSN:
0042-8450
,
2406-0720
Language:
English
Publisher:
National Library of Serbia
Publication Date:
2014
detail.hit.zdb_id:
2169819-3
SSG:
15,3
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