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Titolo:
Cardiovascular reflex testing contributes to clinical evaluation and differential diagnosis of Parkinsonian syndromes
Autore:
Holmberg, B; Kallio, M; Johnels, B; Elam, M;
Indirizzi:
Univ Gothenburg, Sahlgrens Hosp, Dept Neurol, Inst Clin Neurosci, SE-41345Gothenburg, Sweden Univ Gothenburg Gothenburg Sweden SE-41345 i, SE-41345Gothenburg, Sweden Univ Gothenburg, Sahlgrens Hosp, Dept Clin Neurophysiol, SE-41345 Gothenburg, Sweden Univ Gothenburg Gothenburg Sweden SE-41345 , SE-41345 Gothenburg, Sweden Univ Oulu, Dept Clin Neurophysiol, Oulu, Finland Univ Oulu Oulu FinlandUniv Oulu, Dept Clin Neurophysiol, Oulu, Finland
Titolo Testata:
MOVEMENT DISORDERS
fascicolo: 2, volume: 16, anno: 2001,
pagine: 217 - 225
SICI:
0885-3185(200103)16:2<217:CRTCTC>2.0.ZU;2-F
Fonte:
ISI
Lingua:
ENG
Soggetto:
MULTIPLE-SYSTEM ATROPHY; PROGRESSIVE SUPRANUCLEAR PALSY; POSITRON EMISSION TOMOGRAPHY; HEART-RATE VARIABILITY; SPHINCTER ELECTROMYOGRAPHY; AUTONOMIC FUNCTION; ANAL-SPHINCTER; DISEASE; MORTALITY; ACCURACY;
Keywords:
Parkinson's disease; multiple system atrophy; progressive supranuclear palsy; autonomic tests; differential diagnosis;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
39
Recensione:
Indirizzi per estratti:
Indirizzo: Holmberg, B Univ Gothenburg, Sahlgrens Hosp, Dept Neurol, Inst Clin Neurosci, SE-41345Gothenburg, Sweden Univ Gothenburg Gothenburg Sweden SE-41345othenburg, Sweden
Citazione:
B. Holmberg et al., "Cardiovascular reflex testing contributes to clinical evaluation and differential diagnosis of Parkinsonian syndromes", MOVEMENT D, 16(2), 2001, pp. 217-225

Abstract

The differentiation between Parkinson's disease (PD). progressive supranuclear palsy (PSP), and multiple system atrophy (MSA) may be difficult but isimportant for prognostic and therapeutic purposes. Varying degrees of autonomic failure have been described in PD and MSA, whereas its involvement inPSP remains controversial. The aim of this study was to investigate autonomic function in patients fulfilling strict clinical diagnostic criteria forthe disorders;above, to evaluate the diagnostic capacity of laboratory autonomic rests. The study group was consecutively recruited among patients referred to a movement disorder unit. Thirty-four patients with PD, 15 patients with PSP, and 47 patients with MSA were compared with 18 healthy age-matched controls. Autonomic tests included analysis of heart rate variability (HRV) in temporal domain, at rest and during forced respiration, as well asblood pressure (BP) changes during 75 degrees head-up tilt. HRV did not differ between groups during quiet breathing but was significantly reduced during forced respiration in MSA (P < 0.01), while PD and PSP groups did not differ from controls. Hypotensive responses during orthostatic provocation were seen in PD (P < 0.01) and MSA (P < 0.001), whereas BP remained stable in most PSP patients, not differing from the healthy controlgroup. On an individual basis, decreased HRV and severe hypotensive responses were seen in MSA patients regardless of age and disease duration, whereas PD patients showed this combination only at high age and long duration. In PSP, only a few cases with decreased HRV and limited hypotensive responses were found. We conclude that cardiovascular reflex tests can supplement the clinical differentiation of Parkinsonian syndromes. <(c)> 2001 MovementDisorder Society.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 21/01/20 alle ore 07:15:56