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Impairment of cerebral hemodynamic response to the cold pressor test in patients with Parkinson's disease.

Abstract：

BACKGROUND AND PURPOSE:Disturbance of the autonomic nervous system (ANS) is frequently encountered in Parkinson's disease (PD). In this study, we examined changes in systemic and cerebral hemodynamics during the cold pressor test (CPT) to determine whether cerebrovascular reactivity, controlled by the sympathetic nervous system, is intact or impaired in patients with PD. METHODS:Forty-nine patients with PD and 49 sex- and age-matched non-PD subjects were evaluated. Measurements were performed in the resting state and over a period of 1min of CPT. The cerebral blood flow velocity (CBFV) and pulsatility index (PI) of the middle cerebral artery (MCA) were recorded by transcranial color-coded Doppler ultrasonography (TCCS). Mean arterial blood pressure (MAP), heart rate (HR), and end-tidal CO(2) (Et-CO(2)) were investigated simultaneously. The resistance of the cerebrovascular bed (CVR) was calculated as the ratio of mean arterial blood pressure to mean cerebral blood flow velocity (Vm). Changes of Vm, PI and CVR in response to the cold pressor test were evaluated. RESULTS:Baseline values for control and PD subjects showed no statistical difference. CPT induced a significant increase in MAP, HR, and Vm in both groups. Pulsatility index (PI) and CVR were decreased in both groups during CPT. Percent increases of Vm (P<0.001) and MAP (P=0.011) were significantly higher while the percent decreases of PI (P=0.002) and CVR (P=0.007) were significantly decreased more in the non-PD group. CONCLUSIONS:This study indirectly shows that ANS-mediated cerebrovascular reactivity is impaired in patients with PD. Further investigations are needed to confirm the hypothesis that using the cold pressor test to evaluate cerebrovascular reactivity might be beneficial in early diagnosis of impairment of ANS-mediated cerebrovascular autoregulation in patients with PD.

journal_name

Parkinsonism Relat Disord

journal_title

Parkinsonism & related disorders

authors

Tsai SJ,Chen SC,Leu TM,Chen CM,Chou HH,Peng HY,Liao JM,Lin TB

doi

10.1016/j.parkreldis.2008.03.007

subject

Has Abstract

pub_date

2009-02-01 00:00:00

pages

94-100

issue

2

eissn

1353-8020

issn

1873-5126

pii

S1353-8020(08)00104-1

journal_volume

15

pub_type

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