Orthostatic Hypotension: a clinical marker for the body-first subtype of patients with Parkinson’s Disease

IF 6.7 1区 医学 Q1 NEUROSCIENCES NPJ Parkinson's Disease Pub Date : 2024-09-11 DOI:10.1038/s41531-024-00787-y
Shanshan Mei, Xue Wang, Wei Mao, Yue Liu, Zichen Tian, Chao Han, Piu Chan
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Abstract

Our study aimed to investigate the clinical characteristics of PD patients stratified by OH status before and after levodopa challenge to explore the hypothesis that OH might serve as a clinical marker for the body-first subtype of PD. Supine and standing blood pressure were measured in a large cross-sectional cohort of PD patients at the OFF status before and after levodopa challenge test (LCT). Based on OH status, patients were divided into three groups: spontaneous OH (SOH), only levodopa-induced OH (LOH) and non-OH (NOH). Clinical characteristics and associated factors were compared among the groups. A total of 928 patients with a mean age of 62.4 years and average disease duration of 7.9 years were included. There were 224 (24.1%) patients with SOH, 321 (34.6%) with LOH, and 383 (41.3%) with NOH. Compared to NOH, both SOH and LOH were associated with older age, motor fluctuations, and probable rapid eye movement sleep behavior disorder (pRBD). In addition, OH was more associated with cardiovascular and digestive dysfunction, disease severity and worse quality of life. Results of the current study suggest that PD patients developed OH which is more likely to comorbid with RBD, severe autonomic dysfunction and motor fluctuations, consistent with the body-first subtype of PD.

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直立性低血压:帕金森病患者 "身体优先 "亚型的临床标记
我们的研究旨在调查左旋多巴挑战前后按OH状态分层的帕金森病患者的临床特征,以探讨OH可能作为帕金森病身体优先亚型临床标志物的假设。对左旋多巴挑战试验(LCT)前后处于OH状态的大量横断面队列中的帕金森病患者进行了仰卧位和站立位血压测量。根据OH状态,患者被分为三组:自发OH(SOH)、仅左旋多巴诱发的OH(LOH)和非OH(NOH)。比较了各组的临床特征和相关因素。共纳入了 928 名患者,他们的平均年龄为 62.4 岁,平均病程为 7.9 年。其中SOH患者224人(24.1%),LOH患者321人(34.6%),NOH患者383人(41.3%)。与 NOH 相比,SOH 和 LOH 均与年龄偏大、运动波动和可能的眼球快速运动睡眠行为障碍(pRBD)有关。此外,OH 与心血管和消化功能障碍、疾病严重程度和生活质量下降的关系更为密切。目前的研究结果表明,帕金森病患者出现OH时更有可能合并RBD、严重的自主神经功能障碍和运动波动,这与帕金森病的身体优先亚型一致。
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来源期刊
NPJ Parkinson's Disease
NPJ Parkinson's Disease Medicine-Neurology (clinical)
CiteScore
9.80
自引率
5.70%
发文量
156
审稿时长
11 weeks
期刊介绍: npj Parkinson's Disease is a comprehensive open access journal that covers a wide range of research areas related to Parkinson's disease. It publishes original studies in basic science, translational research, and clinical investigations. The journal is dedicated to advancing our understanding of Parkinson's disease by exploring various aspects such as anatomy, etiology, genetics, cellular and molecular physiology, neurophysiology, epidemiology, and therapeutic development. By providing free and immediate access to the scientific and Parkinson's disease community, npj Parkinson's Disease promotes collaboration and knowledge sharing among researchers and healthcare professionals.
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