Session Information
Date: Monday, June 20, 2016
Session Title: Parkinson's disease: Non-motor symptoms
Session Time: 12:30pm-2:00pm
Location: Exhibit Hall located in Hall B, Level 2
Objective: To compare cerebral vasoreactivity in Parkinson´s disease (PD) and multiple system atrophy (MSA) patients with or without cardiovascular autonomic failure (CAF).
Background: CAF is frequently observed in PD and MSA patients. Recent reports suggest that CAF may trigger cerebral ischemic damage in PD and MSA, despite of preserved cerebrovascular autoregulation. The key feature of CAF is orthostatic hypotension and it may be accompanied by supine and/or nocturnal hypertension in up to 50% of patients. Cerebral vasoreactivity refers to the vasodilatory response of cerebral arterioles to elevation of CO2 partial pressure and depends upon a preserved endothelial function. Since a disrupted blood pressure control may trigger endothelial damage, we hypothesize that CAF may affect this endothelium-dependent mechanism.
Methods: Cerebral vasoreactivity was quantified by means of the breath holding index (BHI) in 12 PD and MSA patients with or without CAF. The patients were invited to hold their breath for 30 seconds in order to reproduce an hypercapnic state. The vasodilatory response was monitored by means of transcranial doppler ultrasound of middle cerebral arteries. The BHI was obtained dividing the percentage increase in mean blood flow velocity by the seconds of apnoea. Cerebral vasoreactivity was tested both in supine position and upon orthostatic stress.
Results: Patients with CAF displayed significantly lower supine (0.773±0.253 vs 1.118±0.257, p=0.043) and orthostatic BHI (0.620±0.202 vs 1.101±0.176, p=0.002) with respect to those without CAF.
Conclusions: Reduced cerebral vasoreactivity may reflect CAF-mediated vascular damage in Parkinsonian patients. This would imply a role for BHI as a simple tool to evaluate cardiovascular risk and guide blood pressure control strategies in Parkinsonian patients with CAF. Further studies on larger cohorts are advised to define this issue.
To cite this abstract in AMA style:
E. Indelicato, F.E. Pontieri, D. Benincasa, A. Fanciulli, F. Orzi, M. Giovannelli, G. Sette. Cerebral vasoreactivity in Parkinson’s disease and multiple system atrophy: A pilot study [abstract]. Mov Disord. 2016; 31 (suppl 2). https://www.mdsabstracts.org/abstract/cerebral-vasoreactivity-in-parkinsons-disease-and-multiple-system-atrophy-a-pilot-study/. Accessed June 14, 2025.« Back to 2016 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/cerebral-vasoreactivity-in-parkinsons-disease-and-multiple-system-atrophy-a-pilot-study/