Cardiovascular autonomic function and MCI in Parkinson's disease. (December 2019)

• Record Type: Journal Article
• Authors: Cicero, Calogero Edoardo; Raciti, Loredana; Monastero, Roberto; Mostile, Giovanni; Donzuso, Giulia; Sciacca, Giorgia; Luca, Antonina; Terravecchia, Claudio; Giuliano, Loretta; Baschi, Roberta; Davì, Marco; Zappia, Mario; Nicoletti, Alessandra
• Is Part Of: Parkinsonism & related disorders. Volume 69(2019)
• Page Start: 55
• Page End: 58
• Publication Date: 2019-12
• Subjects: Parkinson's disease -- Mild cognitive impairment -- Autonomic system -- Cardiovascular dysautonomia; Parkinson's disease -- Periodicals; Movement disorders -- Periodicals; Movement Disorders -- Periodicals; Nerve Degeneration -- Periodicals; Nervous System Diseases -- Periodicals; Parkinson Disease -- Periodicals; Tremor -- Periodicals; Parkinson, Maladie de -- Périodiques; Parkinson's disease; 616.833
• DOI: 10.1016/j.parkreldis.2019.10.023
• Languages: English
• ISSNs: 1353-8020

Abstract

Abstract: Introduction: dysautonomic dysfunction and cognitive impairment represent the most disabling non-motor features of Parkinson's Disease (PD). Recent evidences suggest the association between Orthostatic Hypotension (OH) and PD-Dementia. However, little is known on the interactions between cardiovascular dysautonomia and Mild Cognitive Impairment (MCI). We aimed to evaluate the association between cardiovascular dysautonomia and MCI in patients with PD. Methods: non-demented PD patients belonging to the PACOS cohort underwent a comprehensive instrumental neurovegetative assessment including the study of both parasympathetic and sympathetic function (30:15 ratio, Expiratory-Inspiratory ratio [E-I] and presence of Orthostatic Hypotension [OH]). Diagnosis of MCI was made according to the MDS criteria level II. Results: we enrolled 185 PD patients of whom 102 (55.1%) were men, mean age was 64.6 ± 9.7 years, mean disease duration of 5.6 ± 5.5 years with a mean UPDRS-ME score of 31.7 ± 10.9. MCI was diagnosed in 79 (42.7%) patients. OH was recorded in 52 (28.1%) patients, altered 30:15 ratio was recorded in 39 (24.1%) patients and an altered E-I ratio was found in 24 (19.1%) patients. Presence of MCI was associated with an altered 30:15 ratio (adjOR 2.83; 95%CI 1.25–6.40) but not with an altered E-I ratio, while OH was associated only with the amnestic MCI subgroup (OR 2.43; 95% CI 1.05–5.06). Conclusion: in our study sample, MCI was mainly associated with parasympathetic dysfunction in PD. Highlights: MCI seems to be associated with cardiovascular autonomic dysfunction in PD. OH is present in almost one third of PD patients. OH is more frequent in patients with amnestic MCI.