Az agyi autoreguláció vizsgálata Parkinson-betegségben.

Translated title of the contribution: Investigation of cerebral autoregulation in Parkinson's disease--a transcranial Doppler study

Róbert Debreczeni, Ilona Amrein, M. Kollai, Z. Lénárd, László Pálvölgyi, Annamária Takáts, Gertrúd Tamás, I. Szirmai

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

BACKGROUND AND PURPOSE: The frequent orthostatic intolerance in Parkinson's disease could be the consequence of cardiovascular autonomic failure and/or a damaged cerebral autoregulation (AR). To clarify this question the regulation of cerebral circulation was investigated by polygraphic method. METHODS: On a tilt table simultaneous and continuous registrations were made of MCA velocity (V(MCA)) by transcranial Doppler, arterial blood pressure by non-invasive method, and end-tidal CO2, in supine and in tilted positions of 10 degrees, 30 degrees, 70 degrees grades. The cerebral autoregulation was characterized by the slope of the curve of the arterial blood pressure at the level of the Willis-circle (BP(W) as MCA perfusion pressure) plotted against the MCA velocity, achieved by linear regression (y = ax + b function, a=AR, or index of autoregulation). PATIENTS: The data of 17 parkinsonian patients (PP) and eight age-matched controls (C) were analyzed. RESULTS: The decrease of blood pressure in parkinsonian patients was significantly lower than in the controls when supine position was restored from 70 degrees (deltaABP 70 degrees - 0 degree pp = -3.1 +/- 7.5 Hgmm; deltaABP 70 degrees - 0(C) degrees = -11.1 +/- 7.3 Hgmm; p <0.05), which suggests a damage to the sympathetic cardiovascular system. A disturbance of the cerebral autoregulation in patients was suggested by a 'progressively decreasing MCA average velocity (V(MCA)) during graded tilt, which was significant at 70 degrees (deltaV(ACM) = 9.8 +/- 8.82% cms(-1); p(C-PP) P 0.5), and by a higher slope of pressure-velocity curve (AR(C) = 0.143 +/- .125% cms(-1)/Hgmm; AR(PP) = 0.38 +/- 0.25% cms(-1)/Hgmm; p(C-PP) <0.05). CONCLUSIONS: The results show that the cerebral blood flow of patients is more dependent on perfusion pressure compared to healthy controls. The disturbance of the sympathetic cardiovascular system and of cerebral autoregulation could be the consequence of a damage to the postganglionic structures in Parkinson's disease. These results could explain the frequent orthostatic intolerance of patients even with normal blood pressure.

Original languageHungarian
Pages (from-to)245-252
Number of pages8
JournalIdeggyógyászati szemle
Volume58
Issue number7-8
Publication statusPublished - Jul 20 2005

Fingerprint

Parkinson Disease
Homeostasis
Cerebrovascular Circulation
Orthostatic Intolerance
Cardiovascular System
Pressure
Arterial Pressure
Perfusion
Circle of Willis
Blood Pressure
Supine Position
Linear Models

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Debreczeni, R., Amrein, I., Kollai, M., Lénárd, Z., Pálvölgyi, L., Takáts, A., ... Szirmai, I. (2005). Az agyi autoreguláció vizsgálata Parkinson-betegségben. Ideggyógyászati szemle, 58(7-8), 245-252.

Az agyi autoreguláció vizsgálata Parkinson-betegségben. / Debreczeni, Róbert; Amrein, Ilona; Kollai, M.; Lénárd, Z.; Pálvölgyi, László; Takáts, Annamária; Tamás, Gertrúd; Szirmai, I.

In: Ideggyógyászati szemle, Vol. 58, No. 7-8, 20.07.2005, p. 245-252.

Research output: Contribution to journalArticle

Debreczeni, R, Amrein, I, Kollai, M, Lénárd, Z, Pálvölgyi, L, Takáts, A, Tamás, G & Szirmai, I 2005, 'Az agyi autoreguláció vizsgálata Parkinson-betegségben.', Ideggyógyászati szemle, vol. 58, no. 7-8, pp. 245-252.
Debreczeni R, Amrein I, Kollai M, Lénárd Z, Pálvölgyi L, Takáts A et al. Az agyi autoreguláció vizsgálata Parkinson-betegségben. Ideggyógyászati szemle. 2005 Jul 20;58(7-8):245-252.
Debreczeni, Róbert ; Amrein, Ilona ; Kollai, M. ; Lénárd, Z. ; Pálvölgyi, László ; Takáts, Annamária ; Tamás, Gertrúd ; Szirmai, I. / Az agyi autoreguláció vizsgálata Parkinson-betegségben. In: Ideggyógyászati szemle. 2005 ; Vol. 58, No. 7-8. pp. 245-252.
@article{e23119c82ee743d6a4639d0693ce193c,
title = "Az agyi autoregul{\'a}ci{\'o} vizsg{\'a}lata Parkinson-betegs{\'e}gben.",
abstract = "BACKGROUND AND PURPOSE: The frequent orthostatic intolerance in Parkinson's disease could be the consequence of cardiovascular autonomic failure and/or a damaged cerebral autoregulation (AR). To clarify this question the regulation of cerebral circulation was investigated by polygraphic method. METHODS: On a tilt table simultaneous and continuous registrations were made of MCA velocity (V(MCA)) by transcranial Doppler, arterial blood pressure by non-invasive method, and end-tidal CO2, in supine and in tilted positions of 10 degrees, 30 degrees, 70 degrees grades. The cerebral autoregulation was characterized by the slope of the curve of the arterial blood pressure at the level of the Willis-circle (BP(W) as MCA perfusion pressure) plotted against the MCA velocity, achieved by linear regression (y = ax + b function, a=AR, or index of autoregulation). PATIENTS: The data of 17 parkinsonian patients (PP) and eight age-matched controls (C) were analyzed. RESULTS: The decrease of blood pressure in parkinsonian patients was significantly lower than in the controls when supine position was restored from 70 degrees (deltaABP 70 degrees - 0 degree pp = -3.1 +/- 7.5 Hgmm; deltaABP 70 degrees - 0(C) degrees = -11.1 +/- 7.3 Hgmm; p <0.05), which suggests a damage to the sympathetic cardiovascular system. A disturbance of the cerebral autoregulation in patients was suggested by a 'progressively decreasing MCA average velocity (V(MCA)) during graded tilt, which was significant at 70 degrees (deltaV(ACM) = 9.8 +/- 8.82{\%} cms(-1); p(C-PP) P 0.5), and by a higher slope of pressure-velocity curve (AR(C) = 0.143 +/- .125{\%} cms(-1)/Hgmm; AR(PP) = 0.38 +/- 0.25{\%} cms(-1)/Hgmm; p(C-PP) <0.05). CONCLUSIONS: The results show that the cerebral blood flow of patients is more dependent on perfusion pressure compared to healthy controls. The disturbance of the sympathetic cardiovascular system and of cerebral autoregulation could be the consequence of a damage to the postganglionic structures in Parkinson's disease. These results could explain the frequent orthostatic intolerance of patients even with normal blood pressure.",
author = "R{\'o}bert Debreczeni and Ilona Amrein and M. Kollai and Z. L{\'e}n{\'a}rd and L{\'a}szl{\'o} P{\'a}lv{\"o}lgyi and Annam{\'a}ria Tak{\'a}ts and Gertr{\'u}d Tam{\'a}s and I. Szirmai",
year = "2005",
month = "7",
day = "20",
language = "Hungarian",
volume = "58",
pages = "245--252",
journal = "Ideggyogyaszati Szemle",
issn = "0019-1442",
publisher = "Ifjusagi Lap-es Konyvkiado Vallalat",
number = "7-8",

}

TY - JOUR

T1 - Az agyi autoreguláció vizsgálata Parkinson-betegségben.

AU - Debreczeni, Róbert

AU - Amrein, Ilona

AU - Kollai, M.

AU - Lénárd, Z.

AU - Pálvölgyi, László

AU - Takáts, Annamária

AU - Tamás, Gertrúd

AU - Szirmai, I.

PY - 2005/7/20

Y1 - 2005/7/20

N2 - BACKGROUND AND PURPOSE: The frequent orthostatic intolerance in Parkinson's disease could be the consequence of cardiovascular autonomic failure and/or a damaged cerebral autoregulation (AR). To clarify this question the regulation of cerebral circulation was investigated by polygraphic method. METHODS: On a tilt table simultaneous and continuous registrations were made of MCA velocity (V(MCA)) by transcranial Doppler, arterial blood pressure by non-invasive method, and end-tidal CO2, in supine and in tilted positions of 10 degrees, 30 degrees, 70 degrees grades. The cerebral autoregulation was characterized by the slope of the curve of the arterial blood pressure at the level of the Willis-circle (BP(W) as MCA perfusion pressure) plotted against the MCA velocity, achieved by linear regression (y = ax + b function, a=AR, or index of autoregulation). PATIENTS: The data of 17 parkinsonian patients (PP) and eight age-matched controls (C) were analyzed. RESULTS: The decrease of blood pressure in parkinsonian patients was significantly lower than in the controls when supine position was restored from 70 degrees (deltaABP 70 degrees - 0 degree pp = -3.1 +/- 7.5 Hgmm; deltaABP 70 degrees - 0(C) degrees = -11.1 +/- 7.3 Hgmm; p <0.05), which suggests a damage to the sympathetic cardiovascular system. A disturbance of the cerebral autoregulation in patients was suggested by a 'progressively decreasing MCA average velocity (V(MCA)) during graded tilt, which was significant at 70 degrees (deltaV(ACM) = 9.8 +/- 8.82% cms(-1); p(C-PP) P 0.5), and by a higher slope of pressure-velocity curve (AR(C) = 0.143 +/- .125% cms(-1)/Hgmm; AR(PP) = 0.38 +/- 0.25% cms(-1)/Hgmm; p(C-PP) <0.05). CONCLUSIONS: The results show that the cerebral blood flow of patients is more dependent on perfusion pressure compared to healthy controls. The disturbance of the sympathetic cardiovascular system and of cerebral autoregulation could be the consequence of a damage to the postganglionic structures in Parkinson's disease. These results could explain the frequent orthostatic intolerance of patients even with normal blood pressure.

AB - BACKGROUND AND PURPOSE: The frequent orthostatic intolerance in Parkinson's disease could be the consequence of cardiovascular autonomic failure and/or a damaged cerebral autoregulation (AR). To clarify this question the regulation of cerebral circulation was investigated by polygraphic method. METHODS: On a tilt table simultaneous and continuous registrations were made of MCA velocity (V(MCA)) by transcranial Doppler, arterial blood pressure by non-invasive method, and end-tidal CO2, in supine and in tilted positions of 10 degrees, 30 degrees, 70 degrees grades. The cerebral autoregulation was characterized by the slope of the curve of the arterial blood pressure at the level of the Willis-circle (BP(W) as MCA perfusion pressure) plotted against the MCA velocity, achieved by linear regression (y = ax + b function, a=AR, or index of autoregulation). PATIENTS: The data of 17 parkinsonian patients (PP) and eight age-matched controls (C) were analyzed. RESULTS: The decrease of blood pressure in parkinsonian patients was significantly lower than in the controls when supine position was restored from 70 degrees (deltaABP 70 degrees - 0 degree pp = -3.1 +/- 7.5 Hgmm; deltaABP 70 degrees - 0(C) degrees = -11.1 +/- 7.3 Hgmm; p <0.05), which suggests a damage to the sympathetic cardiovascular system. A disturbance of the cerebral autoregulation in patients was suggested by a 'progressively decreasing MCA average velocity (V(MCA)) during graded tilt, which was significant at 70 degrees (deltaV(ACM) = 9.8 +/- 8.82% cms(-1); p(C-PP) P 0.5), and by a higher slope of pressure-velocity curve (AR(C) = 0.143 +/- .125% cms(-1)/Hgmm; AR(PP) = 0.38 +/- 0.25% cms(-1)/Hgmm; p(C-PP) <0.05). CONCLUSIONS: The results show that the cerebral blood flow of patients is more dependent on perfusion pressure compared to healthy controls. The disturbance of the sympathetic cardiovascular system and of cerebral autoregulation could be the consequence of a damage to the postganglionic structures in Parkinson's disease. These results could explain the frequent orthostatic intolerance of patients even with normal blood pressure.

UR - http://www.scopus.com/inward/record.url?scp=32944456520&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=32944456520&partnerID=8YFLogxK

M3 - Article

C2 - 16173273

AN - SCOPUS:32944456520

VL - 58

SP - 245

EP - 252

JO - Ideggyogyaszati Szemle

JF - Ideggyogyaszati Szemle

SN - 0019-1442

IS - 7-8

ER -