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Impaired cardiovascular autonomic control in newly and long-term-treated patients with Parkinson's disease: involvement of L-dopa therapy.
Auton Neurosci. 2004 Nov 30; 116(1-2):30-8.AN

Abstract

In idiopathic Parkinson's disease (PD), autonomic dysfunction is frequent, causing orthostatic hypotension. The respective roles of disease progression and dopaminergic treatment remain unclear. In this study, we investigated the autonomic control of cardiovascular functions and its relation to L-dopa therapy in both newly diagnosed (ND) and long-term-treated (LT) patients. Study subjects were: (1) nine ND patients never having undergone treatment with L-dopa; (2) 18 LT patients who had been receiving L-dopa treatment for a long period. ND patients were investigated before L-dopa treatment and after stabilization of their L-dopa dosage. LT patients were investigated once with their regular treatment and once after a 12-h interruption of L-dopa treatment; (3) nine healthy subjects served as controls. At each test session, blood pressure (BP), heart rate (HR), plasma catecholamines, heart rate variability (HRV), and spontaneous baroreflex sensitivity were assessed in the supine and upright positions. Before receiving L-dopa medication, ND patients had reduced E/I ratios (HR response/deep breathing) and lowered HRV when compared to controls; this was evidence of early effects of the disease on autonomic HR control. Introduction of L-dopa treatment reduced BP, HR, and plasma levels of adrenaline and noradrenaline. Similar changes were found in LT patients when contrasting the short-term treatment interruption and the usual L-dopa dosage. The treatment-linked increase in plasma dopamine also correlated with the decrease in noradrenaline. These results showed that mild impairment of autonomic cardiovascular control occurred early in the course of PD. They also provided evidence that the side effects of L-dopa aggravated the impairment of the autonomic control of BP and HR.

Authors+Show Affiliations

Physiologie--Explorations Fonctionnelles Rénales and UPRES EA479 IFR133, Centre Hospitalier Universitaire, Besançon F-25030, France. malika.bouhaddi@ufc-chu.univ-fcomte.frNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

15556835

Citation

Bouhaddi, M, et al. "Impaired Cardiovascular Autonomic Control in Newly and Long-term-treated Patients With Parkinson's Disease: Involvement of L-dopa Therapy." Autonomic Neuroscience : Basic & Clinical, vol. 116, no. 1-2, 2004, pp. 30-8.
Bouhaddi M, Vuillier F, Fortrat JO, et al. Impaired cardiovascular autonomic control in newly and long-term-treated patients with Parkinson's disease: involvement of L-dopa therapy. Auton Neurosci. 2004;116(1-2):30-8.
Bouhaddi, M., Vuillier, F., Fortrat, J. O., Cappelle, S., Henriet, M. T., Rumbach, L., & Regnard, J. (2004). Impaired cardiovascular autonomic control in newly and long-term-treated patients with Parkinson's disease: involvement of L-dopa therapy. Autonomic Neuroscience : Basic & Clinical, 116(1-2), 30-8.
Bouhaddi M, et al. Impaired Cardiovascular Autonomic Control in Newly and Long-term-treated Patients With Parkinson's Disease: Involvement of L-dopa Therapy. Auton Neurosci. 2004 Nov 30;116(1-2):30-8. PubMed PMID: 15556835.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Impaired cardiovascular autonomic control in newly and long-term-treated patients with Parkinson's disease: involvement of L-dopa therapy. AU - Bouhaddi,M, AU - Vuillier,F, AU - Fortrat,J O, AU - Cappelle,S, AU - Henriet,M T, AU - Rumbach,L, AU - Regnard,J, PY - 2003/10/20/received PY - 2004/06/21/revised PY - 2004/06/29/accepted PY - 2004/11/24/pubmed PY - 2005/2/16/medline PY - 2004/11/24/entrez SP - 30 EP - 8 JF - Autonomic neuroscience : basic & clinical JO - Auton Neurosci VL - 116 IS - 1-2 N2 - In idiopathic Parkinson's disease (PD), autonomic dysfunction is frequent, causing orthostatic hypotension. The respective roles of disease progression and dopaminergic treatment remain unclear. In this study, we investigated the autonomic control of cardiovascular functions and its relation to L-dopa therapy in both newly diagnosed (ND) and long-term-treated (LT) patients. Study subjects were: (1) nine ND patients never having undergone treatment with L-dopa; (2) 18 LT patients who had been receiving L-dopa treatment for a long period. ND patients were investigated before L-dopa treatment and after stabilization of their L-dopa dosage. LT patients were investigated once with their regular treatment and once after a 12-h interruption of L-dopa treatment; (3) nine healthy subjects served as controls. At each test session, blood pressure (BP), heart rate (HR), plasma catecholamines, heart rate variability (HRV), and spontaneous baroreflex sensitivity were assessed in the supine and upright positions. Before receiving L-dopa medication, ND patients had reduced E/I ratios (HR response/deep breathing) and lowered HRV when compared to controls; this was evidence of early effects of the disease on autonomic HR control. Introduction of L-dopa treatment reduced BP, HR, and plasma levels of adrenaline and noradrenaline. Similar changes were found in LT patients when contrasting the short-term treatment interruption and the usual L-dopa dosage. The treatment-linked increase in plasma dopamine also correlated with the decrease in noradrenaline. These results showed that mild impairment of autonomic cardiovascular control occurred early in the course of PD. They also provided evidence that the side effects of L-dopa aggravated the impairment of the autonomic control of BP and HR. SN - 1566-0702 UR - https://www.unboundmedicine.com/medline/citation/15556835/Impaired_cardiovascular_autonomic_control_in_newly_and_long_term_treated_patients_with_Parkinson's_disease:_involvement_of_L_dopa_therapy_ DB - PRIME DP - Unbound Medicine ER -