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[Utility of the study of the vegetative nervous system in the differential diagnosis between Parkinson's disease and multiple system atrophy].
Neurologia. 2006 Apr; 21(3):119-23.N

Abstract

INTRODUCTION

The aim of this study is to show if the exploration of the autonomic nervous system is useful to improve the specificity of clinical criteria of Parkinson's Disease (PD) and Multiple System Atrophy (MSA).

PATIENTS AND METHODS

20 patients with PD and 13 patients with MSA were studied. After 12 hours in off medication, NE and GH were measured in supine position and NE after 5 minutes standing. Later, GH levels were recorded at 15, 30, 45 and 60 minutes after a dose of 0.005 mg/kg of apomorphine. Finally, analysis of the symptoms of autonomic dysfunction and levodopa test were carried out.

RESULTS

Sympathetic response to postural changes was significantly higher in patients with PD (NE increase in relation to basal: PD: 170.90 +/- 110.08 pg/ml; MSA: 91.33 +/- 73.79 pg/ml; p = 0.029). No differences were found in the response of GH to apomorphine (GH peak at 45 minutes: PD: 2.37 +/- 2.7 ng/ml; MSA: 1.69 +/- 1.90 ng/ml; ns). The symptoms of autonomic dysfunction were more frequently in patients with MSA. The stridor was specific to MSA. Improvement in motor scores in the levodopa test was higher in patients with PD (PD: 39.7 %; MSA: 17.89; p = 0.019).

DISCUSSION

Sympathetic response to postural changes, description of symptoms of autonomic dysfunction, and motor response to levodopa test are useful tools in order to improve specificity of the diagnostic criteria of PD and MSA. The GH test with apomorphine was not useful for a differential diagnosis.

Authors+Show Affiliations

Servicio de Neurología, Hospital de Cruces, Baracaldo, Vizcaya. i.rouco@telefonica.netNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

English Abstract
Journal Article

Language

spa

PubMed ID

16575624

Citation

Rouco, I, et al. "[Utility of the Study of the Vegetative Nervous System in the Differential Diagnosis Between Parkinson's Disease and Multiple System Atrophy]." Neurologia (Barcelona, Spain), vol. 21, no. 3, 2006, pp. 119-23.
Rouco I, Gómez JC, Lezcano E, et al. [Utility of the study of the vegetative nervous system in the differential diagnosis between Parkinson's disease and multiple system atrophy]. Neurologia. 2006;21(3):119-23.
Rouco, I., Gómez, J. C., Lezcano, E., Aniel-Quiroga, M. A., Velasco, F., Barcena, J., Pérez Bas, M., Hurtado, P., Cruz Lachén, M., & Zarranz, J. J. (2006). [Utility of the study of the vegetative nervous system in the differential diagnosis between Parkinson's disease and multiple system atrophy]. Neurologia (Barcelona, Spain), 21(3), 119-23.
Rouco I, et al. [Utility of the Study of the Vegetative Nervous System in the Differential Diagnosis Between Parkinson's Disease and Multiple System Atrophy]. Neurologia. 2006;21(3):119-23. PubMed PMID: 16575624.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Utility of the study of the vegetative nervous system in the differential diagnosis between Parkinson's disease and multiple system atrophy]. AU - Rouco,I, AU - Gómez,J C, AU - Lezcano,E, AU - Aniel-Quiroga,M A, AU - Velasco,F, AU - Barcena,J, AU - Pérez Bas,M, AU - Hurtado,P, AU - Cruz Lachén,M, AU - Zarranz,J J, PY - 2006/4/1/pubmed PY - 2006/10/4/medline PY - 2006/4/1/entrez SP - 119 EP - 23 JF - Neurologia (Barcelona, Spain) JO - Neurologia VL - 21 IS - 3 N2 - INTRODUCTION: The aim of this study is to show if the exploration of the autonomic nervous system is useful to improve the specificity of clinical criteria of Parkinson's Disease (PD) and Multiple System Atrophy (MSA). PATIENTS AND METHODS: 20 patients with PD and 13 patients with MSA were studied. After 12 hours in off medication, NE and GH were measured in supine position and NE after 5 minutes standing. Later, GH levels were recorded at 15, 30, 45 and 60 minutes after a dose of 0.005 mg/kg of apomorphine. Finally, analysis of the symptoms of autonomic dysfunction and levodopa test were carried out. RESULTS: Sympathetic response to postural changes was significantly higher in patients with PD (NE increase in relation to basal: PD: 170.90 +/- 110.08 pg/ml; MSA: 91.33 +/- 73.79 pg/ml; p = 0.029). No differences were found in the response of GH to apomorphine (GH peak at 45 minutes: PD: 2.37 +/- 2.7 ng/ml; MSA: 1.69 +/- 1.90 ng/ml; ns). The symptoms of autonomic dysfunction were more frequently in patients with MSA. The stridor was specific to MSA. Improvement in motor scores in the levodopa test was higher in patients with PD (PD: 39.7 %; MSA: 17.89; p = 0.019). DISCUSSION: Sympathetic response to postural changes, description of symptoms of autonomic dysfunction, and motor response to levodopa test are useful tools in order to improve specificity of the diagnostic criteria of PD and MSA. The GH test with apomorphine was not useful for a differential diagnosis. SN - 0213-4853 UR - https://www.unboundmedicine.com/medline/citation/16575624/[Utility_of_the_study_of_the_vegetative_nervous_system_in_the_differential_diagnosis_between_Parkinson's_disease_and_multiple_system_atrophy]_ DB - PRIME DP - Unbound Medicine ER -