Heterogeneous pattern of autonomic dysfunction in Parkinson ’s disease

AbstractDysautonomic symptoms are frequent non-motor complaints in patients with Parkinson ’s disease. Numerous neuropathological studies have shown that Lewy bodies and neurites, the pathological hallmarks of Parkinson’s disease, are widely distributed throughout the peripheral autonomic nervous systems and across end organs. However, few investigations integrally explored the sympto ms and physiology of dysautonomia in Parkinson’s disease. We, therefore, performed a comprehensive evaluation of the autonomic function in a prospective group of 45 patients with idiopathic Parkinson’s disease. Autonomic components (pupillomotor, tear, salivary, cardiovascular, digestive, urinar y, sexual, sudomotor functions and skin sensitivity) were evaluated using questionnaires and functional tests. Skin biopsy was performed for intraepidermal nerve fibre density quantification. In addition, all patients underwent polysomnography and a complete neuropsychological and neurological asses sment. The analysis association of autonomic components showed that dysautonomic signs and symptoms were heterogeneously distributed among patients. Skin denervation as assessed by intraepidermal nerve fibre density quantification was only associated with quantitative thermal sensory testing (OR =  12.0,p = 0.02), constipation (OR = 5.5,p = 0.01) and ocular dryness symptoms (OR = 8.29,p = 0.04). Cognitive alteration was associated with cardiovascular symptoms (OR = 4.33,p = 0.03) and d...
Source: Journal of Neurology - Category: Neurology Source Type: research