Rotigotine Improves Abnormal Circadian Rhythm of Blood Pressure in Parkinson’s Disease

Introduction: Cardiovascular autonomic failure is commonly associated with Parkinson’s disease (PD), affecting the daily lives of patients. Rotigotine was recently reported not to influence cardiovascular autonomic responses in contrast to other dopaminergic drugs. The effect of rotigotine on daily blood pressure (BP) fluctuations might reflect autonomic failure in patients with PD. Methods: Twenty-five PD patients who were receiving rotigotine and 12 patients not receiving rotigotine were recruited. Systolic BP during the daytime and nighttime was measured by 24-h BP monitoring at an interval of 2 years. The patients were divided into 3 groups according to the BP fluctuation type: dippers (nocturnal fall in BP ≥10%), non-dippers (0–10%), and risers (< 0%). The time course of BP was compared between the patients given rotigotine and those not given rotigotine. Results: Among the 25 patients who received rotigotine, the BP type worsened in 2 patients, was unchanged in 16 patients, and improved in 7 patients. Among the 12 patients who were not receiving rotigotine, the BP type worsened in 5 patients, was unchanged in 4 patients, and improved only in 3 patients (p = 0.042). Conclusion: Rotigotine improves the abnormal circadian rhythm of BP in patients with PD. Rotigotine was suggested to have favorable effects on cardiovascular autonomic responses and circadian rhythm in patients with PD.

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Schizophrenia, Parkinson’s disease, and attention deficit hyperactivity disorder

10.1093/oso/9780198824091.003.0009 ◽

2018 ◽

Author(s):

Richard J. Beninger

Keyword(s):

Parkinson’S Disease ◽

Attention Deficit Hyperactivity Disorder ◽

Parkinson's Disease ◽

Attention Deficit ◽

Antipsychotic Treatment ◽

Incentive Learning ◽

Dopaminergic Drugs ◽

Dopaminergic Neurotransmission ◽

Hyperactivity Disorder ◽

Incentive Value

Schizophrenia, Parkinson’s disease, and attention deficit hyperactivity disorder (ADHD) discusses how hyperactive dopaminergic neurotransmission appears to underlie schizophrenia’s positive symptoms, loss of dopaminergic neurons in adulthood leads to Parkinson’s disease, and dopamine neuron hypofunction in childhood and adolescence may underlie ADHD. Positive schizophrenia symptoms may arise from excessive incentive learning that is gradually lost with antipsychotic treatment. Declarative learning and memory may contribute to delusions based on excessive incentive learning. Loss of responsiveness to environmental stimuli in Parkinson’s may result from a decrease of their conditioned incentive value and inverse incentive learning. Conditioned incentive stimuli not encountered while in a state of decreased dopaminergic neurotransmission may retain their incentive value, producing apparent kinesia paradoxa. Dopamine hypofunction in juveniles does not lead to hypokinesia but may result in loss of incentive learning that focuses attention. Pro-dopaminergic drugs have a calming effect in ADHD, presumably because they reinstate normal incentive learning.

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Blood Pressure Patterns in Patients with Parkinson’s Disease: A Systematic Review

Journal of Personalized Medicine ◽

10.3390/jpm11020129 ◽

2021 ◽

Vol 11 (2) ◽

pp. 129

Author(s):

Delia Tulbă ◽

Liviu Cozma ◽

Paul Bălănescu ◽

Adrian Buzea ◽

Cristian Băicuș ◽

...

Keyword(s):

Blood Pressure ◽

Parkinson’S Disease ◽

Parkinson's Disease ◽

Ambulatory Blood Pressure Monitoring ◽

Ambulatory Blood Pressure ◽

Blood Pressure Monitoring ◽

Pressure Monitoring ◽

Pressure Profiles ◽

Pubmed Database ◽

Blood Pressure Patterns

(1) Background: Cardiovascular autonomic dysfunction is a non-motor feature in Parkinson’s disease with negative impact on functionality and life expectancy, prompting early detection and proper management. We aimed to describe the blood pressure patterns reported in patients with Parkinson’s disease, as measured by 24-h ambulatory blood pressure monitoring. (2) Methods: We conducted a systematic search on the PubMed database. Studies enrolling patients with Parkinson’s disease undergoing 24-h ambulatory blood pressure monitoring were included. Data regarding study population, Parkinson’s disease course, vasoactive drugs, blood pressure profiles, and measurements were recorded. (3) Results: The search identified 172 studies. Forty studies eventually fulfilled the inclusion criteria, with 3090 patients enrolled. Abnormal blood pressure profiles were commonly encountered: high blood pressure in 38.13% of patients (938/2460), orthostatic hypotension in 38.68% (941/2433), supine hypertension in 27.76% (445/1603) and nocturnal hypertension in 38.91% (737/1894). Dipping status was also altered often, 40.46% of patients (477/1179) being reverse dippers and 35.67% (310/869) reduced dippers. All these patterns were correlated with negative clinical and imaging outcomes. (4) Conclusion: Patients with Parkinson’s disease have significantly altered blood pressure patterns that carry a negative prognosis. Ambulatory blood pressure monitoring should be validated as a biomarker of PD-associated cardiovascular dysautonomia and a tool for assisting therapeutic interventions.

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Association of depressive symptoms with circadian blood pressure alterations in Parkinson's disease

Parkinsonism & Related Disorders ◽

10.1016/j.parkreldis.2015.10.117 ◽

2016 ◽

Vol 22 ◽

pp. e57

Author(s):

Maria Stella Pisciotta ◽

Davide Liborio Vetrano ◽

Vincenzo Brandi ◽

Maria Rita Lo Monaco ◽

Alice Laudisio ◽

...

Keyword(s):

Blood Pressure ◽

Parkinson’S Disease ◽

Parkinson's Disease ◽

Depressive Symptoms ◽

Circadian Blood Pressure

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Dissociation between urate and blood pressure in mice and in people with early Parkinson's disease

EBioMedicine ◽

10.1016/j.ebiom.2018.10.039 ◽

2018 ◽

Vol 37 ◽

pp. 259-268 ◽

Cited By ~ 3

Author(s):

Xiqun Chen ◽

Chizoba C. Umeh ◽

Robert E. Tainsh ◽

Danielle D. Feng ◽

Michael Maguire ◽

...

Keyword(s):

Blood Pressure ◽

Parkinson’S Disease ◽

Parkinson's Disease ◽

Early Parkinson’S Disease

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Time course of changes in striatal dopamine transporters and D2 receptors with specific iodinated markers in a rat model of Parkinson's disease

Synapse ◽

10.1002/(sici)1098-2396(199902)31:2<134::aid-syn6>3.0.co;2-v ◽

1999 ◽

Vol 31 (2) ◽

pp. 134-139 ◽

Cited By ~ 35

Author(s):

Sylvie Chalon ◽

Patrick Emond ◽

Sylvie Bodard ◽

Marie-Paule Vilar ◽

Cynthia Thiercelin ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Rat Model ◽

Time Course ◽

D2 Receptors ◽

Striatal Dopamine ◽

Dopamine Transporters

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Myocardial123I-MIBG Uptake and Cardiovascular Autonomic Function in Parkinson’s Disease

Parkinson s Disease ◽

10.1155/2015/805351 ◽

2015 ◽

Vol 2015 ◽

pp. 1-5 ◽

Cited By ~ 1

Author(s):

Akira Katagiri ◽

Masato Asahina ◽

Nobuyuki Araki ◽

Anupama Poudel ◽

Yoshikatsu Fujinuma ◽

...

Keyword(s):

Blood Pressure ◽

Parkinson’S Disease ◽

Parkinson's Disease ◽

Autonomic Function ◽

Low Frequency ◽

Washout Rate ◽

Tilt Test ◽

Mibg Uptake ◽

Cardiovascular Autonomic Function ◽

Frequency Power

Introduction. Patients with Parkinson’s disease (PD) showed reduced myocardial123I-MIBG uptake, which may affect autonomic regulation. We investigated correlation between MIBC accumulation and cardiovascular autonomic function in PD.Methods. We performed myocardial MIBG scintigraphy, heart rate variability (HRV) analysis, and the head-up tilt test (HUT) in 50 PD patients (66.4±7.8years; duration5.5±5.9years). Autonomic function tests were also performed in 50 healthy controls (66.5±8.9years). As HRV parameters, a high-frequency power (HF, 0.15–0.4 Hz), a low-frequency power (LF, 0.04–0.15 Hz), and LF/HF ratio were used.Results. Our PD patients had a significant reduction in LF and HF compared with the controls (P=0.005andP=0.01). In HUT, systolic and diastolic blood pressure falls in the PD group were significantly greater than those in the controls (P=0.02andP=0.02). The washout rate of MIBG was negatively correlated with blood pressure changes during HUT.Conclusion. Our PD patients showed reduced HRV, blood pressure dysregulation, and reduced MIBG accumulation, which was correlated with blood pressure dysregulation. Orthostatic hypotension in PD may be mainly caused by sympathetic postganglionic degeneration.

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O-017: Association of circadian blood pressure alterations and disease features in Parkinson's disease

European Geriatric Medicine ◽

10.1016/s1878-7649(15)30031-0 ◽

2015 ◽

Vol 6 ◽

pp. S9-S10

Author(s):

D.L. Vetrano ◽

M.S. Pisciotta ◽

V. Brandi ◽

M.R. Lo Monaco ◽

A. Laudisio ◽

...

Keyword(s):

Blood Pressure ◽

Parkinson’S Disease ◽

Parkinson's Disease ◽

Circadian Blood Pressure

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Acute Cardiovascular Responses to Self-selected Intensity Exercise in Parkinson's Disease

International Journal of Sports Medicine ◽

10.1055/a-1529-6480 ◽

2021 ◽

Author(s):

Hélcio Kanegusuku ◽

Gabriel Grizzo Cucato ◽

Paulo Longano ◽

Erika Okamoto ◽

Maria Elisa Pimentel Piemonte ◽

...

Keyword(s):

Blood Pressure ◽

Parkinson’S Disease ◽

Heart Rate ◽

Parkinson's Disease ◽

Pulse Wave ◽

Augmentation Index ◽

Cardiovascular Responses ◽

Cycle Ergometer ◽

Control Session ◽

Wave Analysis

AbstractParkinson’s disease patients frequently present cardiovascular dysfunction. Exercise with a self-selected intensity has emerged as a new strategy for exercise prescription aiming to increase exercise adherence. Thus, the current study evaluated the acute cardiovascular responses after a session of aerobic exercise at a traditional intensity and at a self-selected intensity in Parkinson’s disease patients. Twenty patients (≥ 50 years old, Hoehn & Yahr 1–3 stages) performed 3 experimental sessions in random order: Traditional session (cycle ergometer, 25 min, 50 rpm, 60–80% maximum heart rate); Self-selected intensity: (cycle ergometer, 25 min, 50 rpm with self-selected intensity); and Control session (resting for 25 min). Before and after 30 min of intervention, brachial and central blood pressure (auscultatory method and pulse wave analysis, respectively), cardiac autonomic modulation (heart rate variability), and arterial stiffness (pulse wave analysis) were evaluated. Brachial and central systolic and diastolic blood pressure, heart rate, and the augmentation index increased after the control session, whereas no changes were observed after the exercise sessions (P<0.01). Pulse wave velocity and cardiac autonomic modulation parameters did not change after the three interventions. In conclusion, a single session of traditional intensity or self-selected intensity exercises similarly blunted the increase in brachial and central blood pressure and the augmentation index compared to a non-exercise control session in Parkinson’s disease patients.

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