scholarly journals Trajectory Analysis of Orthostatic Hypotension in Parkinson’s Disease: Results From Parkinson’s Progression Markers Initiative Cohort

2021 ◽  
Vol 13 ◽  
Author(s):  
Kui Chen ◽  
Kangshuai Du ◽  
Yichen Zhao ◽  
Yongzhe Gu ◽  
Yanxin Zhao
Keyword(s):  
Blood Pressure ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Orthostatic Hypotension ◽  
Trajectory Analysis ◽  
Latent Class ◽  
Stepwise Logistic Regression ◽  
Stable Class ◽  
Male Sex

Background: Orthostatic hypotension (OH) in Parkinson’s disease (PD) can lead to falls, impair quality of life, and increase mortality. A trajectory analysis of OH could be useful to predict and prevent the hypotension incidence early.Methods: The longitudinal data of 660 patients with PD with disease duration up to 12 years were extracted from an integrated PD database. We used latent class mixed modeling (LCMM) to identify patient subgroups, demonstrating trajectories of changes in orthostatic blood pressure (BP) over time. The optimal number of subgroups was selected by several criteria including the Bayesian Information Criterion. Baseline information comparison between groups and backward stepwise logistic regression were conducted to define the distinguishing characteristics of these subgroups and to investigate the predictors for BP trajectory.Results: We identified three trajectories for each orthostatic change of systolic blood pressure (ΔSBP), namely, Class 1 (i.e., the increasing class) consisted of 18 participants with low ΔSBP that increased continuously during the follow-up; Class 2 (i.e., the low-stable class) consisted of 610 participants with low ΔSBP that remained low throughout the follow-up; and Class 3 (i.e., the high-stable class) consisted of 32 participants with high ΔSBP at baseline that was relatively stable throughout the follow-up. Several parameters differed among subgroups, but only male sex [odds ratio (OR) = 4.687, 95% confidence interval (CI) = 1.024–21.459], lower supine diastolic blood pressure (DBP) (OR = 0.934, 95% CI = 0.876–0.996), and lower level of total protein at baseline (OR = 0.812, 95% CI = 0.700–0.941) were significant predictors of an increasing ΔSBP trajectory.Conclusion: This study provides new information on the longitudinal development of ΔSBP in patients with PD with distinct trajectories of rapidly increasing, low-stable, and high-stable class. The parameters such as male sex, lower supine DBP, and lower total proteins help to identify the rapidly increasing class.

scholarly journals Sleep disturbance subtypes in Parkinson’s disease based on the cross-culturally validated Korean version of the Parkinson’s Disease Sleep Scale-2

2019 ◽  
Author(s):  
Hui-Jun Yang ◽  
Han-Joon Kim ◽  
Seong-Beom Koh ◽  
Joong-Seok Kim ◽  
Tae-Beom Ahn ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Latent Class Analysis ◽  
Sleep Disturbance ◽  
Latent Class ◽  
Intraclass Correlation ◽  
Class Analysis ◽  
Korean Version ◽  
The Cross

Abstract Background: Sleep-related problems in Parkinson’s disease (PD) have received greater attention in recent years due to their clinical influence on morbidity, disability, and the health-related quality of life (HRQoL) of patients. This study aimed to evaluate the clinimetric properties of the Korean version of the Parkinson’s Disease Sleep Scale-2 (K-PDSS-2), and to analyze whether distinct sleep disturbance subtypes could be empirically identified in patients with PD based on the cross-culturally validated K-PDSS-2. Methods: The internal consistency, test-retest reliability, scale precision, and convergent validity of the K-PDSS-2 were assessed in a nationwide, multicenter study of 122 patients with PD. Latent class analysis (LCA) was used to derive subgroups of patients who experienced similar patterns of sleep-related problems and nocturnal disabilities. Results: The mean total K-PDSS-2 scores were 11.67 ± 9.87 (mean ± standard deviation) at baseline, and 12.61 ± 11.17 upon follow up testing. The Cronbach’s α coefficients of the total K-PDSS-2 score at baseline and at follow up testing were 0.851 and 0.880 respectively. Intraclass correlation coefficient over the 2-week period ranged from 0.672 to 0.848. The total K-PDSS-2 score was strongly correlated to HRQoL measures and other corresponding nonmotor scales. LCA indicated three distinct sleep disturbance classes in the study patients, namely “less troubled sleepers”, “PD-related nocturnal difficulties”, and “disturbed sleepers”. Conclusions: The K-PDSS-2 showed good clinimetric attributes in accordance with prior studies that were using the original version of the PDSS-2, therefore confirming the cross-cultural usefulness of the scale. Further, this study documents the first application of an LCA approach for identifying sleep disturbance subtypes in patients with PD. Keywords: Parkinson’s disease; sleep; PDSS-2; validity; reliability; Korean version; latent class analysis.

Ambulatory blood pressure in patients with Parkinson's disease without and with orthostatic hypotension

1992 ◽  
Vol 2 (2) ◽  
pp. 99-104 ◽  
Author(s):  
Jean-Michel Senard ◽  
Bernard Chamontin ◽  
André Rascol ◽  
Jean-Louis Montastruc
Keyword(s):  
Blood Pressure ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Orthostatic Hypotension ◽  
Ambulatory Blood Pressure

scholarly journals Orthostatic Hypotension in Parkinson's Disease: The Relation of Blood Pressure Tests and Symptoms in Daily Life

2016 ◽  
Vol 4 (3) ◽  
pp. 329-334 ◽  
Author(s):  
Daan C. Velseboer ◽  
Rob J. de Haan ◽  
Bart Post ◽  
C.T.P. Paul Krediet ◽  
Hein J. Verberne ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Orthostatic Hypotension ◽  
Daily Life ◽  
Pressure Tests

scholarly journals Delayed orthostatic hypotension in Parkinson’s disease

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Sang-Won Yoo ◽  
Joong-Seok Kim ◽  
Ji-Yeon Yoo ◽  
Eunkyeong Yun ◽  
Uicheul Yoon ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Orthostatic Hypotension ◽  
Disease Severity ◽  
Cortical Thickness ◽  
Early Stage ◽  
Brain Magnetic Resonance Imaging ◽  
Clinical Scales ◽  
Drug Naïve

AbstractOrthostatic hypotension (OH) is relatively common in the early stage of Parkinson’s disease (PD). It is divided into delayed OH and classical OH. Classical OH in PD has been investigated widely, however, the clinical implications of delayed OH in PD have seldom been studied. The purpose of this study is to characterize delayed OH in PD. A total of 285 patients with early drug-naïve PD were enrolled and divided into three groups according to orthostatic change: no-OH, delayed OH, and classical OH. The disease severity in terms of motor, non-motor, and cognitive functions was assessed. The cortical thickness of 82 patients was analyzed with brain magnetic resonance imaging. The differences among groups and linear tendency in the order of no-OH, delayed OH, and classical OH were investigated. Seventy-seven patients were re-evaluated. Initial and follow-up evaluations were explored to discern any temporal effects of orthostasis on disease severity. Sixty-four (22.5%) patients were defined as having delayed OH and 117 (41.1%) had classical OH. Between-group comparisons revealed that classical OH had the worst outcomes in motor, non-motor, cognitive, and cortical thickness, compared to the other groups. No-OH and delayed OH did not differ significantly. Linear trends across the pre-ordered OH subtypes found that clinical parameters worsened along with the orthostatic challenge. Clinical scales deteriorated and the linear gradient was maintained during the follow-up period. This study suggests that delayed OH is a mild form of classical OH in PD. PD with delayed OH has milder disease severity and progression.

Frequency of Orthostatic Hypotension in Parkinson’s Disease

2021 ◽  
Vol 15 (11) ◽  
pp. 2886-2889
Author(s):  
Ali Qayyum ◽  
Ehsan Ul Haq ◽  
Shoaib Zafar ◽  
Javaria . ◽  
Muhammad Moss ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Orthostatic Hypotension ◽  
Diastolic Blood Pressure ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Female Ratio ◽  
Parkinson’S Diseases ◽  
The Mean

Background: Parkinson’s Diseases (PD) cause some non-motor issues that could lead to disability. One of such determinal non-motor symptoms is orthostatic hypotension (OH) which is still understudied in our local setting despite of its high prevalence worldwide among patients of PD. Aim: To determine frequency of orthostatic hypotension in Parkinson’s disease Methods: This Cross-sectional study was conducted at Department of Neurology, Mayo Hospital, Lahore for 6 months after the approval of synopsis [April 9, 2018 till Oct 9, 2018]. A sample of 95 cases was selected using non probability consecutive sampling from 95 patients of Parkinson’s Disease aged 25 years and more. After taking consent from patient and recording sociodemographic information, a lying-to-standing orthostatic test was performed to evaluate the orthostatic hypotension and SBP and DBP was recorded. All data was collected using a self structured proforma and analyzed using SPSS v 21. Results: The mean age of cases was 47.46 ± 8.97 years with male to female ratio of 1.97:1. The mean systolic and diastolic blood pressure was 120.60 ± 11.80 and 86.20 ± 8.68 respectively. The frequency of orthostatic hypotension was seen in 51(53.7%) while other 44(46.3%) cases did not have orthostatic hypotension. Conclusion: Through the findings of this study we conclude that frequency of orthostatic hypotension in Parkinson’s disease is very much high i.e. 53.7% with highest frequency in cases with longer duration of disease. Keywords: Autonomic diseases, Parkinson’s disease, Systolic blood pressure, diastolic blood pressure, Orthostatic hypotension,

scholarly journals Nondipping in Parkinson's Disease

2011 ◽  
Vol 2011 ◽  
pp. 1-5 ◽  
Author(s):  
Sita Sommer ◽  
Billur Aral-Becher ◽  
Wolfgang Jost
Keyword(s):  
Blood Pressure ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Arterial Hypertension ◽  
Orthostatic Hypotension ◽  
Autonomic Dysfunction ◽  
Blood Pressure Monitoring ◽  
Pressure Monitoring ◽  
Blood Pressure Fall ◽  
High Prevalence

Objective. The aim of this study was to identify patients with Parkinson's disease who showed loss or decrease of nocturnal blood pressure fall (nondipper patients) as a marker of autonomic dysfunction. Presence or absence of orthostatic hypotension was considered to investigate whether alterations in circadian blood pressure pattern are associated with posture-related dysregulation of blood pressure.Methods. 40 patients with Parkinson's disease underwent 24-hour blood pressure monitoring. 21 patients were diagnosed with arterial hypertension and received anti-hypertensive drugs. Nondipper patients were defined as having nocturnal decrease of mean systolic and diastolic blood pressure less than 10%. Presence or absence of orthostatic hypotension was determined by Schellong's test.Results. We identified 35 nondipper patients (88%). Nondipping was detected in 20 patients with orthostatic hypotension (95%) and in 15 patients without orthostatic hypotension (79%). 18 patients with hypertensive and 22 patients with normal blood pressure values were detected.Conclusions. In conclusion 24-hour blood pressure monitoring showed a high prevalence of nondipping in 40 patients with Parkinson's disease with and without orthostatic hypotension independent of coexisting arterial hypertension and antihypertensive treatment. 24-hour blood pressure monitoring may be useful to identify non-dipping as a marker of autonomic dysfunction in patients with Parkinson's disease.

scholarly journals Evolution of Orofacial Symptoms and Disease Progression in Idiopathic Parkinson’s Disease: Longitudinal Data from the Jönköping Parkinson Registry

2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
Seyed-Mohammad Fereshtehnejad ◽  
Örjan Skogar ◽  
Johan Lökk
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Routine Care ◽  
Autonomic Disturbance ◽  
Advanced Stages ◽  
Male Sex ◽  
Late Stages ◽  
Updrs Part ◽  
Registry Database

Background. Orofacial symptoms are common in Parkinson’s disease (PD) both as initial manifestations and late markers of disease complications. We aimed to investigate the evolution of orofacial manifestations and their prognostic value throughout PD progression. Methods. Data was obtained from “Jönköping Parkinson Registry” database on routine care visits of 314 people with idiopathic PD in southern Sweden. Information on baseline symptomatology, orofacial features, UPDRS, and medications was recorded at baseline and during each follow-up visit within an average of 4.2 (range: 1–12) years. Results. Hypomimia, affected speech, drooling, and impaired swallowing were present in 37.3%/91.6%, 14.1%/65.5%, 11.7%/55.3%, and 10.2%/34.5% at baseline/follow-up, respectively. Male sex [OR = 2.4 (95% CI: 1.0–5.9)], UPDRS motor scores [OR = 1.2 (95% CI: 1.1–1.3)], dominant rigidity [OR = 5.2 (95% CI: 1.4–19.1)], and autonomic disturbance [OR = 3.4 (95% CI: 1.1–10.9)] were risk factors for drooling. Individuals with more severe orofacial burden at baseline had shorter median time to develop UPDRS-Part III > 28 [3rd tertile = 4.7 yr, 2nd tertile = 6.2 yr, and 1st tertile = 7.8 yr; p = 0.014]. Conclusions. Majority of people with PD manifest orofacial manifestations at either early or late stages of the disease. PD severity, symmetry of motor disturbances, and autonomic disorders correlate with orofacial symptoms. Individuals with more severe orofacial burden at baseline progressed faster to more advanced stages.

scholarly journals Ambulatory blood pressure in patients with Parkinson's disease without and with orthostatic hypotension

1992 ◽  
Vol 2 (5) ◽  
pp. 354-354
Author(s):  
Jean-Michel Senard ◽  
Bernard Chamontin ◽  
André Rascol ◽  
Jean-Louis Montastruc
Keyword(s):  
Blood Pressure ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Orthostatic Hypotension ◽  
Ambulatory Blood Pressure

scholarly journals Rehabilitation training improves subjective cognitive decline in Parkinson's disease patients: A prospective analysis

2020 ◽  
Author(s):  
Shi Rong Wen ◽  
Guang Yang ◽  
Si Jia Xu ◽  
Yan Liu ◽  
Yu Jun Pan
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cognitive Decline ◽  
Cognitive Performance ◽  
Subjective Cognitive Decline ◽  
Stepwise Logistic Regression ◽  
Semantic Fluency ◽  
Stepwise Logistic Regression Analysis ◽  
Rehabilitation Training

Abstract Background: The predictive value of subjective cognitive decline in Parkinson's disease (PD-SCD) remains controversial. However, there is growing evidence that individuals with subjective cognitive decline (SCD) are associated with Alzheimer's disease pathology and are a higher risk for cognitive decline. The aim of the present study is to characterize PD-SCD and its progression, assess the effects of rehabilitation training programs on cognitive function in PD patients.Methods: Forty-two PD patients were evaluated with a neuropsychological protocol, and classified depending on the presence (PD-SCD+, n=22) or absence of SCD (PD-SCD-,n=20). After a mean follow-up of 3.0 years (2.0-4.0 years), we repeated the cognitive assessments with the same subjects. The rehabilitation training for individuals with PD for six months after the re-assessment.Results: The clinical characteristics and overall cognitive performance of the 2 groups did not differ from baseline. During the follow-up assessment, patients with PD-SCD exhibited a more significant annual decline in Chinese-Beijing version of Montreal Cognitive Assessment-Test (BJ-MoCA) and semantic fluency than patients without PD-SCD. Stepwise logistic regression analysis showed that the MMSE Scores(P=0.000), HAMD Scores (P=0.008), male (P=0.026), and the presence of SCD (P=0.022) were risk factors for language and related functions domain. There are significant improvements detected in 2 groups after rehabilitation training in terms of BJ-MoCA. Pairwise comparisons showed that language at post-intervention in the PD-SCD+ groups were significantly higher than at pre-intervention in the PD-SCD-.Conclusion: With the progression of the disease, the cognitive performance of patients with PD-SCD+ was worse than PD-SCD-. Meanwhile, the present data indicate that semantic fluency might be a key component to evaluate the cognitive subset of PD. Rehabilitation training is a viable intervention for PD that can improve several non-motor domains, produced larger improvements in cognition.

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