FUNCTIONAL STATE OF THE AUTONOMIC NERVOUS SYSTEM IN PATIENTS WITH PARKINSON'S DISEASE
DOI:
https://doi.org/10.11603/1811-2471.2022.v.i1.13007Keywords:
Parkinson's disease, autonomic dysfunction, non-motor manifestations, diagnosis, prognosisAbstract
SUMMARY. The aim – to assess the prevalence of functional disorders of the autonomic nervous system in patients with Parkinson's disease (PD) according to the regional registry of extrapyramidal pathology.
Material and Methods. The study was conducted on the basis of the neurological department of the Regional Clinical Hospital (Odesa) during 2011-2021. 364 patients were diagnosed with PD on the basis of diagnostic criteria of the British Brain Bank. Clinical and demographic data were studied: age, sex, severity according to the UPDRS scale, stage of the disease according to the Hoehn-Yahr scale, manifestations of autonomic dysfunction and their nature. Statistical processing was performed by analysis of variance and correlation analysis using Statistica 13.0 software (TIBCO, USA).
Results. According to the register, various manifestations of vegetative dysfunctions (VD) were determined in all patients with PD, whereas in 216 (59.3 %) cases VD significantly limited normal life. The most common in these patients were lability of blood pressure (94 cases or 25.8 %), palpitations (29 cases or 8.0 %), hot flashes and heat in the face (14 cases or 3.8 %). 167 (45.9 %) had sleep disorders. 26 (7.1 %) complained of increased sweating, 17 (4.7 %) patients had oily skin. Emotional lability was common (72 cases or 19.8 %).
The studied contingent was dominated by patients with severe parasympathicotonia – 324 cases or 265 (72.8 %) patients had increased autonomic reactivity, 90 (24.7 %) – decreased. Tension of trophotropic suprasegmental structures was observed in 283 (77.7 %) patients.
Conclusions: 1. Manifestations of autonomic dysfunction are identified in all patients with PD, but only 59.3 % of them have manifested autonomic stigmas
- The severity of autonomic disorders correlated with the stage of the disease (r=0.73) and the overall UPDRS score (r=0.69).
- Unbalanced autonomic supply indicates the involvement of suprasegmental structures of the autonomic nervous system, which was bilateral in most patients with PD
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