Cardiovascular dysautonomia and cognitive impairment in Parkinson’s disease (Review).

Cardiovascular dysautonomia and cognitive impairment in Parkinson’s disease (Review).

Publication date: Jul 09, 2024

Cognitive impairment is a prevalent non-motor symptom of Parkinson’s disease (PD), which can result in significant disability and distress for patients and caregivers. There is a marked variation in the timing, characteristics and rate at which cognitive decline occurs in patients with PD. This decline can vary from normal cognition to mild cognitive impairment and dementia. Cognitive impairment is associated with several pathophysiological mechanisms, including the accumulation of β-amyloid and tau in the brain, oxidative stress and neuroinflammation. Cardiovascular autonomic dysfunctions are commonly observed in patients with PD. These dysfunctions play a role in the progression of cognitive impairment, the incidents of falls and even in mortality. The majority of symptoms of dysautonomia arise from changes in the peripheral autonomic nervous system, including both the sympathetic and parasympathetic nervous systems. Cardiovascular changes, including orthostatic hypotension, supine hypertension and abnormal nocturnal blood pressure (BP), can occur in both the early and advanced stages of PD. These changes tend to increase as the disease advances. The present review aimed to describe the cognitive changes in the setting of cardiovascular dysautonomia and to discuss strategies through which these changes can be modified and managed. It is a multifactorial process usually involving decreased blood flow to the brain, resulting in the development of cerebral ischemic lesions, an increased presence of abnormal white matter signals in the brain, and a potential influence on the process of neurodegeneration in PD. Another possible explanation is this association being independent observations of PD progression. Patients with clinical symptoms of dysautonomia should undergo 24-h ambulatory BP monitoring, as they are frequently subtle and underdiagnosed.

Concepts Keywords
Amyloid cardiac MIBG
Dementia cognitive impairment
Early dementia
Neuroinflammation dysautonomia
Supine mild cognitive impairment
non-motor symptoms
orthostatic hypotension
PD
supine hypertension

Semantics

Type Source Name
disease MESH dysautonomia
disease MESH cognitive impairment
disease MESH Parkinson’s disease
disease MESH dementia
disease MESH oxidative stress
disease MESH neuroinflammation
disease MESH orthostatic hypotension
disease MESH hypertension
drug DRUGBANK Iobenguane

Original Article

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