This Article Full Text Full Text (PDF) All Versions of this Article: 49/1/21    most recent 01.HYP.0000250920.38461.edv1 Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Biaggioni, I. Search for Related Content PubMed PubMed Citation Articles by Biaggioni, I. Pubmed/NCBI databases Medline Plus Health Information Autonomic Nervous System Disorders Parkinson's Disease Patient Rights Related Collections Autonomic, reflex, and neurohumoral control of circulation Related Article

(Hypertension. 2007;49:21.)
© 2007 American Heart Association, Inc.

Editorial Commentaries

Parkinson’s Disease

Autonomic Neuronopathy With Impaired Cardiovascular Regulation

Italo Biaggioni

From the Department of Medicine, Division of Clinical Pharmacology, and the Autonomic Dysfunction Center, Vanderbilt University School of Medicine, Nashville, Tenn.

Correspondence to Italo Biaggioni, 1500 21st Avenue South, Suite 3500, Clinical Trials Center, Vanderbilt University, Nashville, TN 37212. E-mail Italo.biaggioni@vanderbilt.edu

An extract of the first 250 words of the full text is provided, because this article has no abstract.

Parkinson’s Disease (PD) is generally considered a movement disorder characterized by loss of dopaminergic neurons in the central nervous system (CNS), most notably in the substantia nigra. The pathogenesis of the neuronal degeneration is not completely understood but is characterized by abnormal protein deposits forming characteristic neuronal inclusions, which are visible by light microscopy of autopsy samples, and termed Lewy bodies. -Synuclein is one of the proteins found in these inclusions and has attracted interest because mutations of the gene encoding for this protein are found in familiar cases of PD. Most of the disability associated with PD is indeed the result of this CNS defect, and the treatment is aimed at increasing dopamine levels in the CNS, while avoiding as much as possible an increase in the periphery.

Less widely recognized is the fact that orthostatic hypotension can occur in PD patients and can become symptomatic and disabling in a significant proportion of patients. The incidence of documented orthostatic hypotension in PD, in community-based studies, ranges from 10% to 40%.

Orthostatic hypotension in PD is commonly attributed to the known adverse effects of dopaminergic drugs. However, over the last decade there is growing evidence that peripheral nerves, particularly autonomic neurons, are also involved in PD. Lewy body inclusions, containing -synuclein, have been found in peripheral autonomic neurons in autopsy cases of otherwise classic PD.¹ Microscopically, eosinophilic ubiquitin- and -synuclein–positive Lewy Bodies and Lewy neurites are not only found in the substantia nigra and locus ceruleus but also are widespread . . . [Full Text of this Article]

Related Article:

Early Abnormalities of Vascular and Cardiac Autonomic Control in Parkinson’s Disease Without Orthostatic Hypotension

Franca Barbic, Francesca Perego, Margherita Canesi, Michela Gianni, Sara Biagiotti, Giorgio Costantino, Giovanni Pezzoli, Alberto Porta, Alberto Malliani, and Raffaello Furlan
Hypertension 2007 49: 120-126. [Abstract] [Full Text] [PDF]

This article has been cited by other articles:

				R. Freeman Neurogenic Orthostatic Hypotension N. Engl. J. Med., February 7, 2008; 358(6): 615 - 624. [Full Text] [PDF]