title: Impaired cardiovascular autonomic function in Parkinson's disease with visual hallucinations.
abstract: We assessed the relations of visual hallucinations (VH) to cardiovascular autonomic dysfunction in patients with Parkinson's disease (PD). The subjects were 37 patients without VH (VH(-)) and 31 with VH (VH(+)). Autonomic function was evaluated on the basis of cardiac 123-radioiodinated metaiodobenzylguanidine (123I-MIBG) uptake and hemodynamic testing with Valsalva maneuver. Systolic blood pressure (SBP) and plasma norepinephrine concentrations (NE) were measured by tilt-table testing. 123I-MIBG uptake was lower in VH(+) than VH(-). Hemodynamic studies showed that VH(-) had only cardiac sympathetic and parasympathetic dysfunction, while VH(+) additionally had reduced vasomotor sympathetic functions. The fall in SBP during tilt-table testing was greater in VH(+) than VH(-). NE and its difference in the supine and upright positions were decreased in VH(+). We conclude that cardiac and vasomotor sympathetic dysfunction is more severe in VH(+) than in VH(-). Severe dysfunction in PD with VH is probably attributed to Lewy-body lesions or neuronal loss in sympathetic ganglia, the central autonomic system, or both.
authors.affiliation: Department of Neurology, Jikei University School of Medicine, Tokyo, Japan.
authors.forename: Hisayoshi
authors.initials: H
authors.lastname: Oka
authors.affiliation: Department of Neurology, Jikei University School of Medicine, Tokyo, Japan.
authors.forename: Masayuki
authors.initials: M
authors.lastname: Yoshioka
authors.affiliation: Department of Neurology, Aoto Hospital, Jikei University School of Medicine, Tokyo, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Onouchi
authors.affiliation: Department of Neurology, Fuji Civilian Central Hospital, Shizuoka, Japan.
authors.forename: Masayo
authors.initials: M
authors.lastname: Morita
authors.affiliation: Department of Neurology, Third Hospital, Jikei University School of Medicine, Tokyo, Japan.
authors.forename: Soichiro
authors.initials: S
authors.lastname: Mochio
authors.affiliation: Department of Neurology, Jikei University School of Medicine, Tokyo, Japan.
authors.forename: Masahiko
authors.initials: M
authors.lastname: Suzuki
authors.affiliation: Department of Neurology, Jikei University School of Medicine, Tokyo, Japan.
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Hirai
authors.affiliation: Division of Clinical Research and Development, Jikei University School of Medicine, Tokyo, Japan.
authors.forename: Mitsuyoshi
authors.initials: M
authors.lastname: Urashima
authors.affiliation: Department of Neurology, Jikei University School of Medicine, Tokyo, Japan.
authors.forename: Kiyoharu
authors.initials: K
authors.lastname: Inoue
mesh_terms: D019797:3-Iodobenzylguanidine; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D001342:Autonomic Nervous System Diseases / Q000000981:diagnostic imaging / Q000209:etiology*; D001794:Blood Pressure / Q000502:physiology; D002318:Cardiovascular Diseases / Q000000981:diagnostic imaging / Q000209:etiology*; D005260:Female; D006212:Hallucinations / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009638:Norepinephrine / Q000097:blood; D010300:Parkinson Disease / Q000150:complications*; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D018667:Tilt-Table Test
chemical_list: D019275:Radiopharmaceuticals; D019797:3-Iodobenzylguanidine; D009638:Norepinephrine