title: Cognitive and MRI correlates of orthostatic hypotension in Parkinson's disease.
abstract: Orthostatic hypotension (OH) is a frequent nonmotor feature of Parkinson's disease (PD), and its occurrence has been associated with cognitive impairment. The underlying mechanism could be mediated by development of cerebrovascular disease induced by chronic or episodic hypoperfusion, but the extent of brain vascular load in PD patients with OH has never been investigated. This study aimed to assess the relationship between OH and cognitive function in PD patients and to investigate the contribution of brain vascular lesions. Forty-eight PD patients underwent a tilt table test (TT) to assess supine and orthostatic blood pressure  as well as an extensive neuropsychological evaluation to evaluate cognitive function. Brain magnetic resonance imaging was acquired in 44/48 patients and analyzed by a visual semiquantitative scale. Twenty-three patients presented OH at TT (13/23 were symptomatic), and 25 did not. There were no differences in motor severity or disease duration between patients with and without OH. In patients with OH we found significantly worse cognitive performance in specific tasks, such as sustained attention, visuospatial and verbal memory, compared with patients without OH. However, there were no differences in vascular burden between the two groups. Our study confirms that there is an association between OH and selective cognitive deficits in PD, but rebuts the hypothesis that this is underlined by the development of cerebrovascular disease.
authors.affiliation: Department of Parkinson Disease and Movement Disorders, IRCCS San Camillo, Lido di Venezia, Venice, Italy. manuela.pilleri@ospedalesancamillo.net
authors.forename: Manuela
authors.initials: M
authors.lastname: Pilleri
authors.forename: Silvia
authors.initials: S
authors.lastname: Facchini
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Gasparoli
authors.forename: Roberta
authors.initials: R
authors.lastname: Biundo
authors.forename: Laura
authors.initials: L
authors.lastname: Bernardi
authors.forename: Mauro
authors.initials: M
authors.lastname: Marchetti
authors.forename: Patrizia
authors.initials: P
authors.lastname: Formento
authors.forename: Angelo
authors.initials: A
authors.lastname: Antonini
mesh_terms: D000368:Aged; D000978:Antiparkinson Agents / Q000627:therapeutic use; D001794:Blood Pressure; D001921:Brain / Q000473:pathology*; D003072:Cognition Disorders / Q000209:etiology*; D003430:Cross-Sectional Studies; D005260:Female; D006339:Heart Rate; D006801:Humans; D007024:Hypotension, Orthostatic / Q000150:complications / Q000209:etiology / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D010300:Parkinson Disease / Q000150:complications* / Q000188:drug therapy; D012307:Risk Factors; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric
chemical_list: D000978:Antiparkinson Agents