title: Association of cognitive dysfunction with neurocirculatory abnormalities in early Parkinson disease.
abstract: OBJECTIVE
  Cognitive impairment and neurocirculatory abnormalities such as orthostatic hypotension (OH), supine hypertension (SH), and failure to decrease blood pressure at night (nondipping) occur relatively commonly in Parkinson disease (PD); however, whether cognitive dysfunction in early PD is related to neurocirculatory abnormalities has not been established. Cognitive dysfunction in PD is associated with white matter hyperintensities on MRI. We report results of an analysis of neuropsychological and hemodynamic parameters in patients with early PD.
  
  
  METHODS
  Among 87 patients, 25 had normal cognition, 48 had mild cognitive impairment, and 14 had dementia, based on comprehensive neuropsychological tests. Orthostatic vital signs and ambulatory 24-hour blood pressure monitoring were recorded, and brain magnetic resonance scans were obtained for all patients.
  
  
  RESULTS
  Cognitive impairment was associated with OH, SH, and white matter hyperintensities but not with nondipping. Dementia and white matter hyperintensities were common in SH. Of 13 patients with OH + SH, every one had mild cognitive impairment or dementia.
  
  
  CONCLUSIONS
  Cognitive dysfunction is related to neurocirculatory abnormalities, especially OH + SH, in early PD, raising the possibility that early detection and effective treatment of those abnormalities might slow the rate of cognitive decline.
authors.affiliation: Department of Neurology, College of Medicine, The Catholic University of Korea, Seoul, Korea. neuronet@catholic.ac.kr
authors.forename: Joong-Seok
authors.initials: JS
authors.lastname: Kim
authors.forename: Yoon-Sang
authors.initials: YS
authors.lastname: Oh
authors.forename: Kwang-Soo
authors.initials: KS
authors.lastname: Lee
authors.forename: Yeong-In
authors.initials: YI
authors.lastname: Kim
authors.forename: Dong-Won
authors.initials: DW
authors.lastname: Yang
authors.forename: David S
authors.initials: DS
authors.lastname: Goldstein
mesh_terms: D000368:Aged; D002561:Cerebrovascular Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology; D060825:Cognitive Dysfunction / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology; D003704:Dementia / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000209:etiology; D007024:Hypotension, Orthostatic / Q000175:diagnosis / Q000209:etiology; D008297:Male; D009483:Neuropsychological Tests; D010300:Parkinson Disease / Q000150:complications* / Q000453:epidemiology / Q000503:physiopathology*