title: 24-Hour Ambulatory Blood Pressure Monitoring in SWEDDs Patients With Parkinsonism.
abstract: BACKGROUND
  Patients diagnosed with Parkinson's disease (PD) on clinics who subsequently turn out to have normal dopamine transporter images have been referred to as scans without evidence of dopaminergic deficits (SWEDDs) patients. Cardiovascular autonomic dysfunction has frequently been reported in PD. In this study, we determined the similarities and differences in cardiac autonomic dysfunction between SWEDDs and PD patients. This study investigated whether 24-hour ambulatory blood pressure monitoring (24-hour ABPM) can help identify possible cases with SWEDDs.
  
  
  METHODS
  We enrolled 28 SWEDDs patients, 46 patients with PD, and 30 healthy controls. To evaluate cardiac autonomic function, 24-hour ABPM was performed on all subjects. Cardiac metaiodobenzylguanidine (MIBG) scintigraphy was performed on the SWEDDs and PD subjects.
  
  
  RESULTS
  The percentage nocturnal decline in blood pressure differed significantly among SWEDDs patients, PD patients, and controls (p<0.05). In addition to the abnormal nocturnal BP, regulation (nondipping and reverse dipping) was significantly higher in SWEDDs and PD subjects than in the control subjects (p<0.05). There was no significant correlation between the % nocturnal blood pressure reduction and parameters of cardiac MIBG uptake ratio. However, orthostatic hypotension was significant correlated with the nocturnal blood pressure dip (%), nocturnal blood pressure patterns, and the cardiac MIBG uptake ratio (early and late) in combined SWEDDs and PD subjects.
  
  
  CONCLUSIONS
  Pathologic nocturnal blood pressure regulation and nocturnal hypertension, known characteristics of PD, are also present in SWEDDs. Moreover, cardiac sympathetic denervation should not be attributed to cardiac autonomic dysfunction in SWEDDs patients. As with PD patients, the SWEDDs patients studied here tended to have cardiac autonomic dysfunction.
authors: 1Department of Neurology,College of Medicine,Hanyang University,Seoul,Republic of Korea.
authors: Seok-Jae
authors: http://orcid.org/0000-0002-2238-4629
authors: SJ
authors: Kang
authors: 2Department of Neurology,Seoul Medical Center,Seoul,Republic of Korea.
authors: Jin Young
authors: JY
authors: Ahn
authors: 3Department of Neurology,The Catholic University College of Medicine,Seoul,Republic of Korea.
authors: Joong-Seok
authors: JS
authors: Kim
authors: 4Department of Neurology,Samsung Medical Center,Sungkyunkwan University School of Medicine,Seoul,Republic of Korea.
authors: Jin Whan
authors: JW
authors: Cho
authors: 5Department of Nuclear Medicine,Hanyang University,College of Medicine,Seoul,Korea.
authors: Ji Young
authors: JY
authors: Kim
authors: 5Department of Nuclear Medicine,Hanyang University,College of Medicine,Seoul,Korea.
authors: Yun Young
authors: YY
authors: Choi
authors: 1Department of Neurology,College of Medicine,Hanyang University,Seoul,Republic of Korea.
authors: Hee-Tae
authors: HT
authors: Kim
mesh_terms: D019797:3-Iodobenzylguanidine / Q000493:pharmacokinetics; D000368:Aged; D001794:Blood Pressure / Q000502:physiology*; D018660:Blood Pressure Monitoring, Ambulatory / Q000379:methods*; D004298:Dopamine / Q000172:deficiency*; D050483:Dopamine Plasma Membrane Transport Proteins / Q000032:analysis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000000981:diagnostic imaging / Q000378:metabolism* / Q000503:physiopathology*; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals / Q000493:pharmacokinetics; D012189:Retrospective Studies; D015898:Tomography Scanners, X-Ray Computed
chemical_list: D050483:Dopamine Plasma Membrane Transport Proteins; D019275:Radiopharmaceuticals; D019797:3-Iodobenzylguanidine; D004298:Dopamine
keywords: 24-hour ambulatory blood pressure monitoring (ABPM); SWEDDs; cardiac MIBG uptake; nocturnal hypotension; non-dipping; orthostatic hypotension