title: Association Between Autonomic Impairment and Structural Deficit in Parkinson Disease.
abstract: Patients with Parkinson disease (PD) have impaired autonomic function and altered brain structure. This study aimed to evaluate the relationship of gray matter volume (GMV) determined by voxel-based morphometry (VBM) to autonomic impairment in patients with PD. Whole-brain VBM analysis was performed on 3-dimensional T1-weighted images in 23 patients with PD and 15 sex- and age-matched healthy volunteers. The relationship of cardiovascular autonomic function (determined by survey) to baroreflex sensitivity (BRS) (determined from changes in heart rate and blood pressure during the early phase II of the Valsalva maneuver) was tested using least-squares regression analysis. The differences in GMV, autonomic parameters, and clinical data were correlated after adjusting for age and sex. Compared with controls, patients with PD had low BRS, suggesting worse cardiovascular autonomic function, and smaller GMV in several brain locations, including the right amygdala, left hippocampal formation, bilateral insular cortex, bilateral caudate nucleus, bilateral cerebellum, right fusiform, and left middle frontal gyri. The decreased GMVs of the selected brain regions were also associated with increased presence of epithelial progenitor cells (EPCs) in the circulation. In patients with PD, decrease in cardiovascular autonomic function and increase in circulating EPC level are associated with smaller GMV in several areas of the brain. Because of its possible role in the modulation of the circulatory EPC pool and baroreflex control, the left hippocampal formation may be a bio-target for disease-modifying therapy and treatment monitoring in PD.
authors.affiliation: From the Departments of Diagnostic Radiology (M-HC, P-CC, H-LC, I-HY, C-CY, W-CL) and Neurology (C-HL, N-WT, C-CH), Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine; Department of Biological Science, National Sun Yat-Sen University (C-HL), Kaohsiung; and Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, Taipei (H-LC), Taiwan.
authors.forename: Meng-Hsiang
authors.initials: MH
authors.lastname: Chen
authors.forename: Cheng-Hsien
authors.initials: CH
authors.lastname: Lu
authors.forename: Pei-Chin
authors.initials: PC
authors.lastname: Chen
authors.forename: Nai-Wen
authors.initials: NW
authors.lastname: Tsai
authors.forename: Chih-Cheng
authors.initials: CC
authors.lastname: Huang
authors.forename: Hsiu-Ling
authors.initials: HL
authors.lastname: Chen
authors.forename: I-Hsiao
authors.initials: IH
authors.lastname: Yang
authors.forename: Chiun-Chieh
authors.initials: CC
authors.lastname: Yu
authors.forename: Wei-Che
authors.initials: WC
authors.lastname: Lin
mesh_terms: D000368:Aged; D001341:Autonomic Nervous System / Q000503:physiopathology*; D016022:Case-Control Studies; D066026:Endothelial Progenitor Cells; D005260:Female; D066128:Gray Matter / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000097:blood / Q000473:pathology* / Q000503:physiopathology*