Physiological, pharmacological and neurohormonal assessment of autonomic function in progressive supranuclear palsy

被引:42
作者
Kimber, J
Mathias, CJ
Lees, AJ
Bleasdale-Barr, K
Chang, HS
Churchyard, A
Watson, L
机构
[1] St Marys Hosp, Imperial Coll, Sch Med, Div Neurosci & Psychol Med,Neurovasc Med Unit, London, England
[2] St Marys Hosp, Imperial Coll, Sch Med, Natl Hosp Neurol & Neurosurg, London, England
[3] UCL, Inst Neurol, Dept Clin Neurol, Auton Unit, London, England
关键词
progressive supranuclear palsy; autonomic function; physiology; neurohormonal; multiple system atrophy; clonidine;
D O I
10.1093/brain/123.7.1422
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
The clinical features of progressive supranuclear palsy (PSP) overlap with other parkinsonian syndromes, including multiple system atrophy (R-ISA), Autonomic dysfunction is a characteristic of MSA, but has also been described in PSP, We therefore report results from a series of physiological studies of cardiovascular autonomic function in 35 PSP and 20 MSA. subjects, and 26 age-matched healthy control subjects, The response to growth hormone-clonidine testing, a neuropharmacological assessment of central adrenoceptor function, was also assessed in 14 PSP and 10 MSA subjects, and compared with 10 controls. None was on meditation which may have affected the results. Orthostatic hypotension did not occur in PSP subjects or controls, unlike II-ISA subjects. Overall there was no evidence of sympathetic vasoconstrictor failure in PSP subjects, unlike MSA subjects, although the presser response to mental arithmetic was reduced, Cardiac parasympathetic function was affected in only a minority (three of 35) of PSP subjects and was abnormal in MSA subjects. After clonidine administration, growth hormone rose in PSP subjects (median increase 4.3; interquartile range 1.8-7.8 mU/l) and controls, unlike MSA subjects (0.9; 0.3-2.4 mU/l; P < 0.005, Mann-Whitney U-test), In conclusion, in PSP subjects, responses to both physiological and pharmacological tests provided evidence against widespread autonomic dysfunction; this differed markedly from MSA subjects. Thus, cardiovascular autonomic dysfunction should be an exclusionary feature in the diagnosis of PSP.
引用
收藏
页码:1422 / 1430
页数:9
相关论文
共 43 条
[1]   Depletion of catecholaminergic neurons of the rostral ventrolateral medulla in multiple systems atrophy with autonomic failure [J].
Benarroch, EE ;
Smithson, IL ;
Low, PA ;
Parisi, JE .
ANNALS OF NEUROLOGY, 1998, 43 (02) :156-163
[2]   ALPHA-2 ADRENERGIC-RECEPTOR SENSITIVITY AND THE MECHANISM OF ACTION OF ANTI-DEPRESSANT THERAPY - THE EFFECT OF LONG-TERM AMITRIPTYLINE TREATMENT [J].
CHARNEY, DS ;
HENINGER, GR ;
STERNBERG, DE .
BRITISH JOURNAL OF PSYCHIATRY, 1983, 142 (MAR) :265-275
[3]   GROWTH-HORMONE AND OTHER RESPONSES TO CLONIDINE IN PATIENTS WITH ENDOGENOUS-DEPRESSION [J].
CHECKLEY, SA ;
SLADE, AP ;
SHUR, E .
BRITISH JOURNAL OF PSYCHIATRY, 1981, 138 (JAN) :51-55
[4]   PROGRESSIVE SUPRANUCLEAR PALSY - NEUROPATHOLOGICALLY BASED DIAGNOSTIC CLINICAL-CRITERIA [J].
COLLINS, SJ ;
AHLSKOG, JE ;
PARISI, JE ;
MARAGANORE, DM .
JOURNAL OF NEUROLOGY NEUROSURGERY AND PSYCHIATRY, 1995, 58 (02) :167-173
[5]  
Daniel S., 1999, AUTONOMIC FAILURE TX, P321
[6]   THE CLINICAL AND PATHOLOGICAL SPECTRUM OF STEELE-RICHARDSON-OLSZEWSKI SYNDROME (PROGRESSIVE SUPRANUCLEAR PALSY) - A REAPPRAISAL [J].
DANIEL, SE ;
DEBRUIN, VMS ;
LEES, AJ .
BRAIN, 1995, 118 :759-770
[7]   SLOWING OF COGNITIVE PROCESSING IN PROGRESSIVE SUPRANUCLEAR PALSY - A COMPARISON WITH PARKINSONS-DISEASE [J].
DUBOIS, B ;
PILLON, B ;
LEGAULT, F ;
AGID, Y ;
LHERMITTE, F .
ARCHIVES OF NEUROLOGY, 1988, 45 (11) :1194-1199
[8]   SOMATOSTATIN AND REGULATION OF PROLACTIN SECRETION [J].
ENJALBERT, A ;
BERTRAND, P ;
LEDAFNIET, M ;
EPELBAUM, J ;
HUGUES, JN ;
KORDON, C ;
MOYSE, E ;
PEILLON, F ;
SHU, C .
PSYCHONEUROENDOCRINOLOGY, 1986, 11 (02) :155-165
[9]   Presymptomatic hypertension is a major feature in the diagnosis of progressive supranuclear palsy [J].
Ghika, J ;
Bogousslavsky, J .
ARCHIVES OF NEUROLOGY, 1997, 54 (09) :1104-1108
[10]  
GOMEZ JM, 1994, CLIN INVESTIGATOR, V72, P489