Neurology
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Figures Only
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Correspondence:
Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when Correspondence are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Google Scholar
Right arrow Articles by Akaogi, Y.
Right arrow Articles by Hattori, T.
PubMed
Right arrow PubMed Citation
Right arrow Articles by Akaogi, Y.
Right arrow Articles by Hattori, T.
NEUROLOGY 2009;73:59-65
© 2009 American Academy of Neurology

Sudomotor, skin vasomotor, and cardiovascular reflexes in 3 clinical forms of Lewy body disease

Y. Akaogi, MD, M. Asahina, MD, PhD, Y. Yamanaka, MD, PhD, Y. Koyama, MD, PhD and T. Hattori, MD, PhD

From the Department of Neurology, Chiba University School of Medicine, Chiba, Japan.

Address correspondence and reprint requests to Dr. Masato Asahina, Department of Neurology, Chiba University School of Medicine, 1-8-1 Inohana Chuo-ku, Chiba, 260-8670 Japan asahina{at}faculty.chiba-u.jp

Objective: To elucidate the differences among dementia with Lewy bodies (DLB), Parkinson disease with dementia (PDD), and Parkinson disease without dementia (PD), with respect to the involvement of the autonomic nervous system, we clinically investigated the cutaneous and cardiovascular autonomic functions in patients with Lewy body disease.

Methods: We studied 36 patients with Lewy body disorders, including 12 patients with DLB (age, 75.4 ± 5.9 years), 12 patients with PDD (71.0 ± 6.8 years), and 12 patients with PD (70.9 ± 4.2 years), and 12 healthy control subjects (69.9 ± 5.3 years). Sympathetic sweat response (SSwR) and skin vasomotor reflex (SkVR) on the palm were recorded to estimate the cutaneous sympathetic function, and the head-up tilt test was performed and coefficient of variation of R-R intervals (CVR-R) was studied to estimate the cardiovascular function.

Results: The patients with DLB, patients with PDD, and patients with PD showed severely reduced SSwR amplitudes, significantly lower than that in the controls. The mean SkVR amplitudes in the patients with DLB and patients with PDD were significantly lower than that in the controls, but not in the patients with PD. The mean decreases in the systolic blood pressure during the head-up tilt test in the patients with DLB and patients with PDD were less than that in the controls. The mean CVR-R value was significantly lower in the patients with DLB.

Conclusion: Sudomotor function on the palm may be severely affected in Lewy body disorders, while skin vasomotor function and the cardiovascular system may be more severely affected in dementia with Lewy bodies and Parkinson disease with dementia than in Parkinson disease.

Abbreviations: ANOVA = analysis of variance; CVR-R = coefficient of variation of R-R intervals; DLB = dementia with Lewy bodies; LBD = Lewy body disease; PD = Parkinson disease; PDD = Parkinson disease with dementia; SkVR = skin vasomotor reflex; SSwR = sympathetic sweat response.

Disclosure: The authors report no disclosures.

Received December 11, 2008. Accepted in final form April 1, 2009.






HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 2009 by AAN Enterprises, Inc.