The Effects of Orthostatic Hypotension on Cognition in Parkinson's Disease

体位性低血压对帕金森病认知的影响

• 批准号: 7614092
• 负责人: Justin Centi
• 金额: $ 4.12万
• 依托单位: BOSTON UNIVERSITY (CHARLES RIVER CAMPUS)
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-04-06 至 2012-04-05
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7614092
• 关键词: Activities of Daily Living; Acute; Affect; Age; Attention; Autonomic nervous system; Blood; Blood flow; Cardiac; Cardiac Output; Cerebrovascular Circulation; Cerebrum; Characteristics; Chronic; Cognition; Cognitive; Cognitive deficits; Dementia; Diagnosis; Disease; Dizziness; Dystonia; Electrocardiogram; Etiology; Exhibits; Failure; Fatigue; Flowmetry; Functional disorder; Goals; Head; Impaired cognition; Intelligence; Investigation; Lead; Lightheadedness; Measurement; Measures; Mediating; Memory; Moods; Motor; Muscle Rigidity; Neuropathy; Neuropsychological Tests; Orthostatic Hypotension; Parkinson Disease; Participant; Patients; Performance; Perfusion; Peripheral; Pharmaceutical Preparations; Physiological; Play; Positioning Attribute; Posture; Prevalence; Quality of life; Questionnaires; Relative (related person); Reporting; Research; Respiratory physiology; Role; Series; Short-Term Memory; Supine Position; Symptoms; Testing; Tremor; Visuospatial; anterior cerebral artery; cerebral hypoperfusion; clinically significant; cognitive function; design; executive function; heart rate variability; hemodynamics; insight; middle cerebral artery; motor control; nervous system disorder; neuropsychological; normotensive; performance tests; pressure; response

DESCRIPTION (provided by applicant): The goal of the proposed application is to investigate the effects of Orthostatic Hypotension (OH) on cognition in Parkinson's Disease (PD). Prevalence estimations of OH in PD range from 20 to 60%, indicating a need for a full understanding as to its effects. The most likely etiology is a cardiac sympathetic neuropathy affecting heart-rate variability and cardiac output. Dopaminergic medications may also play a role in exacerbating OH in PD. To date, no study has investigated the acute effects of OH on cognition in PD. This study will use objective measures of autonomic function, including electrocardiogram, arterial pressures, and transcranial Doppler flowmetry to assess the effects of a sixty-degree head-up tilt on sympathetic activation and gravitational compensatory responses. These physiological measurements will be analyzed against several neuropsychological test measures administered in both the supine and tilted positions. The participant groups will include PD patients with OH, PD patients without OH, and demographically matched normotensive control participants. Previous research suggests that OH will lead to cerebral hypoperfusion in the upright position, inducing symptoms of lightheadedness, dizziness, and fatigue. It is hypothesized that PD participants with OH will show within- subject detriments in several domains of cognitive function while tilted, and that PD participants with OH will demonstrate poorer overall performance than both PD participants without OH and normal control participants while supine. Test measures will include assessments of working memory, attention, executive function, as well as assessments of mood and activities of daily living. A variety of cognitive deficits have been reported in PD, and a small body of research suggests that PD patients with OH demonstrate poorer performance across several domains. By understanding the effects of OH on cognition in PD, emphasis on controlling compensatory responses to postural change will allow for an increased quality of life with more independence. Furthermore, maintaining adequate cerebral blood flow may allow for better cognitive abilities for the duration of the disorder.

描述（由申请人提供）：拟议申请的目的是研究体位性低血压（OH）对帕金森氏病（PD）认知的影响。 OH在PD中的患病率估计范围为20％至60％，表明需要对其影响有充分的了解。最可能的病因是影响心率变异性和心脏输出的心脏交感神经病。多巴胺能药物也可能在加剧PD中发挥作用。迄今为止，尚无研究研究OH对PD认知的急性影响。这项研究将使用自主功能的客观度量，包括心电图，动脉压力和经颅多普勒流量指标来评估60度头部倾斜对交感神经激活和重力补偿反应的影响。这些生理测量将针对在仰卧和倾斜位置进行的几种神经心理测试措施进行分析。参与者组将包括患有OH，无OH的PD患者的PD患者，以及人口统计学匹配的正常对照参与者。先前的研究表明，OH将导致直立位置的脑灌注不足，从而引起头晕，头晕和疲劳的症状。假设具有OH的PD参与者将在倾斜时表现出在认知功能的多个领域的受试者损害，而OH的PD参与者的总体表现较差，而PD参与者则在仰卧时没有OH和正常对照参与者的PD参与者。测试措施将包括对工作记忆，注意力，执行功能以及情绪和日常生活活动的评估的评估。 PD中已经报道了多种认知缺陷，一小部分研究表明，OH的PD患者在几个领域表现出较差的性能较差。通过了解OH对PD认知的影响，强调控制对姿势变化的补偿性反应将使生活质量提高，并具有更大的独立性。此外，维持足够的脑血流量可以在该疾病期间具有更好的认知能力。