Abstract
Background and Objectives: Autonomic system dysfunctions in parkinson disease(PD) are not uncommon. Mechanisms of this abnormalities are degeneration of neuronal structures. Clinical manifestations of autonomic dysfunction in PD are abnormalities in the sudomotor, gastrointestinal and urinary functions, postural dizziness, hypersalivation, seborrhea and impotence. Postprandial hypotension and disturbances of sleep and breathing have also been reported as manifestations of autonomic dysregulation. The overall prevalence of autonomic symptoms varies from 76% to 93%.
Materials and Methods: In this study 28 out of patients referred to Neurology Department were evaluated for autonomic system dysfunction clinically and also by two sensitive tests: baroreflex sensitivity test and skin sympathtetic skin response test. The control group included 20 patients without any neurologic disease and other medical problems with known autonomic complications such as diabetes mellitus or cardiac problems and hypertension.
Results: The study shows that autonomic system dysfunction symptoms are common in PD than control group.The symptoms such as constipation, frequency, impotence and blurred vision differences were significant (p<0.05). Also normal orthostatic heart rate in PD is lower than control group. Our study shows that carotid baroreflex response in PD is weaker than the control group. R-R interval in EKG of patients with PD and control group in supine position are not different but with sitting position this parameter significantly differs between two groups. The results of sympathetic skin response (SSR) test showed abnormal response in patients with PD and distal latencies of tibial nerve stimulation were significantly high in them.
Conclusion: Autonomic system involvement in PD is common and we recommend that physicians managing these patients shoud be aware of this fact. Therapeutic considerations are necessary in these situations. These involvements should not always be considered as drug side effects.
MJTUMS, NO. 64, 16-23, 2005