J Korean Neurol Assoc.  2018 Nov;36(4):302-309. 10.17340/jkna.2018.4.5.

Orthostatic Hypotension and Cognitive Function in Parkinson's Disease

Affiliations
  • 1Department of Neurology, Chungnam National University School of Medicine, Daejeon, Korea. aelee@cnu.ac.kr

Abstract

BACKGROUND
Although orthostatic hypotension (OH) and cognitive impairment (CI) are common non-motor symptoms of Parkinson's disease (PD), the relationship between OH and CI remains to be clarified. This study was aimed to investigate the relationship between OH and CI in PD.
METHODS
We recruited 192 patients who were diagnosed as PD based on the UK Brain Bank diagnostic criteria. The Hoehn & Yahr stages were ranged I to III and patients underwent extensive clinical evaluation, including brain magnetic resonance imaging (MRI) for cerebral white matter hyperintensity (WMH), tilt table test, the Korean version of Montreal Cognitive Assessments and the Korean version of Mini-Mental Status Examination in one month from the first clinic visit. The participants were divided into two groups according to the presence of OH (OH+ vs. OH−) and cognitive function (cognitive normal, CN vs. CI), respectively.
RESULTS
Significant relationship between OH and cognitive function (p=0.04) was found in our patients. The patients with OH+ had higher risk of CI by 2.6 times than that of OH+ patients. Maximum heart rate change during tilt table test was correlated with cognitive function and white matter changes, whereas blood pressure change during tilt table test showed no correlation with those parameters.
CONCLUSIONS
There was significant relationship between OH and CI in PD. Therefore, PD patients with either symptom may need periodic evaluation and proper management for OH and cognitive functions.

Keyword

Orthostatic hypotension; Parkinson disease; Autonomic nervous system; Cognition

MeSH Terms

Ambulatory Care
Autonomic Nervous System
Blood Pressure
Brain
Cognition Disorders
Cognition*
Heart Rate
Humans
Hypotension, Orthostatic*
Magnetic Resonance Imaging
Parkinson Disease*
Tilt-Table Test
White Matter
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