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Ege F, Kazci Ö. Median Nerves' Electrical Activation Reduces Ipsilateral Brachial Arteries' Blood Flow and Diameter. Ann Indian Acad Neurol 2023; 26:883-888. [PMID: 38229617 PMCID: PMC10789422 DOI: 10.4103/aian.aian_345_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 06/13/2023] [Accepted: 06/30/2023] [Indexed: 01/18/2024] Open
Abstract
Purpose Our main objective in this study was to determine whether there is a difference between ipsilateral and contralateral brachial arteries' flow parameters in response to median nerves' electrical activation. Material and Methods The study was conducted in healthy and active subjects. The arterial diameter and flow were measured using the probe from the brachial artery. Then, the median nerve was stimulated for 5 seconds via the bipolar stimulus electrode. Arterial diameter and flow were measured once more with the Doppler transducer, which kept going to monitor continuously just after the fifth stimulus. After a week, the same subjects are invited for the purpose of measuring the contralateral brachial arteries' vasomotor response to the same stimulus. Results Before electrical stimulation, the median flow rate was 72.15 ml/min; after stimulation, the median flow rate was 39.20 ml/min. The drop in flow after stimulation was statistically significant (P < 0.001). While the median value of brachial artery vessel diameter before median nerve stimulation in the entire study group was 3.50 mm, the median value of vessel diameter after stimulation was 2.90 mm. After stimulation, the median nerve diameter narrowed statistically significantly (P < 0.001). As for the contralateral brachial in response to the right median nerves' activation, no significant flow or diameter change was found (P = 0.600, P = 0.495, respectively). Conclusion We discovered that electrical stimulation of the median nerve caused significant changes in ipsilateral brachial artery blood flow and diameter in healthy volunteers. The same stimulation does not result in flow parameter changes in the contralateral brachial artery.
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Affiliation(s)
- Fahrettin Ege
- Department of Neurology, VM Medicalpark Hospital, Ankara, Türkiye
| | - Ömer Kazci
- Department of Radiology, Ankara Training and Research Hospital, Ankara, Türkiye
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Bougea A, Stefanis L, Chrousos G. Stress system and related biomarkers in Parkinson's disease. Adv Clin Chem 2022; 111:177-215. [DOI: 10.1016/bs.acc.2022.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
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Wang JY, Wang MY, Liu RP, Li Y, Zhang WY, Ovlyakulov B, Zhang X, Zhu JH. Association Analyses of Autonomic Dysfunction and Sympathetic Skin Response in Motor Subtypes of Parkinson's Disease. Front Neurol 2020; 11:577128. [PMID: 33224091 PMCID: PMC7669620 DOI: 10.3389/fneur.2020.577128] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Accepted: 10/09/2020] [Indexed: 11/13/2022] Open
Abstract
Introduction: Autonomic dysfunction is a common and disabling non-motor symptom of Parkinson's disease (PD). We aimed to understand autonomic dysfunction in PD motor subtypes, the pattern of sympathetic skin response (SSR) to motor asymmetry, and the association of SSR with autonomic and motor dysfunctions. Methods: A total of 101 PD patients of Han Chinese were included. Unified PD rating scale (UPDRS), scales for outcomes in PD-autonomic symptoms (SCOPA-AUT), orthostatic hypotension, and SSR were evaluated. Results: SCOPA-AUT and incidences of orthostatic hypotension and absent SSR were worse in the subtype of postural instability gait disorder (PIGD) than the subtypes of tremor dominant and intermediate. SSR latency and amplitude were asymmetrical corresponding to the accentuation of motor severity. Patients with absent SSR had worse UPDRS and SCOPA-AUT scores. SSR parameters of the severe side in patients with SSR showed no independent association with the scores. Conclusion: Our results support that autonomic dysfunction is more severe in the PIGD than other subtypes and demonstrate an asymmetry of SSR in PD patients. Absent SSR may indicate worse autonomic and motor symptoms, but SSR parameters are not sufficient to evaluate the severity of the dysfunctions.
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Affiliation(s)
- Jian-Yong Wang
- Department of Geriatrics & Neurology, The Second Affiliated Hospital and Yuying Children's Hospital, Wenzhou Medical University, Wenzhou, China.,Department of Preventive Medicine, Wenzhou Medical University, Wenzhou, China
| | - Meng-Yan Wang
- Department of Geriatrics & Neurology, The Second Affiliated Hospital and Yuying Children's Hospital, Wenzhou Medical University, Wenzhou, China
| | - Rong-Pei Liu
- Department of Geriatrics & Neurology, The Second Affiliated Hospital and Yuying Children's Hospital, Wenzhou Medical University, Wenzhou, China
| | - Yan Li
- Department of Geriatrics & Neurology, The Second Affiliated Hospital and Yuying Children's Hospital, Wenzhou Medical University, Wenzhou, China
| | - Wen-Yuan Zhang
- Department of Geriatrics & Neurology, The Second Affiliated Hospital and Yuying Children's Hospital, Wenzhou Medical University, Wenzhou, China
| | - Begench Ovlyakulov
- Department of Geriatrics & Neurology, The Second Affiliated Hospital and Yuying Children's Hospital, Wenzhou Medical University, Wenzhou, China
| | - Xiong Zhang
- Department of Geriatrics & Neurology, The Second Affiliated Hospital and Yuying Children's Hospital, Wenzhou Medical University, Wenzhou, China
| | - Jian-Hong Zhu
- Department of Geriatrics & Neurology, The Second Affiliated Hospital and Yuying Children's Hospital, Wenzhou Medical University, Wenzhou, China.,Department of Preventive Medicine, Wenzhou Medical University, Wenzhou, China
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Biobehavioral Framework of Symptom and Health Outcomes of Uncertainty and Psychological Stress in Parkinson Disease. J Neurosci Nurs 2017; 48:E2-E9. [PMID: 27824807 DOI: 10.1097/jnn.0000000000000244] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Parkinson disease (PD) is a debilitating, progressive neurodegenerative disorder characterized by complex motor and nonmotor symptoms that fluctuate in onset, severity, level of disability, and responsiveness to treatment. The unpredictable nature of PD and the inability to halt or slow disease progression may result in uncertainty and psychological stress. Uncertainty and psychological stress have important implications for symptom and health outcomes in PD. Uncertainty and psychological stress have been shown to worsen symptoms, functional capacity, and quality of life in chronic illnesses; however, the causal mechanisms have yet to be elucidated. We propose a biobehavioral framework for examining uncertainty and psychological stress in PD. The framework considers factors that may contribute to uncertainty and neuroendocrine-immune mechanisms of uncertainty and psychological stress that may influence symptom and health outcomes in PD, for the ultimate purpose of improving symptom and disease progression, functional capacity, and quality of life.
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Siepmann T, Pintér A, Buchmann SJ, Stibal L, Arndt M, Kubasch AS, Kubasch ML, Penzlin AI, Frenz E, Zago W, Horváth T, Szatmári S, Bereczki D, Takáts A, Ziemssen T, Lipp A, Freeman R, Reichmann H, Barlinn K, Illigens BMW. Cutaneous Autonomic Pilomotor Testing to Unveil the Role of Neuropathy Progression in Early Parkinson's Disease (CAPTURE PD): Protocol for a Multicenter Study. Front Neurol 2017; 8:212. [PMID: 28603514 PMCID: PMC5445122 DOI: 10.3389/fneur.2017.00212] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Accepted: 05/01/2017] [Indexed: 12/11/2022] Open
Abstract
Background In Parkinson’s disease (PD), alpha-synuclein accumulation in cutaneous autonomic pilomotor and sudomotor nerve fibers has been linked to autonomic nervous system disturbances even in the early stages of the disease. This study aims to assess the association between alpha-synuclein-mediated structural autonomic nerve fiber damage and function in PD, elucidate the role of neuropathy progression during the early disease stages, and test reproducibility and external validity of pilomotor function assessment using quantitative pilomotor axon-reflex test and sudomotor function via quantitative direct and indirect test of sudomotor function. Methods/design A prospective controlled study will be conducted at four study sites in Europe and the USA. Fifty-two male and female patients with idiopathic PD (Hoehn and Yahr 1–2) and 52 age- and sex-matched healthy controls will be recruited. Axon-reflex-mediated pilomotor erection will be induced by iontophoresis of phenylephrine on the dorsal forearm. Silicone impressions of the response will be obtained, scanned, and quantified for pilomotor muscle impressions by number, impression size, and area of axon-reflex spread. Axon-reflex-mediated sweating following acetylcholine iontophoresis will be quantified for number and size of droplets and axon-reflex spread. Sympathetic skin responses, autonomic and motor symptoms will be evaluated. Tests will be performed at baseline, after 2 weeks, 1, 2, and 3 years. Skin biopsies will be obtained at baseline and after 3 years and will be analyzed for nerve fiber density and alpha-synuclein accumulation. Discussion We anticipate that progression of autonomic nerve dysfunction assessed via pilomotor and sudomotor axon-reflex tests is related to progression of autonomic symptom severity and alpha-synuclein deposition. Potential applications of the techniques include interventional studies evaluating disease-modifying approaches and clinical assessment of autonomic dysfunction in patients with PD. Clinical trail registration TRN NCT03043768.
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Affiliation(s)
- Timo Siepmann
- Department of Neurology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Alexandra Pintér
- Department of Family Medicine, Semmelweis University, Budapest, Hungary
| | - Sylvia J Buchmann
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States.,Department of Neurology, Charite University Medicine Berlin, Berlin, Germany
| | - Leonie Stibal
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States
| | - Martin Arndt
- Department of Neurology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Anne Sophie Kubasch
- Center for Rare Diseases, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Marie Luise Kubasch
- Department of Neurology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.,Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States
| | - Ana Isabel Penzlin
- Department of Neurology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Elka Frenz
- Department of Neurology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Wagner Zago
- Prothena Biosciences Inc., Portland, OR, United States
| | - Tamás Horváth
- Department of Hydrodynamic Systems, Budapest University of Technology and Economics, Budapest, Hungary
| | | | - Dániel Bereczki
- Department of Neurology, Semmelweis University, Budapest, Hungary
| | - Annamária Takáts
- Department of Neurology, Semmelweis University, Budapest, Hungary
| | - Tjalf Ziemssen
- Department of Neurology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Axel Lipp
- Department of Neurology, Charite University Medicine Berlin, Berlin, Germany
| | - Roy Freeman
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States
| | - Heinz Reichmann
- Department of Neurology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Kristian Barlinn
- Department of Neurology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Ben Min-Woo Illigens
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States
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Ke JQ, Shao SM, Zheng YY, Fu FW, Zheng GQ, Liu CF. Sympathetic skin response and heart rate variability in predicting autonomic disorders in patients with Parkinson disease. Medicine (Baltimore) 2017; 96:e6523. [PMID: 28471954 PMCID: PMC5419900 DOI: 10.1097/md.0000000000006523] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
The purpose of this study was to evaluate sympathetic skin response (SSR) and heart rate variability (HRV) in determining autonomic nervous system (ANS) involvement in patients with Parkinson disease (PD). Forty-eight idiopathic PD patients and 30 healthy controls participated in this study. SSR, HRV, Unified Parkinson's Disease Rating Scale (UPDRS) III, the Scales for outcomes in Parkinson's Disease-Autonomic (SCOPA-AUT), Hoehn and Yahr (H&Y) scale were evaluated. Absent lower limb SSR was determined unilaterally in 2, bilaterally in 1 of 3 advanced PD patients; there was significant difference between PD and control groups in terms of the SSR (P < 0.01), significant prolonged SSR latencies and decreased SSR amplitudes from bilateral hands and feet. Significant difference was noted in HRV between PD and control groups except for root mean square of successive differences (rMSSD) and high-frequency (HF) power (P < 0.05). There was a significant different correlation between the parameters of SSR and the SCOPA-AUT, and between the parameters (except HF power) of HRV and the SCOPA-AUT. Some parameters of SSR were relevantly associated with HRV. The right hand SSR amplitude correlated positively with the (SD) of all R-R interval, total spectral power, very low frequency. The right foot amplitude correlated positively with total spectral power. Both SSR and HRV parameters are sensitive in determining ANS dysfunction not only in late but also in the early stage of PD, which can be used for early detection of autonomic dysfunction in patients with PD and have the potential to serve as electrophysiological markers of dysautonomia of PD.
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Affiliation(s)
- Jiang-Qiong Ke
- Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, the Second Affiliated Hospital of Soochow University, Suzhou
- Department of Neurology, the Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Sheng-Min Shao
- Department of Neurology, the Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Yuan-Yuan Zheng
- Department of Neurology, the Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Fang-Wang Fu
- Department of Neurology, the Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Guo-Qing Zheng
- Department of Neurology, the Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Chun-Feng Liu
- Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, the Second Affiliated Hospital of Soochow University, Suzhou
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Coraci D, Santilli V, Giovannini S, Imbimbo I, Padua L. Consideration about "Polyneuropathy in levodopa-treated Parkinson's patients". J Neurol Sci 2017; 375:1-2. [PMID: 28320110 DOI: 10.1016/j.jns.2017.01.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2016] [Accepted: 01/10/2017] [Indexed: 10/20/2022]
Affiliation(s)
- Daniele Coraci
- Board of Physical Medicine and Rehabilitation, Department of Orthopaedic Science, "Sapienza" University, Rome, Italy; Don Carlo Gnocchi ONLUS Foundation, Milan, Italy.
| | - Valter Santilli
- Board of Physical Medicine and Rehabilitation, Department of Orthopaedic Science, "Sapienza" University, Rome, Italy; Physical Medicine and Rehabilitation Unit, Azienda Policlinico Umberto I, Rome, Italy
| | - Silvia Giovannini
- Rehabilitation Units, Policlinico Universitario Agostino Gemelli Foundation, Rome, Italy
| | | | - Luca Padua
- Don Carlo Gnocchi ONLUS Foundation, Milan, Italy; Department of Geriatrics, Neurosciences and Orthopaedics, Università Cattolica del Sacro Cuore, Rome, Italy
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Austin KW, Ameringer SW, Cloud LJ. An Integrated Review of Psychological Stress in Parkinson's Disease: Biological Mechanisms and Symptom and Health Outcomes. PARKINSON'S DISEASE 2016; 2016:9869712. [PMID: 28058129 PMCID: PMC5183774 DOI: 10.1155/2016/9869712] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/08/2016] [Revised: 09/28/2016] [Accepted: 11/01/2016] [Indexed: 12/13/2022]
Abstract
Parkinson's disease (PD) is characterized by complex symptoms and medication-induced motor complications that fluctuate in onset, severity, responsiveness to treatment, and disability. The unpredictable and debilitating nature of PD and the inability to halt or slow disease progression may result in psychological stress. Psychological stress may exacerbate biological mechanisms believed to contribute to neuronal loss in PD and lead to poorer symptom and health outcomes. The purpose of this integrated review is to summarize and appraise animal and human research studies focused on biological mechanisms, symptom, and health outcomes of psychological stress in PD. A search of the electronic databases PubMed/Medline and CINAHL from 1980 to the present using the key words Parkinson's disease and stress, psychological stress, mental stress, and chronic stress resulted in 11 articles that met inclusion criteria. The results revealed significant associations between psychological stress and increased motor symptom severity and loss of dopamine-producing neurons in animal models of PD and between psychological stress and increased symptom severity and poorer health outcomes in human subjects with PD. Further research is needed to fully elucidate the underlying biological mechanisms responsible for these relationships, for the ultimate purpose of designing targeted interventions that may modify the disease trajectory.
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Affiliation(s)
- Kim Wieczorek Austin
- Virginia Commonwealth University School of Nursing, 1100 East Leigh Street, Richmond, VA 23219, USA
| | - Suzanne Weil Ameringer
- Virginia Commonwealth University School of Nursing, 1100 East Leigh Street, Richmond, VA 23219, USA
| | - Leslie Jameleh Cloud
- Virginia Commonwealth University Parkinson's and Movement Disorders Center and VCU Health Neuroscience, Orthopaedic, and Wellness Center, 11958 West Broad Street, Richmond, VA 23233, USA
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Li K, Reichmann H, Ziemssen T. Recognition and treatment of autonomic disturbances in Parkinson’s disease. Expert Rev Neurother 2015; 15:1189-203. [DOI: 10.1586/14737175.2015.1095093] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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10
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Zheng Z, Liu G, Chen Y, Wei S. Olfactory ensheathing cell transplantation improves sympathetic skin responses in chronic spinal cord injury. Neural Regen Res 2014; 8:2849-55. [PMID: 25206606 PMCID: PMC4146016 DOI: 10.3969/j.issn.1673-5374.2013.30.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2013] [Accepted: 08/20/2013] [Indexed: 12/14/2022] Open
Abstract
Forty-three patients with chronic spinal cord injury for over 6 months were transplanted with bryonic olfactory ensheathing cells, 2-4 × 10(6), into multiple sites in the injured area under the surgical microscope. The sympathetic skin response in patients was measured with an electromyography/evoked potential instrument 1 day before transplantation and 3-8 weeks after transtion. Spinal nerve function of patients was assessed using the American Spinal Injury Association impairment scale. The sympathetic skin response was elicited in 32 cases before olfactory ensheathing cell transplantation, while it was observed in 34 cases after transplantation. tantly, sympathetic skin response latency decreased significantly and amplitude increased cantly after transplantation. Transplantation of olfactory ensheathing cells also improved American Spinal Injury Association scores for movement, pain and light touch. Our findings indicate that factory ensheathing cell transplantation improves motor, sensory and autonomic nerve functions in patients with chronic spinal cord injury.
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Affiliation(s)
- Zuncheng Zheng
- Department of Orthopedics, Taian Central Hospital, Taian 271000, Shandong Province, China
| | - Guifeng Liu
- Department of Orthopedics, Taian Central Hospital, Taian 271000, Shandong Province, China
| | - Yuexia Chen
- Department of Orthopedics, Taian Central Hospital, Taian 271000, Shandong Province, China
| | - Shugang Wei
- Department of Spine and Spinal Cord, Taian Rongjun Hospital, Taian 271000, Shandong Province, China
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