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首页> 外文期刊>Movement disorders >Generalized and neurotransmitter-selective noradrenergic denervation in Parkinson's disease with orthostatic hypotension.
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Generalized and neurotransmitter-selective noradrenergic denervation in Parkinson's disease with orthostatic hypotension.

机译：帕金森氏病伴直立性低血压的全身性和神经递质选择性去甲肾上腺素能神经支配。

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Patients with Parkinson's disease (PD) often have manifestations of autonomic failure. About 40% have neurogenic orthostatic hypotension (NOH), and among PD+NOH patients virtually all have evidence of cardiac sympathetic denervation; however, whether PD+NOH entails extra-cardiac noradrenergic denervation has been less clear. Microdialysate concentrations of the main neuronal metabolite of norepinephrine (NE) and dihydroxyphenylglycol (DHPG) were measured in skeletal muscle, and plasma concentrations of NE and DHPG were measured in response to i.v. tyramine, yohimbine, and isoproterenol, in patients with PD+NOH, patients with pure autonomic failure (PAF), which is characterized by generalized catecholaminergic denervation, and control subjects. Microdialysate DHPG concentrations were similarly low in PD+NOH and PAF compared to control subjects (163 +/- 25, 153 +/- 27, and 304 +/- 27 pg/mL, P < 0.01 each vs. control). The two groups also had similarly small plasma DHPG responses to tyramine (71 +/- 58 and 82 +/- 105 vs. 313 +/- 94 pg/mL; P < 0.01 each vs. control) and NE responses to yohimbine (223 +/- 37 and 61 +/- 15 vs. 672 +/- 130 pg/mL, P < 0.01 each vs. control), and virtually absent NE responses to isoproterenol (20 +/- 34 and 14 +/- 15 vs. 336 +/- 78 pg/mL, P < 0.01 each vs. control). Patients with PD+NOH had normal bradycardia responses to edrophonium and normal epinephrine responses to glucagon. The results support the concept of generalized noradrenergic denervation in PD+NOH, with similar severity to that seen in PAF. In contrast, the parasympathetic cholinergic and adrenomedullary hormonal components of the autonomic nervous system seem intact in PD+NOH.
机译：帕金森氏病（PD）患者通常表现出自主神经衰竭。大约40％的人患有神经源性体位性低血压（NOH），而在PD + NOH患者中，几乎所有患者都有心脏交感神经支配的证据。然而，PD + NOH是否需要进行心脏外去甲肾上腺素能神经去神经还不清楚。测定骨骼肌中去甲肾上腺素（NE）和二羟基苯基乙二醇（DHPG）的主要神经元代谢产物的微透析液浓度，并测量i.v.响应时的NE和DHPG血浆浓度。 PD + NOH患者，以全身儿茶酚胺能神经支配为特征的单纯自主神经功能衰竭（PAF）患者和对照组为酪胺，育亨宾和异丙肾上腺素。与对照组相比，PD + NOH和PAF中的微透析液DHPG浓度同样较低（163 +/- 25、153 +/- 27和304 +/- 27 pg / mL，相对于对照组，P <0.01）。两组对酪胺的血浆DHPG响应也较小（71 +/- 58和82 +/- 105 vs. 313 +/- 94 pg / mL;对对照组各P <0.01）和NE对育亨宾的响应（223 +/- 37和61 +/- 15 vs.672 +/- 130 pg / mL，相对于对照各P <0.01），并且几乎没有对异丙肾上腺素的NE反应（20 +/- 34和14 +/- 15 vs. 336 +/- 78 pg / mL，相对于对照，每个P <0.01）。 PD + NOH患者对edrophonium的心动过缓反应正常，对胰高血糖素的肾上腺素反应正常。结果支持PD + NOH中普遍的去甲肾上腺素能神经退变的概念，其严重程度与PAF相似。相比之下，PD + NOH中自主神经系统的副交感神经胆碱能和肾上腺髓质激素成分完好无损。

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