Delayed orthostatic hypotension in Parkinson’s disease

Abstract Orthostatic hypotension (OH) is relatively common in the early stage of Parkinson’s disease (PD). It is divided into delayed OH and classical OH. Classical OH in PD has been investigated widely, however, the clinical implications of delayed OH in PD have seldom been studied. The purpose of...

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Autores principales:	Sang-Won Yoo, Joong-Seok Kim, Ji-Yeon Yoo, Eunkyeong Yun, Uicheul Yoon, Na-Young Shin, Kwang-Soo Lee
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/70e730a25fae485da34bb376208d802d
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spelling	oai:doaj.org-article:70e730a25fae485da34bb376208d802d2021-12-02T18:03:32ZDelayed orthostatic hypotension in Parkinson’s disease10.1038/s41531-021-00181-y2373-8057https://doaj.org/article/70e730a25fae485da34bb376208d802d2021-04-01T00:00:00Zhttps://doi.org/10.1038/s41531-021-00181-yhttps://doaj.org/toc/2373-8057Abstract Orthostatic hypotension (OH) is relatively common in the early stage of Parkinson’s disease (PD). It is divided into delayed OH and classical OH. Classical OH in PD has been investigated widely, however, the clinical implications of delayed OH in PD have seldom been studied. The purpose of this study is to characterize delayed OH in PD. A total of 285 patients with early drug-naïve PD were enrolled and divided into three groups according to orthostatic change: no-OH, delayed OH, and classical OH. The disease severity in terms of motor, non-motor, and cognitive functions was assessed. The cortical thickness of 82 patients was analyzed with brain magnetic resonance imaging. The differences among groups and linear tendency in the order of no-OH, delayed OH, and classical OH were investigated. Seventy-seven patients were re-evaluated. Initial and follow-up evaluations were explored to discern any temporal effects of orthostasis on disease severity. Sixty-four (22.5%) patients were defined as having delayed OH and 117 (41.1%) had classical OH. Between-group comparisons revealed that classical OH had the worst outcomes in motor, non-motor, cognitive, and cortical thickness, compared to the other groups. No-OH and delayed OH did not differ significantly. Linear trends across the pre-ordered OH subtypes found that clinical parameters worsened along with the orthostatic challenge. Clinical scales deteriorated and the linear gradient was maintained during the follow-up period. This study suggests that delayed OH is a mild form of classical OH in PD. PD with delayed OH has milder disease severity and progression.Sang-Won YooJoong-Seok KimJi-Yeon YooEunkyeong YunUicheul YoonNa-Young ShinKwang-Soo LeeNature PortfolioarticleNeurology. Diseases of the nervous systemRC346-429ENnpj Parkinson's Disease, Vol 7, Iss 1, Pp 1-8 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Neurology. Diseases of the nervous system RC346-429
spellingShingle	Neurology. Diseases of the nervous system RC346-429 Sang-Won Yoo Joong-Seok Kim Ji-Yeon Yoo Eunkyeong Yun Uicheul Yoon Na-Young Shin Kwang-Soo Lee Delayed orthostatic hypotension in Parkinson’s disease
description	Abstract Orthostatic hypotension (OH) is relatively common in the early stage of Parkinson’s disease (PD). It is divided into delayed OH and classical OH. Classical OH in PD has been investigated widely, however, the clinical implications of delayed OH in PD have seldom been studied. The purpose of this study is to characterize delayed OH in PD. A total of 285 patients with early drug-naïve PD were enrolled and divided into three groups according to orthostatic change: no-OH, delayed OH, and classical OH. The disease severity in terms of motor, non-motor, and cognitive functions was assessed. The cortical thickness of 82 patients was analyzed with brain magnetic resonance imaging. The differences among groups and linear tendency in the order of no-OH, delayed OH, and classical OH were investigated. Seventy-seven patients were re-evaluated. Initial and follow-up evaluations were explored to discern any temporal effects of orthostasis on disease severity. Sixty-four (22.5%) patients were defined as having delayed OH and 117 (41.1%) had classical OH. Between-group comparisons revealed that classical OH had the worst outcomes in motor, non-motor, cognitive, and cortical thickness, compared to the other groups. No-OH and delayed OH did not differ significantly. Linear trends across the pre-ordered OH subtypes found that clinical parameters worsened along with the orthostatic challenge. Clinical scales deteriorated and the linear gradient was maintained during the follow-up period. This study suggests that delayed OH is a mild form of classical OH in PD. PD with delayed OH has milder disease severity and progression.
format	article
author	Sang-Won Yoo Joong-Seok Kim Ji-Yeon Yoo Eunkyeong Yun Uicheul Yoon Na-Young Shin Kwang-Soo Lee
author_facet	Sang-Won Yoo Joong-Seok Kim Ji-Yeon Yoo Eunkyeong Yun Uicheul Yoon Na-Young Shin Kwang-Soo Lee
author_sort	Sang-Won Yoo
title	Delayed orthostatic hypotension in Parkinson’s disease
title_short	Delayed orthostatic hypotension in Parkinson’s disease
title_full	Delayed orthostatic hypotension in Parkinson’s disease
title_fullStr	Delayed orthostatic hypotension in Parkinson’s disease
title_full_unstemmed	Delayed orthostatic hypotension in Parkinson’s disease
title_sort	delayed orthostatic hypotension in parkinson’s disease
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/70e730a25fae485da34bb376208d802d
work_keys_str_mv	AT sangwonyoo delayedorthostatichypotensioninparkinsonsdisease AT joongseokkim delayedorthostatichypotensioninparkinsonsdisease AT jiyeonyoo delayedorthostatichypotensioninparkinsonsdisease AT eunkyeongyun delayedorthostatichypotensioninparkinsonsdisease AT uicheulyoon delayedorthostatichypotensioninparkinsonsdisease AT nayoungshin delayedorthostatichypotensioninparkinsonsdisease AT kwangsoolee delayedorthostatichypotensioninparkinsonsdisease
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Delayed orthostatic hypotension in Parkinson’s disease

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