Non-dipping nocturnal blood pressure and psychosis parameters in Parkinson disease

Conclusion: These results suggest that, among PD patients, a non-dipping circadian rhythm is associated with more severe symptoms of psychosis than is a dipping circadian rhythm. This association warrants further investigation

24 hour-ambulatory blood pressure and heart rate profiles in diagnosing orthostatic hypotension in Parkinson’s disease and Multiple System Atrophy

Background:24-hour ambulatory blood pressure and heart rate monitoring (24hr-ABPM) can provide vital information on circadian blood pressure (BP) profiles, which are commonly abnormal in Parkinson’s disease with and without autonomic failure (PD+AF and PD) and multiple system atrophy (MSA). 24hr-ABPM has not been directly compared between these disorders regarding cardiovascular autonomic function. We aim to determine the usefulness of 24hr-ABPM with diary compared to Head-up Tilting (HUT) in diagnosing orthostatic hypotension (OH) in these patients. Methods: 74 patients (23 MSA,18 PD+AF,33 PD) underwent cardiovascular autonomic screening followed by 24hr-ABPM with diary. Standing tests were included during 24hr-ABPM. The sensitivity and specificity in detecting OH from the 24hr-ABPM standing test were compared with HUT. Results: There was no difference in OH during HUT between MSA and PD+AF (p>0.05). MSA and PD+AF had a higher proportion of abnormal BP circadian rhythms compared to PD (p0.05). Patients were divided into groups with (OH+) and without OH (OH-) on HUT. Using the standing test during 24hr-ABPM, a SBP fall of >20 mmHg showed a sensitivity and specificity of 82% and 100 % (AUC 0.91, 95% CI 0.84-0.98) in differentiating OH+ from OH-, respectively. Conclusions:PD+AF and MSA patients had similar circadian BP patterns suggesting that autonomic dysfunction influences abnormal BP circadian patterns similarly in these disorders. The higher sensitivity and specificity in detecting OH using a SBP fall of >20 mmHg compared to a DBP fall of >10 mmHg during standing test supports its usefulness to assess autonomic function in MSA and PD

SNAKE: The Plain and Its People

Idaho\u27s longest river curves west through desert landscapes, cutting deep through ancient formations, flowing through space and time. How have humans dealt with the desert? How have we been shaped by the land? SNAKE: The Plain and Its People explores the physical and ecological roots of Idaho civilization through science, social science, photography and art.https://scholarworks.boisestate.edu/fac_books/1371/thumbnail.jp

Non-dipping nocturnal blood pressure and psychosis parameters in Parkinson`s Disease

Financial disclosure: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. Funding sources for study: None 2 Background: Non-motor symptoms are increasingly recognized in Parkinson's Disease (PD) and include physical as well as psychological symptoms. A psychological condition that has been well studied in PD is psychosis. Cardiovascular autonomic dysfunction in PD can include a reversed or lack of blood pressure (BP) circadian rhythm, referred to as nocturnal non-dipping. The aim of this study was to determine the relationship between 24 hr ambulatory blood pressure measurements (ABPM), e.g., absence or presence of nocturnal dipping, and psychosis scores in PD. Methods: 21 patients with Parkinson's disease underwent 24 hr ABPM using an autonomic protocol. A decrease in nocturnal mean arterial blood pressure (MAP) of less than 10% was defined as non-dipping. Patients were interviewed (including the Brief Psychiatric Rating Scale; BPRS) for the assessment of psychosis. Results: 11 patients were dippers and 10 were non-dippers. BPRS scores were higher in non-dippers who on average met the criteria for psychosis (mean non-dipper BPRS: 34.3± 7,3 vs mean dipper BPRS: 27.5 ±5,3; cut off for "mildly ill" 31). There was a correlation between BPRS scores and non-dipping, indicating that those patients who had a blunted nocturnal fall in BP were more prone to psychotic symptoms.(Pearson's Correlation = .554, p =.009). Conclusion: These results suggest that a blunted BP rhythm in Parkinson's disease patients may possibly be associated with psychosis symptoms compared to patients whose BP decreases physiologically at night. This association warrants further investigation.