Non-dipping nocturnal blood pressure and psychosis parameters in Parkinson disease
File(s)
Author(s)
Type
Journal Article
Abstract
Background
Non-motor symptoms are increasingly recognized in Parkinson 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 loss of blood pressure (BP) circadian rhythm, referred to as nocturnal non-dipping. The aim of this study was to determine the relationship between 24 h ambulatory blood pressure measurements (ABPM), i.e., absence or presence of nocturnal dipping, and psychosis scores in PD.
Methods
Twenty-one patiens with PD underwent 24 h ABPM using an autonomic protocol. A decrease in nocturnal mean arterial blood pressure 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
Eleven 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; cutoff 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 = 0.554, p = 0.009).
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.
Non-motor symptoms are increasingly recognized in Parkinson 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 loss of blood pressure (BP) circadian rhythm, referred to as nocturnal non-dipping. The aim of this study was to determine the relationship between 24 h ambulatory blood pressure measurements (ABPM), i.e., absence or presence of nocturnal dipping, and psychosis scores in PD.
Methods
Twenty-one patiens with PD underwent 24 h ABPM using an autonomic protocol. A decrease in nocturnal mean arterial blood pressure 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
Eleven 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; cutoff 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 = 0.554, p = 0.009).
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.
Date Issued
2015-02-18
Date Acceptance
2015-01-13
Citation
Clinical Autonomic Research, 2015, 25 (2), pp.109-116
ISSN
1619-1560
Publisher
Springer Verlag (Germany)
Start Page
109
End Page
116
Journal / Book Title
Clinical Autonomic Research
Volume
25
Issue
2
Copyright Statement
© Springer-Verlag 2015. The final publication is available at Springer via http://dx.doi.org/10.1007/s10286-015-0270-5
Subjects
Science & Technology
Life Sciences & Biomedicine
Clinical Neurology
Neurosciences
Neurosciences & Neurology
Circadian
24 h
Psychosis
Dipper
Parkinson disease
CIRCADIAN-RHYTHM DISRUPTION
ORTHOSTATIC HYPOTENSION
NONMOTOR SYMPTOMS
SLEEP
RECOMMENDATIONS
DISORDERS
SCALE
ASSOCIATION
MANAGEMENT
DIAGNOSIS
Aged
Blood Pressure
Blood Pressure Monitoring, Ambulatory
Circadian Rhythm
Female
Humans
Male
Middle Aged
Parkinson Disease
General Clinical Medicine
1103 Clinical Sciences
Publication Status
Published