TY - JOUR
T1 - Cerebral autoregulation and white matter lesions in Parkinson's disease and multiple system atrophy
AU - Indelicato, Elisabetta
AU - Fanciulli, Alessandra
AU - Poewe, Werner
AU - Antonini, Angelo
AU - Pontieri, Francesco E.
AU - Wenning, Gregor K.
PY - 2015/12/1
Y1 - 2015/12/1
N2 - Cerebral autoregulation is a complex homeostatic process which ensures constant brain blood supply, despite continuous blood pressure fluctuations. Recent evidence suggests that in Parkinson's disease (PD) and multiple system atrophy (MSA) this process is maintained in a broadened range of blood pressure values, consistent with an adaptive mechanism to increase tolerance to orthostatic hypotension. In PD and MSA orthostatic hypotension may be accompanied by supine hypertension which has been recently linked with cerebral white matter lesions in these conditions. We hypothesize that cerebral autoregulation adaptation to chronic orthostatic hypotension may be directly related with an increase susceptibility to hypertensive peaks. Evaluation of cerebral autoregulatory behavior may thus represent a novel approach to simultaneously target orthostatic symptoms and silent end-organ damage in alpha-synucleinopathies, with a beneficial impact on cerebrovascular and cognitive outcome.
AB - Cerebral autoregulation is a complex homeostatic process which ensures constant brain blood supply, despite continuous blood pressure fluctuations. Recent evidence suggests that in Parkinson's disease (PD) and multiple system atrophy (MSA) this process is maintained in a broadened range of blood pressure values, consistent with an adaptive mechanism to increase tolerance to orthostatic hypotension. In PD and MSA orthostatic hypotension may be accompanied by supine hypertension which has been recently linked with cerebral white matter lesions in these conditions. We hypothesize that cerebral autoregulation adaptation to chronic orthostatic hypotension may be directly related with an increase susceptibility to hypertensive peaks. Evaluation of cerebral autoregulatory behavior may thus represent a novel approach to simultaneously target orthostatic symptoms and silent end-organ damage in alpha-synucleinopathies, with a beneficial impact on cerebrovascular and cognitive outcome.
KW - Cerebral autoregulation
KW - Cerebral white matter lesions
KW - Multiple system atrophy
KW - Orthostatic hypotension
KW - Parkinson's disease
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U2 - 10.1016/j.parkreldis.2015.10.018
DO - 10.1016/j.parkreldis.2015.10.018
M3 - Article
C2 - 26578037
AN - SCOPUS:84955631465
VL - 21
SP - 1393
EP - 1397
JO - Parkinsonism and Related Disorders
JF - Parkinsonism and Related Disorders
SN - 1353-8020
IS - 12
ER -