Abstract
Clinical diagnostic criteria indicate presence of autonomic features as the primary hallmark of Multiple System Atrophy (MSA). However involvement of the autonomic system is also a recognized feature of Parkinson's Disease (PD), yielding a broad clinical overlap between the two diseases. Laboratory assessments may help in the differential diagnosis between PD and MSA. Ambulatory Monitoring of Blood Pressure (AMBP) is a suitable tool to study the circadian rhythm of blood pressure (BP) and heart rate (HR). Different studies reported a reduction of physiological BP nocturnal dipping in PD and MSA patients, but failed to identify a distinctive pattern discriminating the two diseases. On the other hand, HR nocturnal behavior has not been exhaustively analyzed. In the present study we compared the profiles of HR circadian rhythm in 61 PD and 19MSA patients who underwent 24h AMBP.We found higher nocturnal HR (nHR) (71.5beats/min±7.4) in MSA compared with PD (63.8 beats/min±9.6) as well as significantly lower nocturnal decline of HR (ndHR) in MSA (7.3%±8.2) vs. PD (14%±7.5). At a Receiver Operating Curve analysis nHR and ndHR significantly discriminated MSA from PD. nHR showed a sensitivity of 84.2% and a specificity of 62.3% (AUC 0.76; 95% IC 0.65-0.85); ndHR showed a sensitivity of 68% of and a specificity of 77% (AUC 0.72; 95% IC 0.61-0.82).According to our findings, nHR is increased and ndHR is reduced in MSA compared to PD. Moreover, these two indices discriminate between the two diseases with acceptable accuracy.
| Original language | English |
|---|---|
| Pages (from-to) | 217-221 |
| Number of pages | 5 |
| Journal | Parkinsonism and Related Disorders |
| Volume | 20 |
| Issue number | 2 |
| DOIs | |
| Publication status | Published - Feb 2014 |
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Keywords
- Cardiovascular function
- Differential diagnosis
- Dysautonomia
- Heart rate
- Multiple system atrophy
- Parkinson disease
ASJC Scopus subject areas
- Geriatrics and Gerontology
- Clinical Neurology
- Neurology
Cite this
Heart rate circadian profile in the differential diagnosis between Parkinson disease and multiple system atrophy. / Pilleri, Manuela; Levedianos, Giorgio; Weis, Luca; Gasparoli, Elisabetta; Facchini, Silvia; Biundo, Roberta; Formento-Dojot, Patrizia; Antonini, Angelo.
In: Parkinsonism and Related Disorders, Vol. 20, No. 2, 02.2014, p. 217-221.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Heart rate circadian profile in the differential diagnosis between Parkinson disease and multiple system atrophy
AU - Pilleri, Manuela
AU - Levedianos, Giorgio
AU - Weis, Luca
AU - Gasparoli, Elisabetta
AU - Facchini, Silvia
AU - Biundo, Roberta
AU - Formento-Dojot, Patrizia
AU - Antonini, Angelo
PY - 2014/2
Y1 - 2014/2
N2 - Clinical diagnostic criteria indicate presence of autonomic features as the primary hallmark of Multiple System Atrophy (MSA). However involvement of the autonomic system is also a recognized feature of Parkinson's Disease (PD), yielding a broad clinical overlap between the two diseases. Laboratory assessments may help in the differential diagnosis between PD and MSA. Ambulatory Monitoring of Blood Pressure (AMBP) is a suitable tool to study the circadian rhythm of blood pressure (BP) and heart rate (HR). Different studies reported a reduction of physiological BP nocturnal dipping in PD and MSA patients, but failed to identify a distinctive pattern discriminating the two diseases. On the other hand, HR nocturnal behavior has not been exhaustively analyzed. In the present study we compared the profiles of HR circadian rhythm in 61 PD and 19MSA patients who underwent 24h AMBP.We found higher nocturnal HR (nHR) (71.5beats/min±7.4) in MSA compared with PD (63.8 beats/min±9.6) as well as significantly lower nocturnal decline of HR (ndHR) in MSA (7.3%±8.2) vs. PD (14%±7.5). At a Receiver Operating Curve analysis nHR and ndHR significantly discriminated MSA from PD. nHR showed a sensitivity of 84.2% and a specificity of 62.3% (AUC 0.76; 95% IC 0.65-0.85); ndHR showed a sensitivity of 68% of and a specificity of 77% (AUC 0.72; 95% IC 0.61-0.82).According to our findings, nHR is increased and ndHR is reduced in MSA compared to PD. Moreover, these two indices discriminate between the two diseases with acceptable accuracy.
AB - Clinical diagnostic criteria indicate presence of autonomic features as the primary hallmark of Multiple System Atrophy (MSA). However involvement of the autonomic system is also a recognized feature of Parkinson's Disease (PD), yielding a broad clinical overlap between the two diseases. Laboratory assessments may help in the differential diagnosis between PD and MSA. Ambulatory Monitoring of Blood Pressure (AMBP) is a suitable tool to study the circadian rhythm of blood pressure (BP) and heart rate (HR). Different studies reported a reduction of physiological BP nocturnal dipping in PD and MSA patients, but failed to identify a distinctive pattern discriminating the two diseases. On the other hand, HR nocturnal behavior has not been exhaustively analyzed. In the present study we compared the profiles of HR circadian rhythm in 61 PD and 19MSA patients who underwent 24h AMBP.We found higher nocturnal HR (nHR) (71.5beats/min±7.4) in MSA compared with PD (63.8 beats/min±9.6) as well as significantly lower nocturnal decline of HR (ndHR) in MSA (7.3%±8.2) vs. PD (14%±7.5). At a Receiver Operating Curve analysis nHR and ndHR significantly discriminated MSA from PD. nHR showed a sensitivity of 84.2% and a specificity of 62.3% (AUC 0.76; 95% IC 0.65-0.85); ndHR showed a sensitivity of 68% of and a specificity of 77% (AUC 0.72; 95% IC 0.61-0.82).According to our findings, nHR is increased and ndHR is reduced in MSA compared to PD. Moreover, these two indices discriminate between the two diseases with acceptable accuracy.
KW - Cardiovascular function
KW - Differential diagnosis
KW - Dysautonomia
KW - Heart rate
KW - Multiple system atrophy
KW - Parkinson disease
UR - http://www.scopus.com/inward/record.url?scp=84893663785&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84893663785&partnerID=8YFLogxK
U2 - 10.1016/j.parkreldis.2013.11.006
DO - 10.1016/j.parkreldis.2013.11.006
M3 - Article
VL - 20
SP - 217
EP - 221
JO - Parkinsonism and Related Disorders
JF - Parkinsonism and Related Disorders
SN - 1353-8020
IS - 2
ER -