Orthostatic hypotension acutely impairs executive functions in Parkinson’s disease
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Orthostatic hypotension is a frequent non-motor symptom of Parkinson’s disease, with negative prognostic role on cognitive functions. Here we measured the acute effects of orthostatic hypotension on executive functions in Parkinson’s disease patients devoid of hypertension, carotid artery stenosis, and significant chronic cerebrovascular pathology. Measurements were carried out during regular visits in outpatient setting. Twenty-eight Parkinson’s disease patients were recruited and studied along scheduled outpatient visits. They were divided into two groups (n = 14 each) based on the presence or lack of orthostatic hypotension. This was diagnosed according to international guidelines. All patients were submitted to the Stroop’s test and to the phonological and semantic verbal fluency test after 10-min resting in supine position and immediately upon standing in upright position. Testing lasted less than 5 min in either position. In upright position, subjects with orthostatic hypotension displayed significantly worse performances at the Stroop’s test word reading time (22.1 ± 4.1 vs. 14.9 ± 4.0 s), interference time (56.1 ± 12.3 vs. 41.4 ± 11.8 s), and number of errors at the interference section (5.8 ± 3.2 vs. 1.3 ± 2.1) as compared to those without orthostatic hypotension. These results demonstrate that worsening of attentive function upon standing can be measured in Parkinson’s disease patients with orthostatic hypotension during routine outpatient visits. These findings suggest that clinically asymptomatic orthostatic hypotension in Parkinson’s disease patients may acutely worsen neuropsychological performances with possible negative impact on daily functioning.
KeywordsCognition Executive functions Orthostatic hypotension Parkinson’s disease
Compliance with ethical standards
The protocol was approved by the Ethical Committee of the “Fondazione Santa Lucia, IRCCS,” and each subject signed informed consent.
Conflict of interest
The authors declare that they have no conflicts of interest.
- 5.Freeman R, Wieling W, Axelrod FB, Benditt DG, Benarroch E, Biaggioni I, Cheshire WP, Chelimsky T, Cortelli P, Gibbons CH, Goldstein DS, Hainsworth R, Hilz MJ, Jacob G, Kaufmann H, Jordan J, Lipsitz LA, Levine BD, Low PA, Mathias C, Raj SR, Robertson D, Sandroni P, Schatz I, Schondorff R, Stewart JM, van Dijk JG (2011) Consensus statement on the definition of orthostatic hypotension, neutrally mediated syncope and the postural tachycardia. Clin Autonom Res 21:69–72CrossRefGoogle Scholar
- 14.Pontieri FE, Assogna F, Pellicano C, Cacciari C, Pannunzi S, Morrone A, Danese E, Caltagirone C, Spalletta G (2015) Sociodemographic, neuropsychiatric and cognitive characteristics of pathological gambling and impulse control disorders NOS in Parkinson’s disease. Eur Neuropsychopharmacol 25:69–76CrossRefPubMedGoogle Scholar