Sabino-Carvalho Jeann L, Vianna Lauro C
NeuroV̇ASQ̇-Integrative Physiology Laboratory, Faculty of Physical Education, University of Brasília, Brasília, Brazil.
Graduate Program in Medical Sciences, Faculty of Medicine, University of Brasília, Brasília, Brazil.
SAGE Open Med. 2020 May 6;8:2050312120921603. doi: 10.1177/2050312120921603. eCollection 2020.
The incidence of Parkinson's disease is increasing worldwide. The motor dysfunctions are the hallmark of the disease, but patients also experience non-motor impairments, and over 40% of the patients experience coexistent abnormalities, such as orthostatic hypotension. Exercise training has been suggested as a coping resource to alleviate Parkinson's disease symptoms and delay disease progression. However, the body of knowledge is showing that the cardiovascular response to exercise in patients with Parkinson's disease is altered. Adequate cardiovascular and hemodynamic adjustments to exercise are necessary to meet the metabolic demands of working skeletal muscle properly. Therefore, since Parkinson's disease affects parasympathetic and sympathetic branches of the autonomic nervous system and the latter are crucial in ensuring these adjustments are adequately made, the understanding of these responses during exercise in this population is necessary. Several neural control mechanisms are responsible for the autonomic changes in the cardiovascular and hemodynamic systems seen during exercise. In this sense, the purpose of the present work is to review the current knowledge regarding the cardiovascular responses to dynamic and isometric/resistance exercise as well as the mechanisms by which the body maintains appropriate perfusion pressure to all organs during exercise in patients with Parkinson's disease. Results from patients with Parkinson's disease and animal models of Parkinson's disease provide the reader with a well-rounded knowledge base. Through this, we will highlight what is known and not known about how the neural control of circulation is responding during exercise and the adaptations that occur when individuals exercise regularly.
帕金森病的发病率在全球范围内呈上升趋势。运动功能障碍是该疾病的标志，但患者也会出现非运动障碍，超过40%的患者存在并存异常，如体位性低血压。运动训练被认为是一种应对手段，可缓解帕金森病症状并延缓疾病进展。然而，现有知识表明帕金森病患者运动时的心血管反应发生了改变。为了适当地满足工作骨骼肌的代谢需求，对运动进行充分的心血管和血液动力学调节是必要的。因此，由于帕金森病会影响自主神经系统的副交感神经和交感神经分支，而后者对于确保这些调节得以充分进行至关重要，所以了解该人群运动期间的这些反应是必要的。几种神经控制机制负责运动期间心血管和血液动力学系统中出现的自主神经变化。从这个意义上讲，本研究的目的是综述关于帕金森病患者动态运动和等长/抗阻运动的心血管反应，以及运动期间身体维持对所有器官适当灌注压的机制的现有知识。帕金森病患者和帕金森病动物模型的研究结果为读者提供了一个全面的知识库。通过这一方式，我们将突出在运动期间循环的神经控制如何反应以及个体定期运动时会发生哪些适应方面，已知和未知的情况。
