Yoo Sang-Won, Kim Joong-Seok, Yoo Ji-Yeon, Yun Eunkyeong, Yoon Uicheul, Shin Na-Young, Lee Kwang-Soo
Department of Neurology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Department of Biomedical Engineering, College of Health and Medical Science, Catholic University of Daegu, Gyeongbuk, Republic of Korea.
NPJ Parkinsons Dis. 2021 Apr 14;7(1):37. doi: 10.1038/s41531-021-00181-y.
Orthostatic hypotension (OH) is relatively common in the early stage of Parkinson's disease (PD). It is divided into delayed OH and classical OH. Classical OH in PD has been investigated widely, however, the clinical implications of delayed OH in PD have seldom been studied. The purpose of this study is to characterize delayed OH in PD. A total of 285 patients with early drug-naïve PD were enrolled and divided into three groups according to orthostatic change: no-OH, delayed OH, and classical OH. The disease severity in terms of motor, non-motor, and cognitive functions was assessed. The cortical thickness of 82 patients was analyzed with brain magnetic resonance imaging. The differences among groups and linear tendency in the order of no-OH, delayed OH, and classical OH were investigated. Seventy-seven patients were re-evaluated. Initial and follow-up evaluations were explored to discern any temporal effects of orthostasis on disease severity. Sixty-four (22.5%) patients were defined as having delayed OH and 117 (41.1%) had classical OH. Between-group comparisons revealed that classical OH had the worst outcomes in motor, non-motor, cognitive, and cortical thickness, compared to the other groups. No-OH and delayed OH did not differ significantly. Linear trends across the pre-ordered OH subtypes found that clinical parameters worsened along with the orthostatic challenge. Clinical scales deteriorated and the linear gradient was maintained during the follow-up period. This study suggests that delayed OH is a mild form of classical OH in PD. PD with delayed OH has milder disease severity and progression.
体位性低血压（OH）在帕金森病（PD）早期相对常见。它分为延迟性OH和经典性OH。PD中的经典性OH已得到广泛研究，然而，PD中延迟性OH的临床意义很少被研究。本研究的目的是描述PD中延迟性OH的特征。共纳入285例未经药物治疗的早期PD患者，并根据体位变化分为三组：无OH组、延迟性OH组和经典性OH组。评估了运动、非运动和认知功能方面的疾病严重程度。对82例患者进行了脑磁共振成像分析皮质厚度。研究了各组之间的差异以及无OH组、延迟性OH组和经典性OH组顺序中的线性趋势。对77例患者进行了重新评估。探索了初始评估和随访评估，以识别体位性对疾病严重程度的任何时间效应。64例（22.5%）患者被定义为患有延迟性OH，117例（41.1%）患有经典性OH。组间比较显示，与其他组相比，经典性OH在运动、非运动、认知和皮质厚度方面的结果最差。无OH组和延迟性OH组无显著差异。在预先排序的OH亚型中发现的线性趋势表明，临床参数随着体位性挑战而恶化。临床量表恶化，且在随访期间线性梯度保持不变。本研究表明，延迟性OH是PD中经典性OH的一种轻度形式。患有延迟性OH的PD疾病严重程度和进展较轻。
