Department of Neurology, Justus-Liebig-University, Giessen, Germany; Department of Physiology, The University of Auckland, New Zealand.
Department of Neurology, Philipps-University, Marburg, Germany.
Clin Neurophysiol. 2021 Jul;132(7):1537-1542. doi: 10.1016/j.clinph.2021.04.012. Epub 2021 May 8.
Changes in baroreflex sensitivity have been reported in patients with idiopathic Parkinson's disease (PD). We sought to investigate the hypothesis that patients with isolated rapid eye movement (REM)-sleep behavior disorder (iRBD), known to be a prodromal stage for PD, will show abnormalities in baroreflex control.
Ten iRBD patients were compared to 10 sex- and age-matched healthy controls. Their cardiovascular parameters and muscle sympathetic nerve activity (MSNA) were evaluated at rest and during baroreflex stimulation.
MSNA at rest was higher in iRBD patients (burst frequency [BF]: 44 ± 3 bursts/min; burst incidence [BI]: 60 ± 8 bursts/100 heartbeats) as compared to the controls (BF: 29 ± 3 bursts/min, p < 0.001; BI: 43 ± 9 bursts/100 heartbeats, p < 0.001). During baroreflex stimulation, iRBD patients showed increased absolute values of MSNA (BF: F = 62.728; p < 0.001; BI: F = 16.277; p < 0.001) as compared to the controls. The iRBD patients had decreased diastolic blood pressure at baseline and during lower body negative pressure, but the level of significance was not met.
Our study shows increased MSNA and impaired baroreflex control in iRBD patients. We propose that the inhibitory effect of locus coeruleus on baroreflex function might be impaired, leading to the disinhibition of sympathetic outflow.
These findings might reflect the destruction of brain areas due to the ascending P-α-synuclein deposits in iRBD patients.
已有研究报道，特发性帕金森病（PD）患者的压力反射敏感性发生改变。我们试图验证这样一个假设，即孤立性快速眼动（REM）睡眠行为障碍（iRBD）患者（已知是 PD 的前驱阶段）的压力反射控制会出现异常。
将 10 名 iRBD 患者与 10 名性别和年龄匹配的健康对照者进行比较。评估他们在休息和压力反射刺激期间的心血管参数和肌间神经丛活性（MSNA）。
与对照组相比，iRBD 患者的 MSNA 在休息时更高（爆发频率[BF]：44±3 次/分钟；爆发次数[BI]：60±8 次/100 次心跳）（BF：29±3 次/分钟，p<0.001；BI：43±9 次/100 次心跳，p<0.001）。在压力反射刺激期间，iRBD 患者的 MSNA 绝对值增加（BF：F=62.728；p<0.001；BI：F=16.277；p<0.001）与对照组相比。与对照组相比，iRBD 患者的基础和下体负压期间舒张压降低，但未达到显著性水平。
我们的研究表明，iRBD 患者的 MSNA 增加和压力反射控制受损。我们提出蓝斑核对压力反射功能的抑制作用可能受损，导致交感神经输出的去抑制。
这些发现可能反映了 iRBD 患者由于上行 P-α-突触核蛋白沉积导致脑区受损。
