Abstract Details

Title Continuous Non-Invasive Arterial Pressure Monitoring To Detect Autonomic Dysfunction in Parkinson's Disease

Topic Movement Disorders

Presentation(s) P06 - (-)

Poster/Presentation
Number 101

Objective

Background BACKGROUND: PD patients commonly experience orthostatic lightheadedness as a result of dysautonomia. Traditional measurement of OH can be insensitive, and alternative methods of measuring CD are costly, requiring specialized equipment or invasive procedures. Clinicians may be unwilling to treat orthostatic lightheadedness in the absence of objectively documented dysautonomia. A reliable, inexpensive, non-invasive tool to measure dysautonomia is needed. Continuous beat-to-beat changes in blood pressure and heart rate can be measured non-invasively using a continuous non-invasive arterial pressure (CNAP) monitoring device, the CNAPTM 500.

Design/Methods DESIGN/METHODS: Participants first undergo traditional blood pressure (BP) and heart rate (HR) measurement at rest and after standing. CNAPTM is then used to measure beat-to-beat BP and HR changes at rest, with standing and during valsalva maneuver. Subjective symptoms are measured using cardiovascular questions of the Non-Motor Symptoms Scale for PD.

Results RESULTS: Thirteen subjects have been enrolled, all Caucasian males. There is no significant difference in age, disease duration, or disease severity between subjects with and without OH. Preliminary results show trends toward greater variation in systolic BP, diastolic BP, and mean arterial pressure during valsalva in subjects with versus without OH, though differences are not statistically significant likely due to the small sample size. There was additional trend toward greater variation in the same measurements in subjects without OH with orthostatic symptoms versus those without OH and without symptoms. One (of two) subjects with symptoms of lightheadedness on standing but without OH by traditional BP measurement was found to lack normal orthostatic response of HR and systolic BP measured by CNAPTM, suggesting this may be more sensitive measure of dyautonomia than traditional measures.

Conclusions CONCLUSIONS: CNAPTM may be a reliable, inexpensive, non-invasive way to sensitively measure dysautonomia in PD.

Authors/Disclosures
Amy Hellman, MD, FAAN (University of Nebraska Medical Center) PRESENTER	The institution of Dr. Hellman has received research support from COBRE-NIH. The institution of Dr. Hellman has received research support from Neurocrine.
John E. Duda, MD (Veterans Affairs Medical Center)	Dr. Duda has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Nature Publishing Group. The institution of Dr. Duda has received research support from Department of Veterans Affairs. The institution of Dr. Duda has received research support from Michael J. Fox Foundation. The institution of Dr. Duda has received research support from Innervace, Incorporated. The institution of Dr. Duda has received research support from National Institutes of Health.
James F. Morley, MD, PhD	Dr. Morley has nothing to disclose.
	No disclosure on file

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