The Experts below are selected from a list of 25710 Experts worldwide ranked by ideXlab platform
Mitsuhiro Yoshita - One of the best experts on this subject based on the ideXlab platform.
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differentiation of idiopathic parkinson s disease from striatonigral degeneration and progressive supranuclear palsy using iodine 123 meta iodobenzylguanidine myocardial scintigraphy
Journal of the Neurological Sciences, 1998Co-Authors: Mitsuhiro YoshitaAbstract:Iodine-123 meta-iodobenzylguanidine (( I)MIBG), an analogue of norepinephrine, is a tracer for functioning of sympathetic neurons. 123 To investigate cardiac sympathetic function in PD, SND, and PSP, ( I)MIBG myocardial scintigraphy was performed in 25 patients with PD, 15 patients with SND, 14 patients with PSP, and 20 control subjects. In planar imaging Studies, the heart-to-mediastinum average count ratio (H / M) was calculated for both early and delayed images. The mean value of H / M in patients with PD was significantly lower than those with SND, PSP, or no disease. Regardless of disease severity or intensity of anti-Parkinsonian pharmacotherapy, mean values for H / M were always low in patients with PD. The mean value of H / M in SND with orthostatic hypotension (OH) was lower than that in SND without OH. Although the mean value of H / M in PSP with amitriptyline treatment was significantly lower than that in PSP patients without amitriptyline treatment, there was no significant difference between the mean value of H / M in PSP patients without amitriptyline treatment and that in control. Thus, PD may have a abnormality of cardiac sympathetic function which has not been detected by previous 123 cardiovascular Autonomic Studies. Moreover, particularly in early stages, ( I)MIBG myocardial scintigraphy may provide helpful diagnostic information in these akinetic-rigid syndromes. © 1998 Elsevier Science B.V.
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differentiation of idiopathic parkinson s disease from striatonigral degeneration and progressive supranuclear palsy using iodine 123 meta iodobenzylguanidine myocardial scintigraphy
Journal of the Neurological Sciences, 1998Co-Authors: Mitsuhiro YoshitaAbstract:Iodine-123 meta-iodobenzylguanidine ([123I]MIBG), an analogue of norepinephrine, is a tracer for functioning of sympathetic neurons. To investigate cardiac sympathetic function in PD, SND, and PSP, [123I]MIBG myocardial scintigraphy was performed in 25 patients with PD, 15 patients with SND, 14 patients with PSP, and 20 control subjects. In planar imaging Studies, the heart-to-mediastinum average count ratio (H/M) was calculated for both early and delayed images. The mean value of H/M in patients with PD was significantly lower than those with SND, PSP, or no disease. Regardless of disease severity or intensity of anti-Parkinsonian pharmacotherapy, mean values for H/M were always low in patients with PD. The mean value of H/M in SND with orthostatic hypotension (OH) was lower than that in SND without OH. Although the mean value of H/M in PSP with amitriptyline treatment was significantly lower than that in PSP patients without amitriptyline treatment, there was no significant difference between the mean value of H/M in PSP patients without amitriptyline treatment and that in control. Thus, PD may have a abnormality of cardiac sympathetic function which has not been detected by previous cardiovascular Autonomic Studies. Moreover, particularly in early stages, [123I]MIBG myocardial scintigraphy may provide helpful diagnostic information in these akinetic-rigid syndromes.
David G Endi - One of the best experts on this subject based on the ideXlab platform.
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swallow deglutition syncope an evaluation of swallowing induced heart rate and hemodynamic changes in affected patients and control subjects
Journal of Cardiovascular Electrophysiology, 2019Co-Authors: Ritsuko Kohno, Wayne O Adkisso, Arry L S Detloff, Sco Sakaguchi, David G EndiAbstract:Background Syncope triggered by swallowing is a well-known but uncommon condition that has been the focus of case reports but is otherwise largely unstudied. To better understand swallow syncope we examined heart rate (HR) and blood pressure (BP) changes during swallowing in clinically suspected swallow syncope patients and asymptomatic control subjects. Methods The study population comprised four individuals with a history suggesting swallow syncope (three men, 53 ± 14.9 years) and 15 (nine men, 46 ± 17.1 years, P = NS vs patients) asymptomatic volunteer control subjects. Studies in all individuals comprised noninvasive beat-to-beat HR and BP measurement during swallowing 150 mL of cold liquid while standing. Additional tests in swallow syncope patients included: active standing, Valsalva maneuver, carotid sinus massage (CSM), and head-up tilt (HUT). Results Swallowing resulted in a greater decrease of both HR (-22 ± 22.1 vs -3 ± 11.7 beats/minute [bpm]; P = 0.045) and BP (-22 ± 17.4 vs - 2 ± 11.8; P = 0.036) in swallow syncope patients than in controls. Further, in swallow syncope patients the time to lowest HR and BP differed (9 ± 5.5 vs 19 ± 7.2 seconds; P = 0.02), suggesting that both cardioinhibitory (CI) and vasodepressor (VD) mechanisms are present but operate independently. Other Autonomic Studies were normal in swallow syncope patients except for CSM pause more than 3 seconds in two patients. Conclusion Swallow syncope is associated with transient and temporally independent CI and VD features, consistent with reflex syncope. Potentially, a swallowing test during Autonomic evaluation may be useful to unmask relative magnitudes of CI and VD responses, thereby facilitating treatment strategy decisions.
Jaime Kulisevsky Bojarski - One of the best experts on this subject based on the ideXlab platform.
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p66 t skin sympathetic activity and Autonomic Studies in ross and harlequin syndrome
Clinical Neurophysiology, 2019Co-Authors: Sara Yague Jimeno, Azahara Aceituno Gonzalez, Misericordia Veciana De Las Heras, Noemi Morollon Sanchezmateos, Javier Sotoca Fernandez, Jordi Pedro Perez, Monica Povedano Panades, Roberto Belvis Nieto, Jaime Kulisevsky BojarskiAbstract:Background Ross syndrome is a degenerative disorder characterized by the clinical triad of tonic pupil, hyporeflexia and segmental anhidrosis. Harlequin syndrome is described as segmental anhidrosis without ocular sympathetic deficit. Harlequin syndrome exhibits a selective abnormality in the peripheral skin sympathetic nerves and Ross syndrome reveals a widespread Autonomic dysfunction. We present 4 patients with sudomotor dysfunction and different patterns of Autonomic abnormalities. Material and methods Patients 1 and 2 complained of unilateral facial and upper limb flushing and sweating impairment. Patients 3 and 4 complained of an extensive anhidrosis and compensatory hyperhidrosis, patient 4 also presented an Adie’s pupil. Patients underwent nerve conduction Studies, sympathetic skin responses (SSR), cardiovascular reflexes (deep breathing, Valsalva maneuver and standing) and laser evoked potentials. Results SSR were absent in the anhidrotic upper limb in patients 1 and 2, either to electric or laser stimuli. No evoked SSR responses were recorded in the four limbs in patients 3 and 4. Patient 4 presented slightly impaired cardiovascular reflexes and patients 2 and 4 presented mild abnormalities in sensory nerve conduction Studies. Serologic screening, brain MRI and cervicothoracic CT were normal in all patients. Patients 1 and 2 were affected by a Harlequin syndrome, patient 3 presented an uncompleted Ross syndrome and patient 4 a classic Ross syndrome. Conclusions Ross and Harlequin syndrome are two clinically distinguishable expressions of partial dysautonomias belonging to a degenerative Autonomic disorder that involves sympathetic, parasympathetic and myelinated nerve fibres with different distribution, extent and degree of impairment.
Jade A Gehrking - One of the best experts on this subject based on the ideXlab platform.
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prospective differentiation of multiple system atrophy from parkinson disease with and without Autonomic failure
JAMA Neurology, 2009Co-Authors: Axel Lipp, Paola Sandroni, Eric J Ahlskog, Robert D Fealey, Kurt Kimpinski, Valeria Iodice, Tonette L Gehrking, Stephen D Weigand, David M Sletten, Jade A GehrkingAbstract:Objective To report preliminary results of a prospective ongoing study of multiple system atrophy (MSA) and Parkinson disease (PD), with a large subset of patients with PD with Autonomic failure (25%), to evaluate Autonomic indices that distinguish MSA from PD. Methods We used consensus criteria, detailed Autonomic Studies (Composite Autonomic Symptom Scale, Composite Autonomic Scoring Scale, thermoregulatory sweat test, and plasma catecholamines), and functional scales (Unified MSA Rating Scale [UMSARS] I-IV and Hoehn-Yahr grading) on a prospective, repeated, and ongoing basis. Results We report the results of a study on 52 patients with MSA (mean [SD], age, 61.1 [7.8] years; body mass index (calculated as weight in kilograms divided by height in meters squared), 27.2 [4.6]; Hoehn-Yahr grade, 3.2 [0.9]; UMSARS I score, 21.5 [7.4]; and UMSARS II score, 22.7 [9.0]) and 29 patients with PD, including PD with Autonomic failure (mean [SD], age, 66.0 [8.1] years; body mass index, 26.6 [5.5]; Hoehn-Yahr grade, 2.2 [0.8]; UMSARS I score, 10.4 [6.1]; and UMSARS II score, 13.0 [5.9]). Autonomic indices were highly significantly more abnormal in MSA than PD ( P Conclusions The severity, distribution, and pattern of Autonomic deficits at study entry will distinguish MSA from PD, and MSA from PD with Autonomic failure. These differences continue and are increased at follow-up. Our ongoing conclusion is that Autonomic function tests can separate MSA from PD. Autonomic indices support the notion that the primary lesion in PD is ganglionic and postganglionic, while MSA is preganglionic.
Ritsuko Kohno - One of the best experts on this subject based on the ideXlab platform.
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swallow deglutition syncope an evaluation of swallowing induced heart rate and hemodynamic changes in affected patients and control subjects
Journal of Cardiovascular Electrophysiology, 2019Co-Authors: Ritsuko Kohno, Wayne O Adkisso, Arry L S Detloff, Sco Sakaguchi, David G EndiAbstract:Background Syncope triggered by swallowing is a well-known but uncommon condition that has been the focus of case reports but is otherwise largely unstudied. To better understand swallow syncope we examined heart rate (HR) and blood pressure (BP) changes during swallowing in clinically suspected swallow syncope patients and asymptomatic control subjects. Methods The study population comprised four individuals with a history suggesting swallow syncope (three men, 53 ± 14.9 years) and 15 (nine men, 46 ± 17.1 years, P = NS vs patients) asymptomatic volunteer control subjects. Studies in all individuals comprised noninvasive beat-to-beat HR and BP measurement during swallowing 150 mL of cold liquid while standing. Additional tests in swallow syncope patients included: active standing, Valsalva maneuver, carotid sinus massage (CSM), and head-up tilt (HUT). Results Swallowing resulted in a greater decrease of both HR (-22 ± 22.1 vs -3 ± 11.7 beats/minute [bpm]; P = 0.045) and BP (-22 ± 17.4 vs - 2 ± 11.8; P = 0.036) in swallow syncope patients than in controls. Further, in swallow syncope patients the time to lowest HR and BP differed (9 ± 5.5 vs 19 ± 7.2 seconds; P = 0.02), suggesting that both cardioinhibitory (CI) and vasodepressor (VD) mechanisms are present but operate independently. Other Autonomic Studies were normal in swallow syncope patients except for CSM pause more than 3 seconds in two patients. Conclusion Swallow syncope is associated with transient and temporally independent CI and VD features, consistent with reflex syncope. Potentially, a swallowing test during Autonomic evaluation may be useful to unmask relative magnitudes of CI and VD responses, thereby facilitating treatment strategy decisions.
