Is Hypotension The Mechanism Behind Cognitive Fluctuations In Parkinson’S Disease Dementia And Dementia With Lewy Bodies?
Posted Date: Oct 29, 2019
- Investigator: Alberto Espay
- Specialties: Neurology, Parkinson's Disease
- Type of Study: Observational/Survey
Cognitive fluctuations are a key source of disability in Parkinson’s disease dementia (PDD) and dementia with Lewy bodies (DLB), with a prevalence of around 30% in PDD and between 42 and 63% in DLB. Episodes of hypotension are common in PDD and DLB, most often due to dysautonomia, which affect overall function and quality of life. The relationship between orthostatic hypotension (OH) and cognitive fluctuations in PDD/DLB patients has only indirectly been evaluated. While it may be merely associative, reflective of the neuropathological involvement of cholinergic regions in both conditions, clinical observations suggest a causal relationship, whereby cognitive fluctuations may correspond with periods of reduced cerebral perfusion. We hypothesize that in PDD and DLB patients, (1) OH will be associated with cortical electroencephalographic signatures (dominant frequency variability between alpha (8.0-12.0 Hz) and pre-alpha (5.5-7.5 Hz) bands), a pattern associated with cognitive fluctuations in PDD/DLB patients, measurable with quantitative electroencephalography (qEEG); and (2) cognitive fluctuations will be time-locked to hypotensive episodes, as measured by 24-hour ambulatory BP monitoring (ABPM).
Cognitive Fluctuations, Parkinson's Disease, Dementia With Lewy Bodies
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