Dementia with Lewy bodies and autonomic regulation of cardiac functions

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Abstract

In dementia with Lewy bodies (DLB) neurodegenerative process affects not only central, but also peripheral nervous structures, most frequently, neurons of autonomic ganglia, which may underlay autonomic dysfunction, including peripheral autonomic failure. The purpose of this study was to analyze autonomic regulation of cardiac functions in patients with DLB with the assessment of the heart rhythm variability. Twenty three patients with probable DLB were enrolled in the study. A control group was composed of healthy individuals comparable by sex and age. In DLB peripheral autonomic failure occurred significantly more frequently. Orthostatic hypotension manifested at already early stages of the disease in half of the patients. Spectral analysis of the heart rhythm in patients with orthostatic hypotension showed relative predominance of high-frequency waves on the background of decreased power of low-frequency waves of the  spectrum, which suggests decrease of sympathic influence on the heart rhythm. Relative parasympathicotonia combined with heart rhythm abnormalities seen as supraventricular extrasystols. Analysis of the influence on the heart rhythm of drugs used for the treatment of cognitive and motor disorders showed that levodopa decreased the heart rhythm variability and parasympathic tonus because of stimulation of cardiac adrenoreceptors. Anticholinesterase medications do not influence the heart rhythm variability, but can decrease severity of orthostatic hypotension.

 

About the authors

I. G. Tishkova

Department of Neurology, I.M. Sechenov Moscow Medical Academy (Moscow)

Author for correspondence.
Email: platonova@neurology.ru
Russian Federation

I. S. Preobrazhenskaya

Department of Neurology, I.M. Sechenov Moscow Medical Academy (Moscow)

Email: platonova@neurology.ru
Russian Federation

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Copyright (c) 2017 Tishkova I.G., Preobrazhenskaya I.S.

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