PT -期刊文章盟Ruiz巴里尼非盟-杨爱瑾,日本AU - Jaunmuktane Zane t . AU -华纳,托马斯AU - De Pablo-Fernandez爱德华多TI -关联直立性低血压和痴呆患者的帕金森病和多系统萎缩- 10.1212 / WNL援助。0000000000201659 DP - 2023年3月7日TA -神经病学首页PG e998——//www.ez-admanager.com/content/100/10/e998.short e1008 VI - 100 IP - 10 4099 - 4100——//www.ez-admanager.com/content/100/10/e998.full——Neurology2023 3月7日;100 AB -背景和目标直立性低血压(OH)增加痴呆风险在帕金森病(PD)患者,虽然底层机制和类似的哦和认知障碍之间的联系是否存在其他synucleinopathies仍然未知。目的是评估之间的联系哦,PD患者和痴呆的风险,风险和认知障碍患者的多系统萎缩(MSA),并探讨相关的临床和neuropathologic因素理解潜在的致病机制。这是一个回顾性队列研究方法。医疗记录在整个疾病过程中连续neuropathology-confirmed PD患者和MSA从女王广场大脑系统总结了银行。时间OH-related症状的发病和严重程度的记录,和他们的协会与其他临床和neuropathologic变量评估。PD患者的痴呆风险和认知障碍的风险MSA患者使用多变量风险回归估计。结果一百三十二例PD与MSA和137是包括在内。发达哦更频繁,MSA患者在疾病早期课程和更严重的症状。累积的PD患者的痴呆患病率较高。多变量回归模型表明,调整早哦,但不是其症状严重性,PD患者的痴呆风险增加了每年14%(危险比[HR] = 0.86;95%可信区间,0.80 - -0.93)和认知障碍风险MSA患者每年41% (HR = 0.59; 95% CI, 0.42–0.83). Early OH was not associated with increased α-synuclein, β-amyloid, tau, Alzheimer, or cerebrovascular pathologies. No significant associations were found between severity of OH symptoms and other clinical or neuropathologic variables.Discussion Early OH, but not its symptom severity, increases the risk of cognitive impairment in patients with PD and MSA. OH is not associated with more extensive Lewy, β-amyloid, tau, Alzheimer, or cerebrovascular pathologies. It is likely that OH contributes to cognitive impairment in patients with PD and MSA by hypoxia-induced nonspecific neurodegeneration. Further research should evaluate whether improving brain perfusion by treating OH may modify the risk of dementia in these conditions.HR=hazard ratio; OH=orthostatic hypotension; PD=Parkinson disease; MSA=multiple system atrophy; SH=supine hypertension