Impairing of Dynamic Cerebral Autoregulation in Patients with Parkinson's Disease Correlate with Autonomic Disfunction

Background To investigate the dynamic cerebral autoregulation (dCA) function in patients with Parkinson's disease (PD) and explore the relevant influencing factors by improved detection and evaluation methods. Methods 100 patients with idiopathic PD (PD group) and 100 age- and gender-matched healthy people (Control group) were recruited to participate in this study. All participants were well understood the purpose and procedures of this study and gave consent. Patients with PD were evaluated and classified by the Movement Disorder Society-sponsored revision of the Unified Parkinson's Disease Rating Scale (MDS-UPDRS) and the Modified Hoehn-Yahr (mHY) Scale to assess the severity of Parkinson's disease; the non-motor symptoms were evaluated by the Non-Motor Symptoms Scale of PD; the symptoms of autonomic nerve damage were evaluated by the Autonomic Nerve Scale. The participants' bilateral middle cerebral artery systolic velocities and finger blood pressure were monitored by a cerebral blood flow autoregulation detector. The obtained data were analysed by transferring function analysis(TFA) to derive some dynamic cerebral blood flow autoregulation parameters (such as phase, gain, and coherence). The differences of these parameters between PD group and Control group were compared. Correlations between dynamic cerebral blood flow autoregulation parameters and clinical characteristics were analysed by Spearman correlation and Partial correlation. Results Compared with the Control group, the peak flow velocity of the middle cerebral artery was slowed down bilaterally in PD group ( p  < 0.01); the bilateral phase difference was significantly reduced ( p  < 0.01), and the bilateral gain was significantly increased ( p  < 0.01), suggesting that the dCA function of patients with PD was impaired. The impairment of dynamic cerebral blood flow autoregulation was correlated to different degrees with different subtypes of Parkinson's patients, classified by MDS-UPDRSIII score, PD-NMSS score, and SCOPA-AUT score. After adjusting the factor of SCOPA-AUT score, there was no correlation between abnormal dCA parameters and subtypes with MDS-UPDRSIII score, and PD-NMSS score. Conclusions The dCA function in patients with PD is impaired, and there is an weak correlation between the impaired dCA function with higher motor symptom scores, non-motor symptom scores. After adjusting the evaluation score, the impaired dCA function is mainly related to autonomic dysfunction.