Home » Parkinson’s: a state-of-the-art system for studying non-motor symptoms

Parkinson’s: a state-of-the-art system for studying non-motor symptoms

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Not just tremors and slow movements. Parkinson’s disease can also be characterized by “non-motor” disorders, such as dysautonomia, a malfunction of the autonomic nervous system (the one that innervates the viscera) that affects about 70% of patients. Symptoms still little known, but which will be possible to study in the new Laboratory for the evaluation of the autonomic nervous system inaugurated at the Asst Gaetano Pini-Cto in Milan, created with the Parkinson and Parkinsonism Center thanks to the Grisons Foundation for Parkinson’s Disease. The ‘heart’ of the laboratory is a sophisticated instrumentation, the ANScovery system, capable of carrying out a series of tests in just 60 minutes that will allow to evaluate the autonomic nervous system and therefore it will be possible to acquire new knowledge on dysautonomic symptoms in Parkinson’s. in the initial stages of the disease, understand its evolution and differentiate it from other atypical parkinsonisms. To date, very few centers in Italy have this equipment and a dedicated team of experts.

Non-motor symptoms

The “non-motor” symptoms concern the autonomic nervous system, that is the system that innervates the viscera and which has the function of regulating all the functions that we do not voluntarily control, such as blood pressure, heart rate, body temperature, digestion, urination and sweating. Malfunction of the autonomic nervous system is called dysautonomia and can occur both in the advanced phase of Parkinson’s disease and in the early stages of the disease, with cardiovascular symptoms, such as hypotension when standing up or when eating, hypertension when lying down and urinary symptoms, such as incontinence. “Parkinson’s disease has always been defined as a motor disease,” he explains Gianni Pezzoli, President of the Grigioni Foundation for Parkinson’s Disease and former Director of the Parkinson and Parkinsonism Center of Asst Gaetano Pini-CTO, Milan: “In reality, it also brings with it non-motor symptoms, some very characteristic”. For example, the expert continues, there is cardiac denervation, which occurs when the heart is no longer innervated by the autonomic nervous system and which causes a pressure drop not compensated by a tachycardia. “When we get up, gravity pulls the blood down and the pressure should drop,” continues Pezzoli. “Actually, the nervous system causes the heart to start beating harder and the arteries to narrow so that the pressure holds.” In patients with Parkinson’s, however, this may not happen so easily.

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The state-of-the-art instrumentation

Thanks to the ANScovery system it will be possible to perform a wide range of tests in just one hour and to continuously monitor biological parameters such as heart rate, respiratory activity and blood pressure: all important tests to arrive at a diagnosis of dysautonomia in Parkinson’s disease. , as they evaluate its presence, severity and its eventual evolution. Furthermore, the examination is simple and non-invasive: the patient is tied to a tilting bed, which from a horizontal position will reach a vertical one. “At this point it is possible, without the patient moving, to observe, for example, the phenomenon of pressure drop and heart rate response”, says Pezzoli: “The combination of cardiological and neurological problems is little studied because it is a borderline between two specialties, where neither of the two specialists tends to venture ”. And the innovation is right here: the study of these phenomena makes it possible to arrive at a correct diagnosis, avoid incongruous therapies and focus on those that can be decisive for the patient.

The importance of research

Given that dysautonomia in Parkinson’s disease affects up to 70% of patients, studying non-motor disorders is essential to improve the quality and life expectancy of these patients. “Having an instrument available in the hands of cardiologists who collaborate directly with neurologists is a rare event”, concludes Pezzoli: “This Laboratory was created with the aim of acquiring new knowledge relating to non-motor disorders to help clarify in this area still little known and pioneering in the neurological field, in order to conduct increasingly innovative research projects and provide patients with increasingly personalized treatments “.

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