{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T07:21:19Z","timestamp":1768807279263,"version":"3.49.0"},"reference-count":35,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2015,7,24]],"date-time":"2015-07-24T00:00:00Z","timestamp":1437696000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["CNS Neurosci Ther"],"published-print":{"date-parts":[[2015,9]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Aims<\/jats:title><jats:p>Disorders of the autonomic nervous system (<jats:styled-content style=\"fixed-case\">ANS<\/jats:styled-content>) have a variable degree of clinical relevance in patients with Parkinson's disease (<jats:styled-content style=\"fixed-case\">PD<\/jats:styled-content>). Here, we assessed whether subclinical autonomic dysfunction, as evaluated by a complete battery of autonomic function tests (<jats:styled-content style=\"fixed-case\">AFT<\/jats:styled-content>s), correlates with <jats:styled-content style=\"fixed-case\">PD<\/jats:styled-content> progression.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A series of 27 consecutive patients with <jats:styled-content style=\"fixed-case\">PD<\/jats:styled-content> underwent extensive <jats:styled-content style=\"fixed-case\">ANS<\/jats:styled-content> investigations including the head\u2010up tilt test (<jats:styled-content style=\"fixed-case\">HUTT<\/jats:styled-content>), Valsalva maneuver, deep\u2010breathing test, and handgrip test (<jats:styled-content style=\"fixed-case\">HG<\/jats:styled-content>); further, they performed 123I\u2010meta\u2010iodobenzylguanidine (<jats:styled-content style=\"fixed-case\">MIBG<\/jats:styled-content>) scintigraphy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Seven of the 27 patients showed orthostatic hypotension (<jats:styled-content style=\"fixed-case\">OH<\/jats:styled-content>) at <jats:styled-content style=\"fixed-case\">HUTT<\/jats:styled-content> and pathological responses to the deep\u2010breathing and <jats:styled-content style=\"fixed-case\">HG<\/jats:styled-content> test and Valsalva maneuver. The majority of the remaining 20 patients with <jats:styled-content style=\"fixed-case\">PD<\/jats:styled-content> showed pathological responses to deep\u2010breathing (n\u00a0=\u00a013) and\/or <jats:styled-content style=\"fixed-case\">HG<\/jats:styled-content> (n\u00a0=\u00a011). Only 3 of 27 suffered relevant <jats:styled-content style=\"fixed-case\">OH<\/jats:styled-content>. <jats:styled-content style=\"fixed-case\">MIBG<\/jats:styled-content> uptake of myocardium was decreased in 19 patients with <jats:styled-content style=\"fixed-case\">PD<\/jats:styled-content> (H\/M ratio 1.3\u00a0\u00b1\u00a00.2). Prolonged clinical observation (&gt;3\u00a0years), persistent response to levodopa, and <jats:styled-content style=\"fixed-case\">MIBG<\/jats:styled-content> repetition allowed us to exclude negative <jats:styled-content style=\"fixed-case\">MIBG<\/jats:styled-content> as attributable to atypical Parkinsonism. <jats:styled-content style=\"fixed-case\">MIBG<\/jats:styled-content> uptake did not correlate with <jats:styled-content style=\"fixed-case\">OH<\/jats:styled-content> and other <jats:styled-content style=\"fixed-case\">AFT<\/jats:styled-content>s. Both <jats:styled-content style=\"fixed-case\">HG<\/jats:styled-content> test response and <jats:styled-content style=\"fixed-case\">MIBG<\/jats:styled-content> did correlate with the Unified Parkinson's Disease Rating Scale (<jats:styled-content style=\"fixed-case\">UPDRS<\/jats:styled-content>) motor score and disease duration. A positive correlation emerged between diastolic blood pressure (<jats:styled-content style=\"fixed-case\">DBP<\/jats:styled-content>) response to <jats:styled-content style=\"fixed-case\">HG<\/jats:styled-content> test and <jats:styled-content style=\"fixed-case\">MIBG<\/jats:styled-content> and with systolic blood pressure (<jats:styled-content style=\"fixed-case\">SBP<\/jats:styled-content>) response at tilt test.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our investigation suggests that <jats:styled-content style=\"fixed-case\">ANS<\/jats:styled-content> impairment affects the majority of patients with <jats:styled-content style=\"fixed-case\">PD<\/jats:styled-content>, even those <jats:styled-content style=\"fixed-case\">PD<\/jats:styled-content> patients showing negative <jats:styled-content style=\"fixed-case\">MIBG<\/jats:styled-content>, irrespective of clinical neurovegetative symptoms. The strict correlation that has been revealed with disease progression supports the routine utilization of <jats:styled-content style=\"fixed-case\">AFT<\/jats:styled-content>s as a reliable and inexpensive tool for monitoring peripheral sympathetic dysfunction in <jats:styled-content style=\"fixed-case\">PD<\/jats:styled-content> and optimizing therapy.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cns.12437","type":"journal-article","created":{"date-parts":[[2015,7,24]],"date-time":"2015-07-24T07:20:20Z","timestamp":1437722420000},"page":"727-732","source":"Crossref","is-referenced-by-count":28,"title":["Autonomic Function Tests and <scp>MIBG<\/scp> in Parkinson's Disease: Correlation to Disease Duration and Motor Symptoms"],"prefix":"10.1111","volume":"21","author":[{"given":"Camilla","family":"Rocchi","sequence":"first","affiliation":[{"name":"Department of System Medicine, Neurology University of Rome \u201cTor Vergata\u201d Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mariangela","family":"Pierantozzi","sequence":"additional","affiliation":[{"name":"Department of System Medicine, Neurology University of Rome \u201cTor Vergata\u201d Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Salvatore","family":"Galati","sequence":"additional","affiliation":[{"name":"Neurocenter of Southern Switzerland Lugano Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Agostino","family":"Chiaravalloti","sequence":"additional","affiliation":[{"name":"Department of Biomedicine and Prevention University of Rome Tor Vergata Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Valerio","family":"Pisani","sequence":"additional","affiliation":[{"name":"IRCCS Fondazione S. 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