{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T20:54:52Z","timestamp":1790456092091,"version":"4.1.0"},"reference-count":58,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Hypertension"],"published-print":{"date-parts":[[2005,12]]},"abstract":"<jats:p>\n            Patients with Parkinson disease often have orthostatic hypotension. Neurocirculatory abnormalities underlying orthostatic hypotension might reflect levodopa treatment. Sixty-six Parkinson disease patients (36 with orthostatic hypotension, 15 off and 21 on levodopa; 30 without orthostatic hypotension) had tests of reflexive cardiovagal gain (decrease in interbeat interval per unit decrease in systolic pressure during the Valsalva maneuver; orthostatic increase in heart rate per unit decrease in pressure); reflexive sympathoneural function (decrease in pressure during the Valsalva maneuver; orthostatic increment in plasma norepinephrine); and cardiac and extracardiac noradrenergic innervation (septal myocardial 6-[\n            <jats:sup>18<\/jats:sup>\n            F]fluorodopamine-derived radioactivity; supine plasma norepinephrine). Severity of orthostatic hypotension did not differ between the levodopa-untreated and levodopa-treated groups with Parkinson disease and orthostatic hypotension (\u221252\u00b16 [SEM] versus \u221249\u00b15 mm Hg systolic). The 2 groups had similarly low reflexive cardiovagal gain (0.84\u00b10.23 versus 1.33\u00b10.35 ms\/mm Hg during Valsalva; 0.43\u00b10.09 versus 0.27\u00b10.06 bpm\/mm Hg during orthostasis); and had similarly attenuated reflexive sympathoneural responses (97\u00b129 versus 71\u00b123 pg\/mL during orthostasis; \u221282\u00b110 versus \u221273\u00b18 mm Hg during Valsalva). In patients off levodopa, plasma norepinephrine was lower in those with (193\u00b119 pg\/mL) than without (348\u00b146 pg\/mL) orthostatic hypotension. Low values for reflexive cardiovagal gain, sympathoneural responses, and noradrenergic innervation were strongly related to orthostatic hypotension. Parkinson disease with orthostatic hypotension features reflexive cardiovagal and sympathoneural failure and cardiac and partial extracardiac sympathetic denervation, independent of levodopa treatment.\n          <\/jats:p>","DOI":"10.1161\/01.hyp.0000188052.69549.e4","type":"journal-article","created":{"date-parts":[[2005,10,11]],"date-time":"2005-10-11T00:33:41Z","timestamp":1128990821000},"page":"1333-1339","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":124,"title":["Neurocirculatory Abnormalities in Parkinson Disease With Orthostatic Hypotension"],"prefix":"10.1161","volume":"46","author":[{"given":"David S.","family":"Goldstein","sequence":"first","affiliation":[{"name":"From the Clinical Neurocardiology Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Md."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Basil A.","family":"Eldadah","sequence":"additional","affiliation":[{"name":"From the Clinical Neurocardiology Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Md."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Courtney","family":"Holmes","sequence":"additional","affiliation":[{"name":"From the Clinical Neurocardiology Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Md."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandra","family":"Pechnik","sequence":"additional","affiliation":[{"name":"From the Clinical Neurocardiology Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Md."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey","family":"Moak","sequence":"additional","affiliation":[{"name":"From the Clinical Neurocardiology Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Md."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed","family":"Saleem","sequence":"additional","affiliation":[{"name":"From the Clinical Neurocardiology Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Md."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yehonatan","family":"Sharabi","sequence":"additional","affiliation":[{"name":"From the Clinical Neurocardiology Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Md."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_1_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF01819025"},{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.hyp.0000081216.11623.c3"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0733-8651(01)00005-4"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM197702102960601"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1212\/01.WNL.0000058766.46428.F3"},{"key":"e_1_3_2_6_2","first-page":"385","volume":"72","year":"1985","unstructured":"Kaakkola S, Mannisto PT, Nissinen E, Vuorela A, Mantyla R. The effect of an increased ratio of carbidopa to levodopa on the pharmacokinetics of levodopa. Acta Neurol Scand. 1985; 72: 385\u2013391.","journal-title":"Acta Neurol Scand"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF00315512"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1159\/000073865"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0197-4580(01)00210-X"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.58.8.1247"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1042\/cs0430851"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF02267723"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF02281111"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/0024-3205(76)90210-1"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1152\/ajpcell.1992.263.6.C1147"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(03)00555-6"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.57.6.1140"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.73.6.776"},{"key":"e_1_3_2_19_2","first-page":"29","volume":"15","year":"2005","unstructured":"Amino T, Orimo S, Takahashi A, Uchihara T, Mizusawa H. Profound cardiac sympathetic denervation occurs in Parkinson disease. Brain Pathol. 2005; 15: 29\u201334.","journal-title":"Brain Pathol"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00401-005-0995-7"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.52.6.1269"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.23.4.283"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1212\/01.WNL.0000138500.73671.DC"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-133-5-200009050-00009"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/0165-1838(91)90005-N"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.1161\/circ.85.5.1572033"},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.1161\/circ.78.1.3383409"},{"key":"e_1_3_2_28_2","doi-asserted-by":"publisher","DOI":"10.1016\/0378-4347(93)E0430-X"},{"key":"e_1_3_2_29_2","doi-asserted-by":"publisher","DOI":"10.1161\/circ.66.2.7094250"},{"key":"e_1_3_2_30_2","doi-asserted-by":"publisher","DOI":"10.1161\/circ.68.2.6407776"},{"key":"e_1_3_2_31_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF01276420"},{"key":"e_1_3_2_32_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199311113292003"},{"key":"e_1_3_2_33_2","first-page":"212.","volume":"3","year":"1993","unstructured":"Robertson D, Hollister AS, Biaggioni I. Arterial baroreflex failure in man. Clin Auton Res. 1993; 3: 212.","journal-title":"Clin Auton Res"},{"key":"e_1_3_2_34_2","doi-asserted-by":"publisher","DOI":"10.1016\/0022-510X(95)00318-V"},{"key":"e_1_3_2_35_2","first-page":"116","volume":"92","year":"1995","unstructured":"Eldrup E, Mogensen P, Jacobsen J, Pakkenberg H, Christensen NJ. CSF and plasma concentrations of free norepinephrine, dopamine, 3,4-dihydroxyphenylacetic acid (DOPAC), 3,4-dihydroxyphenylalanine (DOPA), and epinephrine in Parkinson\u2019s disease. Acta Neurol Scand. 1995; 92: 116\u2013121.","journal-title":"Acta Neurol Scand"},{"key":"e_1_3_2_36_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2362.1990.tb01909.x"},{"key":"e_1_3_2_37_2","doi-asserted-by":"publisher","DOI":"10.1097\/00002826-199102000-00007"},{"key":"e_1_3_2_38_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.37.3.386"},{"key":"e_1_3_2_39_2","first-page":"259","volume":"45","year":"1987","unstructured":"Turkka JT, Juujarvi KK, Lapinlampi TO, Myllyla VV. Serum norepinephrine response to standing in patients with Parkinson\u2019s disease. Adv Neurol. 1987; 45: 259\u2013261.","journal-title":"Adv Neurol"},{"key":"e_1_3_2_40_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF02281627"},{"key":"e_1_3_2_41_2","doi-asserted-by":"publisher","DOI":"10.1097\/00002826-199302000-00008"},{"key":"e_1_3_2_42_2","doi-asserted-by":"publisher","DOI":"10.1002\/ana.410260410"},{"key":"e_1_3_2_43_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.43.5.986"},{"key":"e_1_3_2_44_2","doi-asserted-by":"publisher","DOI":"10.1097\/00005072-199111000-00006"},{"key":"e_1_3_2_45_2","doi-asserted-by":"publisher","DOI":"10.1002\/ana.410330405"},{"key":"e_1_3_2_46_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.42.11.2106"},{"key":"e_1_3_2_47_2","doi-asserted-by":"publisher","DOI":"10.1016\/0022-510X(95)00155-U"},{"key":"e_1_3_2_48_2","doi-asserted-by":"publisher","DOI":"10.1002\/ana.410270405"},{"key":"e_1_3_2_49_2","doi-asserted-by":"publisher","DOI":"10.1016\/0304-3940(95)11489-J"},{"key":"e_1_3_2_50_2","doi-asserted-by":"publisher","DOI":"10.1007\/s004150050002"},{"key":"e_1_3_2_51_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00702-002-0808-2"},{"key":"e_1_3_2_52_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.54.4.963"},{"key":"e_1_3_2_53_2","doi-asserted-by":"publisher","DOI":"10.1212\/01.WNL.0000052690.91036.FF"},{"key":"e_1_3_2_54_2","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.1975.00490430072013"},{"key":"e_1_3_2_55_2","doi-asserted-by":"publisher","DOI":"10.3143\/geriatrics.37.255"},{"key":"e_1_3_2_56_2","doi-asserted-by":"publisher","DOI":"10.1002\/cpt1979252137"},{"key":"e_1_3_2_57_2","first-page":"1461","volume":"57","year":"2000","unstructured":"Kujawa K, Leurgans S, Raman R, Blasucci L, Goetz CG. Acute orthostatic hypotension when starting dopamine agonists in Parkinson\u2019s disease. Arch Neurol. 2000; 57: 1461\u20131463.","journal-title":"Arch Neurol"},{"key":"e_1_3_2_58_2","doi-asserted-by":"publisher","DOI":"10.1017\/S0317167100037938"}],"container-title":["Hypertension"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/01.HYP.0000188052.69549.e4","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,12]],"date-time":"2024-05-12T16:46:27Z","timestamp":1715532387000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/01.HYP.0000188052.69549.e4"}},"subtitle":["Independence From Levodopa Treatment"],"short-title":[],"issued":{"date-parts":[[2005,12]]},"references-count":58,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2005,12]]}},"alternative-id":["10.1161\/01.HYP.0000188052.69549.e4"],"URL":"https:\/\/doi.org\/10.1161\/01.hyp.0000188052.69549.e4","relation":{},"ISSN":["0194-911X","1524-4563"],"issn-type":[{"value":"0194-911X","type":"print"},{"value":"1524-4563","type":"electronic"}],"subject":[],"published":{"date-parts":[[2005,12]]},"assertion":[{"value":"2005-07-19","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2005-09-11","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2005-10-10","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}