Parkinson’s disease from the viewpoint of orthostatic hypotension

Abstract

Orthostatic hypotension is one of the typical non-motor symptoms of Parkinson’s disease. Parkinson’s disease with orthostatic hypotension is associated with cognitive dysfunction, and motor symptoms progress rapidly and the prognosis for life is poor, thus its management is important. Cardiac sympathetic denervation is one of the major causes of orthostatic hypotension. The first α-synuclein change as the onset mechanism of Parkinson’s disease has been proposed as a route that starts from the intestinal tract and spreads to the central nervous system via vagus nerve, but it has also been experimentally proved to reach the heart from the intestinal tract via the sympathetic nerve. There is also the possibility that it will spread to the central nervous system via the sympathetic nervous system including the heart, and further research is needed to clarify the pathophysiology of the onset of Parkinson’s disease.