Durch die kontinuierliche Blutdruckmessung lässt sich ein transienter orthostatischer Blutdruckabfall bei idiopathischer REM-Schlaf-Verhaltensstörung nachweisen ^[#]

Zusammenfassung

Ziel der Studie Es gibt wenige Daten zum orthostatischen Blutdruck (BD) Verhalten und Veränderungen der Herzratenvariabilität (HRV) bei idiopathischer REM-Schlaf-Verhaltensstörung (iRBD). Unsere Hypothese war, dass orthostatische BD Veränderungen vorübergehend sind.

Methodik Wir untersuchten 16 männliche iRBD Patienten und 15 altersgematchte männliche Kontrollprobanden (HC) im Hinblick auf eine Dysautonomie, HRV und kontinuierliche BD Messung während der Kipptischuntersuchung.

Ergebnisse Die BD Abfälle in den ersten 5 Minuten Stehzeit waren bei iRBD Patienten signifikant größer. IRBD Patienten hatten häufiger eine reduzierte respiratorische Sinusarrhythmie (RSA).

Schlussfolgerungen Mittels kontinuierlicher BD Messung ließen sich transiente orthostatische BD Abfälle bei iRBD detektieren. Longitudinale Daten werden zeigen, ob diese Änderungen Hinweise für eine periphere sympathoneurale Dysfunktion darstellen und frühe Marker einer späteren orthostatischen Hypotonie sein können.

Abstract

Introduction Whereas orthostatic intolerance and changes in heart rate variability (HRV) are well documented in α-synucleinopathies, data in idiopathic REM-sleep behaviour disorder (iRBD) are rare. We hypothesised that orthostatic blood pressure (BP) changes may be transient and compensated.

Methods 16 male iRBD patients and 15 age-matched healthy male controls (HC) were studied for symptoms of dysautonomia, HRV and beat-to-beat BP during tilt-table.

Results Orthostatic hypotension was not more frequent in iRBD, but orthostatic BP drop during the first five minutes of standing was significantly larger than in HC. While in HC HRV was mainly altered by age, reduced respiratory sinus arrhythmia occurred more frequently in iRBD.

Conclusion Beat-to-beat BP monitoring detects transient BP drop in iRBD. Longitudinal studies will show if these BP changes reflect peripheral sympathoneural failure and are early predictors of manifest orthostatic hypotension in α-synucleinopathies.

Schlüsselwörter

REM-Schlaf-Verhaltensstörung - Orthostatische Hypotonie - Kipptischuntersuchung - Autonome Dysfunktion - kontinuierliche Blutdruckmessung

Key words

REM-sleep behaviour disorder - orthostatic hypotension - tilt-table test - autonomic dysfunction - beat-to beat blood pressure monitoring

^# Wir danken allen Studienteilnehmern für Ihre Teilnahme. Teile dieser Studie wurden als Poster auf dem DGN Kongress 2014, P429, München, präsentiert

^* diese Autoren teilen sich die Letztautorenschaft

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