Baroreflex dysfunction in Parkinson's disease: integration of central and peripheral mechanisms

Author(s)

Sabino-Carvalho, Jeann L. ^[1] ; Falquetto, Barbara ^[2] ; Takakura, Ana C. ^[2] ; Vianna, Lauro C. ^{[1, 3]}

Affiliation

^[1] Univ Brasilia, Fac Phys Educ, NeuroVASQ Integrat Physiol Lab, Brasilia, DF - Brazil

^[2] Univ Sao Paulo, Inst Biomed Sci, Dept Pharmacol, Sao Paulo - Brazil

^[3] Univ Brasilia, Grad Program Med Sci, Fac Med, Brasilia, DF - Brazil

• Document type: Review article
• Source: Journal of Neurophysiology; v. 125, n. 4, p. 1425-1439, APR 2021.
• Web of Science Citations: 1

Abstract

The incidence of Parkinson's disease (PD) is increasing worldwide. Although the PD hallmark is the motor impairments, nonmotor dysfunctions are now becoming more recognized. Recently, studies have suggested that baroreflex dysfunction is one of the underlying mechanisms of cardiovascular dysregulation observed in patients with PD. However, the large body of literature on baroreflex function in PD is unclear. The baroreflex system plays a major role in the autonomic, and ultimately blood pressure and heart rate, adjustments that accompany acute cardiovascular stressors on a daily basis. Therefore, impaired baroreflex function (i.e., decreased sensitivity or gain) can lead to altered neural cardiovascular responses. Since PD affects parasympathetic and sympathetic branches of the autonomic nervous system and both are orchestrated by the baroreflex system, understanding of this crucial mechanism in PD is necessary. In the present review, we summarize the potential altered central and peripheral mechanisms affecting the feedback-controlled loops that comprise the reflex arc in patients with PD. Major factors including arterial stiffness, reduced number of C1 and activation of non-C1 neurons, presence of central a-synuclein aggregation, cardiac sympathetic denervation, attenuated muscle sympathetic nerve activity, and lower norepinephrine release could compromise baroreflex function in PD. Results from patients with PD and from animal models of PD provide the reader with a clearer picture of baroreflex function in this clinical condition. By doing so, our intent is to stimulate future studies to evaluate several unanswered questions in this research area. (AU)

• FAPESP's process: 19/00065-1 - Oxidative stress in respiratory control of Parkinson Disease animal model
• Grantee: Bárbara Falquetto
• Support Opportunities: Research Grants - Young Investigators Grants
• FAPESP's process: 19/01236-4 - Effects of pharmacological and non-pharmacological treatments on respiratory changes observed in a murine model of Parkinson's disease
• Grantee: Ana Carolina Takakura Moreira
• Support Opportunities: Regular Research Grants