Crosstalk between bladder-cardiovascular autonomic nervous system in synucleinopathies

IF 3.3 4区医学 Q2 NEUROSCIENCES

Autonomic Neuroscience-Basic & Clinical Pub Date : 2025-07-09 DOI:10.1016/j.autneu.2025.103320

Ryuji Sakakibara , Tomoyuki Uchiyama , Tatsuya Yamamoto

{"title":"Crosstalk between bladder-cardiovascular autonomic nervous system in synucleinopathies","authors":"Ryuji Sakakibara , Tomoyuki Uchiyama , Tatsuya Yamamoto","doi":"10.1016/j.autneu.2025.103320","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><div>Parkinson's disease (PD) and multiple system atrophy (MSA) are major neurogenerative diseases characterized pathologically by abnormal alpha-synuclein aggregation, called synucleinopathy. PD and MSA are clinically characterized by motor disorder and autonomic dysfunction (particularly lower urinary tract dysfunction, LUTD and orthostatic hypotension, OH). However, few literatures are available concerning mutual interaction between bladder-cardiovascular autonomic disorders in PD or MSA.</div></div><div><h3>Method</h3><div>A narrative review including the past 10-year PubMed research papers on this topic. We also included dementia with Lewy bodies (DLB) that shares pathology with PD.</div></div><div><h3>Results</h3><div>The LUTD in MSA is more severe than that in PD for large post-void residual (PVR) or urinary retention. These LUTDs presumably reflect the different nervous system pathologies. Of particular importance is that MSA may presents with LUTD alone initially, and some PD or MSA presents with OH alone (called pure autonomic failure, PAF); needs early diagnosis and management. For treating autonomic dysfunction in PD or MSA, mutual interactions between bladder-cardiovascular are worth considering, particularly when we prescribe urology drugs (alpha blockers might worsen OH) or cardiology drugs (antihypertensive drugs might worsen OH, and drugs to treat OH might worsen PVR). Care should also be taken for micturition syncope. This care improves individual's quality of life in PD or MSA; it can also prevent emergency hospitalizations, and early institutionalization.</div></div><div><h3>Conclusions</h3><div>This review summarizes the pathophysiology and practical management of (mutual) bladder-cardiovascular autonomic disorders in individuals with PD or MSA.</div></div>","PeriodicalId":55410,"journal":{"name":"Autonomic Neuroscience-Basic & Clinical","volume":"261 ","pages":"Article 103320"},"PeriodicalIF":3.3000,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Autonomic Neuroscience-Basic & Clinical","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1566070225000827","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"NEUROSCIENCES","Score":null,"Total":0}

引用次数: 0

Abstract

Objective

Parkinson's disease (PD) and multiple system atrophy (MSA) are major neurogenerative diseases characterized pathologically by abnormal alpha-synuclein aggregation, called synucleinopathy. PD and MSA are clinically characterized by motor disorder and autonomic dysfunction (particularly lower urinary tract dysfunction, LUTD and orthostatic hypotension, OH). However, few literatures are available concerning mutual interaction between bladder-cardiovascular autonomic disorders in PD or MSA.

Method

A narrative review including the past 10-year PubMed research papers on this topic. We also included dementia with Lewy bodies (DLB) that shares pathology with PD.

Results

The LUTD in MSA is more severe than that in PD for large post-void residual (PVR) or urinary retention. These LUTDs presumably reflect the different nervous system pathologies. Of particular importance is that MSA may presents with LUTD alone initially, and some PD or MSA presents with OH alone (called pure autonomic failure, PAF); needs early diagnosis and management. For treating autonomic dysfunction in PD or MSA, mutual interactions between bladder-cardiovascular are worth considering, particularly when we prescribe urology drugs (alpha blockers might worsen OH) or cardiology drugs (antihypertensive drugs might worsen OH, and drugs to treat OH might worsen PVR). Care should also be taken for micturition syncope. This care improves individual's quality of life in PD or MSA; it can also prevent emergency hospitalizations, and early institutionalization.

Conclusions

This review summarizes the pathophysiology and practical management of (mutual) bladder-cardiovascular autonomic disorders in individuals with PD or MSA.

查看原文本刊更多论文

突触核蛋白病中膀胱-心血管自主神经系统间的串扰

目的帕金森病（PD）和多系统萎缩（MSA）是主要的神经发生疾病，病理特征为α -突触核蛋白异常聚集，称为突触核蛋白病。PD和MSA的临床特征是运动障碍和自主神经功能障碍（特别是下尿路功能障碍，LUTD和直立性低血压，OH）。然而，关于PD或MSA患者膀胱-心血管自主神经障碍之间相互作用的文献很少。方法回顾过去10年PubMed关于该主题的研究论文。我们还纳入了与PD有共同病理的路易体痴呆（DLB）。结果MSA患者的尿路缺损以大量空后残留（PVR）或尿潴留较PD患者更为严重。这些lutd可能反映了不同的神经系统病理。特别重要的是，MSA最初可能仅表现为LUTD，而一些PD或MSA仅表现为OH（称为纯粹自主神经衰竭，PAF）；需要早期诊断和治疗。在治疗PD或MSA的自主神经功能障碍时，膀胱-心血管之间的相互作用值得考虑，特别是当我们开泌尿科药物（α受体阻滞剂可能加重OH）或心脏病学药物（降压药可能加重OH，治疗OH的药物可能加重PVR）时。对排尿性晕厥也要注意。这种护理提高了PD或MSA患者的生活质量；它还可以防止紧急住院和早期机构化。本文综述了PD或MSA患者（互）膀胱-心血管自主神经障碍的病理生理学和实际治疗。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Autonomic Neuroscience-Basic & Clinical 医学-神经科学

CiteScore

5.80

自引率

7.40%

发文量

审稿时长

66 days

期刊介绍： This is an international journal with broad coverage of all aspects of the autonomic nervous system in man and animals. The main areas of interest include the innervation of blood vessels and viscera, autonomic ganglia, efferent and afferent autonomic pathways, and autonomic nuclei and pathways in the central nervous system. The Editors will consider papers that deal with any aspect of the autonomic nervous system, including structure, physiology, pharmacology, biochemistry, development, evolution, ageing, behavioural aspects, integrative role and influence on emotional and physical states of the body. Interdisciplinary studies will be encouraged. Studies dealing with human pathology will be also welcome.