Regional analysis of cerebral hemodynamic changes during the head-up tilt test in Parkinson's disease patients with orthostatic intolerance

Zephaniah Phillips, Jung Bin Kim, Seung Ho Paik, Shin Young Kang, Nam Joon Jeon, Beop Min Kim, Byung Jo Kim

Research output: Contribution to journalArticlepeer-review

Abstract

Significance: Cerebral oxygenation changes in the superior, middle, and medial gyri were used to elucidate spatial impairments of autonomic hemodynamic recovery during the head-up tilt table test (HUTT) in Parkinson's disease (PD) patients with orthostatic intolerance (OI) symptoms. Aim: To analyze dynamic oxygenation changes during the HUTT and classify PD patients with OI symptoms using clinical and oxygenation features. Approach: Thirty-nine PD patients with OI symptoms [10: orthostatic hypotension (PD-OH); 29: normal HUTT results (PD-NOR)] and seven healthy controls (HCs) were recruited. Prefrontal oxyhemoglobin (HbO) changes during the HUTT were reconstructed with diffuse optical tomography and segmented using the automated anatomical labeling system. Decision trees were used for classification. Results: HCs and PD-NOR patients with positive rates of HbO change (PD-POS) showed the greatest HbO recovery in the superior frontal gyrus (SFG) during tilt. PD-OH and PD-NOR patients with negative rates of HbO change (PD-NEG) showed asymmetric reoxygenation. The classification accuracy was 89.4% for PD-POS versus PD-NEG, 71% for PD-NOR versus PD-OH, and 55.8% for PD-POS versus PD-NEG versus PD-OH. The oxygenation features were more discriminative than the clinical features. Conclusions: PD-OH showed decreased right SFG function, which may be associated with impaired compensatory autonomic responses to orthostatic stress.

Original languageEnglish
Article number045006
JournalNeurophotonics
Volume7
Issue number4
DOIs
Publication statusPublished - 2020 Oct 1
Externally publishedYes

Keywords

  • Parkinson's disease
  • automated anatomical labeling
  • autonomic dysfunction
  • diffuse optical tomography
  • head-up tilt
  • orthostatic hypotension

ASJC Scopus subject areas

  • Neuroscience (miscellaneous)
  • Radiological and Ultrasound Technology
  • Radiology Nuclear Medicine and imaging

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