الفهرس 
material and methodsOnly 14 pages are availabe for public view
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Abstract
The effects of Parkinson’s disease on movement the muscle stiffness the slowness of movement and the tremo¢are
well known to individuals with Parkinson’s disease and their
families. The potential effects of Parkinson’s disease on mental
functioning depression and memory impairment are less well
known but still familiar to many. What has received little
attention and is therefore, often unknown and unrecognized is
the possible involvement of the autonomic-nervous system In
Parkinson’s disease.
The aim of this work was to study the autonomic nervous
system dysfunction in Parkinsonian patients, and to correlate
them to the different stages of the disease according to
Webster’s rating scale.
52 PO patients were subjected to a thorough general
medical and neurological examination in addition to:
• Webster’s rating scale and the autonomic division of the
investigator rating scale.
• Cardiovascular tests.
• Urodynamic study
• Serum norepinephrine assessment and other laboratory
tests including blood sugar and urine analysis.
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The results were compared to those obtained from 20 age
and sex matched healthy individuals and revealed that:
• The frequency of autonomic symptoms in PO patients was
significantly higher than in controls
• On all cardiovascular tests PO patients performing worse
than controls In both groups age exerts a moderate
influence on HR and BP, the difference in relation to age
was only significant in standing up test for HR
• The severity of PO had a consistently detrimental effect on
autonomic function, which reached significance for two of
the three HR tests and for the BP hall on standing.
0.-
• Urodynamic studies re-veled that PO patient who had abnormal findings had more disease severity according to
Webster’ scale. higher scores on investigation scale, and
longer duration of than those with normal urodynamic
findings
• Resting plasma norepinephrine concentrations were similar
In PO patients and controls, However a diminished rise In
NE during the orthostatic procedure was reported in the
severely diseased group In comparison to the mildly
diseased group who had a response almost identical to
controls
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According to the results PO patients suffered more
autonomic dysfunction than their matched controls.
Furthermore the cardiovascular responses and norepmephrine
levels alternation on standing were positively related to
the severity and duration of illness, this supports the hypothesis
that autonomic dysfunction in PO caused by the extension of
the disease process (Lewy bodies) to autonomic structure,
rather than the mere effect of normal aging process
So we recommend the use of simple clinical, physiological
and laboratory tests to detect autonomic dysfunction in early
PO, which may help in confirming the diagnosis, adjusting the treatment regimen and forecasting the prognosis for those patients.