The locus coeruleus story in PD: norepinephrinergic system, Zarow, hypertension, hypotension

[aspergerian]

This post is prompted by parkie13's description of blood pressure

extremes. Is it possible that the BP extremes Mary described are being

induced by PD pathology and not by more common causes? Damage to the

locus coeruleus (aka ceruleus) often precedes and may

exceed damage to the substantia nigra. In PD, more than dopamine merits

attention.

healthunlocked.com/parkinso...

"recent evidence suggests that LP in the locus coeruleus (LC), the

brain's main source of norepinephrine (NE), precedes that of the SN,

and, may be one of the very first etiological events in PD."

Targeting the

norepinephrinergic system in Parkinson's disease and related

disorders: The locus coeruleus story.

ncbi.nlm.nih.gov/pubmed/278...

See text excerpt in image.

Neuronal loss

is greater in the locus coeruleus than nucleus basalis and

substantia nigra in Alzheimer and Parkinson diseases.

jamanetwork.com/journals/ja...

"Because PD involves postganglionic sympathetic noradrenergic lesions,

the disease seems to be not only a movement disorder with dopamine loss

in the nigrostriatal system of the brain, but also a dysautonomia, with

norepinephrine loss in the sympathetic nervous system of the heart."

"These findings suggest that, in PD, orthostatic hypotension results

from the disease process, not the treatment, although drugs that

directly or indirectly produce vasodilation can worsen orthostatic

tolerance and decrease blood pressure when the patient stands."

Dysautonomia in Parkinson disease.

ncbi.nlm.nih.gov/pmc/articl...

The noradrenaline transporter as site of action for the anti-Parkinson drug amantadine.

ncbi.nlm.nih.gov/pubmed/221...

"Non-motor aspects of Parkinson disease (PD) are now recognized to be

important both clinically and scientifically. Among these facets are

abnormalities in blood pressure regulation. As much as 40% of PD

patients have orthostatic hypotension (OH), which is usually associated

with supine hypertension (SH). Symptoms of OH range from

light-headedness to falls with serious trauma. SH, while typically

asymptomatic, poses a significant increased risk for cardiovascular

morbidity and mortality. Neuroimaging, neurochemical, and

neuropharmacological studies indicate cardiac and extra-cardiac

sympathetic noradrenergic denervation and baroreflex failure in

virtually all PD patients with OH, and cardiac sympathetic denervation

has been confirmed histopathologically."

Mechanisms of orthostatic hypotension and supine hypertension in Parkinson disease.

ncbi.nlm.nih.gov/pmc/articl...

[aspergerian]

Here may be the image I omitted from initial post.

[parkie13]

Thank you it's going to take me a little while to go through them all Mary

[parkie13]

Very informative thank you Mary

[hopeful88]

Acetylcholine is the body's most important neurotransmitter. PD and related disorders have significant stress and die-off of the cholinergic neurons over time. This plays a big part in cognitive and speech dysfunction, and whether or not your PD will convert to MCI and dementia

A combination of creatine and co-q 10 offers robust protection to the brain in PD, preventing the development of cognitive issues and dementia

ncbi.nlm.nih.gov/pubmed/257...

[aspergerian]

Hopeful88, Thank you for the creatine/CoQ10 citation. That article

is cited by 4 others. Here are links to three.

Combination therapies: The next logical Step for the treatment of

synucleinopathies?

ncbi.nlm.nih.gov/pubmed/263...

Is Modulation of Oxidative Stress an Answer? The State of the Art of

Redox Therapeutic Actions in Neurodegenerative Diseases.

ncbi.nlm.nih.gov/pubmed/268...

The effectiveness of creatine treatment for Parkinson's disease: an

updated meta-analysis of randomized controlled trials.

ncbi.nlm.nih.gov/pubmed/285...

"Previous studies have reported conflicting results regarding the

effect of creatine as a treatment for PD, and it remains unclear

whether creatine treatment can improve clinical outcomes when

compared with a placebo [18–22]."

Among cites 18-22, it appears that only one focused upon creatine

with CoQ10.

[silvestrov in reply to aspergerian]

Do not use creatine and any caffeinated drink/supplement:

ncbi.nlm.nih.gov/pubmed/263...

[aspergerian in reply to silvestrov]

Thanks for posting the link. Here's another:

ncbi.nlm.nih.gov/pubmed/283...

[alexask]

Yikes - that was my first symptom . Am definitely going for a run this pm.

[aspergerian13]

Search for words locus coeruleus Zarow hypotension in this group.