Parkinson’s disease: autonomic neuronopathy with impaired cardiovascular regulation. Hypertension 2007

Parkinson’s Disease (PD) is generally considered amovement disorder characterized by loss of dopami-nergic neurons in the central nervous system (CNS), most notably in the substantia nigra. The pathogenesis of the neuronal degeneration is not completely understood but is characterized by abnormal protein deposits forming charac-teristic neuronal inclusions, which are visible by light micros-copy of autopsy samples, and termed Lewy bodies. -Synuclein is one of the proteins found in these inclusions and has attracted interest because mutations of the gene encoding for this protein are found in familiar cases of PD. Most of the disability associated with PD is indeed the result of this CNS defect, and the treatment is aimed at increasing dopamine levels in the CNS, while avoiding as much as possible an increase in the periphery. Less widely recognized is the fact that orthostatic hypo-tension can occur in PD patients and can become symptom