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Signs or symptoms of impaired autonomic regulation of circulation often attend Parkinson disease (PD). This review covers biomarkers and mechanisms of autonomic cardiovascular abnormalities in PD and related alpha-synucleinopathies. The clearest clinical laboratory correlate of dysautonomia in PD is loss of myocardial noradrenergic innervation, detected by(More)
BACKGROUND As a common neurological disorder, the diagnosis of essential tremor (ET) is considered routine. Despite this, previous work suggests that misdiagnoses may be common. Among other things, these misdiagnoses can lead to treatment errors. OBJECTIVES To estimate how often other tremor disorders are misdiagnosed as ET and to identify factors that(More)
BACKGROUND In Parkinson's disease (PD), neurodegenerative changes have been observed in autonomic pathways involving multiple organ systems. We explore pupillary and cardiac autonomic measures as physiological manifestations of PD neurodegeneration. METHODS Pupil measures (pupillary unrest (spontaneous changes of pupil diameter in darkness), constriction(More)
Parkinson disease (PD) is a neurodegenerative disorder afflicting more than 1 million aging Americans, incurring $23 billion in annual medical costs in the U.S. alone. Approximately 90% Parkinson patients undergoing treatment have mobility related problems related to medication which prevent them doing their activities of daily living. Efficient management(More)
OBJECTIVE Olfactory impairment occurs early in Parkinson’s disease (PD), as may dysautonomia. We investigated the relationship between olfaction and dysautonomia as well as other non-motor manifestations of PD. METHODS Olfaction [University of Pennsylvania Smell Identification Test (UPSIT)], autonomic function in the pupillary (constriction and redilation(More)
BACKGROUND Arousal symptoms (e.g., sleepiness) are common in Parkinson's disease, and pupillary unrest (spontaneous changes in pupil diameter) is positively associated with sleepiness. We explored pupillary unrest in Parkinson's disease. METHODS Arousal symptoms (Epworth sleepiness scale and sleep/fatigue domain of the nonmotor symptoms scale for(More)