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Fig. 1 | Journal of Clinical Movement Disorders

Fig. 1

From: Cognitive fluctuations in Parkinson’s disease dementia: blood pressure lability as an underlying mechanism

Fig. 1

Theoretical relationship between blood pressure lability and cognitive fluctuations according to burden of Lewy body pathology. The undulating red line represents the erratic ambulatory blood pressure recording of a patient with a Lewy body disorder and dysautonomia over the waking hours of a single day, with BP wandering between and over thresholds of hypotension and hypertension. The blue panels represent mild, moderate, and severe Lewy body pathology. As the BP lability increases with disease progression so does the frequency of hypotension-induced cerebral hypoperfusion episodes, which may correlate with cognitive fluctuations. Although this has not been directly examined, we propose that with severe cortical pathology (right-most panel), the cognitive fluctuations may become subclinical, obscured by a higher baseline dementia, which precludes inter-episode lucidity

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