Our study aimed to investigate the clinical characteristics of PD patients stratified by OH status before and after levodopa challenge to explore the hypothesis that OH might serve as a clinical marker for the body-first subtype of PD. Supine and standing blood pressure were measured in a large cross-sectional cohort of PD patients at the OFF status before and after levodopa challenge test (LCT). Based on OH status, patients were divided into three groups: spontaneous OH (SOH), only levodopa-induced OH (LOH) and non-OH (NOH). Clinical characteristics and associated factors were compared among the groups. A total of 928 patients with a mean age of 62.4 years and average disease duration of 7.9 years were included. There were 224 (24.1%) patients with SOH, 321 (34.6%) with LOH, and 383 (41.3%) with NOH. Compared to NOH, both SOH and LOH were associated with older age, motor fluctuations, and probable rapid eye movement sleep behavior disorder (pRBD). In addition, OH was more associated with cardiovascular and digestive dysfunction, disease severity and worse quality of life. Results of the current study suggest that PD patients developed OH which is more likely to comorbid with RBD, severe autonomic dysfunction and motor fluctuations, consistent with the body-first subtype of PD.

我们的研究旨在调查左旋多巴攻击前后按 OH 状态分层的 PD 患者的临床特征，以探讨 OH 可能作为 PD 身体优先亚型的临床标志物的假设。在左旋多巴激发试验（LCT）之前和之后，对处于关闭状态的大型 PD 患者进行卧位和站立血压测量。根据 OH 状态，患者分为三组：自发性 OH (SOH)、仅左旋多巴诱发的 OH (LOH) 和非 OH (NOH)。比较各组之间的临床特征和相关因素。共纳入 928 名患者，平均年龄 62.4 岁，平均病程 7.9 年。 224 名（24.1%）名 SOH 患者，321 名（34.6%）名 LOH 患者，383 名（41.3%）名 NOH 患者。与 NOH 相比，SOH 和 LOH 均与年龄较大、运动波动和可能的快速动眼睡眠行为障碍 (pRBD) 相关。此外，OH 与心血管和消化功能障碍、疾病严重程度和生活质量较差更相关。目前的研究结果表明，PD患者发生OH，更有可能合并RBD、严重的自主神经功能障碍和运动波动，这与PD的身体优先亚型一致。