My PD Story

2024 Melvin Yahr Parkinson’s Disease Clinical Research Award

How Lying Down Could Counter the Risks of Standing Up in Parkinson’s

People with Parkinson’s disease (PD) often experience disruptions related to the autonomic nervous system, which regulates all the “automatic” bodily functions. One of these affected functions is blood pressure, which can cause those with PD to develop a condition called neurogenic orthostatic hypotension (nOH). This condition creates bouts of low blood pressure after standing, which can lead to dizziness or fainting.

Heba Deraz, MD, PhD, recipient of the 2024 Melvin Yahr Parkinson’s Disease Clinical Research Award, jointly awarded by the Parkinson’s Foundation and the International Association of Parkinsonism and Related Disorders (IAPRD), believes that a potential solution to nOH could be prescribed periods of lying down.

“This research aims to improve the understanding of orthostatic hypotension in Parkinson’s disease, a common but underrecognized source of disability. By identifying clinical patterns, it could lead to earlier detection and more targeted interventions.” – Dr. Deraz

In contrast to nOH, supine hypertension (SH) is when blood pressure increases when lying down. Dr. Deraz theorizes that regularly lying down, increasing blood pressure, will counterbalance the low blood pressure episodes of nOH when standing up. The difficulty is that sustained SH can also be a health hazard, so finding the right ratio of lying down to standing to maximize safety and relief is key.

Working in the lab of Dr. Alberto Espay at the University of Cincinnati, Dr. Deraz will enlist the help of 60 people living with PD to test her hypothesis. Each will be equipped with 24-hour blood pressure monitoring devices which will capture bouts of decreased blood pressure from standing, as well as increased blood pressure from lying down. This data will be collected over several weeks, during which Dr. Deraz and her team will assess each person’s quality of life and nOH severity through routine questionnaires.

At the end of the experiment, Dr. Deraz expects to see that those with a greater number of SH episodes relative to nOH episodes have increased quality of life and reduced blood pressure problems when standing. These results could inform practical medical guidance for those with PD and nOH, offering relief from this hazardous condition by simply optimizing time spent lying down.

As a neurologist who works with many people with PD in her medical practice at Cairo University Hospitals in Egypt, Dr. Deraz knows firsthand what the impacts of such a study would mean for the PD community.

“This support motivates me to build a career dedicated to improving understanding and treatment of these often-overlooked autonomic dysfunction symptoms,” said Dr. Deraz. “Ultimately, this work could contribute to a broader focus on autonomic dysfunction as a key component of Parkinson’s care and research.”

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