Objective: To investigate the relationship between different domains of autonomic dysfunction and postural stability in PD patients.

Background: Onset of autonomic symptoms are common in PD and worsen as the disease progresses. Autonomic symptoms can be classified into the domains of gastrointestinal, urinary, cardiovascular, thermoregulatory, and pupillomotor dysfunction depending on the symptoms present. Motor symptoms can also worsen as PD progresses, as patients face difficulty controlling their standing posture. Structures within the autonomic nervous system (e.g., reticular formation and the reticulospinal tract) contribute to both autonomic control and postural control. Research has shown that PD patients under the PIGD sub-type were more likely to suffer from thermoregulatory and pupillomotor symptoms compared to the TD sub-type. Thus, there may be a relationship between different domains of autonomic dysfunction and postural stability.

Method: 28 participants (17F, Age (59.8±9.12), MDS-UPDRS-III (18.2±9.58), Hoehn & Yahr (1.82±0.611), MoCA (26.6±2.82), STAI-S (31.2±8.41), STAI-T (36.1±11.5)) who completed the gait sub-study were extracted from the PPMI database. Autonomic symptoms were extracted using the SCOPA-AUT and assigned to separate domains. Postural stability variables included sway velocity, path, frequency, and jerk in both open and closed eyes conditions during a standing balance task. Spearman’s correlation was used to investigate the association between the SCOPA-AUT domain scores to the postural stability variables.

Results: Moderate correlations were observed between the cardiovascular domain and sway jerk (rho= 0.440, p=0.0191) in the closed eye condition. Sway frequency in the open-eye condition was also significantly correlated with the urinary domain (rho=0.53, p=0.003). No other domains (pupillomotor, gastrointestinal, thermoregulatory) were significantly correlated with postural stability. No correlations were found between STAI-S or STAI-T scores and the autonomic domains or measures of postural stability.

Conclusion: Postural stability was correlated to the domains of cardiovascular and urinary dysfunction and may be associated with autonomic dysfunction beyond thermoregulatory and pupillomotor domains. These results provide some evidence that presence of cardiovascular and urinary dysfunction may be associated with postural instability in PD.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/postural-stability-relates-to-autonomic-dysfunction-in-parkinsons-disease/