Objective: To identify potential EEG biomarkers associated with orthostatic hypotension in Parkinson Disease (PD) and evaluate their relationship with clinical measures of autonomic dysfunction.
Background: Orthostatic hypotension (OH) is a common non-motor symptom in PD, affecting approximately 50% of patients and contributing significantly to falls, poorer quality of life, and reduced survival. While clinical assessment typically relies on blood pressure measurements and questionnaires, neurophysiological correlates of OH in PD are poorly characterized.
Method: We conducted a cross-sectional study at baseline of 24 PD participants enrolled in a clinical study at UNC Neurology (NCT05205772). Orthostatic vitals were measured at baseline, prior to EEG recording. Four minute eyes open resting-state 128-channel EEG was recorded while seated. We calculated correlation coefficients between EEG spectral power values at rest and the magnitude of both systolic and diastolic blood pressure reduction.
Results: We found that bilateral gamma (30-50 Hz) frontal-parietal oscillations correlated with systolic blood pressure reduction (r = 0.52, p = 0.0087). Left fronto-temporal beta (13-30 Hz) brain activity correlated with systolic blood pressure reduction (r = 0.53, p = 0.0082). Theta (4-7 Hz) brain activity did not significantly correlate with blood pressure reduction.
Conclusion: Resting-state brain activity in the beta and gamma range was associated with OH. Increased beta activity is a known finding in PD, however, the correlation with OH severity is novel. These results may support a mechanistic model of OH in PD where pathologically elevated prefrontal beta point to impaired function of prefrontal central autonomic system function. Our findings suggest that neuronal oscillations may serve as objective neurophysiologic markers of autonomic failure in PD which could enhance early detection of autonomic failure, allow for more precise monitoring of disease progression, and serve as network-based targets for neuromodulation in PD.
To cite this abstract in AMA style:
A. Frohlich, J. Riddle, F. Frohlich, D. Rubinow, E. Dayan, M. Sklerov. EEG Correlates of Orthostatic Hypotension in Parkinson’s Disease: Novel Biomarkers for Autonomic Failure [abstract]. Mov Disord. 2025; 40 (suppl 1). https://www.mdsabstracts.org/abstract/eeg-correlates-of-orthostatic-hypotension-in-parkinsons-disease-novel-biomarkers-for-autonomic-failure/. Accessed October 5, 2025.« Back to 2025 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/eeg-correlates-of-orthostatic-hypotension-in-parkinsons-disease-novel-biomarkers-for-autonomic-failure/