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Correlation analysis for postural instability and autonomic dysfunction in patients with Parkinson’s disease

S. You, S.H. Lim, H. Lee, H.A. Kim (Dague, Korea)

Meeting: 2016 International Congress

Abstract Number: 1222

Keywords: Autonomic nervous system, Parkinsonism, Posture

Session Information

Date: Wednesday, June 22, 2016

Session Title: Parkinson's disease: Neuroimaging and neurophysiology

Session Time: 12:00pm-1:30pm

Location: Exhibit Hall located in Hall B, Level 2

Objective: To investigate correlation between postural instability and autonomic dysfunction in early stage Parkinson’s disease patients.

Background: Brainstem pathology may link postural instability (PI) and autonomic dysfunction in Parkinson’s disease (PD). The purpose of this study was to determine the nature of the relationship between autonomic dysfunction and postural instability estimated by computerized dynamic posturography (CDP) in early stage PD.

Methods: Patients with the Hoehn and Yahr (H&Y) Stage 1 or 2 defined as an early stage of PD were included. PI was assessed by the CDP protocol including the sensory organization test (SOT) and the motor control test. Standardized autonomic function tests were performed including tilt table, Valsalva maneuver, heart rate response to deep breathing and quantitative sudomotor axon reflex test. The composite Autonomic Severity Score (CASS) was also used to assess the severity and distribution of autonomic dysfunction. The patients were evaluated in ‘OFF’ state. We also recuited 21 age matched healthy controls for normal data of CDP.

Results: We identified 20 consecutive patients (9 men, mean age, 67.6 years) with early stage PD. Ninety (18/20) percent of the patients showed mild (3 or less on CASS) to severe (7 to 10 on CASS) autonomic dysfunction. Deficits were predominantly adrenergic (17/20, 85%) and cardiovagal (13/20, 65%) subscores. Posturography results of PD patients are within normal range, but PREP and composite SOT scores are significantly lower than scores of normal control. Patients who had higher variability on Valsalva ratio (High frequency) tended to have higher equlibrium score on composite SOT score (r2=0.517, p=0.020).

Conclusions: Our result suggests the correlation between parasympathetic autonomic nervous system and PI in PD. Further study including a large number of cases with early PD is needed to clarify the issue on how autonomic dysfunction is associated with PI in PD.

To cite this abstract in AMA style:

S. You, S.H. Lim, H. Lee, H.A. Kim. Correlation analysis for postural instability and autonomic dysfunction in patients with Parkinson’s disease [abstract]. Mov Disord. 2016; 31 (suppl 2). https://www.mdsabstracts.org/abstract/correlation-analysis-for-postural-instability-and-autonomic-dysfunction-in-patients-with-parkinsons-disease/. Accessed July 9, 2025.
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