Session Information
Date: Monday, October 8, 2018
Session Title: Parkinson's Disease: Non-Motor Symptoms
Session Time: 1:15pm-2:45pm
Location: Hall 3FG
Objective: To test the hypothesis that the vagus nerve is measurably atrophic in idiopathic Parkinson’s disease (PD).
Background: The vagus nerve is discussed to represent one major route of disease progression in PD. So far it is unknown whether there is vagus nerve degeneration in PD.
Methods: The cross-sectional areas (CSA) of the mid-cervical vagus, accessory and phrenic nerves were measured in 20 patients with PD (disease duration, 10.1±7.4 years; range, 1-26 years) and 61 control subjects using a novel high-resolution ultrasonography-based method. Non-motor symptoms were assessed in all participants using the PD Non-Motor Symptoms Questionnaire. As an electrocardiographic parameter of parasympathetic (vagal) cardiac innervation the root mean square of successive differences of R-R intervals was calculated from 5-minute 4-lead electrocardiogram recorded in a resting, non-fasting state with 0.2-Hz metronom-guided breathing.
Results: Mean vagus nerve CSA was smaller in patients with PD compared to age-matched controls (right: 0.64±0.17 vs. 1.04±0.20; left: 0.69±0.18 vs. 0.87±0.15 mm2; two-sided t-tests, P<.001) while spinal accessory CSA and phrenic nerve CSA did not differ (each, P>.1). In the controls accessory and phrenic nerve CSA decreased with increasing age (Spearman test, P<.005), unlike vagus nerve CSA. Bilateral vagus nerve CSA did not correlate with PD duration (P=.25), however, left vagus nerve CSA correlated with the severity of PD motor symptoms (R=.58; P=.007). In the combined group of study participants, CSA of the bilateral vagus nerves correlated with the burden of non-motor symptoms (R=-.54; P<.001). CSA of the right vagus nerve correlated with the parasympathetic domain of heart rate variability (R=.58; P=.001).
Conclusions: In PD there is measurable atrophy of the vagus nerve but not of the spinal accessory nerve or the phrenic nerve. Our findings suggest the degeneration predominantly of viscero-afferent and viscero-efferent vagal fibers in PD.
To cite this abstract in AMA style:
U. Walter, P. Tsiberidou, M. Kersten, A. Storch, M. Löhle. Degeneration of vagus nerve but not of accessory and phrenic nerve in Parkinson’s disease revealed by high-resolution ultrasound [abstract]. Mov Disord. 2018; 33 (suppl 2). https://www.mdsabstracts.org/abstract/degeneration-of-vagus-nerve-but-not-of-accessory-and-phrenic-nerve-in-parkinsons-disease-revealed-by-high-resolution-ultrasound/. Accessed June 14, 2025.« Back to 2018 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/degeneration-of-vagus-nerve-but-not-of-accessory-and-phrenic-nerve-in-parkinsons-disease-revealed-by-high-resolution-ultrasound/