Session Time: 1:15pm-2:45pm
Location: Hall 3FG
Objective: Heart rate deceleration capacity (DC) and heart rate variability index (HRVI) as potential biomarkers for autonomic dysregulation were studied in subjects (each group N=10) with Parkinson`s disease (PD), REM sleep behavior disorder (RBD), Progressive Supranuclear Palsy (PSP), Multiple System Atrophy (MSA) and healthy controls (HC).
Background: Autonomic dysregulation is a common and early symptom in parkinsonian syndromes. Divergences have been reported regarding parasympathetic dysfunction in different parkinsonian syndromes. DC quantifies deceleration-related modulations of heart rate and is therefore regarded as marker of parasympathetic function. In contrast, HRVI as a global marker of HRV reflects both, parasympathetic and sympathetic regulations.
Methods: Subjects underwent a resting 30 minute ECG recording (Getemed, CardioMem®, CM3000SMA) under controlled conditions (shaded, quiet room, supine position, withdrawal of food and medication before measurement). Subjects with known cardiac diseases or on medication affecting the autonomic nervous system were excluded. After manual preprocessing of the data, DC and HRVI were assessed by established technologies (Bauer et al. 2006). Differences between groups were analyzed by Kruskal-Wallis-H-Test and in case of overall significance, Mann-Whitney U-Tests were used for pairwise comparisons.
Results: In both atypical parkinsonian cohorts (PSP: mean DC: 3.35±2.5 & MSA mean DC: 3.75±1.3), DC was significantly decreased (p<0.0001) compared to healthy controls (mean DC:9.66±4.7) and PD patients (mean DC: 7.79±2.5; PD vs. MSA: p=0.001; PD vs. PSP: p=0.002). DC of RBD (mean DC: 5.85±2.4) compared to MSA patients was significantly higher (p=0.043). HRVI of PSP patients (mean DC: 13.29±5.0) is significantly lower (p=0.034) compared to MSA patients (mean DC: 18.97± 6.2).
Conclusions: Different patterns of cardiac parasympathetic denervation by means of DC may help to facilitate the diagnoses of idiopathic versus atypical parkinsonian syndromes. Further longitudinal studies will address DC in RBD as a potential indicator to distinguish between prodromal PD and prodromal MSA.
References: Bauer A, Kantelhardt JW, Barthel P, Schneider R, Mäkikallio T, Ulm K, Hnatkova K, Schömig A, Huikuri H, Bunde A, Malik M, Schmidt G., 2006. Deceleration capacity of heart rate as a predictor of mortality after myocardial infarction: cohort study. Lancet. 20;367(9523):1674-81.
To cite this abstract in AMA style:F. Bernhard, G. Mayer, K. Kesper, A. Bauer, A. Janzen, E. Sittig, W. Cassel, D. Vadasz, N. Mix, V. Ries, W. Oertel. Is Heart Rate variability a differential biomarker in REM sleep behavior disorder, Parkinson’s disease, multiple system atrophy and progressive supranuclear palsy? [abstract]. Mov Disord. 2018; 33 (suppl 2). https://www.mdsabstracts.org/abstract/is-heart-rate-variability-a-differential-biomarker-in-rem-sleep-behavior-disorder-parkinsons-disease-multiple-system-atrophy-and-progressive-supranuclear-palsy/. Accessed November 29, 2023.
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