Category: Parkinson's Disease: Neurophysiology
Objective: The aim of this study is to assess cardiac autonomic dysfunction in Parkinson’s disease (PD) patients.
Background: Autonomic nervous system dysfunction (AD) is a common morbidity in patients with PD. The neurodegenerative process affects major brain regions concerned with autonomic control. AD precedes motor symptoms, hence assessing this AD at an early stage (sub clinically) would enhance treatment strategies and assessing disease progression.
Method: We conducted an observational cross-sectional study among 15 PD (disease onset 5.6 ± 2.2 years) and 30 healthy controls (HC). All participants underwent short term heart rate variability (HRV), baroreceptor sensitivity (BRS), conventional cardiac autonomic function- Ewing’s protocol (deep breathing test, valsalva manoeuvre, isometric handgrip test, orthostatic test) and tilt table test.
Results: The mean age was 56.6 ± 7.1 years and 57.2 ± 8.6 years in PD and HC respectively. The data were compared between PD and HC using the Mann-Whitney U test. Among the short term HRV parameters, total power, low-frequency power, and high-frequency power were lower in PD patients (p<0.001) as compared to HC. While the LF/HF ratio of PD patients was similar to healthy controls. Total BRS was lower in PD patients (p<0.001) as compared to healthy controls. Ewing’s protocol showed that deep breathing difference and Valsalva ratio were lower in PD patients (p<0.01). However, there was no significant difference seen in diastolic BP during isometric handgrip manoeuvre and 5 min Orthostatic test. Tilt table test showed that five PD patients (33%) had delayed OH with a median drop in BP = 21/14mmHg.
Conclusion: Cardiac autonomic dysfunction is seen in PD patients as evidenced by the reduced total power of HRV, reduced total BRS and abnormal conventional cardiac autonomic tests. These findings suggest AD develops even at an earlier stage of the disease and would guide physicians in planning treatment strategies and disease prognosis.
To cite this abstract in AMA style:
T.N Sathyaprabha, G. Inbaraj, N. Kuravatti, M.R Rukmani, B.S Krishnaprasad, R. Ravi, K. Mrudula, P. John. Subclinical cardiac autonomic dysfunction in patients with Parkinson’s disease: A pilot study [abstract]. Mov Disord. 2020; 35 (suppl 1). https://www.mdsabstracts.org/abstract/subclinical-cardiac-autonomic-dysfunction-in-patients-with-parkinsons-disease-a-pilot-study/. Accessed June 15, 2025.« Back to MDS Virtual Congress 2020
MDS Abstracts - https://www.mdsabstracts.org/abstract/subclinical-cardiac-autonomic-dysfunction-in-patients-with-parkinsons-disease-a-pilot-study/