Impaired circadian heart rate variability in Parkinson's disease: a time-domain analysis in ambulatory setting

BMC Neurol. 2020 Apr 23;20(1):152. doi: 10.1186/s12883-020-01722-3.

Abstract

Background: Heart rate variability (HRV) decreases in Parkinson's disease (PD) and it can be considered a marker for cardiovascular dysautonomia. The purpose of this pilot study is to evaluate long-term time-domain analysis of HRV of PD patients and compare the results with those of matched healthy individuals.

Methods: Idiopathic PD patients without comorbidity impairing HRV, and age-matched healthy individuals were recruited in a pilot study. A long-term time domain analysis of HRV using 24-h ambulatory ECG was performed.

Results: Overall, 18 PD patients fulfilling inclusion criteria completed the evaluation (mean age was 55.6 ± 8.8, disease duration: 5.0 ± 4.7). Mean SCOPA-AUT score was 10.1 ± 7.3. Patients were on Hoehn & Yahr stage 1-2 and mean Levodopa Equivalent Dose (LED) was 311 ± 239.9. Mean of the 5-min standard deviation (SD) of R-R intervals distribution (SDNN) for all 5 min segments of the entire recording (ISDNN) was significantly lower in patients compared to controls. ISDNN was significantly different between Parkinson's disease patients and healthy controls.

Conclusions: In our population characterized by mild to moderate disease severity, time-domain assessment of HRV seemed to be a potential tool to characterize cardiovascular dysautonomia. Decrease of ISDNN in PD may reflect an autonomic derangement extending all day and night long.

Keywords: Autonomic disorders; Heart rate variability, SCOPA-AUT; Non-motor symptoms.

MeSH terms

  • Aged
  • Antiparkinson Agents / therapeutic use
  • Cardiovascular Diseases* / diagnosis
  • Cardiovascular Diseases* / etiology
  • Cardiovascular Diseases* / physiopathology
  • Circadian Rhythm / physiology
  • Heart Rate / physiology*
  • Humans
  • Levodopa / therapeutic use
  • Middle Aged
  • Parkinson Disease* / complications
  • Parkinson Disease* / drug therapy
  • Parkinson Disease* / physiopathology
  • Pilot Projects
  • Primary Dysautonomias / diagnosis
  • Primary Dysautonomias / etiology
  • Primary Dysautonomias / physiopathology

Substances

  • Antiparkinson Agents
  • Levodopa