Parkinson's disease exhibited significantly more severe autonomic impairment across all measures compared to vascular parkinsonism (all P<0.001), with six indices yielding high AUCs (0.94-0.99).
Cross-Sectional (n=120)
Do autonomic function assessments differentiate between Parkinson's disease and vascular parkinsonism?
Comprehensive autonomic function assessments, including HRV and VMA, can effectively differentiate Parkinson's disease from vascular parkinsonism.
Effect estimate: AUC 0.94-0.99
p-value: p=<0.001
This study aimed to evaluate autonomic function differences between Parkinson's disease (PD) and vascular parkinsonism (VP) for improved differential diagnosis. A total of 120 patients (60 PD, 60 VP) underwent comprehensive autonomic assessments, including skin scratch test, oculocardiac reflex, postural heart rate changes, heart rate variability (HRV), and 24-hour urinary vanillylmandelic acid (VMA). Disease severity was measured using MDS-UPDRS and Hoehn-Yahr staging in PD and NIHSS in VP. Results demonstrated significantly more severe autonomic impairment in PD across all measures (all P 0.80). In VP, autonomic abnormalities were milder and showed no sex-related differences. ROC analysis identified six autonomic indices with high discriminative power (AUC 0.94-0.99). A composite score incorporating red streak duration, HRV, and VMA effectively distinguished PD from VP. These findings indicate that PD is characterized by more extensive autonomic dysfunction than VP, influenced by disease progression and sex. The developed autonomic function score provides a practical, non-invasive tool for differential diagnosis, facilitating individualized management of these parkinsonian disorders.
Liu et al. (Fri,) conducted a cross-sectional in Parkinson's disease and vascular parkinsonism (n=120). Parkinson's disease vs. Vascular parkinsonism was evaluated on Autonomic function differences (AUC 0.94-0.99, p=<0.001). Parkinson's disease exhibited significantly more severe autonomic impairment across all measures compared to vascular parkinsonism (all P<0.001), with six indices yielding high AUCs (0.94-0.99).