Key result
Very early stage Parkinson disease was associated with well-preserved heart rate and blood pressure control, showing only subtle differences in baroreflex function compared to healthy controls.
Why the study?
It was unclear whether cardiovascular autonomic dysregulation could be detected in the very early stage of Parkinson disease.
Does very early stage Parkinson disease affect autonomic cardiovascular control compared to healthy controls?
Case-Control (n=38)
Does very early stage Parkinson disease affect autonomic cardiovascular control compared to healthy controls?
In very early stage Parkinson disease, motor signs dominate while cardiovascular autonomic control remains largely preserved with only subtle impairments.
Cardiovascular autonomic control remains largely preserved in very early Parkinson disease; leaves open whether subtle baroreflex changes predict later progression.
Objective . Non-motor symptoms including those reflecting autonomic cardiovascular dysregulation are often present in Parkinson disease. It is unclear whether it is possible to detect cardiovascular autonomic dysregulation in the very early stage of Parkinson disease potentially supporting the concept of the upstream propagation of nervous system damage through autonomic nerves. We hypothesized that cardiovascular dysregulation should precede the motor symptoms and at the time of their occurrence autonomic dysregulation should be clearly demonstrable. Therefore, the aim of this study was to assess the various aspects of autonomic cardiovascular control in the very early stage of Parkinson disease. Approach . We performed prospective case-control study on 19 patients with Parkinson disease (<6 months after motor signs occurrence) and 19 healthy control subjects. For each phase of study protocol (supine, head-up tilt, supine recovery), we calculated a wide array of cardiovascular control related parameters reflecting cardiac chronotropic, cardiac inotropic and vasomotor control and baroreflex mediated cardiovascular response. Main results . We observed the well-preserved heart rate and blood pressure control in patients with early stage of Parkinson disease. However, causal analysis of interactions between heart rate and blood pressure oscillations revealed subtle differences in baroreflex function and baroreflex mediated vasoconstriction response to orthostasis. Furthermore, a tendency towards a decreased contraction strength in Parkinson disease was observed. Significance . Considering only subtle cardiovascular control impairment in our study employing a wide array of sensitive methods at the time when motor signs were clearly expressed, we suggest that motor signs dominated in this stage of Parkinson disease.
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Oleksakova et al. (2023) conducted a case-control in Parkinson disease (n=38). Very early stage Parkinson disease vs. Healthy control subjects was evaluated on Cardiovascular control related parameters reflecting cardiac chronotropic, cardiac inotropic and vasomotor control and baroreflex mediated cardiovascular response. Very early stage Parkinson disease was associated with well-preserved heart rate and blood pressure control, showing only subtle differences in baroreflex function compared to healthy controls.
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