What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Parkinson's disease (n=40). Intervention: Parkinson's disease severity (MDS-UPDRS score). Primary outcome: Correlation between disease severity (MDS-UPDRS score) and sympathovagal balance (LF/HF ratio) (r = 0.965, p=<0.001).

What question did this study set out to answer?

This study aims to explore the relationship between cardiac autonomic function, cognitive parameters, and disease severity in individuals with mild-to-moderate Parkinson's disease.

June 19, 2026Cureus0 citationsOpen Access

Association of Cardiac Autonomic Dysfunction and Cognitive Impairment With Disease Severity in Parkinson’s Disease: A Cross-Sectional Study

Q: What are the key findings of this study?

Increasing Parkinson's disease severity was significantly correlated with cardiac autonomic imbalance (LF/HF ratio r=0.965), cognitive impairment, and elevated oxidative stress markers.

Q: What question did this study set out to answer?

This study aims to explore the relationship between cardiac autonomic function, cognitive parameters, and disease severity in individuals with mild-to-moderate Parkinson's disease.

UDUsha DhanaradjaJawaharlal Institute of Post Graduate Medical Education and Research RRRajasegaran RajalakshmiJawaharlal Institute of Post Graduate Medical Education and Research RARajeswari AghoramJawaharlal Institute of Post Graduate Medical Education and Research

Key Result

Increasing Parkinson's disease severity was significantly correlated with cardiac autonomic imbalance (LF/HF ratio r=0.965), cognitive impairment, and elevated oxidative stress markers.

Key Points

This study aims to explore the relationship between cardiac autonomic function, cognitive parameters, and disease severity in individuals with mild-to-moderate Parkinson's disease.
Forty individuals aged 35 to 70 with Parkinson's disease were recruited for the study.
Cardiac autonomic function was evaluated using heart rate variability analysis and autonomic function tests.
Cognitive function was assessed with event-related potentials and reaction time measurements, while biomarkers were measured using ELISA.
Positive correlations were found between UPDRS scores and HRV indices of sympathetic activity (LF power, LFnu) and cognitive metrics (P300 latency, reaction times).
Negative correlations were found between UPDRS scores and parasympathetic HRV indices (HF power, HF nu) and P300 amplitude.
Overall, increased disease severity was linked to cardiac autonomic imbalance and cognitive impairment.

Study Design

Type

Cross-Sectional (n=40)

Multicenter

Structured PICO

Does disease severity in Parkinson's disease correlate with cardiac autonomic dysfunction, cognitive impairment, and biochemical markers?

Population

40 adults aged 35 to 70 years with mild-to-moderate Parkinson's disease on stable therapy were evaluated in a cross-sectional study to assess systemic disease involvement.

Outcome

Correlation between cardiac autonomic function (HRV), cognitive parameters (P300 and reaction time), biochemical markers (HCY and 8-OHdG), and disease severity (MDS-UPDRS Part III)surrogate

Increasing disease severity in Parkinson's disease is associated with cardiac autonomic imbalance, cognitive impairment, and elevated markers of cardiovascular risk and oxidative stress.

Main Result

Effect estimate: r = 0.965

p-value: p=<0.001

Limitations

Cross-sectional study design precludes establishing causal relationships.
Absence of a healthy control group limits direct comparison with normative values.
Small sample size limits the generalizability of the findings.
Did not account for potential confounding variables such as age, gender, disease duration, medication use, and educational status.
Autonomic and cognitive assessments were not stratified according to ON/OFF medication states.

Abstract

Background Parkinson's disease (PD) is a neurodegenerative disorder characterized by the presence of both motor and non-motor features. Although cardiac autonomic imbalance and cognitive derangement are well documented in PD, their relationship with the severity of the disease has not been explored using a multimodal approach. Objective This study aimed to assess the correlation between cardiac autonomic function, cognitive parameters (P300 and reaction time), and biochemical markers (homocysteine (HCY) and 8-hydroxy-2′-deoxyguanosine (8-OHdG)) with disease severity in individuals with mild-to-moderate PD. Methods Forty individuals aged 35 to 70 years diagnosed with PD were recruited. Cardiac autonomic function was assessed using heart rate variability (HRV) analysis and conventional autonomic function tests. Cognitive function was evaluated by recording P300 event-related potentials and auditory and visual reaction time. Serum HCY and serum 8‑OHdG were measured as biomarkers of cardiovascular risk and oxidative stress, respectively, using ELISA. Disease severity was assessed using the Movement Disorder Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS) Part III. Correlation between the study parameters was assessed using the Pearson or Spearman’s rank correlation coefficient test. P<0.05 was considered statistically significant. Results Significant positive correlations were observed between UPDRS scores and HRV indices of sympathetic activity (LF power, LFnu), sympathovagal balance (LF/HF), P300 latency, reaction times, and biomarker levels. Significant negative correlations were observed between UPDRS scores and parasympathetic HRV indices (HF power, HF nu), total HRV, conventional autonomic function parameters, and P300 amplitude. Conclusion Increasing disease severity in PD is associated with cardiac autonomic imbalance, cognitive impairment, and elevated markers of cardiovascular risk and oxidative stress, suggesting a multi-system involvement.

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