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Cardiac parasympathetic dysfunction in the early phase of Parkinson’s disease

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Abstract

Cardiac parasympathetic function is strongly affected by aging. Although sympathetic dysfunction has been well documented in Parkinson’s disease (PD), cardiac parasympathetic dysfunction has not been well studied. The objective of this study was to clarify the development of cardiac parasympathetic dysfunction in the early phase of PD and to explore the age-corrected correlation between cardiac parasympathetic dysfunction and cardiac sympathetic dysfunction. We reviewed 25 healthy controls and 56 patients with idiopathic PD of Hoehn and Yahr stages I–III. We evaluated cardiac parasympathetic function using the Valsalva ratio, the baroreflex sensitivity (BRS) and the coefficient of variation of RR intervals in the resting state (resting-CVRR) and during deep breathing (DB-CVRR). In addition, we measured cardiac 123I-metaiodobenzylguanidine (MIBG) uptake to investigate the relationship between cardiac sympathetic and parasympathetic dysfunction in PD. Compared with healthy controls, patients with PD showed significantly decreased cardiac parasympathetic parameters (resting-CVRR 2.8 ± 1.3 vs. 1.7 ± 0.6%, p < 0.001; DB-CVRR 5.8 ± 2.3 vs. 3.8 ± 1.7%, p < 0.001; Valsalva ratio 1.52 ± 0.26 vs. 1.34 ± 0.17, p < 0.01; BRS 10.6 ± 9.5 vs. 5.0 ± 5.4 ms/mmHg, p < 0.01). In particular, resting-CVRR and DB-CVRR were significantly decreased in the early phase of PD. In age-corrected analyses, none of the parasympathetic indices correlated with the delayed cardiac 123I-MIBG uptake. These observations indicate that cardiac parasympathetic dysfunction occurs in the early phase of PD, but not necessarily in parallel with cardiac sympathetic dysfunction.

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Authors and Affiliations

  1. Department of Neurology, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho Showa-ku, Nagoya, 466-8550, Japan

    Masashi Suzuki, Tomohiko Nakamura, Miki Ueda, Masahisa Katsuno & Gen Sobue

  2. Department of Pathophysiological Laboratory Science, Nagoya University Graduate School of Medicine, Nagoya, Japan

    Masaaki Hirayama

  3. Research Division of Dementia and Neurodegeneration Disease, Nagoya University Graduate School of Medicine, Nagoya, Japan

    Gen Sobue

Authors
  1. Masashi Suzuki
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  2. Tomohiko Nakamura
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  3. Masaaki Hirayama
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  4. Miki Ueda
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  5. Masahisa Katsuno
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  6. Gen Sobue
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Corresponding authors

Correspondence to Tomohiko Nakamura or Gen Sobue.

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Funding sources

This work was supported by JSPS KAKENHI Grant Nos. JP24590691, JP16K09713; and Grants from the Ministry of Health, Labor and Welfare of Japan.

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None of the authors reports any financial interests or potential conflicts of interest.

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Suzuki, M., Nakamura, T., Hirayama, M. et al. Cardiac parasympathetic dysfunction in the early phase of Parkinson’s disease. J Neurol 264, 333–340 (2017). https://doi.org/10.1007/s00415-016-8348-0

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  • DOI: https://doi.org/10.1007/s00415-016-8348-0

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