Abstract
Parkinson’s disease (PD) can present with different motor subtypes depending on the predominant symptoms (tremor or rigidity/bradykinesia). Slower disease progression and less cognitive decline are observed in tremor-dominant patients compared to those with akinetic-rigid subtype. Autonomic cardiovascular disorders have been described in parkinsonian patients, although the definite correlations with different subtypes of PD are not clear. In this context, heart rate variability (HRV) analysis represents a non-invasive and established tool in assessing cardiovascular autonomic modulation. We investigate cardiovascular autonomic modulation in PD patients with tremor dominant subtype in comparison to akinetic rigid dominant subtype subjects using HRV analysis. Twenty-eight PD patients (17 with tremor dominant subtype and 11 with akinetic rigid dominant subtype) were enrolled and compared to 17 age and sex-matched healthy controls. HRV was analyzed in time- and frequency-domains. Low-frequency (LF) values were significantly lower in the akinetic rigid dominant subtype than in the tremor dominant group [LF 41.4 ± 13.6 vs 55.5 ± 11.6 (p < 0.007)] indicating that the disease led to a more evident impairment of the baroreflex modulation of the autonomic outflow mediated by both sympathetic and parasympathetic systems in the first class of patients. These findings support the biological relevance of clinical subtypes supporting the idea of a different pathophysiological process between these subtypes. These differences also suggest that different subtypes may also result in different responses to therapy or in the possible development of cardiovascular side effects of dopaminergic drugs in these different populations.
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Acknowledgments
Authors gratefully thank Mr. Barry Mark Wheaton for his editorial and linguistic assistance. Dr. Paolo Solla gratefully acknowledges Sardinia Regional Government for the financial support (P.O.R. Sardegna F.S.E. Operational Programme of the Autonomous Region of Sardinia, European Social Fund 2007–2013—Axis IV Human Resources, Objective l.3, Line of Activity l.3.1 “Avviso di chiamata per il finanziamento di Assegni di Ricerca”). Dr. Paolo Solla gratefully acknowledges Fondazione Banco di Sardegna for the financial support.
Conflict of interest
The authors declare that they have no conflict of interest. P. Solla has received institutional research funding from the University of Cagliari, received funding from the Fondazione Banco di Sardegna, and received research grant from the Dystonia Europe. Christian Cadeddu reports no disclosures relevant to the manuscript. Antonino Cannas reports no disclosures relevant to the manuscript. Martino Deidda reports no disclosures relevant to the manuscript. Nicola Mura reports no disclosures relevant to the manuscript. Giuseppe Mercuro reports no disclosures relevant to the manuscript. Francesco Marrosu reports no disclosures relevant to the manuscript.
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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
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P. Solla and C. Cadeddu contributed equally to this study.
G. Mercuro and F. Marrosu are senior authors and contributed equally to this study.
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Solla, P., Cadeddu, C., Cannas, A. et al. Heart rate variability shows different cardiovascular modulation in Parkinson’s disease patients with tremor dominant subtype compared to those with akinetic rigid dominant subtype. J Neural Transm 122, 1441–1446 (2015). https://doi.org/10.1007/s00702-015-1393-5
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DOI: https://doi.org/10.1007/s00702-015-1393-5