title: The association of heart rate variability with parkinsonian motor symptom duration.
abstract: OBJECTIVE
  Impaired cardiovascular autonomic regulation is a non-motor symptom of Parkinson's disease (PD) and may increase long-term morbidity. This study applied frequency-domain analysis of heart rate variability (HRV) to understand the progression of sympathetic and parasympathetic cardiac regulation in patients with PD.
  
  
  METHODS
  In this cross-sectional study, 21 male and 11 female Taiwanese patients with advanced PD and 32 healthy gender- and age-matched subjects were enrolled. To minimize artifacts due to subject motion, daytime electrocardiograms for 5 minutes were recorded in awake patients during levodopa-on periods and controls. Using fast Fourier transformation, heart rate variables were quantified into a high-frequency power component [0.15-0.45 Hz, considered to reflect vagal (parasympathetic) regulation], low-frequency power component (0.04-0.15 Hz, reflecting mixed sympathetic and parasympathetic regulation), and low-frequency power in normalized units (reflecting sympathetic regulation). The significance of between-group differences was analyzed using the paired t-test. Pearson correlation analysis and stepwise regression analysis were applied to assess the correlation of patient age, PD duration, and disease severity (represented by the Unified Parkinson's Disease Rating Scale) with each heart rate variables.
  
  
  RESULTS
  Impaired HRV is significantly correlated with the duration of PD, but not with disease severity and patient age. Meanwhile, parasympathetic heart rate variable is more likely than sympathetic heart rate variable to be affected by PD.
  
  
  CONCLUSIONS
  PD is more likely to affect cardiac parasympathetic regulation than sympathetic regulation by time and the heart rate variables have the association with Parkinsonian motor symptom duration.
authors.affiliation: Surgical Intensive Care Unit, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan.
authors.forename: Dorji
authors.initials: D
authors.lastname: Harnod
authors.affiliation: Department of Public Health, College of Medicine, Tzu Chi University, Hualien, Taiwan.
authors.forename: Shu-Hui
authors.initials: SH
authors.lastname: Wen
authors.affiliation: Department of Neurosurgery, Buddhist Tzu Chi General Hospital, College of Medicine, Tzu Chi University, Hualien, Taiwan.
authors.forename: Shin-Yuan
authors.initials: SY
authors.lastname: Chen
authors.affiliation: Department of Neurosurgery, Buddhist Tzu Chi General Hospital, College of Medicine, Tzu Chi University, Hualien, Taiwan. nsha@tzuchi.com.tw.
authors.forename: Tomor
authors.initials: T
authors.lastname: Harnod
mesh_terms: D000328:Adult; D000368:Aged; D001341:Autonomic Nervous System / Q000503:physiopathology*; D003430:Cross-Sectional Studies; D004562:Electrocardiography; D005260:Female; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000150:complications / Q000503:physiopathology*; D012044:Regression Analysis
keywords: Autonomic; Parkinson's disease; heart rate variability