title: Influence of Deep Breathing on Heart Rate Variability in Parkinson's Disease: Co-relation with Severity of Disease and Non-Motor Symptom Scale Score.
abstract: BACKGROUND
  Dysautonomia and non-motor symptoms (NMS) in Parkinson's disease (PD) are frequent, disabling and reduce quality of life of patient.
  
  
  OBJECTIVE
  There is a paucity of studies on autonomic dysfunction in PD in Indian population. The study aimed to evaluate autonomic dysfunction in PD patients and co-relate the findings with severity of PD and Non-Motor Symptoms Scale (NMSS) score.
  
  
  METHODS
  We evaluated autonomic function in 30 diagnosed patients of PD (age 55-70 years) and 30 healthy age-matched controls by 3 min deep breathing test (DBT). NMSS was used to identify non-motor symptoms and Hoehn and Yahr (HY) Scale to grade severity of PD. The DBT findings were co-related with severity of PD (HY staging) and NMSS score.
  
  
  RESULTS
  DBT was found to be abnormal in 40% while it was on borderline in 33.3% of PD patients. There was a statistically significant difference (p<0.01) between patients and control group for the DBT. NMS were reported across all the stages of PD but with variable frequency and severity for individual symptom. A negative co-relation was found between results of deep breathing test and clinical severity of disease and NMSS score.
  
  
  CONCLUSIONS
  Abnormalities of autonomic function and NMS were integral and present across all the stages of PD patients. Early recognition and treatment of these may decrease morbidity and improve quality of life of PD patients.
authors.affiliation: Assistant Professor, Department of Physiology, Topiwala National Medical College & BYL Nair Charitable Hospital , Mumbai, India .
authors.forename: Mukta Pritam
authors.initials: MP
authors.lastname: Bidikar
authors.affiliation: Resident, Department of Physiology, Topiwala National Medical College & BYL Nair Charitable Hospital , Mumbai, India .
authors.forename: Gayatri J
authors.initials: GJ
authors.lastname: Jagtap
authors.affiliation: Associate Professor & In-charge Department of Neurology, Topiwala National Medical College & BYL Nair Charitable Hospital , Mumbai, India .
authors.forename: Rahul T
authors.initials: RT
authors.lastname: Chakor
keywords: Autonomic dysfunction; Indian population; Lewy bodies; NMSS; Parkinson’s disease