title: Heart rate variability shows different cardiovascular modulation in Parkinson's disease patients with tremor dominant subtype compared to those with akinetic rigid dominant subtype.
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.
authors: Department of Public Health, Clinical and Molecular Medicine, Movement Disorders Centre, University of Cagliari, Cagliari, Italy.
authors: Paolo
authors: P
authors: Solla
authors: Department of Medical Sciences "Mario Aresu", University Hospital of Cagliari, University of Cagliari, Strada Statale 554, Km 4.500, Monserrato, 09042, Cagliari, Italy. cadedduc@unica.it.
authors: Christian
authors: C
authors: Cadeddu
authors: Department of Public Health, Clinical and Molecular Medicine, Movement Disorders Centre, University of Cagliari, Cagliari, Italy.
authors: Antonino
authors: A
authors: Cannas
authors: Department of Medical Sciences "Mario Aresu", University Hospital of Cagliari, University of Cagliari, Strada Statale 554, Km 4.500, Monserrato, 09042, Cagliari, Italy.
authors: Martino
authors: M
authors: Deidda
authors: Department of Medical Sciences "Mario Aresu", University Hospital of Cagliari, University of Cagliari, Strada Statale 554, Km 4.500, Monserrato, 09042, Cagliari, Italy.
authors: Nicola
authors: N
authors: Mura
authors: Department of Medical Sciences "Mario Aresu", University Hospital of Cagliari, University of Cagliari, Strada Statale 554, Km 4.500, Monserrato, 09042, Cagliari, Italy.
authors: Giuseppe
authors: G
authors: Mercuro
authors: Department of Public Health, Clinical and Molecular Medicine, Movement Disorders Centre, University of Cagliari, Cagliari, Italy.
authors: Francesco
authors: F
authors: Marrosu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000978:Antiparkinson Agents / Q000627:therapeutic use; D001341:Autonomic Nervous System / Q000503:physiopathology; D017704:Baroreflex / Q000502:physiology; D005260:Female; D006334:Heart Function Tests; D006339:Heart Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D009127:Muscle Rigidity / Q000188:drug therapy / Q000503:physiopathology*; D010300:Parkinson Disease / Q000145:classification / Q000188:drug therapy / Q000503:physiopathology*; D014202:Tremor / Q000188:drug therapy / Q000503:physiopathology*
chemical_list: D000978:Antiparkinson Agents
keywords: Akinetic rigid dominant subtype; Cardiovascular modulation; Dysautonomia; Heart rate variability; Parkinson’s disease; Tremor dominant subtype