Parkinson's disease effect on autonomic modulation: an analysis using geometric indices

ABSTRACT

Background: Parkinson's disease (PD) produces autonomic changes, indicating lower parasympathetic modulation and global variability, but these changes need further studying regarding geometric methods. Objective: To investigate the autonomic modulation in individuals with PD using heart rate variability (HRV) indices obtained through geometric methods. Methods: This is a cross-sectional study that assessed 50 individuals, split into two groups: PD group (PDG; n=26; 75.36±5.21 years) and control group (CG; n=24; 75.36±5.21 years). We evaluated the autonomic modulation by measuring the heart rate beat-to-beat for 30 min with the individual in supine rest using a heart rate monitor and assessed geometric indices (RRtri, TINN, SD1, SD2, SD1/SD2 ratio, and qualitative analysis of the Poincaré plot). Results: Significant reductions were found in RRtri, TINN, SD1, and SD2 indices among PDG compared to CG. Regarding the SD1/SD2 ratio, no significant changes were detected between the groups. The Poincaré plot demonstrated that individuals with PD had lower beat-to-beat dispersion in RR intervals, in addition to greater long-term dispersion of RR intervals compared to CG. Conclusions: The results suggest a reduction in the parasympathetic autonomic modulation and global variability in individuals with PD compared to controls, regardless of sex, age, and body mass index.

RESUMO

Introdução: A doença de Parkinson (DP) produz alterações autonômicas, que indicam menor modulação parassimpática e variabilidade global, mas que devem ser investigadas quanto aos métodos geométricos. Objetivo: Investigar a modulação autonômica em indivíduos com DP, por meio de índices de variabilidade da frequência cardíaca (VFC) obtidos pelos métodos geométricos. Métodos: Estudo transversal, no qualforam avaliados 50 voluntários, divididos em dois grupos: o grupo doença de Parkinson (GDP; n=26; 75,36±5,21 anos) e o grupo controle (GC; n=24; 75,36±5,21 anos). Para a avaliação da modulação autonômica a frequência cardíaca foi captada batimento a batimento por meio de um cardiofrequencímetro com os indivíduos em decúbito dorsal por 30 min e índices geométricos da VFC foram avaliados (RRtri, TINN, SD1, SD2 e plot de Poincaré). Resultados: Houve reduções nos índices RRtri, TINN, SD1 e SD2 para o GDP em comparação ao GC. Para a relação SD1/SD2, diferenças significantes não foram observadas entre os grupos. O plot de Poincaré mostrou que indivíduos com DP têm menor dispersão batimento a batimento dos intervalos RR, bem como maior dispersão dos intervalos RR a longo prazo em relação ao GC. Conclusão: Os resultados sugerem haver diminuição da modulação autonômica parassimpática e da variabilidade global em indivíduos com DP em relação a indivíduos sem a doença, as quais são independentes de sexo, idade e índice de massa corporal.

Keywords:

Parkinson Disease - Autonomic Nervous System - Primary Dysautonomias - Neurodegenerative Diseases

Palavras-chave:

Doença de Parkinson - Sistema Nervoso Autônomo - Disautonomias Primárias - Doenças Neurodegenerativas

Authors’ contribution:

Study conception and design: Mileide Cristina Stoco-Oliveira and Luiz Carlos Marques Vanderlei; Data collection: Mileide Cristina Stoco-Oliveira, Heloisa Balotari Valente, Vitor Eduardo dos Santos Silva, Larissa Borba André, and Augusto Cesinando de Carvalho; Data analysis: Ana Laura Ricci-Vitor, Laís Manata Vanzella, and David M. Garner; Manuscript drafting: Mileide Cristina Stoco-Oliveira, Luiz Carlos Marques Vanderlei, Ana Laura Ricci-Vitor, and Laís Manata Vanzella.

Support:

This study was financed in part by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior – Brasil (CAPES) – Finance Code 001.

Publication History

Received: 07 March 2020

Accepted: 25 June 2020

Article published online:
04 July 2023

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