Sympathetic skin response and heart rate variability in predicting autonomic disorders in patients with Parkinson disease

Abstract

The purpose of this study was to evaluate sympathetic skin response (SSR) and heart rate variability (HRV) in determining autonomic nervous system (ANS) involvement in patients with Parkinson disease (PD). Forty-eight idiopathic PD patients and 30 healthy controls participated in this study. SSR, HRV, Unified Parkinson's Disease Rating Scale (UPDRS) III, the Scales for outcomes in Parkinson's Disease-Autonomic (SCOPA-AUT), Hoehn and Yahr (H&Y) scale were evaluated. Absent lower limb SSR was determined unilaterally in 2, bilaterally in 1 of 3 advanced PD patients; there was significant difference between PD and control groups in terms of the SSR (P < 0.01), significant prolonged SSR latencies and decreased SSR amplitudes from bilateral hands and feet. Significant difference was noted in HRV between PD and control groups except for root mean square of successive differences (rMSSD) and high-frequency (HF) power (P < 0.05). There was a significant different correlation between the parameters of SSR and the SCOPA-AUT, and between the parameters (except HF power) of HRV and the SCOPA-AUT. Some parameters of SSR were relevantly associated with HRV. The right hand SSR amplitude correlated positively with the (SD) of all R-R interval, total spectral power, very low frequency. The right foot amplitude correlated positively with total spectral power. Both SSR and HRV parameters are sensitive in determining ANS dysfunction not only in late but also in the early stage of PD, which can be used for early detection of autonomic dysfunction in patients with PD and have the potential to serve as electrophysiological markers of dysautonomia of PD.

Association Analyses of Autonomic Dysfunction and Sympathetic Skin Response in Motor Subtypes of Parkinson's Disease

“…As a note, age is a rather important factor affecting SSR. Two previous studies with 48 and 58 PD patients, respectively, showed inverse correlations of SSR amplitude with SCOPA-AUT and UPDRS tremor scores (14,33). On the other hand, Giza et al (15) studied 29 PD patients without clinical manifestation of dysautonomia and found that their SSR was similar to controls regardless a presence of correlation between UPDRS-III score and SSR.…”

Propolis as a Potential Disease-Modifying Strategy in Parkinson’s disease: Cardioprotective and Neuroprotective Effects in the 6-OHDA Rat Model

“…Taken together, the HRV measurements suggest that propolis has a cardioprotective effect on the 6-OHDA rat model of PD. Previous studies have shown statistically significant reductions in frequency domain and time domain measures (RMSSD and SDNN) of HRV, suggesting compromised autonomic cardiovascular regulation in PD patients, which is associated with greater risk of mortality [ 95 , 96 , 97 , 98 ]. Studies have suggested that HRV analysis is a major approach for assessing early sign of autonomic dysfunction in patients with PD and is more accurate than the conventional cardiovascular tests that are commonly used, such as Valsalva maneuver and head-up tilt test, among others [ 22 , 24 , 99 ].…”

Cardiovascular alterations in rats with Parkinsonism induced by 6-OHDA and treated with Domperidone

“…PD is known to decrease patient’s heart rate variability (HRV) 28,29 . Several studies on cardiologic conditions reports an association between reduced HRV with sudden unexpected death 30 .…”