Objective: The aim of the study was the instrumental evaluation of occurrence and intensity of autonomic and sleep disturbances in patients with idiopathic PD.

Background: Non-motor symptoms are common in advanced Parkinson’s disease. Autonomic nervous system (ANS) dysfunction and sleep disturbances correlate with dementia, depression and faster progression of motor symptoms.

Method: 52 patients with idiopathic PD have been examined. Neurological and psychological examination including cognitive functions have been performed each patients. Then, ANS function was evaluated with five minutes resting heart rate variability (HRV) test, where two components were analyzed: LF (component of the low-frequency range, modulated by sympathetic and parasympatheticNS and associated with baroreceptor activity) and HF (component of the high-frequency range, modulated by the parasympathetic NS. The blood pressure has been measured in horizontal position, and in the 1,3 and 5th minute after tilting to 60° during tilt test. The results were presumed as positive and the orthostatic hypotension (OH) has been diagnosed when systolic blood pressure has dropped >20 mmHg, and diastolic blood pressure >10mmHg. Sleeping problems have been self-reported by patients, and were assessed with the PDSS(Parkinson’s Disease Sleepness Scale), and ESS (Epwhort Sleepness Scale). Polysomnography examination have been performed in selected cases.

Results: Based on the tilt test results, PD patients were divided into two groups with and without OH. PD-OH patients had significantly longer disease duration, more advanced motor symptoms, and cognitive decline. RBD has been reported in 37,5 %PD-OH cases, and 20% of PD without OH, but the difference was not significant. Correlation between cognitive impairment severity and sleep disturbance have not been found. In PD-OH autonomic dysfunction has been confirmed. In HRV frequency analysis both components of LF and HF ranges and in statistical analysis SDNN (standard deviation of NN intervals) were significantly lower (p<0,05) in PD-OH when compared with PD without OH.

Conclusion: HRV analysis, tilt test and sleep study are objective and sensitive instruments for evaluation of non-motor symptoms in PD patients. OH is one of the main elements of ANS disturbances in PD correlated with cognitive decline and worse motor condition.

« Back to 2019 International Congress

MDS Abstracts - https://www.mdsabstracts.org/abstract/instrumental-evaluation-of-sleep-disturbance-and-autonomic-nervous-system-dysfunction-in-idiopathic-parkinsons-disease/