The Association of Heart Rate Variability with Parkinsonian Motor Symptom Duration

다국어 초록 (Multilingual Abstract)

Purpose: Impaired cardiovascular autonomic regulation is a non-motor symptom of Parkinson’s disease (PD) and may increase long-term morbidity. This study appliedfrequency-domain analysis of heart rate variability (HRV) to understand the progression of sympathetic and parasympathetic cardiac regulation in patients with PD. Materials and Methods: In this cross-sectional study, 21 male and 11 female Taiwanese patients with advanced PD and 32 healthy gender- and age-matched subjects were enrolled. To minimize artifacts due to subject motion, daytime electrocardiogramsfor 5 minutes were recorded in awake patients during levodopa-on periods and controls. Using fast Fourier transformation, heart rate variables were quantified into a high-frequency power component [0.15--0.45 Hz, considered to reflect vagal (parasympathetic) regulation], low-frequency power component (0.04--0.15 Hz, reflecting mixed sympathetic and parasympathetic regulation), and low-frequency power in normalized units (reflecting sympathetic regulation). The significance of between-group differences was analyzed using the paired t-test. Pearson correlation analysis and stepwise regression analysis were applied to assessthe correlation of patient age, PD duration, and disease severity (represented by the Unified Parkinson’s Disease Rating Scale) with each heart rate variables. Results: Impaired HRV is significantly correlated with the duration of PD, but not with disease severity and patient age. Meanwhile, parasympathetic heart rate variableis more likely than sympathetic heart rate variable to be affected by PD. Conclusion:PD is more likely to affect cardiac parasympathetic regulation than sympatheticregulation by time and the heart rate variables have the association with Parkinsonian motor symptom duration.

참고문헌 (Reference)

1 Byrne EA, "Role of aerobic capacity and body mass index in the age-associated decline in heart rate variability" 81 : 743-750, 1996

2 Wakabayashi K, "Neuropathology of autonomic nervous system in Parkinson’s disease" 38 (38): 2-7, 1997

3 Lucetti C, "Long-term clinical evaluation in patients with Parkinson’s disease and early autonomic involvement" 12 : 279-283, 2006

4 Benarroch EE, "Involvement of the ventrolateral medulla in parkinsonism with autonomic failure" 54 : 963-968, 2000

5 Papapetropoulos S, "Insular pathology in Parkinson’s disease patients with orthostatic hypotension" 13 : 308-311, 2007

6 Bouhaddi M, "Impaired cardiovascular autonomic control in newly and long-term-treated patients with Parkinson’s disease: involvement of L-dopa therapy" 116 : 30-38, 2004

7 Stein PK, "Heart rate variability: a measure of cardiac autonomic tone" 127 : 1376-1381, 1994

8 "Heart rate variability. Standards of measurement, physiological interpretation, and clinical use. Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology" 17 : 354-381, 1996

9 Takase B, "Heart rate variability in patients with diabetes mellitus, ischemic heart disease, and congestive heart failure" 25 : 79-88, 1992

10 Harnod T, "Heart rate variability in children with refractory generalized epilepsy" 17 : 297-301, 2008

11 Jankovic J, "Functional decline in Parkinson disease" 58 : 1611-1615, 2001

12 Lucreziotti S, "Five-minute recording of heart rate variability in severe chronic heart failure: correlates with right ventricular function and prognostic implications" 139 : 1088-1095, 2000

13 "Enhanced catecholamine transporter binding in the locus coeruleus of patients with early Parkinson disease" 11 : 88-, 2011

14 Ludwig J, "Effects of subthalamic nucleus stimulation and levodopa on the autonomic nervous system in Parkinson’s disease" 78 : 742-745, 2007

15 Kuo TB, "Effect of aging on gender differences in neural control of heart rate" 277 (277): H2233-H2239, 1999

16 Langston JW, "Core assessment program for intracerebral transplantations (CAPIT)" 7 : 2-13, 1992

17 Löhle M, "Controversies in neurology: why monoamine oxidase B inhibitors could be a good choice for the initial treatment of Parkinson’s disease" 11 : 112-, 2011

18 Kallio M, "Comparison of heart rate variability analysis methods in patients with Parkinson’s disease" 40 : 408-414, 2002

19 Nakagawa M, "Circadian rhythm of the signal averaged electrocardiogram and its relation to heart rate variability in healthy subjects" 79 : 493-496, 1998

20 Oka H, "Cardiovascular dysautonomia in de novo Parkinson’s disease" 241 : 59-65, 2006

21 Vanderlei LC, "Basic notions of heart rate variability and its clinical applicability" 24 : 205-217, 2009

22 Jost WH, "Autonomic dysfunctions in idiopathic Parkinson’s disease" 250 (250): I28-I30, 2003