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Auton Neurosci. 2017 Jul;205:93-98. doi: 10.1016/j.autneu.2017.04.002. Epub 2017 Apr 14.

Autonomic and electrocardiographic findings in Parkinson's disease.

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Department of Neurology, Beth Israel Deaconess Medical Center and Harvard Medical School, 330 Brookline Avenue, Boston, MA 02215, USA. Electronic address:
Department of Neurology, Beth Israel Deaconess Medical Center and Harvard Medical School, 330 Brookline Avenue, Boston, MA 02215, USA.
Department of Biostatistics, University of Texas Health Science Center School of Public Health at Houston, Houston, TX 77030, USA.
Department of Neurology, School of Medicine, University of California, San Francisco, USA.
Department of Clinical Pharmacy and Neurology, University of Colorado, Anschutz Medical Campus, Skaggs School of Pharmacy and Pharmaceutical Sciences, Aurora, CO, USA.
Department of Neurology, Oregon Health & Science University, USA.
Department of Neurology, Michigan State University, USA.
Department of Neurological Sciences, University of Vermont College of Medicine, USA.
Department of Neurology, Miller School of Medicine, University of Miami, Miami, FL, USA.
Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
Department of Neurology and Ophthalmology, State University of New York, Downstate Medical Center, USA.
Department of Pharmacy, Singapore General Hospital, Singapore.


Parkinson disease (PD) is a progressive neurodegenerative disorder characterized by motor and non-motor symptoms and signs. Many reports suggest that diminished heart rate variability occurs early, even prior to the cardinal signs of PD. In a longitudinal study of PD, we evaluated whether heart rate variability (HRV) obtained using a 10-second ECG tracing, and the electrocardiographic QT-interval would be associated with PD severity and progression. Subjects were derived from a longitudinal study of 1741 individuals with early, stable PD. The severity of PD was measured using the global statistical test (GST). In a subset, the heart rate corrected QT-interval (QTcB) was calculated for each electrocardiogram (ECG). The HRV was measured for each ECG and then transformed to fit a normal distribution. The baseline analysis included 653 subjects, with 256 completing the 5-year follow up study. There was an association (P<0.05) between QTcB and PD severity in individuals that were taking QT-interval affecting drugs. A longer QT-interval at baseline was associated with more advanced PD at 5years (P<0.05), and greater disease progression over 5years (P<0.05). There was an association between diminished HRV and an orthostatic decrease in standing blood pressure at baseline in individuals with PD (P<0.05). HRV was not associated with PD severity or progression. In conclusion, we were able to detect measurable associations between the QTcB interval and PD severity, PD severity 5years later, and the change in disease over time. However, routine ECG tracings appear inadequate for the evaluation of autonomic function in PD.


Autonomic; Electrocardiogram; Heart rate variability; Parkinson's disease

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