Cardiac sympathetic index identifies patients with Parkinson's disease and REM behavior disorder |
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| Institution: | 1. Neuroimaging Research Unit, Institute of Bioimaging and Molecular Physiology, National Research Council, Germaneto, Catanzaro, Italy;2. Institute of Neurology, Department of Medical Sciences, University Magna Graecia, Catanzaro, Italy;1. Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan 410008, People''s Republic of China;2. Department of Neurology, Xiangya 3rd Hospital, Central South University, Changsha, Hunan 410013, People''s Republic of China;3. Clinical Pharmacology Center, Xiangya 3rd Hospital, Central South University, Changsha, Hunan 410013, People''s Republic of China;4. Molecular Neurobiology Section, National Institute of Mental Health, National Institutes of Health, Bethesda, MD 20892-1363, USA;5. Department of Psychiatry, Brain Research Center, The University of British Columbia, 2255 Wesbrook Mall, Vancouver, BC V6T 1Z3, Canada;6. Key Laboratory of Hunan Province in Neurodegenerative Disorders, Central South University, Changsha, Hunan 410008, People''s Republic of China;7. State Key Laboratory of Medical Genetics, Central South University, Changsha, Hunan 410078, People''s Republic of China;1. Institute of Biomedical Engineering, TU Dresden, Dresden, Germany;2. Department of Information Technology, FH Dortmund, Dortmund, Germany;3. Department of Neurology, University Hospital Carl Gustav Carus, TU Dresden, Germany;4. German Centre for Neurodegenerative Diseases (DZNE), Dresden, Germany |
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| Abstract: | ObjectiveTo compare circadian autonomic fluctuations in patients with Parkinson's Disease (PD) with or without REM sleep behavior disorder (RBD) by using heart rate variability (HRV) analysis.MethodsThis is a case-control study including 20 PD patients with RBD (PD-RBD) and 20 PD patients without RBD (PD). In all patients, we measured the components of HRV in the frequency domain during 24-h with daytime and night time recordings. Selected variables considered were low-frequency (LF) influenced by the sympathetic system and high-frequency (HF) influenced by the parasympathetic system. Moreover, we calculated night-to-day ratio for both LF (cardiac sympathetic index) and HF (cardiac parasympathetic index) spectral components. Video-polysomnography was performed in all patients to diagnose RBD.ResultsBoth nocturnal LF and HF spectral power values were significantly higher in PD-RBD patients than in PD patients (P < 0.001 and P = 0.004 respectively). Moreover, in PD-RBD patients LF and HF values were higher at night than during the day while no difference between night time and daytime values was observed in patients with PD. Cardiac sympathetic index value was significantly higher in PD-RBD patients (median 1.83, range 1.65–3.66) than in PD patients (median 0.93, range 0.44–1.3) without overlap of individual values between groups (accuracy 100%). By contrast, cardiac parasympathetic index had sensitivity of 45% and specificity of 100% for differentiating between PD groups.ConclusionsCardiac sympathetic index distinguishes PD-RBD patients from those with PD on an individual basis, thus representing a valid help in everyday clinical practice for screening of RBD in PD patients. |
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| Keywords: | Parkinson's disease REM sleep behavior disorder Heart rate variability |
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