Ambulatory ECG and analysis of heart rate variability in Parkinson's disease
Open accessAbstract
OBJECTIVES: Cardiovascular reflex tests have shown both sympathetic and parasympathetic failure in Parkinson's disease. These tests, however, describe the autonomic responses during a restricted time period and have great individual variability, providing a limited view of the autonomic cardiac control mechanisms. Thus, they do not reflect tonic autonomic regulation. The aim was to examine tonic autonomic cardiovascular regulation in untreated patients with Parkinson's disease. METHODS: 24 Hour ambulatory ECG was recorded in 54 untreated patients with Parkinson's disease and 47 age matched healthy subjects. In addition to the traditional spectral (very low frequency, VLF; low frequency, LF; high frequency, HF) and non-spectral components of heart rate variability, instantaneous beat to beat variability (SD1) and long term continuous variability (SD2) derived from Poincaré plots, and the slope of the power law relation were analysed. RESULTS: All spectral components (p<0.01) and the slope of the power-law relation (p<0.01) were lower in the patients with Parkinson's disease than in the control subjects. The Unified Parkinson's disease rating scale total and motor scores had a negative correlation with VLF and LF power spectrum values and the power law relation slopes. Patients with mild hypokinesia had higher HF values than patients with more severe hypokinesia. Tremor and rigidity were not associated with the HR variability parameters. CONCLUSIONS: Parkinson's disease causes dysfunction of the diurnal autonomic cardiovascular regulation as demonstrated by the spectral measures of heart rate variability and the slope of the power law relation. This dysfunction seems to be more profound in patients with more severe Parkinson's disease.
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Prominent changes in 24-hour rhythms of heart rate and blood pressure have been repeatedly reported in Parkinson's disease.
“Similar to motor function, prominent changes in 24-hour rhythms of heart rate and blood pressure have been repeatedly reported in PD.”
From Circadian dysregulation in Parkinson's disease (2017) · cites this paper as Haapaniemi et al., 2001
Studies report reversal of the normal diurnal rhythm of blood pressure with increased diurnal variability of blood pressure and elevations of overnight blood pressure, along with loss of diurnal heart rate variability and a disappearance of the sympathetic morning peak in Parkinson's disease.
“These studies report reversal of the normal diurnal rhythm of BP with increased diurnal variability of BP and elevations of overnight BP along with loss of diurnal HR variability and a disappearance of the sympathetic morning peak (Haapaniemi et al., 2001, Kallio et al., 2000, Kallio et al., 2004, Mastrocola et al., 1999).”
From Circadian dysregulation in Parkinson's disease (2017) · cites this paper as Haapaniemi et al., 2001
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- Authors
- Haapaniemi, T. H.
- Affiliations
- University of Oulu (FI)
- Corresponding author
- Haapaniemi, T H
- Venue
- Journal of Neurology, Neurosurgery & Psychiatry
- Publisher
- BMJ
- Published
- 2001-03-01
- Volume
- 70
- Issue
- 3
- Pages
- 305-310
- ISSN
- 0022-3050 (ISSN-L)
- PMC
- PMC1737270
- OpenAlex
- W2107699610
- Cited by
- 193
- References
- 55
- Citations by year
- 2026: 3 · 2025: 14 · 2024: 8 · 2023: 6 · 2022: 4 · 2021: 12 · 2020: 10 · 2019: 6 · 2018: 5 · 2017: 9 · 2016: 16 · 2015: 6 · 2014: 9 · 2013: 10 · 2012: 13
- FWCI
- 3.67
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Neurology Neurosurgery & Psychiatry (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
- Health Sciences › Medicine › Neurology › Parkinson's Disease Mechanisms and Treatments
- Health Sciences › Medicine › Surgery › Cardiovascular Syncope and Autonomic Disorders
- Keywords
- Parkinson's disease, heart rate variability, autonomic dysfunction, Holter monitoring, Poincaré plot, power-law relationship, spectral analysis, hypokinesia, untreated Parkinson's disease
- MeSH terms
- Aged, Circadian Rhythm, Electrocardiography, Female, Heart Rate, Humans, Male, Middle Aged, Parkinson Disease
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