Universidade Estadual Paulista "Júlio de Mesquita Filho", Faculdade de Ciências e Tecnologia, Departamento de Fisioterapia, Presidente Prudente SP, Brazil.
Arq Neuropsiquiatr. 2022 Jul;80(7):689-698. doi: 10.1055/s-0042-1755225. Epub 2022 Sep 29.
The Parkinson disease (PD) is frequently associated with autonomic dysfunctions. However, data regarding the influence of PD on the autonomic responses to postural changes is limited.
To analyze and compare the autonomic responses, evaluated through linear and non-linear methods of heart rate variability, and cardiorespiratory parameters in two groups: Parkinson disease (PDG) and control (CG), at rest and during the active tilt test.
A total of 48 participants were analyzed (PDG: = 25;73.40 ± 7.01 years / CG: = 23;70.17 ± 8.20 years). The autonomic modulation and cardiorespiratory parameters were evaluated at rest and during the active tilt test. To assess the autonomic modulation the linear indices, at the time (rMSSD, SDNN) and frequency (LF, HF, LF/HF) domains, and the non-linear indices, obtained through the Poincaré plot (SD1, SD2, SD1/SD2), were calculated. The cardiorespiratory parameters evaluated were heart rate (HR), systolic (SBP), and diastolic blood pressure (DBP), peripheral oxygen saturation (SpO), and respiratory rate.
At rest, the PDG presented significantly lower values of rMSSD, SDNN, LF, HF, SD1, SD2, and DBP, and higher values of SpO. During test, in the PD group, modifications were observed in HR, and SBP, besides a reduced parasympathetic response, and an increased global modulation. The qualitative analysis of the Poincaré plot showed that the PDG has a lower dispersion of the RR intervals during rest and the active tilt test.
Individuals with PD present reduced global variability and parasympathetic modulation at rest, and reduced parasympathetic response and damage in HR regulation when performing the active tilt test, compared with controls.
帕金森病（PD）常伴有自主功能障碍。然而，关于 PD 对姿势变化时自主反应影响的数据有限。
通过心率变异性的线性和非线性方法分析和比较两组（帕金森病组 [PDG] 和对照组 [CG]）的自主反应，评估两组在静息和主动倾斜试验时的自主反应、心率变异性和心肺参数。
共分析了 48 名参与者（PDG： = 25；73.40 ± 7.01 岁；CG： = 23；70.17 ± 8.20 岁）。在静息和主动倾斜试验时评估自主调节和心肺参数。为了评估自主调节，计算了线性指标（rMSSD、SDNN）和频率（LF、HF、LF/HF）域以及通过 Poincaré 图获得的非线性指标（SD1、SD2、SD1/SD2）。评估的心肺参数包括心率（HR）、收缩压（SBP）、舒张压（DBP）、外周血氧饱和度（SpO）和呼吸频率。
在静息状态下，PDG 的 rMSSD、SDNN、LF、HF、SD1、SD2 和 DBP 明显较低，SpO 较高。在测试期间，PD 组的 HR 和 SBP 发生变化，并且副交感神经反应降低，整体调节增加。Poincaré 图的定性分析表明，PDG 在静息和主动倾斜试验时 RR 间期的离散度降低。
与对照组相比，PD 患者在静息时表现出整体变异性和副交感神经调节降低，在进行主动倾斜试验时副交感神经反应降低，HR 调节受损。
