Veldkamp Kars I, Schootemeijer Sabine, Joosten Hilde, Bloem Bastiaan R, Evers Luc J W, de Vries Nienke M
Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Department of Neurology, Center of Expertise for Parkinson and Movement Disorders, Nijmegen, the Netherlands.
Department of Sports Medicine, Canisius Wilhelmina Hospital, Nijmegen, the Netherlands.
Mov Disord Clin Pract. 2025 Nov;12(11):1882-1890. doi: 10.1002/mdc3.70172. Epub 2025 Jun 9.
Both autonomic dysfunction and low levels of physical activity could contribute to reduced cardiorespiratory fitness in people with Parkinson's disease (PD). However, the interrelationship between these concepts is not well understood.
Our aim was to gain more insight into autonomic dysfunction and physical activity in relation to cardiorespiratory fitness in PD.
We included 59 individuals with PD (37% women, mean age 65.1 years; mean disease duration 4.5 years; Hoehn and Yahr stage 1-3). All participants completed a cardiopulmonary exercise test (CPET). We examined the association between parameters assessed during a CPET (peak oxygen consumption [VO], maximum heart rate [HR], heart rate recovery at 1 and 3 mins [HR, HR]), autonomic dysfunction (Scales for Outcomes in Parkinson's disease-Autonomic dysfunction, SCOPA-AUT), and physical activity in daily life (step counts, measured using a smartphone for a period of 4 weeks). Using multivariable regression, we adjusted for age, sex, and beta blocker use.
Higher SCOPA-AUT was associated with lower HR (β = -0.72, 95% CI = [-1.40, -0.04], P = 0.040). Higher step counts were associated with higher HR (β = 3.21, 95% CI = [0.56, 5.86], P = 0.019), and with higher VO (β = 1.16, 95% CI = [0.10, 2.22], P = 0.032). No statistically significant associations were found between both SCOPA-AUT and step counts with HR.
Both autonomic dysfunction and physical activity are associated with a reduced cardiorespiratory response to exercise in PD, but affected different CPET parameters. Future studies should determine the responsiveness of these CPET parameters to change, in order to implement such parameters as endpoints in clinical trials.
自主神经功能障碍和低水平身体活动都可能导致帕金森病（PD）患者心肺适能下降。然而，这些概念之间的相互关系尚未得到充分理解。
我们的目的是更深入地了解与PD患者心肺适能相关的自主神经功能障碍和身体活动情况。
我们纳入了59例PD患者（37%为女性，平均年龄65.1岁；平均病程4.5年；Hoehn和Yahr分期为1 - 3期）。所有参与者均完成了心肺运动试验（CPET）。我们研究了CPET期间评估的参数（峰值耗氧量[VO]、最大心率[HR]、1分钟和3分钟时的心率恢复情况[HR，HR]）、自主神经功能障碍（帕金森病自主神经功能障碍结局量表，SCOPA - AUT）和日常生活身体活动（步数，使用智能手机测量4周）之间的关联。我们使用多变量回归对年龄、性别和β受体阻滞剂的使用情况进行了校正。
较高的SCOPA - AUT与较低的HR相关（β = -0.72，95%CI = [-1.40，-0.04]，P = 0.040）。较高的步数与较高的HR相关（β = 3.21，95%CI = [0.56，5.86]，P = 0.019），也与较高的VO相关（β = 1.16，95%CI = [0.10，2.22]，P = 0.032）。未发现SCOPA - AUT和步数与HR之间存在统计学上的显著关联。
自主神经功能障碍和身体活动均与PD患者运动时心肺反应降低有关，但影响不同的CPET参数。未来的研究应确定这些CPET参数对变化的反应性，以便在临床试验中采用这些参数作为终点指标。
