Siche-Pantel Franziska, Mühlenberg Manfred, Buschfort Rüdiger, Michels Heinke, Jakobsmeyer Rasmus, Oesterschlink Julian, Reinsberger Claus
Department of Exercise and Health, Faculty of Science, Institute of Sports Medicine, Paderborn University, Warburger Str. 100, Paderborn, 33098, Germany.
Neurologic department, Gräfliche Kliniken, Marcus Klinik GmbH und Co. KG, Bad Driburg, 33014, Germany.
BMC Neurol. 2025 Jun 26;25(1):253. doi: 10.1186/s12883-025-04281-7.
BACKGROUND: Parkinson's Disease (PD) bears a variety of sex differences and is associated with cardiovascular dysregulation (CDR). Variation in the routinely assessed standard parameters heart rate (HR) and blood pressure (BP) seem not well understood within the frame of sex-specific developments under therapy. Parameters of heart rate variability (RMSSD) and electrodermal activity (meanEDA) may assist the understanding of underlying autonomic developments. This pilot study aims to describe sex-specific cardiovascular and autonomic responses to a multimodal inpatient rehabilitation program in patients with PD. METHODS: Forty-one PD patients (24 male, 17 female) participated in a stationary, multimodal therapy intervention (MTI). Before and after MTI, HR, BP, RMSSD, and meanEDA were assessed in supine baseline (5 min of rest before orthostasis) and during supine adaption to rest (5 min of rest after orthostasis). Differences between baseline and adaption to rest as well as differences over time of MTI were calculated using Wilcoxon test; sex differences using Mann-Whitney-U test. RESULTS: Before MTI, women's supine HR (p = .034*; d = .17) and BP (p = .015*, d = 0.4) were significantly higher during adaption to rest than during baseline. After MTI, women's supine HR (p = .020*; d = .84) and BP (p = .022*, d = 0.5) during adaption to rest had decreased significantly. Men's HR and BP remained constant and without differences between the supine conditions. RMSSD and meanEDA remained steady in both sexes. CONCLUSION: The sex-specific responsiveness to MTI supports the concept of sex-sensitive therapeutic management for cardiovascular symptoms in PD. In both sexes, peripheral cardiovascular outcomes appeared not attributable to corresponding outcomes in autonomic regulation. Further examination of autonomic parameters could provide a foundation for developing therapeutic approaches that address central nervous system mechanisms. The study was officially registered (08/2020). The data supporting the findings of this study are available under http://apps.who.int/trialsearch/ under trial number DRKS00022773.
背景：帕金森病（PD）存在多种性别差异，且与心血管调节功能障碍（CDR）相关。在治疗过程中，针对性别特异性发展情况，常规评估的标准参数心率（HR）和血压（BP）的变化似乎尚未得到充分理解。心率变异性（RMSSD）和皮肤电活动（平均EDA）参数可能有助于理解潜在的自主神经发展情况。这项初步研究旨在描述PD患者对多模式住院康复计划的性别特异性心血管和自主神经反应。 方法：41名PD患者（24名男性，17名女性）参与了一项固定的多模式治疗干预（MTI）。在MTI前后，分别在仰卧位基线（直立前休息5分钟）和仰卧位适应休息期间（直立后休息5分钟）评估HR、BP、RMSSD和平均EDA。使用Wilcoxon检验计算基线与适应休息之间的差异以及MTI随时间的差异；使用Mann-Whitney-U检验计算性别差异。 结果：在MTI之前，女性在适应休息期间的仰卧位HR（p = 0.034*；d = 0.17）和BP（p = 0.015*，d = 0.4）显著高于基线期间。在MTI之后，女性在适应休息期间的仰卧位HR（p = 0.020*；d = 0.84）和BP（p = 0.022*，d = 0.5）显著下降。男性的HR和BP保持不变，仰卧位条件之间无差异。RMSSD和平均EDA在两性中均保持稳定。 结论：对MTI的性别特异性反应支持了对PD心血管症状进行性别敏感治疗管理的概念。在两性中，外周心血管结果似乎与自主神经调节的相应结果无关。对自主神经参数的进一步研究可为开发针对中枢神经系统机制的治疗方法提供基础。该研究已正式注册（2020年8月）。支持本研究结果的数据可在http://apps.who.int/trialsearch/ 上获取，试验编号为DRKS00022773。
J Parkinsons Dis. 2025-4-29
Cochrane Database Syst Rev. 2018-2-6
Cochrane Database Syst Rev. 2016-3-31
Am J Physiol Regul Integr Comp Physiol. 2023-4-1
Trends Cardiovasc Med. 2023-11
Brain Sci. 2021-11-3
Front Physiol. 2021-3-19
Zotero 插件
