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帕金森病患者在肌肉代谢反射激活开始时的心脏迷走神经再激活并未进一步受损。

Cardiac vagal reactivation at the onset of muscle Metaboreflex activation is not further impaired in patients with Parkinson's disease.

作者信息

Sabino-Carvalho Jeann L, Guerrero Rosa V, Teixeira André L, Brandão Pedro R P, Vianna Lauro C

机构信息

Division of Renal Medicine, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia; NeuroVASQ - Integrative Physiology Laboratory, Faculty of Physical Education, University of Brasília, Brasília, DF, Brazil.

NeuroVASQ - Integrative Physiology Laboratory, Faculty of Physical Education, University of Brasília, Brasília, DF, Brazil.

出版信息

Auton Neurosci. 2025 Aug;260:103311. doi: 10.1016/j.autneu.2025.103311. Epub 2025 Jun 17.

Abstract

Parkinson's disease (PD) is a common neurodegenerative disorder characterized by non-motor symptoms and marked altered sympathetic and parasympathetic activity. However, it is currently unclear if inappropriate autonomic adjustments are manifested during rapid parasympathetic adjustments that occur following cessation of exercise and at the onset of isolated post-exercise ischemia (PEI). Herein, we tested the hypothesis that, compared to older and young men, PD patients would show attenuated heart rate (HR) recovery at exercise cessation due to impaired cardiac vagal reactivation. Eleven PD patients (66 ± 9 yr), 9 age-matched controls (64 ± 7 yr), and 10 young controls (21 ± 1 yr) were studied. All participants performed 90-s of isometric handgrip at 40 % of maximal voluntary contraction, followed by 3-min of PEI. HR (electrocardiography) was continuously recorded. HR recovery was defined as the difference between HR at the end of the exercise and at the end of the first 30-s of PEI. HR variability (HRV) during the first 30-s of recovery was quantified. Following the cessation of exercise, the HR recovery was significantly lower in PD and age-matched controls compared to young controls (Δ-10 ± 5 vs. Δ-14 ± 6 vs. Δ-26 ± 8 beats.min - 1 at 30s; P < 0.001; respectively). compared to controls. HRV increased less post-exercise in PD and age-matched controls compared to young controls. In summary, PD patients and age-matched controls demonstrate blunted parasympathetic reactivation. However, contrary to our hypothesis, PD patients did not exhibit further attenuation in HR recovery compared to age-matched controls, suggesting that PD does not exacerbate vagal reactivation impairments beyond those associated with aging.

摘要

帕金森病(PD)是一种常见的神经退行性疾病,其特征为非运动症状以及交感神经和副交感神经活动显著改变。然而,目前尚不清楚在运动停止后以及孤立性运动后缺血(PEI)开始时发生的快速副交感神经调节过程中,是否会出现不适当的自主神经调节。在此,我们检验了这样一个假设:与老年男性和年轻男性相比,帕金森病患者由于心脏迷走神经再激活受损,在运动停止时心率(HR)恢复会减弱。我们研究了11名帕金森病患者(66±9岁)、9名年龄匹配的对照者(64±7岁)和10名年轻对照者(21±1岁)。所有参与者以最大自主收缩力的40%进行90秒的等长握力运动,随后进行3分钟的PEI。连续记录心率(心电图)。心率恢复定义为运动结束时与PEI最初30秒结束时的心率差值。对恢复最初30秒内的心率变异性(HRV)进行量化。运动停止后,帕金森病患者和年龄匹配的对照者的心率恢复显著低于年轻对照者(30秒时分别为Δ-10±5 vs. Δ-14±6 vs. Δ-26±8次·分钟-1;P<0.001)。与对照者相比,帕金森病患者和年龄匹配的对照者运动后HRV增加较少。总之,帕金森病患者和年龄匹配的对照者表现出副交感神经再激活减弱。然而,与我们的假设相反,与年龄匹配的对照者相比,帕金森病患者在心率恢复方面并未表现出进一步减弱,这表明帕金森病并不会使迷走神经再激活损伤超过与衰老相关的损伤。

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