Autonomic dysfunction frequently occurs in the context of Parkinson disease ( PD ) and may precede onset of motor symptoms. Limited data exist on the prospective association of heart rate variability ( HRV ), a marker of autonomic function, with PD risk.
12,162 participants of the Atherosclerosis Risk in Communities study, a community-based cohort, without a diagnosis of Parkinson’s disease at baseline ( 1987–1989 ) and with available HRV data ( mean age = 54 years, 57% women ) were included.
A 2-minute electrocardiogram was used to measure HRV.
Incident Parkinson’s disease was identified through 2008 from multiple sources, and adjudicated.
During a mean follow-up of 18 years, investigators identified 78 incident Parkinson cases.
Lower values of the root mean square of successive differences in normal-to-normal R-R intervals ( rMSSD ) and standard deviation of normal-to-normal R-R intervals ( SDNN ), markers of parasympathetic activity and total variability, respectively, were associated with higher risk of Parkinson’s disease during follow-up.
In multivariate models, the hazard ratio ( 95% CI ) of Parkinson’s disease in the bottom quartiles of rMSSD and SDNN compared to the top quartiles were 2.1 ( 1.0–4.3 ) and 2.9 ( 1.4–6.1 ), respectively.
Other measures of cardiac autonomic function, including mean R-R interval and frequency-domain measurements, were not associated with Parkinson risk.
In this prospective cohort, decreased HRV was associated with an increased risk of Parkinson’s disease. Assessment of cardiac autonomic function may help identify individuals at risk for Parkinson’s disease. ( Xagena )
Alonso A et al, Ann Neurol 2015;77:877–883