Research overview
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Objective To determine whether established parameters of cardiac autonomic function are associated with incident Parkinson’s disease, independent of clinical characteristics, and established autonomic prodromal features. Methods Population-based cohort study of UK Biobank participants who performed a standardized bicycle exercise test (2009-2013), followed until November 2022, and analyzed in January 2024. Heart rate increase from rest to exercise, and the decrease in heart rate from peak exercise to recovery were extracted and associated with incident Parkinson’s disease. Associations were adjusted using multivariable models consisting of clinical characteristics only and combined with prodromal autonomic features. Results 69,288 eligible participants (male 48%, mean age 56.8 [SD 8.2]) were followed for 12.5 years (median; IQR 0.3): 319 (0.5%) developed Parkinson’s disease. Median lag time to diagnosis was 9.3 years (IQR 4.4). Both heart rate increase (37.5 [SD 11.5] vs 40.8 [SD 12.4] beats/min, p Interpretation These findings suggest that cardiac autonomic dysfunction precedes clinically manifest Parkinson’s disease, and that heart rate recovery might serve as a quantitative prodromal marker.
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