Parkinson hastalığında erken parasempatik disfonksiyon: bilgi-teorik analizden elde edilen bilgiler.

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IntroductionParasympathetic nervous system (PNS) dysfunction in Parkinson's disease (PD) has been frequently evaluated using heart rate variability (HRV) analysis in the time and frequency domains. Findings across studies have been inconsistent, limiting a unified understanding of early autonomic impairment.MethodsIn this study, we applied both conventional and advanced analytical methods to evaluate cardiovascular PNS function in the early-stage PD patients. Sixteen individuals with PD (ResultsEarly-stage PD patients exhibited signs of parasympathetic impairment, particularly during orthostatic stress. HRV analysis showed reduced HF power during head-up tilt, while causal BRS was significantly lower across all protocol phases in the PD group. PID analysis further demonstrated a significant reduction in baroreflex-mediated mechanism of RespHRV during head-up tilt in PD patients compared with healthy controls, indicating early dysfunction of the cardiac chronotropic baroreflex. This impairment was more pronounced in the group with gastrointestinal issues (with the presence of constipation).DiscussionThese findings support the α-Synuclein Origin site and Connectome model, which proposes that PD patients whose neurodegeneration originates in the peripheral autonomic nervous system are characterized by early and more severe autonomic dysfunction.

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