Heart rate variability and Parkinson's disease severity

Heart rate variability (HRV) decrease in Parkinson's disease (PD) could only be a consequence of reduce motor activity besides of being a marker of cardiovascular dysautonomia. Under continuously recorded and standardised motor activity, we studied thirty patients compared to controls in 3 PD stages: group I: less than 2 year-evolution, slight impaired without L-dopa; group II: mildly impaired with L-dopa; group III: advanced PD with motor complications. No difference was observed between group I and controls. The diurnal low frequency power (LF) and the ratio of LF/high frequency (HF) power decreased in groups II and III. The nocturnal vagal indicators: HF power and pNN50 were decreased in group III. Those parameters were correlated with Off-drug-motor handicap, suggesting an evolutive HRV decrease with disease severity but not with On-drug-motor activity. The low LF despite the higher motor activity in group III, due to dyskinesias, suggested a defective cardiovascular up-regulation.