Dysautonomia in Parkinson's disease: relationship to motor disability

Disturbances of autonomic nervous system functions are common in patients with Parkinson's disease (PD) and may develop as a result of pathology in centers of autonomic regulation such as the hypothalamus, brainstem, and sympathetic ganglia. We examined the relationship between the degree of motor disability, as determined from the Hoehn and Yahr scale (1967), and the presence of pandysautonomia, as determined by the assessment of noninvasive cardiovascular reflexes, in 29 unmedicated PD patients (mean age: 72.0 years, SD = 8.9). In addition, we investigated the relationship of pandysautonomia to CT scan measures of cerebral atrophy and to the presence or absence of pineal calcification. Nine patients (31.0%) were found to have pandysautonomia with deficits in both sympathetic and parasympathetic cardiovascular functions. Pandysautonomia was statistically related only to the degree of motor disability (p < .01). These findings demonstrate a significant association between motor disability and objective impairment of central cardiovascular functions in PD.