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Parasympathetic Dysfunction Prevails in GBA1-Associated Parkinson's Disease
Tiziana De Santis1,2, Antoniangela Cocco1,3, Paolo Castiglioni4,5
1Department of Neurology, IRCCS Humanitas Research Hospital, Rozzano, Italy.
Background:
The role played by sympathetic and parasympathetic autonomic branches in patients with Parkinson's disease carrying variants in the GBA1 gene (GBA-PD) is still elusive.
Objectives:
To characterize cardiovascular autonomic function in GBA-PD and I-PD patients with early and mid-stage disease.
Methods:
These assessments were performed: cardiovascular autonomic tests, analysis of heart rate and blood pressure variability, cardiac noradrenergic imaging. The frequency and severity of autonomic symptoms were comparatively assessed with the SCOPA-AUT questionnaire.
Results:
Compared to the I-PD cohort, GBA-PD patients displayed an increased burden of autonomic symptoms. Autonomic tests revealed worse parasympathetic scores in GBA-PD while sympathetic indexes and the degree of cardiac sympathetic binding were comparable in the two groups. Heart rate variability indexes also revealed lower vagal modulation in the GBA-PD group.
Conclusions:
The cardiovascular autonomic profile in GBA PD is characterized by a prominent cardiovagal dysfunction compared to I-PD.
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