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Updated: Sep 10, 2025

Controlling Parkinson's Disease With Adaptive Deep Brain Stimulation
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Enhancing Cardiovascular Autonomic Regulation in Parkinson's Disease Through Non-Invasive Interventions.

Aastha Suthar1,2, Ajmal Zemmar3, Andrei Krassioukov4,5,6

  • 1Department of Neurological Surgery, University of Louisville, Louisville, KY 40202, USA.

Life (Basel, Switzerland)
|August 28, 2025
PubMed
Summary

Non-invasive therapies show promise for improving baroreflex sensitivity (BRS) and cardiovascular autonomic function in Parkinson's disease (PD). These methods offer a safer alternative to traditional treatments for managing symptoms like orthostatic hypotension.

Keywords:
Parkinson’s diseasebaroreflex sensitivitynon-invasive rehabilitation

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Area of Science:

  • Neurology
  • Cardiovascular Physiology
  • Autonomic Neuroscience

Background:

  • Parkinson's disease (PD) frequently causes autonomic dysfunction, particularly impaired baroreflex sensitivity (BRS), leading to orthostatic hypotension (OH).
  • Current treatments for PD-related autonomic dysfunction have limitations, necessitating exploration of safer, accessible alternatives.
  • Non-invasive interventions are being investigated to improve cardiovascular autonomic regulation in PD patients.

Purpose of the Study:

  • To systematically review non-invasive interventions for enhancing cardiovascular autonomic function in Parkinson's disease.
  • To evaluate the efficacy of somatosensory stimulation, exercise, thermal therapies, and positional strategies in improving BRS and related metrics.

Main Methods:

  • A systematic literature search was conducted across major scientific databases (PubMed, Embase, MEDLINE, Google Scholar, ScienceDirect, Web of Science) for studies published between January 2014 and December 2024.
  • Eight original studies involving 205 participants were included for the analysis of cardiac sympathovagal balance.
  • Interventions evaluated included various non-invasive modalities targeting autonomic function.

Main Results:

  • Five studies reported significant increases in baroreflex sensitivity (BRS) post-intervention.
  • Favorable shifts in heart rate variability (HRV) and the low-frequency/high-frequency (LF/HF) ratio were commonly observed.
  • Systolic blood pressure (SBP) decreased by an average of 5%, with some benefits lasting up to 24 hours.

Conclusions:

  • Non-invasive neuromodulation techniques show potential for enhancing BRS and cardiovascular regulation in Parkinson's disease.
  • Despite small sample sizes and varied protocols, findings suggest these methods can improve autonomic function.
  • Future research should focus on standardized, higher-intensity, or combined protocols with longer follow-up to achieve clinically meaningful improvements in PD patients.