Electrocardiographic Changes in the Off-medication State in Parkinson’s Disease

Parkinson’s disease (PD) is a chronic, progressive, neurodegenerative disorder characterized by motor and non-motor manifestations. The male/female PD ratio is 3:2, with PD incidence varying between 10 and 15 in 100,000 people. PD prevalence increases with age, occurring in 1.5–2% of the population older than 65 years of age and in 3–5% of that older than 85 years of age. Patients with advanced PD develop ON and OFF periods. In the OFF period, patients exhibit non-motor signs, such as depression and anxiety, as well as symptoms associated with autonomic dysfunction. Cardiovascular dysfunction is common in PD. Autonomic dysfunction, in particular, can involve both the sympathetic and parasympathetic systems that control heart activity. The prevalence of cardiovascular autonomic dysfunction in PD patients is 20-30%, and it typically manifests itself in the advanced stages of the disease. The most frequently observed symptom of autonomic dysfunction in PD is orthostatic hypotension (OH), a fall in blood pressure of ≥ 20 mmHg systolic or 10 mmHg diastolic when moving from the supine to the standing position; OH occurs in 52% of PD patients. Frequency-domain analysis of heart rate (HR) changes can be used to assess the sympathetic and Acta Medica Mediterranea, 2015, 31: 735