Cardiac autonomic nervous system evaluation in Parkinson disease and multisystem atrophy

A protocol for Cardiac Autonomic Nervous System Evaluation (CANSE) was used to quantify the degree of dysautonomia in Parkinson disease (PD) and Multisystem Atrophy (MSA) patients (pts). Methods: 14 pts, 12 with PD, 2 with MSA and 14 normal controls (NC) studied. Neurological derangement quantified with UPDR III and Hoehn/Yahr scales (HYS). CANSE performed according to the 5-tests Ewing Score (ES) [0-1/10 (normal), 2-4/10 (borderline), 5-10/10 (abnormal)] and with and Heart Rate Variability analysis (HRV), carried out in the time-domain (TD) and frequency-domain (FD), calculated in 5-minutes intervals during sleep and activity from 24h ECG Holter recordings. Results: only for HYS evidenced significantly higher value in MSA as compared with PD (p< 0.01). ES was higher in MSA (mean score 5.5) compared with PD (2.88), PD + diabetes (3.66) and NC (1.5). SDNN index and r-MSSD (p< 0.05) were abnormal in PD+MSA. Total Power, LF-HF components and LF/HF ratio were abnormal in PD/MSA. Higher ES and HRV abnormality correlated with neurological derangement. Conclusions: CANSE provides accurate assessment of ANS derangement in PD/MDA pts, useful to guide clinical and drugs management.