Cardiac autonomic denervation in Parkinson's disease is linked to REM sleep behavior disorder§

Authors

  • Ronald B. Postuma MD, MSc,

    1. Department of Neurology, McGill University, Montreal General Hospital, Montreal, Quebec, Canada
    2. Centre d'étude du sommeil et des rythmes biologiques, Hôpital du Sacré-Cœur, Montréal, Québec, Canada
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  • Jacques Montplaisir MD, PhD,

    1. Centre d'étude du sommeil et des rythmes biologiques, Hôpital du Sacré-Cœur, Montréal, Québec, Canada
    2. Department of Psychiatry, Université de Montréal, Quebec, Canada
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  • Paola Lanfranchi MD, MSc,

    1. Centre d'étude du sommeil et des rythmes biologiques, Hôpital du Sacré-Cœur, Montréal, Québec, Canada
    2. Department of Medicine, Division of Cardiology, Hôpital du Sacré-Coeur Montréal and Université de Montréal, Québec, Canada
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  • Hélène Blais BSc,

    1. Centre d'étude du sommeil et des rythmes biologiques, Hôpital du Sacré-Cœur, Montréal, Québec, Canada
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  • Sylvie Rompré,

    1. Centre d'étude du sommeil et des rythmes biologiques, Hôpital du Sacré-Cœur, Montréal, Québec, Canada
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  • Roberto Colombo BEng,

    1. Servizio di Bioingegneria, Fondazione Salvatore Maugeri, Veruno, Italy
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  • Jean-François Gagnon PhD

    Corresponding author
    1. Centre d'étude du sommeil et des rythmes biologiques, Hôpital du Sacré-Cœur, Montréal, Québec, Canada
    2. Department of Psychology, Université du Québec à Montréal, Québec, Canada
    • Centre d'étude du sommeil et des rythmes biologiques, Hôpital du Sacré-Cœur de Montréal, 5400 boul. Gouin ouest, Montréal, Québec, H4J 1C5, Canada
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  • Relevant conflicts of interest/financial disclosures: Nothing to report.

  • This study was supported by the Canadian Institutes of Health Research and by the Fonds de la recherche en santé du Québec.

  • §

    Full financial disclosures and author roles may be found in the online version of this article.

Abstract

Background:

Recent studies have suggested a close connection between autonomic dysfunction and rapid eye movement sleep behavior disorder, which differs in nature from other early-stage markers of Parkinson's disease. In this study we examined the relationship between rapid eye movement sleep behavior disorder and autonomic dysfunction in Parkinson's disease as measured by cardiac beat-to-beat variability.

Methods:

In 53 patients with Parkinson's disease and 36 controls, electrocardiographic trace from a polysomnogram was assessed for measures of beat-to-beat RR variability including RR-standard deviation and frequency domains (low- and high-frequency components). Results were compared between patients with Parkinson's disease and controls, and between patients with Parkinson's disease with and without rapid eye movement sleep behavior disorder.

Results:

On numerous cardiac autonomic measures, patients with Parkinson's disease showed clear abnormalities compared with controls. However, these abnormalities were confined only to those patients with associated rapid eye movement sleep behavior; those without were not different than controls.

Conclusions:

As with other clinical autonomic variables, cardiac autonomic denervation is predominantly associated not with Parkinson's disease itself, but with the presence of rapid eye movement sleep behavior disorder. © 2011 Movement Disorder Society

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