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The Effect of Dysautonomia on Motor, Behavioral, and Cognitive Fluctuations in Parkinson's Disease

Year: 2024

Type: article

Abstract: BACKGROUND: Motor and nonmotor fluctuations adversely impact the quality of life in Parkinson's disease (PD). Dysautonomia, a feature frequently associated with PD and a possible adverse effect of dopaminergic therapy, may be comorbid with fluctuations. OBJECTIVE: We sought to evaluate the effect of dysautonomia on motor and nonmotor fluctuations in PD. METHODS: Two hundred subjects with PD were evaluated in both on and off dopamine states to assess changes in symptoms related to dopaminergic fluctuations. Multivariable logistic regression was performed to assess the association of dysautonomia with motor, cognitive, and psychiatric worsening from on to off states with adjustment for disease duration, levodopa equivalent daily dosage (LEDD), and dopamine-agonist LEDD. RESULTS: Subjects with dysautonomia had greater odds of clinically meaningful change in motor features (odds ratio [OR]: 3.0), cognition (OR: 3.4), and anxiety (OR: 4.3) compared to those without dysautonomia. CONCLUSIONS: Dysautonomia may be a contributory mechanism behind fluctuations in PD. The exact nature of this relationship deserves further evaluation. © 2024 International Parkinson and Movement Disorder Society.

Source: Movement Disorders

DOI: 10.1002/mds.30044

Authors: Abhimanyu Mahajan, Christopher B. Morrow, Joseph Seemiller, Kelly A. Mills, Gregory M. Pontone

Institutions: University of Cincinnati, Johns Hopkins University, Johns Hopkins Medicine, University of Florida Health, University of Florida

Language: English

Topic: Parkinson's Disease Mechanisms and Treatments

Subfield: Neurology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: green