Analysis of autonomic modulation of heart rate in patients with Parkinson's disease and elderly individuals submitted to game therapy training

2017 ◽  
Vol 18 (1) ◽  
pp. 20-25 ◽  
Author(s):  
Rodrigo Santiago Barbosa Rocha ◽  
Larissa Salgado De Oliveira Rocha ◽  
Elza Sara Maués Pena ◽  
Laiz Cristinna Ponce Caldas ◽  
Marlene Aparecida Moreno
2021 ◽  
Vol 79 (2) ◽  
pp. 114-121
Author(s):  
Mileide Cristina Stoco-Oliveira ◽  
Ana Laura Ricci-Vitor ◽  
Laís Manata Vanzella ◽  
Heloisa Balotari Valente ◽  
Vitor Eduardo dos Santos Silva ◽  
...  

ABSTRACT Background: Parkinson's disease (PD) produces autonomic changes, indicating lower parasympathetic modulation and global variability, but these changes need further studying regarding geometric methods. Objective: To investigate the autonomic modulation in individuals with PD using heart rate variability (HRV) indices obtained through geometric methods. Methods: This is a cross-sectional study that assessed 50 individuals, split into two groups: PD group (PDG; n=26; 75.36±5.21 years) and control group (CG; n=24; 75.36±5.21 years). We evaluated the autonomic modulation by measuring the heart rate beat-to-beat for 30 min with the individual in supine rest using a heart rate monitor and assessed geometric indices (RRtri, TINN, SD1, SD2, SD1/SD2 ratio, and qualitative analysis of the Poincaré plot). Results: Significant reductions were found in RRtri, TINN, SD1, and SD2 indices among PDG compared to CG. Regarding the SD1/SD2 ratio, no significant changes were detected between the groups. The Poincaré plot demonstrated that individuals with PD had lower beat-to-beat dispersion in RR intervals, in addition to greater long-term dispersion of RR intervals compared to CG. Conclusions: The results suggest a reduction in the parasympathetic autonomic modulation and global variability in individuals with PD compared to controls, regardless of sex, age, and body mass index.


2021 ◽  
Author(s):  
Lucas Shinoda ◽  
Laís Damasceno ◽  
Leandro Freitas ◽  
Sergio Cravo ◽  
Ruy Campos ◽  
...  

Abstract A classic method to evaluate autonomic dysfunction is through the evaluation of heart rate variability (HRV). HRV provides a series of coefficients, such as SDNN (Standard Deviation of n-n intervals) and RMSSD (Root Mean Square of Successive Differences), which have well-established physiological associations. However, using only electrocardiogram (ECG) signals, it is difficult to identify proper autonomic activity, and the standard techniques are not sensitive and robust enough to distinguish pure autonomic modulation in heart dynamics from cardiac dysfunctions. By using Poincaré mapping and Recurrence Quantification Analysis (RQA), we were able to identify and characterize stochasticity and chaoticity dynamics in ECG recordings, using them to describe autonomic and heart dynamics. By applying these nonlinear techniques in the ECG signals recorded from a set of Parkinson disease animal model (6-OHDA), we show they present less variability in long time epochs and more stochasticity in short-time epochs, in their autonomic dynamics, when compared with those of the sham group. These results indicate that PD (Parkinson’s Disease) animal models present more “rigid heart rate” associated with “trembling ECG” and bradycardia, which are direct expressions of Parkinsonian symptoms. We also compared the RQA factors calculated from the ECG of animal models using four computational ECG signals under different noise and autonomic modulatory conditions, emulating atrial fibrillation and QT-long syndrome. We concluded, from Poincaré Map and RQA techniques, that PD animal models are more correlated with atrial fibrillation, with high variation according to autonomic modulation. As the Abstract should be able stand independantly of the main text, please do not abbreviate terms used only once in the Abstract.


2021 ◽  
Vol 11 (8) ◽  
pp. 959
Author(s):  
Konstantin G. Heimrich ◽  
Thomas Lehmann ◽  
Peter Schlattmann ◽  
Tino Prell

Recent evidence suggests that the vagus nerve and autonomic dysfunction play an important role in the pathogenesis of Parkinson’s disease. Using heart rate variability analysis, the autonomic modulation of cardiac activity can be investigated. This meta-analysis aims to assess if analysis of heart rate variability may indicate decreased parasympathetic tone in patients with Parkinson’s disease. The MEDLINE, EMBASE and Cochrane Central databases were searched on 31 December 2020. Studies were included if they: (1) were published in English, (2) analyzed idiopathic Parkinson’s disease and healthy adult controls, and (3) reported at least one frequency- or time-domain heart rate variability analysis parameter, which represents parasympathetic regulation. We included 47 studies with 2772 subjects. Random-effects meta-analyses revealed significantly decreased effect sizes in Parkinson patients for the high-frequency spectral component (HFms2) and the short-term measurement of the root mean square of successive normal-to-normal interval differences (RMSSD). However, heterogeneity was high, and there was evidence for publication bias regarding HFms2. There is some evidence that a more advanced disease leads to an impaired parasympathetic regulation. In conclusion, short-term measurement of RMSSD is a reliable parameter to assess parasympathetically impaired cardiac modulation in Parkinson patients. The measurement should be performed with a predefined respiratory rate.


Author(s):  
Hélcio Kanegusuku ◽  
Gabriel Grizzo Cucato ◽  
Paulo Longano ◽  
Erika Okamoto ◽  
Maria Elisa Pimentel Piemonte ◽  
...  

AbstractParkinson’s disease patients frequently present cardiovascular dysfunction. Exercise with a self-selected intensity has emerged as a new strategy for exercise prescription aiming to increase exercise adherence. Thus, the current study evaluated the acute cardiovascular responses after a session of aerobic exercise at a traditional intensity and at a self-selected intensity in Parkinson’s disease patients. Twenty patients (≥ 50 years old, Hoehn & Yahr 1–3 stages) performed 3 experimental sessions in random order: Traditional session (cycle ergometer, 25 min, 50 rpm, 60–80% maximum heart rate); Self-selected intensity: (cycle ergometer, 25 min, 50 rpm with self-selected intensity); and Control session (resting for 25 min). Before and after 30 min of intervention, brachial and central blood pressure (auscultatory method and pulse wave analysis, respectively), cardiac autonomic modulation (heart rate variability), and arterial stiffness (pulse wave analysis) were evaluated. Brachial and central systolic and diastolic blood pressure, heart rate, and the augmentation index increased after the control session, whereas no changes were observed after the exercise sessions (P<0.01). Pulse wave velocity and cardiac autonomic modulation parameters did not change after the three interventions. In conclusion, a single session of traditional intensity or self-selected intensity exercises similarly blunted the increase in brachial and central blood pressure and the augmentation index compared to a non-exercise control session in Parkinson’s disease patients.


2018 ◽  
Vol 33 (3) ◽  
pp. 428-438 ◽  
Author(s):  
Marguerite Harvey ◽  
Kathryn L Weston ◽  
William K Gray ◽  
Ailish O’Callaghan ◽  
Lloyd L Oates ◽  
...  

Objectives: To investigate whether people with Parkinson’s disease can exercise at a high-intensity across a 12-week intervention and to assess the impact of the intervention on cardiorespiratory fitness. Design: This is a randomized, controlled, feasibility study with waiting list control. Assessors were blinded to group allocation. Setting: The intervention took place at an exercise centre and assessments at a district general hospital. Subjects: This study included 20 people with idiopathic Parkinson’s disease. Intervention: A total of 36 exercise sessions over 12 weeks, with each session lasting ~45 minutes, were conducted. Main measures: The main measures were maximal heart rates achieved during exercise, recruitment rate, attendance, drop-out, change in peak oxygen consumption, cardiac output, cognitive function and quality of life. The study was considered technically feasible if participants achieved ⩾85% of maximal heart rate during exercise. Results: There were 12 male and 8 female participants; they had a mean age of 68.5 years (standard deviation 6.825). Two participants were of Hoehn and Yahr stage I, 11 stage II and 7 stage III. In all, 17 participants completed the intervention. The median (interquartile range) proportion of repetitions delivered across the intervention which met our high-intensity criterion was 80% (67% to 84%). Mean peak heart rate was 88.8% of maximal. Peak oxygen consumption increased by 2.8 mL kg−1 min−1 in the intervention group and 1.5 mL kg−1 min−1 in the control group after 12 weeks of exercise. We estimate that a fully powered randomized controlled trial would require 30 participants per group. Conclusion: High-intensity interval exercise is feasible in people with Parkinson’s disease. Improvements in cardiorespiratory function are promising.


2020 ◽  
Vol 10 (s1) ◽  
pp. S21-S27
Author(s):  
Jay L. Alberts ◽  
Anson B. Rosenfeldt

Over the past two decades, aerobic exercise has emerged as a mainstream recommendation to aid in treating Parkinson’s disease (PD). Despite the acknowledgement of the benefits of exercise for people with PD (PwPD), frequently, exercise recommendations lack specificity in terms of frequency, intensity and duration. Additionally, conflating physical activity with exercise has contributed to providing vague exercise recommendations to PwPD. Therefore, the beneficial effects of exercise may not be fully realized in PwPD. Data provided by animal studies and select human trials indicate aerobic exercise may facilitate structural and functional changes in the brain. Recently, several large human clinical trials have been completed and collectively support the use of aerobic exercise, specifically high-intensity aerobic exercise, in improving PD motor symptoms. Data from these and other studies provide the basis to include aerobic exercise as an integral component in treating PD. Based on positive clinical findings and trials, it is advised that PwPD perform aerobic exercise in the following dose: 3x/week, 30–40-minute main exercise set, 60–80% of heart rate reserve or 70–85% of heart rate max. In lieu of heart rate, individuals can achieve an intensity of 14–17 on a 20-point RPE scale. Ongoing clinical trials, SPARX3 and CYCLE-II, have potential to further develop patient-specific exercise recommendations through prognostic modeling.


2002 ◽  
Vol 249 (11) ◽  
pp. 1535-1540 ◽  
Author(s):  
Ville Pursiainen ◽  
Tarja H. Haapaniemi ◽  
Juha T. Korpelainen ◽  
Heikki V. Huikuri ◽  
Kyösti A. Sotaniemi ◽  
...  

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