Autonomic Nervous System Dysfunction in Patients with Parkinson’s Disease

Abstract Background Despite significant advances in the treatment of motor symptoms in patients with PD over the past 20 years, autonomic and neuropsychiatric events, also known as non-motor symptoms, are increasingly at the forefront of the clinical picture of the disease. Among these, autonomic dysfunctions are important and frequently observed events. These include a wide range of gastrointestinal, urinary, cardiovascular, thermoregulatory and sexual problems. Autonomic symptoms occurring virtually in all PD patients at some stages of the disease aggravate it further. Hence the need to use different methods for their early detection and to use suitable therapy when possible. Instrumental and imaging tests require specialized equipment and laboratory conditions, testing methods are labor-consuming and expensive, and interpretation of results is not always unequivocal. Questionnaires to assess subjective feelings associated with dysfunction of the autonomic nervous system are relatively easy to use as a screening method for patients’ needs to be referred to a specialized examination of autonomic functions. Objective To investigate the characteristics and correlates of different autonomic symptoms in Egyptian patients with PD and to assess the vagus nerve structure using high resolution ultrasound, and its correlation to autonomic symptoms. Patients and Methods The study was carried out at Movement disorders clinic of neurology department at Ain Shams University Hospital to patients with Idiopathic Parkinson disease according to MDS diagnostic clinical having at least one non-motor symptom. Participants were selected as sample sizes of 60 according to those meeting the inclusion Criteria for participant: patients older than 18 years and meeting the MDS diagnostic clinical criteria with a written consent for approval. Results Our results show that, compared with a group of matched controls, patients with PD experience significant autonomic dysfunction across different scales as SCOPA-AUT scale, PDQ-39, and non-motor scale with a P-value of < 0.001 and no significance was shown regarding vagus nerve cross sectional area. Conclusion This study showed that autonomic symptoms was more prominent in PD cases as compared to controls however with no correlation to the vagus nerve cross-sectional area.