BackgroundMotor 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.ObjectiveWe sought to evaluate the effect of dysautonomia on motor and nonmotor fluctuations in PD.MethodsTwo 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.ResultsSubjects 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.ConclusionsDysautonomia 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.

中文翻译：

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自主神经功能障碍对帕金森病运动、行为和认知波动的影响


背景运动和非运动波动对帕金森病 （PD） 的生活质量产生不利影响。自主神经功能障碍是经常与 PD 相关的特征，也是多巴胺能治疗的可能不良反应，可能与波动共病。目的我们试图评估自主神经功能障碍对 PD 运动和非运动波动的影响。方法对 200 名 PD 受试者在开启和关闭多巴胺状态下进行评估，以评估与多巴胺能波动相关的症状变化。进行多变量 logistic 回归以评估自主神经功能障碍与运动、认知和精神从开到关状态恶化的相关性，并调整病程、左旋多巴等效日剂量 （LEDD） 和多巴胺激动剂 LEDD。结果与没有自主神经功能障碍的受试者相比，自主神经功能障碍的受试者在运动特征 （比值比 [OR]： 3.0） 、认知 （OR： 3.4） 和焦虑 （OR： 4.3） 方面发生临床意义变化的几率更大。结论自主神经功能障碍可能是 PD 波动背后的一个促成机制。这种关系的确切性质值得进一步评估。© 2024 年国际帕金森和运动障碍协会。