The development of autonomic dysfunction is associated with a more rapid development of disease milestones and shorter survival in patients with Parkinson’s disease (PD), according to research published in JAMA Neurology.
A team led by BRC supported Dr Eduardo De Pablo-Fernandez reviewed the medical records of 100 donors with post-mortem confirmed PD from the Queen Square Brain Bank, enabling them to determine how quickly their illness had deteriorated and analyse information about their autonomic symptoms during life.
The team found that individuals with earlier autonomic dysfunction had more severe parkinsonian symptoms and reduced survival rate. They did not however have more widespread pathology in the brain when microscopic analysis of brain tissue was performed. The findings suggest poor prognosis may be directly related to complications of the autonomic symptoms and not necessarily associated with a more aggressive form of PD.
Dr De Pablo-Fernandez said: “Autonomic symptoms are the result of disruption of automatic body functions such as heart rate, blood pressure, bladder and bowel control and can include dizziness when standing up, constipation, urinary frequency, erectile dysfunction or excessive sweating. These symptoms can be common and troublesome for people with Parkinson’s disease, significantly affecting their quality of life. The results showed that autonomic dysfunction is not only responsible for common and disabling symptoms in people with PD, but also has an impact on the disease course and patients’ life expectancy.”
Autonomic symptoms are well recognised in other neurodegenerative conditions where they are associated with a poor prognosis. In PD, such symptoms have not been well characterised, specifically whether development of autonomic symptoms is associated with a rapid disease progression and reduced survival in PD.
Dr De Pablo-Fernandez said: “the fact that the poor prognosis might be a direct consequence of complications of the autonomic dysfunction means that earlier and optimal treatment of these symptoms could potentially improve life expectancy and prognosis in PD patients.”
