Autonomic Function in Patients With Parkinson's Disease: From Rest to Exercise

Author: Jeann L Sabino-Carvalho1, James P Fisher2, Lauro C Vianna1,3
1 NeuroV̇ASQ̇ - Integrative Physiology Laboratory, Faculty of Physical Education, University of Brasília, Brasília, Brazil.
2 Manaaki Mānawa - The Centre for Heart Research, Department of Physiology, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand.
3 Graduate Program in Medical Sciences, Faculty of Medicine, University of Brasília, Brasília, Brazil.
Conference/Journal: Front Physiol
Date published: 2021 Mar 19
Other: Volume ID: 12 , Pages: 626640 , Special Notes: doi: 10.3389/fphys.2021.626640. , Word Count: 145

Parkinson's disease (PD) is a common neurodegenerative disorder classically characterized by symptoms of motor impairment (e.g., tremor and rigidity), but also presenting with important non-motor impairments. There is evidence for the reduced activity of both the parasympathetic and sympathetic limbs of the autonomic nervous system at rest in PD. Moreover, inappropriate autonomic adjustments accompany exercise, which can lead to inadequate hemodynamic responses, the failure to match the metabolic demands of working skeletal muscle and exercise intolerance. The underlying mechanisms remain unclear, but relevant alterations in several discrete central regions (e.g., dorsal motor nucleus of the vagus nerve, intermediolateral cell column) have been identified. Herein, we critically evaluate the clinically significant and complex associations between the autonomic dysfunction, fatigue and exercise capacity in PD.

Keywords: blood pressure; dorsal motor nucleus of the vagus nerve; exercise; parasympathetic activity; sympathetic activity.

PMID: 33815139 PMCID: PMC8017184 DOI: 10.3389/fphys.2021.626640