Autonomic nervous system dysfunction in Parkinson’s disease patients

Abstract

Background: Parkinson’s disease (PD) PD ranks second among the common neurodegenerative disease next only to Alzheimer’s dementia. Autonomic symptoms in Parkinson’s disease is very common.  This study assesses the autonomic dysfunction in PD, their prevalence, type and severity in related to staging.Methods: The study was conducted in Rajiv Gandhi government general hospital, Institute of neurology Madras medical college between 2011 to 2013, 141 patients fulfilling the criteria of Parkinson’s disease brain bank society were included in the study. All the patients were clinically examined with special attention to history, clinical features and symptoms and signs of Autonomic dysfunction. The patients were graded using the Hoehn and Yahr staging system.Results: Among 141 patients, 118 (83.7%) had autonomic dysfunction. Among 87 males, 72 patients had ANS dysfunction and among 54 females, 46 patients had ANS dysfunction. Stage wise 39 patients of 53 patients (73.6%) belonging to Stage I; 37 of 44 (84.1%) belonging to Stage II; 26 of 28 (92.8%) belonging to Stage III and all patients belonging to Stage IV and V had ANS dysfunction.Conclusions: ANS dysfunction in Parkinson’s disease is a common problem and the prevalence of it is 82.75% in males and 85.2% in females and overall in 83.7% of patients. The prevalence of ANS dysfunction in Males and females increases as the Hoehn and Yahr stage increases as evidenced by 68.7% of males and 80.9% of females have ANS dysfunction in stage I, while 100% of males and females in stage IV and V have ANS dysfunction. Sexual dysfunction (84.7%) ranks first followed by gastrointestinal (56.9%), and thermoregulatory (51.3%) autonomic disturbances in males and urinary disturbances (78.3%), ranks first followed by thermoregulatory (65.2%), and cardiovascular disturbances (56.5%) in females.