The Association of Heart Rate Variability with Parkinsonian Motor Symptom Duration

PURPOSE: Impaired cardiovascular autonomic regulation is a non-motor symptom of Parkinson's disease (PD) and may increase long-term morbidity. This study applied frequency-domain analysis of heart rate variability (HRV) to understand the progression of sympathetic and parasympathetic cardiac regulation in patients with PD. MATERIALS AND METHODS: In this cross-sectional study, 21 male and 11 female Taiwanese patients with advanced PD and 32 healthy gender- and age-matched subjects were enrolled. To minimize artifacts due to subject motion, daytime electrocardiograms for 5 minutes were recorded in awake patients during levodopa-on periods and controls. Using fast Fourier transformation, heart rate variables were quantified into a high-frequency power component [0.15-0.45 Hz, considered to reflect vagal (parasympathetic) regulation], low-frequency power component (0.04-0.15 Hz, reflecting mixed sympathetic and parasympathetic regulation), and low-frequency power in normalized units (reflecting sympathetic regulation). The significance of between-group differences was analyzed using the paired t-test. Pearson correlation analysis and stepwise regression analysis were applied to assess the correlation of patient age, PD duration, and disease severity (represented by the Unified Parkinson's Disease Rating Scale) with each heart rate variables. RESULTS: Impaired HRV is significantly correlated with the duration of PD, but not with disease severity and patient age. Meanwhile, parasympathetic heart rate variable is more likely than sympathetic heart rate variable to be affected by PD. CONCLUSION: PD is more likely to affect cardiac parasympathetic regulation than sympathetic regulation by time and the heart rate variables have the association with Parkinsonian motor symptom duration.

Epilepsy surgery programs in Taiwan

Currently there are 3 epilepsy surgery programs in Taiwan, Taipei �Veterans General Hospital �or adults and children from 1987, �Lin�kou Cheng Gung �emorial Hospital �from 1988, and Hualien Tzu Chi �Medical Center �from 2��002��. To date, more than 8�00 patients ha�ve �been operated, including lesionectomy, callosotomy, hemispherectomy, deep brain stimulation and vagus nerve stimulation. The development of epilepsy surgery service was attributed to establishment of Taiwan Epilepsy Society in 1990, and availability of various modern techniques to determine the lesions, epileptogenic foci and cortical function.