Assessment of Autonomic Function in Iraqi Patients with Parkinson’s Disease

Background: Parkinson’s disease (PD) is a neurodegenerative disorder that is second to Alzheimer’s regarding its prevalence. It is characterized by motor and non-motor symptoms. The outcomes of the latter can be used to evaluate and depict prognoses of the quality of life in PD patients. Objectives: To evaluate the autonomic function patterns in PD patients in three settings using electromyography (EMG). Methods: The current study is a case-control study involving 40 PD patients and 40 healthy controls collected from Ghazi Al-Hariri Hospital (Baghdad, Iraq). R-R interval variability (RRIV) of each participant was estimated at rest (RRIVr), during deep breath (RRIVdb), and Valsalva maneuver (RRIVv). Results: The results showed a significant reduction in the RRIV values of PD patients compared to the control. The most significant reduction was observed in RRIVv value. Moreover, the values of RRIV were correlated positively in PD patients. Also, RRIVv has shown excellent sensitivity in the diagnosis of PD with 97% sensitivity and 90% specificity, which was better than RRIVr and RRIVdb. Conclusions: Thus, using RRIVv settings can reflect a very sensitive tool in the assessment of autonomic function for the diagnosis and prognosis of PD that can overwhelm the other RRIV settings for better management of PD patients.