Relationship between cervical vagus nerve cross-sectional area and cardiovascular autonomic nerve dysfunction in Parkinson's disease patients
Objective To observe the variation of cervical vagus nerve cross-sectional area(CAS)in patients with Parkinson's disease(PD),and to investigate the relationship between CAS and cardiovascular autonomic nerve dysfunction.Methods Forty-five patients with PD(PD group)received Parkinson's Disease Rating Scale Ⅲ(UPDRS-Ⅲ)scoring and Hoehn-Yahr(H-Y)grading in Henan Provincial People's Hospital from October 2019 to October 2022.Another 45 healthy individuals who underwent health examination during the same period were as controls(control group).The autonomic nerve function was evaluated by Scale for Outcomes in Parkinson's Disease-Autonomic symptoms(SCOPA-AUT)in PD group on admission and in control group on the day of health examination to record cardiovascular SCOPA-AUT score,and cervical ultrasonography was done to measure the left and right cervical vagus nerve CASs.The 24-h Holter electrocardiography was performed to monitor the heart rate variability and to record the standard deviation normal R-R interval(SDNN),root mean square of successive R-R interval differences(rMSSD),high frequency power(HF)and low frequency power(LF).The gender,age,body mass index,SCOPA-AUT score,cardiovascular SCOPA-AUT score,cervical vagus nerve CAS,SDNN,rMSSD,HF and LF were compared between two groups.Pearson correlation method was used to analyze the correlations of left and right cervical vagus nerve CASs with PD disease course,UPDRS-Ⅲ score,H-Y grade,SCOPA-AUT score and cardiovascular SCOPA-AUT score,and the correlations of right cervical vagus nerve CAS with SDNN,rMSSD,HF and LF in PD patients.Results(1)The SCOPA-AUT score and cardiovascular SCOPA-AUT score were higher in PD group(16.22±5.21,3.40±1.68)than those in control group(3.12±1.78,1.05±0.77)(t=15.147,P＜0.001;t=8.496,P＜0.001),and there were no significant differences in the gender ratio,age and body mass index between two groups(P＞0.05).(2)The left and right cervical vagus nerve CASs were smaller in PD group[(2.77±0.66),(3.02±0.77)mm2]than those in control group[(3.37±0.65),(3.67±0.88)mm2](P＜0.01),and the CASs of right cervical vagus nerve were larger than those of left one in both groups(P＜0.05).(3)The SDNN,rMSSD and HF were lower in PD group[(131.63± 21.38)ms,(20.86±4.52)ms,(827.89±167.5)Hz]than those in control group[(142.98±19.95)ms,(28.40± 3.65)ms,(914.33±99.52)Hz](P＜0.05),and the LF showed no significant difference between two groups(P＞0.05).(4)The UPDRS-Ⅲ score and H-Y grade were 26.19±14.53 and 2.51±0.78 in PD patients.The CAS of the right cervical vagus nerve was negatively correlated with H-Y grade(r=-0.343,P=0.023),SCOPA-AUT score(r=-0.415,P=0.006)and cardiovascular COPA-AUT score(r=-0.448,P=0.002),and was positively correlated with rMSSD(r=0.318,P=0.040)and HF(r=0.409,P=0.006).Conclusions Bilateral cervical vagus nerve CASs decrease in PD patients.The smaller the right cervical vagus nerve CAS,the severer the cardiovascular autonomic nerve dysfunction.The right cervical vagus nerve CAS could be used as an indicator to quantify cardiovascular autonomic nerve dysfunction in PD patients.
NETL
NSTL
万方数据
维普
