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Autonomic Dysfunction Symptoms in Patients with PD

Neurology; ePub 2018 May 4; Dayan, Sklerov, et al

Patients with Parkinson disease (PD) with symptoms of autonomic dysfunction show disrupted thalamo-striato-hypothalamic functional connectivity independently of overall motor dysfunction, disease duration, age and cognitive function, a recent study found. These findings suggest that symptoms of autonomic dysfunction in PD are accompanied by central deficits in the neural circuits that regulate autonomic function and their interaction with the basal ganglia. Resting-state fMRI scans from patients with PD were analyzed, comparing patients with the highest (n=24) and lowest (n=28) quartile scores in a questionnaire assessing autonomic dysfunction in PD (Scales for Outcomes in Parkinson's Disease–Autonomic [SCOPA-AUT]), obtained from a larger pool of patients (n=93). Researchers found:

  • Relative to patients with PD with lower SCOPA-AUT scores, patients with higher scores displayed significantly reduced functional connectivity between the hypothalamus and the striatum (caudate, putamen) and thalamus.
  • The significant association between striato-thalamo-hypothalamic functional connectivity and SCOPA-AUT scores was retained after controlling for each patient's corresponding Movement Disorder Society Unified Parkinson's Disease Rating Scale scores, age, disease duration, and cognitive function.


Dayan E, Sklerov M, Brower N. Disrupted hypothalamic functional connectivity in patients with PD and autonomic dysfunction. [Published online ahead of print May 4, 2018]. Neurology. doi:10.1212/WNL.0000000000005641.