Autonomic symptoms in early-stage Parkinson’s patients and their relationship with cognition and disease parameters

Aims: Autonomic dysfunction is a prevalent feature throughout various stages of the disease and can significantly exacerbate the overall impact of the condition. Moreover, it is linked to accelerated disease advances and diminished vitality rates in individuals with Parkinson’s disease (PD). The main goal of this study is to evaluate the prevalence of autonomic symptoms and cognitive findings and investigate their associations with disease-related factors in early-stage PD patients. Methods: A total of 49 individuals diagnosed with PD were enrolled in this study. Disease severity was assessed using the Unified Parkinson’s Disease Rating Scale (UPDRS), and the disease stage was determined through the modified Hoehn & Yahr Rating Scale (mHYRS). By the mH&Y scale, only individuals in the early stages (≤2.5) of the disease were included in this investigation. The evaluation of autonomic symptoms in PD was conducted using the Scales for Outcomes in Parkinson’s Disease for Autonomic Symptoms (SCOPA-AUT) scale. The cognitive functions of the patients were assessed utilizing the Turkish version of the Montreal Cognitive Assessment Scale (MOCA-TR). Results: The study included 44% (n=22) females and 56% (n=27) males as participants. The average age was 61.5±10.1 years. The mean SCOPA-AUT score was 18.9±9.36, with the most prevalent autonomic symptoms related to the gastrointestinal system. A positive correlation was shown with autonomic symptoms and disease stages (p=0.024, r=0.322). However, no significant relationship was found between autonomic symptoms, other disease parameters, and cognition. We observed a notable inverse correlation between the disease stage and cognitive status (p=0.003, r=-0.417). Conclusion: Our study concluded that autonomic dysfunctions manifest from the early stages of Parkinson’s disease and can intensify as the disease progresses. Identifying and addressing these dysfunctions at an early stage would play a pivotal role in lessening the overall impact of the disease.