Autonomic dysfunction (AutD) is common and debilitating in Parkinson’s disease (PD). Predictors of AutD are unclear, and data are limited on the biological relevance of AutD in PD. Here, we evaluated the baseline prevalence and 2-year longitudinal assessment of AutD in patients with de novo PD compared with healthy controls (HC). Moreover, we also assessed various variables that could predict longitudinal changes in AutD in early PD. Parkinson’s Progression Markers Initiative (PPMI) was utilized to evaluate untreated PD participants at baseline and HC. Autonomic function was assessed using the 25-item Scale for Outcomes in Parkinson’s Disease-Autonomic (SCOPA-AUT) score at baseline and 2 years. Clinical and biological variables were measured for their correlations with AuD for up to 2 years. Two hundred and ninety PD subjects and 170 HC were enrolled and followed for 2 years. SCOPA-AUT mean (SD) scores increased from baseline 8.49 ± 5.23 to 10.12 ± 5.77 at year 2 in PD subjects (p < 0.001) versus from 4.98 ± 3.34 to 5.03 ± 374 in HC (p = 0.496), with a significant difference between the groups (p < 0.001). Among them, 242 PD participants and 151 HC completed the SCOPA-AUT assessment, including sexual function. In the multivariate analysis, a higher baseline SCOPA-AUT score was associated with higher baseline MDS-UPDRS Part I scores (p < 0.001). Moreover, a longitudinal increase in autonomic function severity was associated with the white race (p = 0.010) at baseline. In contrast, there was no association with the CSF biomarkers. MDS-UPDRS Part I score may predict AuD in patients with early PD, which is correlated with nonmotor symptoms and race.

自主神经功能障碍 (AutD) 在帕金森病 (PD) 中很常见且使人衰弱。AutD 的预测因素尚不清楚，并且关于 AutD 在 PD 中的生物学相关性的数据有限。在这里，我们与健康对照 (HC) 相比，评估了新发 PD 患者 AutD 的基线患病率和 2 年纵向评估。此外，我们还评估了可以预测早期 PD 中 AutD 纵向变化的各种变量。帕金森病进展标记计划 (PPMI) 用于评估未经治疗的帕金森病参与者的基线和 HC。使用帕金森病自主神经结果 25 项量表 (SCOPA-AUT) 评分在基线和 2 年评估自主神经功能。测量临床和生物学变量与 AuD 的相关性长达 2 年。290 名 PD 受试者和 170 名 HC 被纳入并随访了 2 年。PD 受试者的 SCOPA-AUT 平均 (SD) 平均分 (SD) 从基线 8.49 ± 5.23 增加到第 2 年的 10.12 ± 5.77 ( p  < 0.001)，而 HC 受试者的 SCOPA-AUT 平均 (SD) 分数从 4.98 ± 3.34 增加到 5.03 ± 374 ( p  = 0.496)，具有显着差异组间 ( p  < 0.001)。其中，242名PD参与者和151名HC完成了SCOPA-AUT评估，包括性功能。在多变量分析中，较高的基线 SCOPA-AUT 评分与较高的基线 MDS-UPDRS 第 I 部分评分相关 ( p  < 0.001)。 此外，基线时自主神经功能严重程度的纵向增加与白种人相关（p = 0.010）。相反，与脑脊液生物标志物没有关联。MDS-UPDRS 第 I 部分评分可以预测早期 PD 患者的 AuD，这与非运动症状和种族相关。