O065 Autonomic Dysregulation During Sleep in Parkinsonian Spectrum Disorders

INTRODUCTION: Symptoms associated with autonomic nervous system dysfunction are common to patients with neurodegenerative disorders (NDD) resulting from the accumulation of α-synuclein in the neurons and glial cells. In this study we investigate whether a novel biomarker, the autonomic activation index, can discriminate these potentially affected NDD groups. METHODS: After ethics review and with informed consent, patients with Lewy body disease (DLB/PDD: n=20%), Alzheimer’s disease dementia (AD: n=27), Parkinson disease (PD: n=14), mild cognitive impairment (MCI: n=37), isolated REM sleep behavior disorder (iRBD: n=15) and a control group (CG: n=58) were studied with the Sleep Profiler. AAI was based on a 6 BPM increase in pulse rate compared to the previous/subsequent 10th second. Between-group comparisons were assessed with Mann-Whitney U and Chi-square tests. RESULTS: The AAI values for the DLB/PDD patients were decreased compared to the AD, MCI (both p<0.03), and CG (p<0.0005), while the PD was less than AD and MCI (both < 0.05) and CG (p<0.002). The proportions of cases with abnormal AAI values (<10 events/h) was greatest in DLB/PDD patients, and greater than in ADem (p<0.02), MCI (p<0.02) and CG (p<0.0001), while AAI in PD and iRBD was greater than in CG (p<0.007 and 0.05 respectively). CONCLUSIONS: These findings suggest that the AAI can be used to objectively confirm subjective complaints of autonomic dysfunction symptoms in patients with synucleinopathies. Longitudinal studies are needed determine factors that influence changes in the AAI.