{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T15:55:49Z","timestamp":1787759749695,"version":"build-2784847793"},"reference-count":45,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,8,2]],"date-time":"2025-08-02T00:00:00Z","timestamp":1754092800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100010269","name":"Wellcome Trust","doi-asserted-by":"publisher","award":["223100\/Z\/21\/Z"],"award-info":[{"award-number":["223100\/Z\/21\/Z"]}],"id":[{"id":"10.13039\/100010269","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Annals of Neurology"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To determine whether established heart rate parameters of exercise, related to cardiac autonomic function, are associated with incident Parkinson's disease, independent of both clinical and autonomic prodromal features.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A study of UK Biobank participants who performed a standardized bicycle exercise test (2009\u20132013), followed until November 2022, and analyzed in January 2024, was carried out. Heart rate increase from rest to exercise, and heart rate decrease from peak exercise to recovery were associated with incident Parkinson's disease. Multivariable adjustment was performed both for clinical characteristics and for prodromal non\u2010cardiac autonomic features.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 69,288 eligible participants (men 48%, mean age 56.8\u2009years [SD 8.2\u2009years]) were followed for 12.5\u2009years: among the 319 (0.5%) who developed Parkinson's disease, recognized prodromal markers (constipation, bladder dysfunction) were more common at baseline. The median lag time to diagnosis was 9.3\u2009years (interquartile range 4.4). Both heart rate increase (37.5 [SD 11.5] vs 40.8 [SD 12.4] b.p.m.,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and recovery (23.4 [SD 8.8] vs. 27.8 [SD 10.3] b.p.m.,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) were significantly lower in incident cases compared with controls. Heart rate recovery was independently associated with incident Parkinson's disease, whereas heart rate increase was not. Specifically, a blunted heart rate lowering during recovery was associated with a 30% higher risk of incident Parkinson's disease (HR 1.3; 95% CI 1.1\u20131.4;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001 per 10 beats less recovery).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interpretation<\/jats:title>\n                    <jats:p>Collectively, this suggests that cardiac autonomic involvement precedes clinically manifest Parkinson's disease, and that heart rate recovery might serve as a quantitative prodromal marker. ANN NEUROL 2025;98:1004\u20131013<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ana.70010","type":"journal-article","created":{"date-parts":[[2025,8,2]],"date-time":"2025-08-02T09:53:46Z","timestamp":1754128426000},"page":"1004-1013","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Heart Rate Profiles During Exercise and Incident Parkinson's Disease"],"prefix":"10.1002","volume":"98","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8897-558X","authenticated-orcid":false,"given":"Stefan","family":"van Duijvenboden","sequence":"first","affiliation":[{"name":"Nuffield Department of Population Health University of Oxford  Oxford UK"},{"name":"Institute of Cardiovascular Science, UCL  London UK"},{"name":"Clinical Pharmacology and Precision Medicine, William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"Ram\u00edrez","sequence":"additional","affiliation":[{"name":"Clinical Pharmacology and Precision Medicine, William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London  London UK"},{"name":"Aragon Institute of Engineering Research, University of Zaragoza  Zaragoza Spain"},{"name":"Biomedical Research Networking Centre on Bioengineering, Biomaterials and Nanomedicine  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Job","family":"Scheurink","sequence":"additional","affiliation":[{"name":"Nuffield Department of Population Health University of Oxford  Oxford UK"},{"name":"Department of Cardiology Radboud University Medical Center  Nijmegen the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4361-4593","authenticated-orcid":false,"given":"Sirwan K. 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