{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T20:05:49Z","timestamp":1780085149236,"version":"3.54.0"},"reference-count":71,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2023,10,13]],"date-time":"2023-10-13T00:00:00Z","timestamp":1697155200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["movementdisorders.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Movement Disord Clin Pract"],"published-print":{"date-parts":[[2023,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Patients with Parkinson's disease (PD) and <jats:italic>GBA<\/jats:italic> gene mutations (GBA\u2010PD) develop nonmotor complications more frequently than noncarriers. However, an objective characterization of both cardiovascular and sudomotor autonomic dysfunction using extensive clinical and instrumental measures has never been provided so far. Survival is reduced in GBA\u2010PD regardless of age and dementia, suggesting that other hitherto unrecognized factors are involved.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To provide instrumental measures of pattern and severity of autonomic dysfunction in GBA\u2010PD and explore their correlation with other non\u2010motor symptoms and implications for clinical practice.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In this cross\u2010sectional study, 21 GBA\u2010PD and 24 matched PD noncarriers underwent extensive assessment of motor and non\u2010motor features, including neuropsychological testing. Cardiovascular autonomic function was explored through a comprehensive battery of indexes, including power spectral analysis of the R\u2010R intervals and blood pressure short\u2010term variability during resting state and active maneuvers. Dynamic Sweat Test was used to assess post\u2010ganglionic sudomotor dysfunction.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Despite minimal or absent clinical correlates, cardiovagal and sympathetic indexes, heart rate variability parameters and sudomotor postganglionic function were more severely impaired in GBA\u2010PD than noncarriers (overcoming relatively preserved compensatory peripheral sympathetic function), suggesting more prominent cardiac sympatho\u2010vagal demodulation, efferent baroreflex failure and peripheral sympathetic dysfunction in GBA\u2010PD. Cardiovascular dysautonomia showed marginal correlations with cognitive impairment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Compared to PD noncarriers, GBA\u2010PD display more severe instrumental autonomic abnormalities, which may be underestimated by purely clinical measures, despite their relevance on morbidity and mortality. This supports the necessity of implementing instrumental autonomic assessment in all GBA\u2010PD, regardless of clinically overt symptoms.<\/jats:p><\/jats:sec>","DOI":"10.1002\/mdc3.13892","type":"journal-article","created":{"date-parts":[[2023,9,23]],"date-time":"2023-09-23T02:58:59Z","timestamp":1695437939000},"page":"1620-1638","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Unraveling Autonomic Dysfunction in <scp>GBA<\/scp>\u2010Related Parkinson's Disease"],"prefix":"10.1002","volume":"10","author":[{"given":"Grazia","family":"Devigili","sequence":"first","affiliation":[{"name":"Fondazione IRCCS Istituto Neurologico Carlo Besta, Department of Clinical Neurosciences, Parkinson and Movement Disorders Unit  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulia","family":"Straccia","sequence":"additional","affiliation":[{"name":"Fondazione IRCCS Istituto Neurologico Carlo Besta, Department of Clinical Neurosciences, Parkinson and Movement Disorders Unit  Milan Italy"},{"name":"Neurology and Stroke Unit C.T.O. 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