{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T23:09:34Z","timestamp":1784070574731,"version":"3.55.0"},"reference-count":43,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T00:00:00Z","timestamp":1779148800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T00:00:00Z","timestamp":1784073600000},"content-version":"vor","delay-in-days":57,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J NeuroEngineering Rehabil"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Cardiac autonomic dysfunction is a prevalent yet underdiagnosed non-motor manifestation in Parkinson disease (PD), and difficult to monitor in daily life. Wrist-worn photoplethysmography (PPG) allows for continuous pulse rate monitoring, with potential to measure cardiac autonomic dysfunction in PD. However, motion artifacts pose significant challenges. We propose a two-step approach to account for PPG motion artifacts, and explore the association between pulse rate characteristics and cardiac autonomic dysfunction in PD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In 444 people with early PD, we used continuous wrist PPG and accelerometer data, collected during two weeks using a one research-grade device model (Verily Study Watch), with an average wear time of 22\u00a0h\/day. Step 1 filters low-quality segments based on PPG morphology using a logistic regression classifier. Step 2 removes remaining segments with periodic motion artifacts (e.g. introduced by tremor). Weekly aggregates were calculated for resting (daytime, nighttime) and maximum (daytime) pulse rates. We studied the effect of filtering on the pulse rate estimates and assessed the relationship between pulse rate aggregates and both subjective and objective autonomic dysfunction measures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Median proportion of high-quality PPG data was 29.2% [IQR: 24.0% to 35.9%] during the daytime, and 86.1% [IQR: 79.3% to 90.6%] during the night. Proportions of high-quality PPG data were similar across different rest tremor severity and dyskinesia scores. However, filtering out periodic motion artifacts (step 2) reduced overestimation of the maximum HR in persons with mild or severe rest tremor. More symptoms of autonomic dysfunction were associated with a lower maximum pulse rate(\u03b2:-0.17, 95% CI [-0.33, -0.00]), while resting pulse rate showed no association. No significant differences in pulse rate metrics were found between individuals with or without orthostatic hypotension.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>PPG-based heart rate estimation in PD improves when periodic motion artifacts are accommodated, representing an important step toward developing digital biomarkers of cardiac autonomic dysfunction. Maximum pulse rate in daily life only demonstrated a weak association with autonomic dysfunction, highlighting the need for more specific markers such as pulse rate variability.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12984-026-01994-9","type":"journal-article","created":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T22:35:41Z","timestamp":1779143741000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Heart rate monitoring using wrist photoplethysmography in Parkinson disease: feasibility and relation with autonomic dysfunction"],"prefix":"10.1186","volume":"23","author":[{"given":"Kars I.","family":"Veldkamp","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luc J. 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The longitudinal progression of autonomic dysfunction in Parkinson\u2019s disease: a 7-year study. 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All participants provided informed consent prior to enrollment.","order":1,"name":"Ethics","label":"Ethics approval and consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"All authors have read and approved the final manuscript, and consented to its publication.","order":2,"name":"Ethics","label":"Consent for publication","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Authors KCH, SS and LSL are currently employed by, and currently hold shares in, Verily Life Sciences, but declare no nonfinancial competing interests. Author BRB serves as the co-Editor in Chief for the Journal of Parkinson\u2019s disease, serves on the editorial board of Practical Neurology and Digital Biomarkers, has received fees from serving on the scientific advisory board for the Critical Path Institute, Gyenno Science, MedRhythms, UCB, Kyowa Kirin and Zambon (paid to the Institute), has received fees for speaking at conferences from AbbVie, Bial, Biogen, GE Healthcare, Oruen, Roche, UCB and Zambon (paid to the Institute), and has received research support from Biogen, Cure Parkinson\u2019s, Davis Phinney Foundation, Edmond J. Safra Foundation, Fred Foundation, Gatsby Foundation, Hersenstichting Nederland, Horizon 2020, IRLAB Therapeutics, Maag Lever Darm Stichting, Michael J Fox Foundation, Ministry of Agriculture, Ministry of Economic Affairs & Climate Policy, Ministry of Health, Welfare and Sport, Netherlands Organization for Scientific Research (ZonMw), Not Impossible, Parkinson Vereniging, Parkinson\u2019s Foundation, Parkinson\u2019s UK, Stichting Alkemade-Keuls, Stichting Parkinson NL, Stichting Woelse Waard, Health Holland \/ Topsector Life Sciences and Health, UCB, Verily Life Sciences, Roche and Zambon. Author BRB does not hold any stocks or stock options with any companies that are connected to Parkinson\u2019s disease or to any of his clinical or research activities. All other authors declare no competing interests.","order":3,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"217"}}