{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T04:05:20Z","timestamp":1792209920344,"version":"4.4.0"},"reference-count":57,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2024,1,4]],"date-time":"2024-01-04T00:00:00Z","timestamp":1704326400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Parkinson\u2019s Disease"],"published-print":{"date-parts":[[2024,1,23]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>An attenuated heart rate response to exercise, termed chronotropic incompetence, has been reported in Parkinson\u2019s disease (PD). Chronotropic incompetence may be a marker of autonomic dysfunction and a cause of exercise intolerance in early stages of PD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>\n                      To investigate the relationship between chronotropic incompetence, orthostatic blood pressure change (supine \u2013 standing), and exercise performance (maximal oxygen consumption, VO\n                      <jats:sub>2peak<\/jats:sub>\n                      ) in individuals with early PD within 5 years of diagnosis not on dopaminergic medications.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We performed secondary analyses of heart rate and blood pressure data from the Study in Parkinson\u2019s Disease of Exercise (SPARX).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      128 individuals were enrolled into SPARX (63.7\u00b19.3 years; 57.0% male, 0.4 years since diagnosis [median]). 103 individuals were not taking chronotropic medications, of which 90 had a normal maximal heart rate response to exercise testing (155.3\u00b114.0 bpm; PDnon-chrono) and 13 showed evidence of chronotropic incompetence (121.3\u00b111.3 bpm; PDchrono, p\u200a&lt;\u200a0.05). PDchrono had decreased VO\n                      <jats:sub>2peak<\/jats:sub>\n                      compared to PDnon-chrono (19.7\u00b14.5\u200amL\/kg\/min and 24.3\u00b15.8\u200amL\/kg\/min, respectively, p\u200a=\u200a0.027). There was a positive correlation between peak heart rate during exercise and the change in systolic blood pressure from supine to standing ( r\u200a=\u200a0.365, p\u200a&lt;\u200a0.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>\n                      A subgroup of individuals with early PD not on dopaminergic medication had chronotropic incompetence and decreased VO\n                      <jats:sub>2peak<\/jats:sub>\n                      , which may be related to autonomic dysfunction. Evaluation of both heart rate responses to incremental exercise and orthostatic vital signs may serve as biomarkers of early autonomic impairment and guide treatment. Further studies should investigate whether cardiovascular autonomic dysfunction affects the ability to exercise and whether exercise training improves autonomic dysfunction.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3233\/jpd-230006","type":"journal-article","created":{"date-parts":[[2024,1,5]],"date-time":"2024-01-05T10:47:04Z","timestamp":1704451624000},"page":"121-133","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":23,"title":["Chronotropic Incompetence During Exercise Testing as a Marker of Autonomic Dysfunction in Individuals with Early Parkinson\u2019s Disease"],"prefix":"10.1177","volume":"14","author":[{"given":"Garett","family":"Griffith","sequence":"first","affiliation":[{"name":"Department of Physical Therapy and Human Movement Sciences, Northwestern University, Chicago, IL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guillaume","family":"Lamotte","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Utah, Salt Lake City, UT, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niyati","family":"Mehta","sequence":"additional","affiliation":[{"name":"Department of Physical Therapy and Human Movement Sciences, Northwestern University, Chicago, IL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peng","family":"Fan","sequence":"additional","affiliation":[{"name":"Department of Physical Therapy and Human Movement Sciences, Northwestern University, Chicago, IL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juliana","family":"Nikolich","sequence":"additional","affiliation":[{"name":"Department of Physical Therapy and Human Movement Sciences, Northwestern University, Chicago, IL, 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USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"MacKenzie","family":"Dunlap","sequence":"additional","affiliation":[{"name":"Cleveland Clinic, Cleveland, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wendy M.","family":"Kohrt","sequence":"additional","affiliation":[{"name":"School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA"},{"name":"Eastern Colorado Veterans Affairs Geriatric Research, Education, and Clinical Center, Denver, CO, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cory L.","family":"Christiansen","sequence":"additional","affiliation":[{"name":"School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA"},{"name":"Eastern Colorado Veterans Affairs Geriatric Research, Education, and Clinical Center, Denver, CO, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward 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