{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T01:35:10Z","timestamp":1760060110517,"version":"build-2065373602"},"reference-count":47,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2025,8,5]],"date-time":"2025-08-05T00:00:00Z","timestamp":1754352000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000002","name":"The National Institutes of Health","doi-asserted-by":"publisher","award":["R01HL150581","R01HL168294"],"award-info":[{"award-number":["R01HL150581","R01HL168294"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Life"],"abstract":"<jats:p>Background: Parkinson\u2019s disease (PD) often involves autonomic dysfunction, most notably impaired baroreflex sensitivity (BRS), which disrupts cardiovascular homeostasis and contributes to orthostatic hypotension (OH). Pharmacological and invasive treatments, including deep brain stimulation, have yielded inconsistent benefits and carry procedural risks, highlighting the need for safer, more accessible alternatives. In this systematic review, we evaluated non-invasive interventions\u2014spanning somatosensory stimulation, exercise modalities, thermal therapies, and positional strategies\u2014aimed at improving cardiovascular autonomic function in PD. Methods: We searched PubMed, Embase, MEDLINE (Ovid), Google Scholar, ScienceDirect, and Web of Science for studies published between January 2014 and December 2024. Eight original studies (n = 8) including 205 participants met the inclusion criteria for analyzing cardiac sympathovagal balance. Results: Five studies demonstrated significant post-intervention increases in BRS. Most reported favorable shifts in heart rate variability (HRV) and favorable changes in the low-frequency\/high-frequency (LF\/HF) ratio. Across modalities, systolic blood pressure (SBP) decreased by an average of 5%, and some interventions produced benefits that persisted up to 24 h. Conclusion: Although sample sizes were small and protocols heterogeneous, the collective findings support the potential of non-invasive neuromodulation to enhance BRS and overall cardiovascular regulation in PD. Future research should focus on standardized, higher-intensity or combined protocols with longer follow-up periods to establish durable, clinically meaningful improvements in autonomic function and quality of life for people living with PD.<\/jats:p>","DOI":"10.3390\/life15081244","type":"journal-article","created":{"date-parts":[[2025,8,5]],"date-time":"2025-08-05T13:44:32Z","timestamp":1754401472000},"page":"1244","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Enhancing Cardiovascular Autonomic Regulation in Parkinson\u2019s Disease Through Non-Invasive Interventions"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3498-3183","authenticated-orcid":false,"given":"Aastha","family":"Suthar","sequence":"first","affiliation":[{"name":"Department of Neurological Surgery, University of Louisville, Louisville, KY 40202, USA"},{"name":"Kentucky Spinal Cord Injury Research Center, University of Louisville, Louisville, KY 40202, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1463-3338","authenticated-orcid":false,"given":"Ajmal","family":"Zemmar","sequence":"additional","affiliation":[{"name":"Department of Surgery, United States Department of Veteran Affairs, 800 Zorn Ave, Louisville, KY 40206, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0022-7972","authenticated-orcid":false,"given":"Andrei","family":"Krassioukov","sequence":"additional","affiliation":[{"name":"International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, BC V5Z 1M9, Canada"},{"name":"Division of Physical Medicine and Rehabilitation, Faculty of Medicine, University of British Columbia, Vancouver, BC V5Z 2G9, Canada"},{"name":"GF Strong Rehabilitation Centre, Vancouver Coastal Health, Vancouver, BC V5Z 2G9, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8067-7630","authenticated-orcid":false,"given":"Alexander","family":"Ovechkin","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Louisville, Louisville, KY 40202, USA"},{"name":"Kentucky Spinal Cord Injury Research Center, University of Louisville, Louisville, KY 40202, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,8,5]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"970","DOI":"10.1001\/jamaneurol.2017.1125","article-title":"Association of Autonomic Dysfunction with Disease Progression and Survival in Parkinson Disease","volume":"74","author":"Tur","year":"2017","journal-title":"JAMA Neurol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"435","DOI":"10.1016\/S0197-4580(01)00210-X","article-title":"Depressed baroreflex sensitivity in patients with Alzheimer\u2019s and Parkinson\u2019s disease","volume":"22","author":"Paprika","year":"2001","journal-title":"Neurobiol. 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