Diagnostic Testing For Autonomic Dysfunction In Parkinsons Disease

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Although simple questioning can identify the presence of autonomic symptoms and lead to initiation of treatment, diagnostic testing may be helpful in confirming the presence of autonomic involvement. Certain studies can also be useful for discriminating PD from multiple system atrophy (MSA), whereas other studies are not useful in this differential diagnosis.

TABLE 1 Autonomic Features of Parkinson's Disease


Orthostatic hypotension Decreased heart rate variability Decreased MIBG cardiac scintigraphy Cardiac arrhythmias Gastrointestinal

Impaired swallowing



Delayed gastric emptying Urinary bladder Frequency Urgency

Urge incontinence Nocturia Sexual dysfunction Decreased desire Decreased arousal Reduced attainment of orgasm Erectile dysfunction Sexual dissatisfaction Sweating abnormalities Hyperhidrosis Anhydrosis

Abbreviation: MIBG, [123I]metaiodobenzylguanidine.

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