Au travers des données cognitives de la cohorte stéphanoise PROOF, l’objectif de ce travail de thèse a été de déterminer quelle pouvait être la valeur pronostique de plusieurs facteurs, entre autres psychosociaux et physiologiques, d’un maintien optimal du fonctionnement cognitif avec l’âge.Le premier axe de recherche de ce travail, a mis en évidence que 70% des 632 participants âgés de 67 ans à la première évaluation cognitive de l’étude PROOF, présentaient une stabilité de leur fonctionnement cognitif après 8 ans de suivi. Le principal facteur mis en cause dans le vieillissement cognitif de cette population, que nous avons qualifié de « réussi », était, pour ces participants, d’avoir un haut niveau d’implication dans des activités sociales.Le second axe de recherche de ce travail, a mis en évidence que la dégradation de la régulation autonomique, et non la présence de facteurs de risque cardiovasculaires classiques, avait un impact négatif sur le fonctionnement mnésique des participants. Confortant ces résultats, nous avons montré que les pathologies respiratoires liées au sommeil avaient un impact négatif sur le vieillissement cognitif normal, avec un impact délétère de la fragmentation autonomique nocturne sur l’évolution des capacités mnésiques. Une préservation de l’activité du Système Nerveux Autonome (SNA) pourrait donc être une clé d’un maintien optimal des capacités mnésiques au cours du vieillissement normal.Le troisième axe de recherche de ce travail, a mis en évidence que les plaintes, qu’elles soient cognitives ou liées à la qualité de sommeil, étaient stables au décours du vieillissement normal. Nous avons pu démontrer que ce n’est pas l’âge qui génère la plainte, mais la qualité de vie et l’état anxiodépressif des personnes qui les expriment. Ceci n’est pas sans nous rappeler que le sujet, son symptôme et son histoire sont autant de déterminants du vieillissement cognitif « réussi ». Le quatrième axe de recherche de ce travail, a enfin mis en exergue que la prise en compte de la richesse des interactions sociales menées tout au long de la vie était un élément déterminant du niveau de performances dans des tâches de cognition sociale de personnes agées de 78 ans, et ce, indépendamment de la nature du fonctionnement exécutif et du niveau socioculturel. En conclusion, le vieillissement cognitif « réussi » n’est pas uniquement une vision optimiste du bien vieillir, allant contre des stéréotypes négatifs sur une perte systématique des fonctions cognitives liée à l’âge. Il s’agit d’un concept multidimensionnel qu’il convient de bien cerner si l’on veut mettre en place des stratégies efficaces susceptibles d’intervenir sur le maintien des capacités cognitives avec l’âge. Ce travail de thèse a permis de mettre en évidence l’identification de quatre facteurs déterminant du vieillissement cognitif « réussi » (et pour lesquels une intervention est possible !) qui sont : 1) le maintien des activités sociales tout au long de sa vie ; 2) la préservation d’un bon équilibre du système sympathique-parasympathique ; 3) l’absence de pathologies respiratoires liés au sommeil ; 4) la stabilité des plaintes (sommeil, cognition) exprimées avec l’âge. / The aim of this thesis was to examine cognitive performances of a large French cohort study of elderlies, i.e. the Saint Etienne PROOF-Siempre cohort, in order to assess among several factors which of them could play a prognostic role on a successful cognitive aging including physiological and psychosocial factors. In order to assess these key factors we developped several research axes frequently examining the long-term changes.The first axis of the research consider the overtime evolution of cognitive function in this population. We found that 70% of the 632 participants 67 yrs old at their inclusion in the study with or without sleep related breathing disorders had stable cognitive data 8-yr later. In this sample that we defined as having a successful cognitive aging, the predictive factor was the "high level of social activities" without any contribution of the demographic data, the hypoxemic load or classical vascular and metabolic factors.The second axis of the research we examined the influence of the autonomic nervous system activity of cognitive performances. In a sample of 916 older people, we found that a parameter reflecting the parasympathetic arm of the ANS, the baroreceptor sensitivity, affect when it was found altered the memory function without interference of other cardiovascular risk factor. These results were confirmed in a 8-yr assessment on 425 subjects of the previous sample in whom again a alteration of baroreceptor sensitity affect the long-term changes on memory function with contribution of the other examined factors. This would suggest that autonomic nervous system may also influence the memory changes with aging and assuring a more successful cognitive aging.The third axis of the research was to define how subjective cognitive and sleep complaints remain stable across time and whether subjective estimation of sleep quality may affect the changes on the subjective cognitive complaints. We found again a stability of the subjective cognitive complaint without any interference of sleep quality and aging itself, the quality of life and the presence of anxiety and depression being the most important factors. The four axis of the research examined the possible effect of the degree of social interaction developed along lifetime on the social cognition. We found in group of 100 elderly aged 78 yrs that quality of social interactions in the life-span was the key factor implicated in late social cognitive skills in the elderly without any effect of the executive function status nor the educational and intellectual level.In conclusion, we have demonstrated that in contrast to the most common recognized of a systematic loss of cognitive functions related to age healthy elderlies may have a successful cognitive aging. The "successful" cognitive aging is a multidimensional concept that should clearly identify if one wants to adopt effective strategies to maintain cognitive abilities with age. The different aspects examined in this thesis have highlighted the identification of four determinants of a "successful" cognitive aging: 1) the maintenance of social activities throughout the life; 2) the preservation of a sympathetic-parasympathetic balance of the autonomic nervous system; 3) the lack of sleep-disordered breathing; and 4) the stability of sleep and cognitive complaints generally reported in older population. The application of those strategies may help to prevent the cognitive decline in older populations.

O aumento da osmolaridade plasmática é conhecido como hiperosmolaridade e é resultado do aumento do aporte de sódio ou, da diminuição do volume plasmático de água. Trata-se de um desafio orgânico capaz de iniciar uma série de respostas neuro-hormonais que incluem a liberação de vasopressina e aumento da atividade simpática, com consequente elevação da pressão arterial. Descrever o papel do sistema nervoso autonômico no desenvolvimento da hipertensão arterial secundária a ingestão de sódio é essencial para elucidar os mecanismos envolvidos na gênese desta patologia. Neste sentido, o RVLM é um importante alvo de estudos, dado seu envolvidos na regulação da atividade simpática, via projeções para a CIML. O RVLM possui um grupo neuronal denominado C1 caracterizado pela presença da enzima PNMT; a ativação destes neurônios já foi descrita em resposta a diversos desafios orgânicos tais como hipóxia, dor, hemorragia, inflamação, hipotensão e hipoglicemia. Sendo a hiperosmolaridade um desequilíbrio da homeostase propusemos investigar a possível participação dos neurônios adrenérgicos do grupamento C1 sobre a hipertensão secundária ao desafio hiperosmótico desencadeado pela ingestão crônica de solução de 2% cloreto de sódio (salina hipertônica de NaCl 2%) por 7 dias. Nossos resultados nos permitem concluir que: 1) a injeção de anti-D&betaH-saporina na região do RVLM causou a depleção de neurônios TH+ nas regiões C1 e A5; 2) A depleção dos neurônios TH+ não alterou o comportamento de ingestão de sódio e, tampouco os valores de hematócrito e osmolaridade plasmática resultados da exposição ao hiperosmótico durante 7 dias, comparado aos animais controle; 3) A lesão prévia dos neurônios do C1 e A5 inibe o desenvolvimento da hipertensão secundária ao estímulo hiperosmótico por ingestão de NaCl 2%. Além disso, propusemos também estudar como estariam as respostas cardiovasculares e de controle hidroeletrolítico em indivíduos normotensos e previamente hipertensos frente a diferentes intensidades de estímulo hiperosmótico desencadeado pela ingesta de salina hipertônica de NaCl 2%. Os resultados demonstraram que 1) a ingestão de sódio desencadeia uma elevação da pressão arterial de maior magnitude nos SHR, quando comparado aos animais Wistar; 2) que não parece estar envolvida com diferenças no balanço hidroeletrolítico, uma vez que observou-se repostas similares entre as duas linhagens; 3) houve ainda, um aumento da expressão do RNAm para neuropeptídeo vasopressina (VP) no núcleo paraventricular do hipotálamo (PVN) tanto em Wistar quanto em SHR decorrente da ingestão de NaCl 2% durante 7 dias. Até o presente momento nossos resultados permitem duas considerações acerca dos mecanismos envolvidos nas repostas geradas frente desafios da osmolaridade: 1) os neurônios TH+ e, potencialmente do grupamento C1, estão envolvidos no desenvolvimento da hipertensão arterial em situações de desafio crônico da osmolaridade; 2) em animais hipertensos (SHR) o estímulo hiperosmótico gera uma elevação da pressão arterial de maior magnitude em comparação aos animais normotensos, fato que sugerimos envolver mecanismos de controle neural da pressão arterial, uma vez que não se observou alterações significativas nos parâmetros hidroeletrolítico e função renal entre as duas linhagens. / Plasma osmolarity increases is known as hyperosmolarity and it is a consequence of high sodium intake or decrease of water plasma content. It is an organic imbalance that elicits neurohormonal responses including release of vasopressin and increased in sympathetic activity, with consequent elevation of blood pressure. To describe the role of the autonomic nervous system in the development of sodium induced hypertension is critical to elucidate the mechanisms involved in the genesis of this pathology. In this sense, the RVLM is an important target, given its involved in the regulation of sympathetic activity, via CIML projections. The RVLM has a neuronal group known as C1 that present the PNMT enzyme; the activation of these neurons has already been described in response to several organic challenges such as hypoxia, pain, hemorrhage, inflammation, hypotension and hypoglycemia. Since hyperosmolarity is an homeostasis imbalance, we propose to investigate the role of adrenergic C1 neurons on sodium induced hypertension, triggered by the chronic ingestion of NaCl2% solution during 7 days. Our results allow us to conclude that: 1) the anti-D&betaH-saporin injection in the RVLM led to a depletion of TH+ neurons in the C1 and A5 regions; 2) Depletion of TH + neurons did not alter the sodium intake behavior, hematocrit and plasma osmolality values result from 7 days NaCl 2% exposure, compared to control animals; 3) Depletion of TH+ in C1 and A5 regions inhibits the development of sodium induced hypertension . In addition, we also proposed to investigate the cardiovascular and hydroelectrolytic responses elicits in normotensive and hypertensive rats, in response to different intensities of hyperosmotic stimulation triggered by the ingestion of hypertonic saline of NaCl 2%. The results demonstrated that: 1) the increase in blood pressure triggers by NaCl 2% intake is higher in SHR when compared to Wistar animals; 2) that does not appear to be involved with differences in hydroelectrolyte balance, since similar responses were observed between the two strains; 3) there was also an increase in mRNA expression for neuropeptide vasopressin (VP) in the paraventricular nucleus of the hypothalamus (PVN) in both strains, Wistar and SHR, in consequence of 7 days NaCl 2% intake. Our results allow two considerations about the mechanisms involved in the responses elicits by osmolarity challenges: 1) TH+ neurons and, potentially C1 neurons, are involved in the development sodium induced hypertension and; 2) in SHRs the hyperosmotic stimulus generates a higher blood pressure increase in comparison to normotensive animals, which seems to be associated with sympathoexcitatory components, since no significant alterations were observed in the hydroelectrolytic parameters and renal function between the two strains.

Orientador: Vitor Engrácia Valenti / Resumo: INTRODUÇÃO: Estudos com diferentes pesos ao nascer (PN) têm demonstrado alterações no sistema nervoso autônomo (SNA) e em alguns casos, demonstrado que estas alterações persistem até a vida adulta, podendo até ser um indicador de risco de doença cardiovascular na vida adulta. OBJETIVO: Analisar se diferentes faixas de pesos ao nascer estão relacionados com o sistema nervoso autônomo. MÉTODOS: I) Desenvolvimento de pesquisa da recuperação parassimpática da frequência cardíaca (FC) após atividade física aeróbia na esteira em mulheres adultas com peso ao nascer dentro da normalidade; e II) Estruturação de uma Revisão Sistemática que abordassem estes dois temas, em qualquer faixa de PN. RESULTADOS: I) Mulheres com menor peso ideal ao nascer apresentaram recuperação parassimpática da FC mais lenta do que as com maior peso dentro desta faixa; II) Nove publicações resultaram que uma alteração no PN, seja extremo, muito baixo, baixo ou elevado, pode causar algum impacto no SNA na vida adulta. CONCLUSÃO: O peso ao nascer pode ter influência negativa no sistema nervoso autônomo, causando disfunção autonômica e aumentando a possibilidade de risco de doenças cardiovasculares na vida adulta. / Mestre

Heart rate varies constantly as a consequence of activity in the sympathetic and parasympathetic autonomic nervous systems (SNS and PNS). In short-term recordings, heart rate variability (HRV) is mostly related to the inhibitory activity of the vagal nerves, which are part of the PNS. HRV is lower when under stress as well as in several illnesses and psychiatric conditions. Decreased HRV is also related to cardiac disease, which is the leading cause of death worldwide. Autonomic imbalance, measured as HRV, is suggested as a mediator between psychosocial distress and cardiovascular disease. The aim of the present thesis was to investigate the connection between HRV and psychosocial distress, including psychiatric problems (studies I and II), and lifestyle factors (study III). In study I, additional physiological measures sensitive to autonomic activity and results from a continuous attention test were investigated in parallel with HRV. In studies II and III the participants were adolescents. The results show that HRV is lower in women with stress-related fatigue and adolescent girls with a psychiatric diagnosis compared to healthy control groups. However, these groups did not exhibit an increase in physiological measures of SNS origin, which supports the assumption that the observed hyperarousal is related to decreased vagal activity rather than increased SNS activity. Women with stress-related fatigue made more impulsive errors and had a “risky” response style in the continuous attention test. There was a negative correlation between test performance and HRV. Decreased vagal activity is thus associated with deficient behavioural inhibition. In study III, HRV in a group of healthy adolescent boys and girls was positively associated with physical activity but not with other lifestyle measures. Even at young age HRV is a sensitive marker of autonomic imbalance resulting from psychosocial stress. Future longitudinal research will show whether HRV can be used for early identification of people at risk of cardiovascular disease and whether such interventions will lower the risk of cardiac morbidity.

Thesis (MSc. (Human Physiology, Faculty of Health Sciences))--University of Pretoria, 2008. / Summary in English. Includes bibliographical references.

Thesis (Ph. D.)--University of Oklahoma. / Includes bibliographical references (leaves 148-162).

Atrial fibrillation is the most prevalent form of cardiac arrhythmia. Studies in animal modelshave provided important insights into arrhythmia mechanisms. However, to date, we do not dispose ofanimal models of spontaneous atrial arrhythmia.Thus, we aimed to develop a model of spontaneous atrial arrhythmia in rats and to assesspathophysiological mechanisms of these arrhythmias by using a multidisciplinary approach. We alsoaimed to assess the presence and the extent of inflammation and endothelial dysfunction, incriminatedin atrial fibrillation-related complications such as stroke, in atrial fibrillation patients.The animal study describes the first animal model of spontaneous atrial arrhythmias. We alsoprovide evidence that multiple mechanisms participate in arrhythmia occurrence in this model,particularly autonomic imbalance with relative vagal hyperactivity, left atrial endocardial fibrosis, anddecreased left atrial expression of the Pitx2 gene. In our clinical study, we found high levels ofvascular endothelial growth factor and von Willebrand factor in atrial fibrillation patients compared tosinus rhythm controls. These results suggest specific thromboembolic risk patterns according to theclinical form of arrhythmia and highlight a parallel evolution of atrial fibrillation and endothelialdysfunction. These results add new insights into the understanding of atrial arrhythmias. This new animalmodel could facilitate studies of pathophysiological mechanisms involved in atrial arrhythmias andallow assessment of efficacy and toxicity of therapeutic agents in a setting that faithfully reproducesthe clinical presentation of the arrhythmia

The potential to track changes in training status and fitness levels of especially team sport participants by making use of more time efficient and accessible methods such as heart rate variability (HRV) and heart rate recovery (HRR) cannot be overlooked and needs to be considered. However, studies that have investigated this aspect in team sport participants are scarce. It is against this background that the main objectives of this study were firstly, to determine the relationships between HRV and HRR as well as the fitness levels of a cohort of university-level rugby players. The second objective was to determine the validity of the BioForce Heart Rate Variability System to determine the HRV of a cohort of university-level rugby players. Twenty-four university-level rugby players (age: 20.1 ± 0.41 years; body stature: 182.7 ± 6.2 cm; body mass: 89.7 ± 12.7 kg) of a South African university’s Rugby Institute participated in the first part of the study. During the test day players’ fasting baseline HRV (baseline HRV) values were taken. This was followed by the measurement of the post-breakfast HRV (Pre-Yo-Yo IR1 HRV). Players were then required to perform the Yo-Yo Intermittent Recovery Test Level 1 (Yo-Yo IR1) while they were fitted with a portable Cosmed K4b2 gas analyser apparatus and a Fix Polar Heart Rate Transmitter Belt. After completion of the test, HRR was taken on 1 and 3 minutes and followed by the measurement of HRV (Post-Yo-Yo IR1 HRV). For the second part of the study a group of twenty u/21 university-level rugby players (age: 20.06 ± 0.40 years; body stature: 181.8 ± 5.5 cm; body mass: 91.1 ± 10.7 kg) of a South African university’s Rugby Institute were recruited to participate in this study. HRV was measured simultaneously by the Actiheart monitor system as well as the BioForce Heart Rate Variability System over three times periods: during the morning in a fasting state just after players had woken up (baseline); in the morning just after the players ate breakfast (pre-anaerobic); after completion of a high-intensity anaerobic training session (post-anaerobic) and after completion of a 20 min recovery session (post-recovery). Significant correlations (p ≤ 0.05) were found between Pre-Yo-Yo IR1 HRV and heart rate (HR) at the respiratory compensation point (RCP-HR (bpm)) (r = -0.468) as well as oxygen uptake at the RCP (RCP- 2max VO (% of 2max VO )) (r = 0.476), respectively. A forward stepwise regression analysis showed that HR at ventilatory threshold 1 (VT1-HR (bpm)) contributed significantly (p ≤ 0.05) to the post-Yo-Yo IR1 HRV with a variance of 39.8%. Final Yo-Yo IR1 level also contributed significantly (p ≤ 0.05) to 3 minute post-Yo-Yo IR1 HRR with a variance of 16.5%. For the second part of the study the majority of significant relationships (p < 0.05) between the Actiheart and Bioforce obtained HRV results were observed for the post-recovery period (Mean RR, SDNN, RMSSD and Peak LF power), followed by the pre-anaerobic period (Mean R-R and SDNN) and the baseline period (LF:HF ratio). No significant relationships were observed between the HRV results of the two apparatuses during the post-anaerobic period. In conclusion, HRV and HRR may have the potential to act as affordable and easy measurement tools of team sport participants’ fitness levels. However, the study results suggested that the BioForce Heart Rate Variability System that is used to obtain team sport participants’ HRV is especially valid to determine HRV after recovery periods that follow hard training sessions. The results do however cast a shadow of doubt over the accuracy of this apparatus when used directly after hard training sessions. / MSc (Sport Science), North-West University, Potchefstroom Campus, 2014

Diss. (sammanfattning) Stockholm : Karolinska institutet, 2010.

Σκοπός της μελέτης : H διερεύνηση της επίδρασης του εν τω βάθει εγκεφαλικού ερεθισμού στον υποθαλάμιο πυρήνα (STN-DBS) στη λειτουργία του Αυτόνομου Νευρικού Συστήματος (ΑΝΣ) σε ασθενείς με Νόσο Πάρκινσον. Μέθοδος-Υλικό: Στη μελέτη έλαβαν μέρος 24 ασθενείς με ιδιοπαθή νόσο Πάρκινσον και 24 υγιείς μάρτυρες με πλήρη αντιστοιχία ως προς το φύλο και την ηλικία (μέσος όρος ηλικίας± σταθερά απόκλιση, 62.1±9.4 έτη). Η εκτίμηση των ασθενών έγινε 3 μέρες προ χειρουργείου ενώ ελάμβαναν κανονικά την αγωγή τους και 6 μήνες μετά την επέμβαση σε “on DBS/ on medication” κατάσταση. Όλοι οι ασθενείς συμπλήρωσαν ένα ερωτηματολόγιο σχετικά με τα συμπτώματα από το ΑΝΣ και υπεβλήθησαν σε μέτρηση της Αρτηριακής Πίεσης (ΑΠ) σε ύπτια θέση καθώς και στο 1ο και 3ο λεπτό μετά από απότομη έγερση από ύπτια σε όρθια θέση. Η νευροφυσιολογική εκτίμηση ασθενών και μαρτύρων περιελάμβανε: α. μέτρηση της συμπαθητικής δερματικής απάντησης (ΣΔΑ) από την παλάμη και το πέλμα με ηλεκτρικό ερεθισμό, β. μελέτη της διακύμανσης του καρδιακού ρυθμού (ΚΡ) ως προς τον χρόνο στις φάσεις της ήρεμης και βαθιάς αναπνοής (Rest RR IV και DB RR IV), κατά τη δοκιμασία Valsalva (Valsalva ratio) και κατά το Τilt-test (Tilt ratio). Με τη φασματική ανάλυση της πεντάλεπτης καταγραφής του ΚΡ σε ηρεμία που πραγματοποιήθηκε αργότερα υπολογίστηκαν οι παράμετροι LF, HF, LFnorm, HF norm, TP και ο λόγος LF/HF. Αποτελέσματα: Το 45,8% των ασθενών είχαν ορθοστατική υπόταση πριν και 12,5% μετά την επέμβαση, αλλά κατά τη στατιστική ανάλυση των μετρήσεων αυτών δεν πρόεκυψε σημαντική διαφορά μεταξύ των δύο ομάδων. Βρέθηκε σημαντική μείωση της συχνότητας των διαταραχών εφίδρωσης, της ακράτειας και της δυσκοιλιότητας στην μετεγχειρητική εκτίμηση (p<0,005). Στη ΣΔΑ μεταξύ των ασθενών πριν και μετά το STN-DBS δε βρέθηκαν στατιστικά σημαντικές διαφορές. Συνολικά 6 ασθενείς είχαν παθολογική ή απούσα ΣΔΑ πριν το χειρουργείο και 7 μετά (χ 2, p=0,114). Στις παραμέτρους Rest RR IV, DB RR IV, Valsalva ratio & Tilt ratio δε διαπιστώθηκε σημαντική διαφορά προ και μετά DBS (p>0.,050) και ήταν μάλιστα και προ- και μετεγχειρητικά μειωμένες στους ασθενείς απ’ ότι στους μάρτυρες (p <0,050). Σημαντική μείωση μόνο της παραμέτρου LF προέκυψε συγκρίνοντας τους ασθενείς πριν και μετά τη χειρουργική επέμβαση ενώ οι ασθενείς μετεγχειρητικά είχαν σημαντικά μειωμένες τιμές των LF, TP και LFnorm σε σχέση με τις αντίστοιχες τιμές των υγιών μαρτύρων. Δε βρέθηκε συσχέτιση (p >0,050) της κινητικής βελτίωσης λόγω DBS με τις ατομικές διαφορές των τιμών των παραμέτρων στον εκάστοτε ασθενή πριν και μετά το χειρουργείο. Συμπεράσματα: Είναι σαφής η θετική επίδραση του DBS στη μείωση της συχνότητας των διαταραχών εφίδρωσης, αλλά το χειρουργείο δεν έπαιξε αξιοσημείωτο ρόλο στις ΣΔΑ. Βρέθηκε μόνο μια μη στατιστικά σημαντική μείωση του ποσοστού των ασθενών με Ο.Υ., ενώ καμία επίδραση δεν υπήρξε στις παθολογικές τιμές του Κ.Ρ. των ασθενών. H φασματική ανάλυση του Καρδιακού Ρυθμού δεν έδειξε αλλαγή στην ισορροπία μεταξύ συμπαθητικής και παρασυμπαθητικής λειτουργίας λόγω DBS. Γενικό συμπέρασμα είναι ότι STN-DBS ωφελεί σημαντικά την κινητική βελτίωση, αλλά δεν έχει αξιόλογη, θετική ή αρνητική, επίδραση στη ρύθμιση της λειτουργίας του ΑΝΣ. / Purpose: To assess the impact of subthalamic nucleus (STN) deep brain stimulation (DBS) on the autonomic nervous system function in patients with advanced Parkinson’s disease (PD). Material- Methods: Twenty-four patients with idiopathic PD (mean age±SD, 62.1±9.4 years old) were examined 3 days before and 6 months after DBS, “on medication” state both times. Each examination session included registration of autonomic symptoms by means of a semi-structural questionnaire, blood pressure (BP) recording at supine position and at the first and third minute after sudden change from supine to standing position and a neurophysiological assessment. The neurophysiological examination included: a. recording of sympathetic skin response (SSR) from both palms and a sole, b. time domain analysis of RR interval variation during normal and deep breathing, during Valsalva manoeuvre and during tilt test. By off-line performed frequency domain analysis of heart rate variation the Total Power, the Low Frequency band, the High Frequency band and their normalized units were estimated. The neurophysiological measurements were compared to those of 24 healthy controls matched for age and sex. Results: Orthostatic hypotension was present in 45.8% of the patients preoperatively and 12.5% postoperatively, whereas statistical analysis showed no significant difference in BP measurements between pre- and post DBS studies. A statistical significant reduction in the frequency of autonomic symptoms such as constipation, sweating disturbances and urgency was established after implantation. In SSR measurements no change was found between patients before and after DBS. Six out of 24 patients has abnormal or absent SSR before surgery and 7 afterwards (χ 2, p =0.114). The values of time domain variables were both pre and postoperatively lower in patients than in controls. A significant reduction was found in LF band after the implantation. There was no correlation between individual, deep brain stimulation-related changes of motor function and corresponding neurophysiological measurements. Conclusions: The positive effect of STN-DBS on the sweating disturbances reported by patients is established, whereas no influence was found on SSR measurements. Subthalamic stimulation had no effect on the abnormal heart rate regulation of the patients, but a non significant reduction in orthostatic hypotension was noticed. Finally through spectral analysis no effect on the balance of sympathetic and parasympathetic function was found. Overall, despite its clear benefit on motor performance, STN-DBS had no considerable, positive or negative, impact on the autonomic regulation.