000162733 001__ 162733 000162733 005__ 20251017144614.0 000162733 0247_ $$2doi$$a10.1002/ana.70010 000162733 0248_ $$2sideral$$a145372 000162733 037__ $$aART-2025-145372 000162733 041__ $$aeng 000162733 100__ $$avan Duijvenboden, Stefan 000162733 245__ $$aHeart Rate Profiles During Exercise and Incident Parkinson's Disease 000162733 260__ $$c2025 000162733 5060_ $$aAccess copy available to the general public$$fUnrestricted 000162733 5203_ $$aObjective: To determine whether established heart rate parameters of exercise, related to cardiac autonomic function, are associated with incident Parkinson’s disease, independent of both clinical and autonomic prodromal features. Methods: A study of UK Biobank participants who performed a standardized bicycle exercise test (2009–2013), followed until November 2022, and analyzed in January 2024, was carried out. Heart rate increase from rest to exer- cise, and heart rate decrease from peak exercise to recovery were associated with incident Parkinson’s disease. Multivariable adjustment was performed both for clinical characteristics and for prodromal non-cardiac autonomic features. Results: A total of 69,288 eligible participants (men 48%, mean age 56.8 years [SD 8.2 years]) were followed for 12.5 years: among the 319 (0.5%) who developed Parkinson’s disease, recognized prodromal markers (constipation, bladder dysfunction) were more common at baseline. The median lag time to diagnosis was 9.3 years (interquartile range 4.4). Both heart rate increase (37.5 [SD 11.5] vs 40.8 [SD 12.4] b.p.m., p < 0.001) and recovery (23.4 [SD 8.8] vs. 27.8 [SD 10.3] b.p.m., p < 0.001) were significantly lower in incident cases compared with controls. Heart rate recovery was independently associated with incident Parkinson’s disease, whereas heart rate increase was not. Specifically, a blunted heart rate lowering during recovery was associated with a 30% higher risk of incident Parkinson’s disease (HR 1.3; 95% CI 1.1–1.4; p < 0.001 per 10 beats less recovery). Interpretation: Collectively, this suggests that cardiac autonomic involvement precedes clinically manifest Parkinson’s disease, and that heart rate recovery might serve as a quantitative prodromal marker. 000162733 540__ $$9info:eu-repo/semantics/openAccess$$aby$$uhttps://creativecommons.org/licenses/by/4.0/deed.es 000162733 655_4 $$ainfo:eu-repo/semantics/article$$vinfo:eu-repo/semantics/publishedVersion 000162733 700__ $$0(orcid)0000-0003-4130-5866$$aRamírez, Julia$$uUniversidad de Zaragoza 000162733 700__ $$aScheurink, Job 000162733 700__ $$aDarweesh, Sirwan K. L. 000162733 700__ $$aOrini, Michele 000162733 700__ $$aTinker, Andrew 000162733 700__ $$aMunroe, Patricia B. 000162733 700__ $$aThannhauser, Jos 000162733 700__ $$aEvers, Luc 000162733 700__ $$aIntHout, Joanna 000162733 700__ $$aLambiase, Pier D. 000162733 700__ $$aBloem, Bastiaan R. 000162733 700__ $$aDoherty, Aiden 000162733 700__ $$aBrouwer, Marc A. 000162733 7102_ $$15008$$2800$$aUniversidad de Zaragoza$$bDpto. Ingeniería Electrón.Com.$$cÁrea Teoría Señal y Comunicac. 000162733 773__ $$g(2025), [10 pp.]$$pAnn. neurol.$$tANNALS OF NEUROLOGY$$x0364-5134 000162733 8564_ $$s529748$$uhttps://zaguan.unizar.es/record/162733/files/texto_completo.pdf$$yVersión publicada 000162733 8564_ $$s2413150$$uhttps://zaguan.unizar.es/record/162733/files/texto_completo.jpg?subformat=icon$$xicon$$yVersión publicada 000162733 909CO $$ooai:zaguan.unizar.es:162733$$particulos$$pdriver 000162733 951__ $$a2025-10-17-14:18:24 000162733 980__ $$aARTICLE