HRV in PD

It is well known that the autonomic nervous system (ANS) is dysregulated in Parkinson's. This inability to regulate the automatic parts of our nervous system (blood pressure, heart rate, body's response to stress or environmental changes in temperature) causes a wide variety of symptoms in PD.

Join us for a discussion about autonomic function, rehab, and HRV as a Parkinson's biomarker.

28 Feb 2025 - 12 pm PT


Patient Experience

There is evidence that low HRV scores are associated with greater Non-Motor Symptom Severity scores. Let's explore whether scores can be raised in PD, and whether or not that might result in improvement of non-motor symptoms.

Researcher Experience

High is good and low is bad, right? Well... mostly...

It's really not so simple.

The devices have limitations, the algorithms vary between studies, and there are different types of HRV

HRV Biofeedback

Meditation, mindfulness, breathing exercises, humming, singing, chanting, vibrating, ... How does one learn how to improve their autonomic function?

What is Heart Rate Variability (HRV)?

HRV Measures Autonomic Nervous System (ANS) Function
  • HRV is the variation in time between heartbeats, controlled by the sympathetic (fight-or-flight) and parasympathetic (rest-and-digest) nervous systems.
  • Higher HRV indicates better autonomic flexibility and overall health.

HRV is Often Reduced in Parkinson’s Disease

  • People with PD commonly have lower HRV, reflecting autonomic dysfunction, particularly reduced parasympathetic (vagal) activity.
  • This contributes to symptoms like orthostatic hypotension, fatigue, and poor cardiovascular regulation.

HRV Impairment in PD May Be Due to Both Pre- and Post-Synaptic Damage

  • Pre-synaptic: Loss of sympathetic nerve terminals that release norepinephrine.
  • Post-synaptic: Impaired receptor function in the heart and blood vessels, making HRV less responsive to interventions.

HRV Can Be Improved with Targeted Interventions

  • Exercise, breathing techniques, vagus nerve stimulation, and mindfulness practices have been shown to enhance HRV in PD.
  • Improvement may be slower or less pronounced than in non-PD individuals but remains clinically meaningful.

HRV is a Potential Biomarker for Disease Progression and Autonomic Health

  • Lower HRV in PD is linked to worse motor and non-motor symptoms, cognitive decline, and increased mortality risk.
  • Tracking HRV over time could help assess disease progression and response to lifestyle interventions.

Dr. Laurie K Mischley

Dr. Mischley has spent the past two decades studying the unique nutritional requirements of people with Parkinsonism and working to find better ways to measure, monitor, predict, and prevent PD.

Her academic training is in naturopathic medicine (ND), nutrition (BS, PhD), and epidemiology (MPH). She created the PRO-PD outcome measure, built the Parkinson Symptom Tracking App (www.pd-symptoms.com), has trained dogs to detect the scent of parkinism in ear wax (ParK-9.com), is lead investigator of the MVP-Study.com, and is founder of the Parkinson Center for Pragmatic Research (CPR). She created Parkinson-School.com in 2020 as a way to empower patients, accelerate education and catalyze some long-overdue conversations.