Heart rate variability shows different cardiovascular modulation in Parkinson's disease patients with tremor dominant subtype compared to those with akinetic rigid dominant subtype.

Parkinson's disease (PD) can present with different motor subtypes depending on the predominant symptoms (tremor or rigidity/bradykinesia). Slower disease progression and less cognitive decline are observed in tremor-dominant patients compared to those with akinetic-rigid subtype. Autonomic cardiovascular disorders have been described in parkinsonian patients, although the definite correlations with different subtypes of PD are not clear. In this context, heart rate variability (HRV) analysis represents a non-invasive and established tool in assessing cardiovascular autonomic modulation. We investigate cardiovascular autonomic modulation in PD patients with tremor dominant subtype in comparison to akinetic rigid dominant subtype subjects using HRV analysis. Twenty-eight PD patients (17 with tremor dominant subtype and 11 with akinetic rigid dominant subtype) were enrolled and compared to 17 age and sex-matched healthy controls. HRV was analyzed in time- and frequency-domains. Low-frequency (LF) values were significantly lower in the akinetic rigid dominant subtype than in the tremor dominant group [LF 41.4 ± 13.6 vs 55.5 ± 11.6 (p < 0.007)] indicating that the disease led to a more evident impairment of the baroreflex modulation of the autonomic outflow mediated by both sympathetic and parasympathetic systems in the first class of patients. These findings support the biological relevance of clinical subtypes supporting the idea of a different pathophysiological process between these subtypes. These differences also suggest that different subtypes may also result in different responses to therapy or in the possible development of cardiovascular side effects of dopaminergic drugs in these different populations.

Socio-Psychological and Design Features Related to Transport Choices: A Focus Group Research in the Metropolitan Area of Cagliari (Sardinia, Italy).

Due to the environmental and health impact of the private transport sector, social scientists have largely focused on psychosocial and contextual factors associated with people's choice over transport means. This study aims to contribute to this line of research by applying a user-centered approach, with the objective of taking into account the specific environmental and social context of the metropolitan area of Cagliari city (Sardinia, Italy). To accomplish this aim, four groups of people were matched according to their shared starting point: car users vs. public transport users (Study 1), and light-rail users vs. non-light-rail users (Study 2). Groups were interviewed using a focus group method. Participants were invited to discuss their everyday travel experiences and to exchange their ideas on different sustainable (e.g., bicycles and public transport) and less sustainable (i.e., private cars) means of transport. Both consolidated drivers/barriers in the field of environmental psychology (e.g., perceived behavioral control, social norms) and public transportation design features (e.g., lighting) have been investigated. Other than highlighting the importance of socio-psychological factors to promote more sustainable transport choices like in previous studies, the present research offers an insight into how these aspects and factors are shaped and experienced in the narratives of residents.