Heart rate variability in Parkinson's disease patients treated with tolcapone

Following the introduction of tolcapone, a potent, reversible Catechol-O-methyltransferase (COMT) inhibitor, it has been possible to optimise the management of Parkinson's disease (PD) patients in chronic Levodopa (L-dopa) therapy. The interaction between tolcapone and the endogenous metabolism of catecholamines points to a possible influence on autonomic cardiovascular function. Cardiovascular reflexes have been analysed in a group of seven PD patients (four males, three females; mean age 69.7 years, mean disease duration 14.1 years) by means of the heart rate variability (HRV) method using a continuous 24-h ECG (ECGD), before and after six months of treatment with tolcapone (in addition to L-dopa). We have observed no statistically significant differences in HRV parameters, nor any changes in the incidence of hyper-kinetic and hypokinetic arrhythmias, which suggest that autonomic cardiovascular function in PD patients is not influenced by six months of treatment with tolcapone. (C) 2000 Elsevier Science Ltd. All rights reserved.