94% of researchers rate our articles as excellent or good
Learn more about the work of our research integrity team to safeguard the quality of each article we publish.
Find out more
ORIGINAL RESEARCH article
Front. Netw. Physiol.
Sec. Networks in the Cardiovascular System
Volume 5 - 2025 | doi: 10.3389/fnetp.2025.1543838
This article is part of the Research TopicWearable Technology: The New Ornament of Network PhysiologyView all 4 articles
Wearable Multimodal Sensing for Quantifying the Cardiovascular Autonomic Effects of Levodopa in Parkinsonism
Provisionally accepted- 1School of Electrical and Computer Engineering, College of Engineering, Georgia Institute of Technology, Atlanta, Georgia, United States
- 2Wallace H. Coulter Department of Biomedical Engineering, College of Engineering, Georgia Institute of Technology, Atlanta, Georgia, United States
- 3Department of Neurology, School of Medicine, Emory University, Atlanta, Georgia, United States
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Levodopa is the most common therapy to reduce motor symptoms of parkinsonism. However, levodopa has potential to exacerbate cardiovascular autonomic (CVA) dysfunction that may co-occur in patients. Heart rate variability (HRV) is the most common method for assessing CVA function, but broader monitoring of CVA function and levodopa effects is typically limited to clinical settings and symptom reporting, which fail to capture its holistic nature. In this study, we evaluated the feasibility of a multimodal wearable chest patch for monitoring changes in CVA function during clinical and 24-hour ambulatory (at home) conditions in 14 patients: 11 with Parkinson's disease (PD) and 3 with multiple system atrophy (MSA). In-clinic data were analyzed to examine the effects of orally administered levodopa on CVA function using a pre (OFF) and 60-minute (ON) post-exposure protocol. Wearable-derived physiological markers related to the electrical and mechanical activity of the heart alongside vascular function were extracted. Preejection period (PEP) and ratio of PEP to left ventricular ejection time index (LVETi) increased significantly (p<0.05) following levodopa, indicating a decrease in cardiac contractility. We further explored dose-response relationships and how CVA responses differed between participants with orthostatic hypotension (OH) from those without OH. Heart rate variability, specifically root-meansquare-of-successive-differences (RMSSD), following levodopa decreased significantly more in participants with OH (n=7) compared to those without (no-OH, n=7). The results suggest that the wearable patch's measures are sensitive to CVA dynamics and provide exploratory insights into levodopa's potential role in inducing a negative inotropic effect and exacerbating CVA dysfunction. This work encourages further evaluation of these wearable-derived physiomarkers for quantifying CVA and informing individualized care of individuals with parkinsonism.
Keywords: Wearable sensing, Parkinson's disease, autonomic dysfunction, cardiovascular monitoring, Multiple System Atrophy, parkinsonism, Levodopa, ambulatory monitoring
Received: 11 Dec 2024; Accepted: 10 Apr 2025.
Copyright: © 2025 Berkebile, Inan and Beach. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: John Alan Berkebile, School of Electrical and Computer Engineering, College of Engineering, Georgia Institute of Technology, Atlanta, 30332, Georgia, United States
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.