Baschieri F, Sambati L, Guaraldi P, et al. - Neurogenic orthostatic hypotension (NOH) was rare in this cohort of early Parkinson disease (PD). At first assessment, asymptomatic mild sympathetic impairment was noted, which progressed with disease evolution. The higher prevalence of OH in PD reported so far could be attributable to secondary OH.

• A cohort of 105 PD patients recruited within 3 years from motor onset was assessed prospectively.

• At baseline (T0) (mean age 61 ± 9 years, disease duration 19 ± 9 months), 4/105 (3.8%) patients had NOH, and 8/105 (7.6%) at T1 (after 16 months).

• Impaired cardiovascular reflex tests responses evaluating sympathetic function were seen in PD patients vs controls at T0, and progressive worsening was evident at T1.

• Orthostatic symptoms with low frequency were found in only 1 patient at T0 and 3 at T1 with NOH, while OH was absent at testing in most of the patients reporting these symptoms.