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CC BY 4.0 · Arq Neuropsiquiatr 2023; 81(01): 009-018
DOI: 10.1055/s-0042-1758862
Original Article

Is there a link between heart rate variability and cognitive decline? A cross-sectional study on patients with mild cognitive impairment and cognitively healthy controls

Existe uma ligação entre a variabilidade da frequência cardíaca e o declínio cognitivo? Um estudo transversal em pacientes com deficiência cognitiva leve e controles cognitivos saudáveis
Bernhard Grässler 
1   Otto von Guericke University, Institute of Sport Science, Magdeburg, Germany.
,
Milos Dordevic 
2   German Center for Neurodegenerative Diseases, Neuroprotection Research Group, Magdeburg, Germany.
3   Otto von Guericke University, Department of Neurology, Medical Faculty, Magdeburg, Germany.
4   University of Potsdam, Faculty of Health Sciences, Degenerative and Chronic Diseases Research Group, Movement, Potsdam, Germany.
,
Sabine Darius 
5   Otto von Guericke University, Faculty of Medicine, Department of Occupational Medicine, Magdeburg, Germany.
,
Fabian Herold 
2   German Center for Neurodegenerative Diseases, Neuroprotection Research Group, Magdeburg, Germany.
3   Otto von Guericke University, Department of Neurology, Medical Faculty, Magdeburg, Germany.
4   University of Potsdam, Faculty of Health Sciences, Degenerative and Chronic Diseases Research Group, Movement, Potsdam, Germany.
,
Giuseppe Forte 
6   Sapienza Università di Roma, Dipartimento di Psicologia, Rome, Italy.
7   IRCCS Fondazione Santa Lucia, Action and Body Lab, Rome, Italy.
,
Corinna Langhans 
1   Otto von Guericke University, Institute of Sport Science, Magdeburg, Germany.
,
Nicole Halfpaap 
1   Otto von Guericke University, Institute of Sport Science, Magdeburg, Germany.
,
Patrick Müller 
2   German Center for Neurodegenerative Diseases, Neuroprotection Research Group, Magdeburg, Germany.
3   Otto von Guericke University, Department of Neurology, Medical Faculty, Magdeburg, Germany.
8   Otto- von- Guericke University Magdeburg, Institute of Cognitive Neurology and Dementia Research, Magdeburg, Germany.
,
Wenzel Glanz 
9   German Research Group Neuroprotection Center for Neurodegenerative Diseases, Magdeburg, Germany.
,
Estélio Henrique Martin Dantas 
10   Universidade Federal do Estado do Rio de Janeiro, Programa de Pós- Graduação em Enfermagem e Biociências, Rio de Janeiro RJ, Brazil.
11   Universidade Tiradentes, Programa de Pós- Graduação em Saúde e Ambiente, Aracaju SE, Brazil.
,
Irina Böckelmann 
5   Otto von Guericke University, Faculty of Medicine, Department of Occupational Medicine, Magdeburg, Germany.
,
Notger Müller 
2   German Center for Neurodegenerative Diseases, Neuroprotection Research Group, Magdeburg, Germany.
3   Otto von Guericke University, Department of Neurology, Medical Faculty, Magdeburg, Germany.
4   University of Potsdam, Faculty of Health Sciences, Degenerative and Chronic Diseases Research Group, Movement, Potsdam, Germany.
12   Center Research Group Neuroprotection for Behavioral Brain Sciences, Magdeburg, Germany.
,
Anita Hökelmann 
1   Otto von Guericke University, Institute of Sport Science, Magdeburg, Germany.
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Abstract

Background Given that, up to date, there is no effective strategy to treat dementia, a timely start of interventions in a prodromal stage such as mild cognitive impairment (MCI) is considered an important option to lower the overall societal burden. Although autonomic functions have been related to cognitive performance, both aspects have rarely been studied simultaneously in MCI.

Objective The aim of the present study was to investigate cardiac autonomic control in older adults with and without MCI.

Methods Cardiac autonomic control was assessed by means of heart rate variability (HRV) at resting state and during cognitive tasks in 22 older adults with MCI and 29 healthy controls (HCs). Resting HRV measurement was performed for 5 minutes during a sitting position. Afterwards, participants performed three PC-based tasks to probe performance in executive functions and language abilities (i.e., Stroop, N-back, and a verbal fluency task).

Results Participants with MCI showed a significant reduction of HRV in the frequency-domain (high frequency power) and nonlinear indices (SD2, D2, and DFA1) during resting state compared to HCs. Older individuals with MCI exhibited decreases in RMSSD and increases in DFA1 from resting state to Stroop and N-back tasks, reflecting strong vagal withdrawal, while this parameter remained stable in HCs.

Conclusion The results support the presence of autonomic dysfunction at the early stage of cognitive impairment. Heart rate variability could help in the prediction of cognitive decline as a noninvasive biomarker or as a tool to monitor the effectiveness of therapy and prevention of neurodegenerative diseases.

Resumo

Antecedentes Como não existe até o momento uma estratégia eficaz para tratar a demência de comprometimento cognitivo leve (MCI, na sigla em inglês), as intervenções em um estágio prodrômico são consideradas uma opção. Embora as funções autonômicas tenham sido relacionadas ao desempenho cognitivo, ambos os aspectos raramente foram estudados simultaneamente no MCI.

Objetivo Investigar o controle autonômico cardíaco em idosos com e sem MCI.

Métodos O controle autonômico cardíaco foi avaliado por meio da variabilidade da frequência cardíaca (HRV, na sigla em inglês) em repouso e durante tarefas cognitivas, em 22 idosos com MCI e 29 controles saudáveis (HCs, na sigla em inglês). A medida da HRV de repouso foi realizada por 5 minutos na posição sentada. Os participantes realizaram três tarefas executadas em computador para testar o desempenho em funções executivas e habilidades de linguagem (o teste de cores e palavras - Stroop, Tarefa N-back auditiva e uma tarefa de fluência verbal).

Resultados Em pacientes com MCI, observou-se uma redução significativa da HRV no domínio da frequência (potência de alta frequência) e índices não lineares (SD2, D2 e DFA1) durante o estado de repouso em comparação com os HCs. Indivíduos mais velhos com MCI exibiram diminuições em RMSSD e aumentos em DFA1 do estado de repouso para Stroop e tarefas N-back, refletindo forte recessão vagal, enquanto este parâmetro permaneceu estável em HC.

Conclusão Observou-se disfunção autonômica na fase inicial da neurodegeneração. A HRV pode ajudar na previsão do declínio cognitivo, como um biomarcador não invasivo, ou como uma ferramenta para monitorar a eficácia da terapia e prevenção de doenças neurodegenerativas.

Keywords

Heart Rate - Cognitive Dysfunction - Cognition - Autonomic Nervous System Diseases

Palavras-chave

Frequência Cardíaca - Disfunção Cognitiva - Cognição - Doenças do Sistema Nervoso Autônomo

Authors' Contributions

BG: writing – original draft; BG, MD, SD, FH, GF, CL, NH, PM, WG, IB, NM, AH, ED: writing – review and editing; BG, MD, CL, NHH, PM, WG, NM: data collection; BG, MD, SD, ED: data analysis; BG, MD, FH, CL: conception and study design; NM, AH: funding acquisition, supervision, and project administration. All authors revised and reviewed the manuscript. All authors have read and approved the final submitted manuscript.


Support

The present study was supported by the European Regional Development Fund (grant number: ZS/2018/08/94206).


European Regional Development Fund.


Grant number: ZS/2018/08/94206.




Publication History

Received: 14 November 2021

Accepted: 02 May 2022

Article published online:
14 March 2023

© 2023. Academia Brasileira de Neurologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

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