Heart Rate Variability Analyses in Parkinson’s Disease: A Systematic Review and Meta-Analysis

Heimrich, Konstantin G.; Prell, Tino

doi:10.3390/brainsci11080959

Cited by 43 publications

(34 citation statements)

References 73 publications

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“…As to the state of the sympathovagal balance at rest, we could observe for the first time a significantly reduced vagal modulation at rest in GBA-PD patients compared to healthy subjects, both through spectral and symbolic analysis. Moreover, as already reported by other authors [with the only exception of patients with longer disease duration (Mihci et al, 2006;Baumert et al, 2012;Strano et al, 2016;Vianna et al, 2016;Heimrich et al, 2021)], iPD patients did not show statistically significant differences compared to the CTR group, and were characterized by a phenotypically intermediate CAC, with values between CTR and the GBA-PD groups for all HRV indices.…”

Section: Discussionsupporting

confidence: 80%

“…Therefore, a lower HRV is associated with autonomic impairment ( Kleiger et al, 2005 ). To date, through the HRV analysis, alterations of the ANS and in particular of the cardiovascular autonomic control (CAC) have already been investigated in iPD patients during wake and sleep, and in other genetic forms of PD, such as cases associated with LRRK2 mutations ( Kallio et al, 2000 ; Visanji et al, 2017 ; Heimrich et al, 2021 ). However, to the best of our knowledge, there are no studies assessing the CAC in GBA-PD patients.…”

Section: Introductionmentioning

confidence: 99%

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Dysautonomia in Parkinson’s Disease: Impact of Glucocerebrosidase Gene Mutations on Cardiovascular Autonomic Control

et al. 2022

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Evidence from clinical practice suggests that PD patients with the Glucocerebrosidase gene mutations (GBA-PD) are characterized by more severe dysautonomic symptoms than patients with idiopathic PD (iPD). Therefore, an accurate assessment of cardiovascular autonomic control (CAC) is necessary to clarify the role of GBA mutations in the pathophysiology of PD. We evaluated the CAC at rest and during orthostatic challenge of 15 iPD, 15 GBA-PD and 15 healthy controls (CTR). ECG and respiration were recorded in supine position and during active standing. The analysis of Heart Rate Variability (HRV) was performed on ECG recordings using two different approaches, linear spectral analysis and non-linear symbolic analysis. GBA-PD patients presented more frequently an akinetic-rigid phenotype and cognitive dysfunction than iPD patients. Both iPD and GBA-PD group were characterized by a lower spectral HRV than CTR group. At rest, the GBA-PD group was characterized by a lower parasympathetic modulation and a shift of the sympathovagal balance toward a sympathetic predominance compared to the CTR group. Moreover, the GBA-PD patients presented a lower HR increment and a lower or absent reduction of the vagal modulation in response to the active standing than iPD patients. Lastly, the cardiovascular autonomic dysfunction in PD patients was associated with longer disease duration, and with the occurrence of REM sleep behavior disorder and constipation. Our findings suggest a more severe impairment of the CAC in PD patients with GBA mutations. These results and further studies on the role of GBA mutations could allow a stratification based on cardiovascular risk in PD patients and the implementation of specific prevention programs.

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Section: Discussionsupporting

confidence: 80%

Section: Introductionmentioning

confidence: 99%

Dysautonomia in Parkinson’s Disease: Impact of Glucocerebrosidase Gene Mutations on Cardiovascular Autonomic Control

et al. 2022

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“…Studies have suggested a decrease in LF and HF powers in patients with PD compared with those in healthy control subjects [ 19 , 20 , 24 – 26 ]. Katagiri A et al have reported a reduction in LF and HF components in patients with PD compared with those in control subjects [ 20 ].…”

Section: Discussionmentioning

confidence: 99%

Power spectral analysis of heart rate variability is useful as a screening tool for detecting sympathetic and parasympathetic nervous dysfunctions in Parkinson’s disease

et al. 2022

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Background Parkinson’s disease (PD) is a progressive neurodegenerative disorder that causes motor symptoms and autonomic dysfunction. However, autonomic function tests commonly performed in PD can only evaluate either the sympathetic or parasympathetic nervous system. Therefore, the purpose of this pilot study is to investigate whether power spectral analysis of heart rate variability could detect both sympathetic and parasympathetic nervous dysfunctions in patients with PD. Methods Seventeen patients with PD and 11 healthy control subjects underwent electrocardiogram recording for the spectral analysis of heart rate variability to obtain values of low-frequency (LF) (0.04–0.15 Hz) and high-frequency (HF) (0.15–0.4 Hz) powers. Moreover, we examined the coefficient of variation of R–R intervals (CVRR) as a parameter of parasympathetic function in all participants and performed 123I-metaiodobenzylguanidine scintigraphy to measure the heart-to-mediastinum ratio as a parameter of cardiac sympathetic innervation in patients with PD. Results The median age of control subjects and PD patients was 63 and 66 years old, respectively. The median Hoehn and Yahr scale of PD patients was stage 2. The values of resting LF and HF powers widely varied. The median values of resting LF powers of control subjects and PD patients and those of HF powers were 169 and 70 ms2, 279 and 65 ms2, respectively, the difference was statistically insignificant. Approximately 41% of patients with PD had values below the first quartile of resting LF powers (< 58 ms2) or HF powers (< 50 ms2); however, no control subject had such low values. Positive correlations were found between resting LF powers and heart-to-mediastinum ratios of 123I-metaiodobenzylguanidine uptake (r = 0.6) and between resting HF powers and CVRRs (r = 0.7). The resting LF power was also associated with CVRRs and constipation. Furthermore, a positive correlation was observed between resting LF powers and resting HF powers in patients with PD (r = 0.8). Conclusions The power spectral analysis of heart rate variability may be useful as a screening tool for detecting autonomic dysfunctions by detecting low resting LF and HF powers in patients with PD. Sympathetic and parasympathetic nerves may be concurrently damaged in patients with PD.

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“…Cardiovascular changes are a non-motor symptom derived from autonomic dysfunction and commonly seen in PD patients. For example, the reduction in both heart frequency and heart rate variability in humans is well described in the literature (Heimrich et al, 2021; Frontiers in Pharmacology frontiersin.org Li et al, 2021;Longinetti et al, 2021) and studies using animal models of 6-OHDA also have mimicked these findings, in addition to bringing other cardiovascular complications as described in human PD (Ariza et al, 2015;Rodrigues et al, 2019;Cabral et al, 2020). In a previous study, our research group found that the use of propolis for 40 days after striatal 6-OHDA lesion provided cardioprotection to PD rats, avoiding a marked decrease in heart rate and its variability (Gonçalves et al, 2020).…”

Section: Discussionmentioning

confidence: 87%

Propolis induces cardiac metabolism changes in 6-hydroxydopamine animal model: A dietary intervention as a potential cardioprotective approach in Parkinson’s disease

et al. 2022

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While there is sustained growth of the older population worldwide, ageing is a consistent risk factor for neurodegenerative diseases, such as Parkinson’s-disease (PD). Considered an emblematic movement disorder, PD comprises a miscellany of non-motor symptoms, for which effective management remains an unfulfilled need in clinical practice. Highlighted are the cardiovascular abnormalities, that cause significant burden in PD patients. Evidence suggests that key biological processes underlying PD pathophysiology can be modulated by diet-derived bioactive compounds, such as green propolis, a natural functional food with biological and pharmacological properties. The effects of propolis on cardiac affection associated to PD have received little coverage. In this study, a metabolomics approach and Positron Emission Tomography (PET) imaging were used to assess the metabolic response to diet supplementation with green propolis on heart outcomes of rats with Parkinsonism induced by 6-hydroxydopamine (6-OHDA rats). Untargeted metabolomics approach revealed four cardiac metabolites (2-hydroxybutyric acid, 3-hydroxybutyric acid, monoacylglycerol and alanine) that were significantly modified between animal groups (6-OHDA, 6-OHDA + Propolis and sham). Propolis-induced changes in the level of these cardiac metabolites suggest beneficial effects of diet intervention. From the metabolites affected, functional analysis identified changes in propanoate metabolism (a key carbohydrate metabolism related metabolic pathway), glucose-alanine cycle, protein and fatty acid biosynthesis, energy metabolism, glutathione metabolism and urea cycle. PET imaging detected higher glucose metabolism in the 17 areas of the left ventricle of all rats treated with propolis, substantially contrasting from those rats that did not consume propolis. Our results bring new insights into cardiac metabolic substrates and pathways involved in the mechanisms of the effects of propolis in experimental PD and provide potential novel targets for research in the quest for future therapeutic strategies.

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Heart Rate Variability Analyses in Parkinson’s Disease: A Systematic Review and Meta-Analysis

Cited by 43 publications

References 73 publications

Dysautonomia in Parkinson’s Disease: Impact of Glucocerebrosidase Gene Mutations on Cardiovascular Autonomic Control

Dysautonomia in Parkinson’s Disease: Impact of Glucocerebrosidase Gene Mutations on Cardiovascular Autonomic Control

Power spectral analysis of heart rate variability is useful as a screening tool for detecting sympathetic and parasympathetic nervous dysfunctions in Parkinson’s disease

Propolis induces cardiac metabolism changes in 6-hydroxydopamine animal model: A dietary intervention as a potential cardioprotective approach in Parkinson’s disease

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