High NIHSS values predict impairment of cardiovascular autonomic control

Area of Science:

• Neurology
• Cardiology
• Autonomic Nervous System Research

Background:

• Stroke is often linked to autonomic dysfunction, leading to secondary cardiovascular issues.
• Current methods for diagnosing autonomic imbalance are limited to specialized centers.
• There is a need for accessible markers to identify autonomic imbalance in stroke patients.

Purpose of the Study:

• To investigate the correlation between stroke severity, assessed by NIHSS scores, and autonomic dysfunction.
• To determine if NIHSS scores can predict the risk of autonomic complications after stroke.

Main Methods:

• Assessed NIHSS scores and autonomic cardiovascular modulation parameters in 50 ischemic stroke patients within 24 hours of onset.
• Compared patient data with 32 healthy controls.
• Correlated NIHSS scores with various autonomic modulation parameters, including sympathetic and parasympathetic tone and baroreflex sensitivity.

Main Results:

• Stroke patients exhibited significantly altered autonomic parameters compared to controls, including lower heart rate variability and baroreflex sensitivity.
• NIHSS scores showed significant correlations with sympathetic dominance markers (normalized RRI-LF/HF-ratios) and indirect correlations with overall autonomic modulation and parasympathetic tone.
• Spearman-Rho values for correlations ranged from 0.29 to 0.47.

Conclusions:

• Increased stroke severity is associated with a progressive decline in autonomic function, reduced parasympathetic tone, and impaired baroreflex sensitivity.
• More severe strokes lead to a shift towards sympathetic dominance, increasing the risk of cardiovascular complications and adverse outcomes.
• NIHSS scores can serve as a valuable tool for predicting autonomic dysregulation and potential autonomic failure in stroke patients.