Relationship between heart rate variability and cognitive function in patients with enlarged perivascular space

Area of Science:

• Neurology
• Cardiology
• Gerontology

Background:

• Enlarged perivascular spaces (EPVS) are increasingly recognized in aging brains and associated with cognitive decline.
• Heart rate variability (HRV) reflects autonomic nervous system function and has been implicated in various neurological conditions.

Purpose of the Study:

• To investigate the association between HRV parameters, the distribution of EPVS in the basal ganglia (BG) and centrum semiovale (CS), and cognitive function in patients with EPVS.
• To determine if HRV can predict cognitive impairment in patients with EPVS.

Main Methods:

• Retrospective analysis of clinical and imaging data from 199 patients with EPVS.
• Assessment of EPVS load in BG and CS regions using Potter's method.
• Cognitive function evaluation using the Montreal Cognitive Assessment Scale.
• Logistic regression and ROC curve analysis to examine relationships and predictive values.

Main Results:

• Significant differences in HRV parameters (rMSSD, PNN50, LF/HF) were found between mild and severe BG-EPVS groups.
• Patients with and without cognitive impairment showed significant differences in various HRV metrics (SDNN, rMSSD, PNN50, LF/HF).
• rMSSD and LF/HF were independent factors for BG-EPVS, while rMSSD independently predicted cognitive impairment.

Conclusions:

• Reduced HRV is implicated in the pathophysiology of BG-EPVS and is independently associated with cognitive impairment in these patients.
• HRV alterations, particularly rMSSD, may serve as a biomarker for cognitive impairment in EPVS patients.
• Interventions aimed at improving HRV could potentially mitigate the progression of EPVS and cognitive decline.