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心脏自主功能障碍,认知障碍和肌缩侧面硬化症患者的生存率之间的关联

Zehui Li¹, Jingjing Fan², Zhenxiang Gong¹

¹Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China.

Clinical autonomic research : official journal of the Clinical Autonomic Research Society

|March 8, 2025

概括

带有认知障碍的肌性侧面硬化症患者表现出心脏自主功能减少和生存率降低. 所有正常RR区间 (SDNN) 的较低标准偏差可能表明ALS的认知问题和生存率降低.

科学领域:

神经学神经学
心脏病学心脏病学
认知科学认知科学

背景情况:

肌缩侧面硬化症 (ALS) 是一种进展性神经退行性疾病,影响运动神经元.
认知障碍在ALS中很常见,并影响患者的结果.
心脏自主功能障碍可能与ALS的疾病进展和生存有关.

研究的目的:

研究心脏自主功能障碍,认知障碍和ALS患者的存活率之间的关系.
探索心率变化 (HRV) 参数与ALS认知领域之间的关联.
确定ALS患者的生存预测因素,考虑认知状态和自主功能.

主要方法:

24小时的霍尔特监测用于评估65名ALS患者 (认知正常或受损) 和38名健康对照者的心脏自主功能.
心率 (HR) 和HRV参数在各组之间进行了比较,并与认知得分相关联 (爱丁堡认知和行为ALS屏幕 - ECAS).
进行了后勤回归和生存分析 (Kaplan-Meier,Cox回归),以确定与认知状态和生存相关的因素.

主要成果:

与健康对照组 (HCs) 和正常认知 (ALS-CN) 的ALS患者相比,认知障碍患者 (ALS-CI) 的HRV参数 (RRI,SDNN,SDNN指数,VLF功率,总功率) 降低了.
与认知领域相关的特定HRV参数:在ALS-CN中,语言与平均HR和几个HRV指标相关;在ALS-CI中,执行功能和ECAS总得分与RMSSD相关.
较低的SDNN (≤100毫秒) 与认知障碍相关,并显示出较差生存率的趋势,而认知障碍本身与更糟糕的结果有显著联系.

结论:

在ALS中,认知障碍与心脏自主调节的减少和认知自主关联的改变有关.
认知障碍是ALS患者生存率降低的重要预测因素.
基线SDNN≤100毫秒可能作为潜在的生物标志物用于认知障碍和ALS中较差的存活率.

关键词:

肌缩性侧面硬化症 (AMLS) 是一种疾病.心脏自主功能障碍是什么心脏自主功能障碍认知障碍认知障碍是一种认知障碍.心率变化心率的变化.

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