A Clinical Study Of Heart Rate Variability In Relation To Severity And Cognitive Impairment In Parkinson’s Disease

Objective:The aim of our study is to explore the relationship of heart rate variability with disease severity and cognitive impairment in patients with PD.Methods:We collected 70 patients with Parkinson’s disease and 39 non-Parkinson’s disease controls admitted to the Department of Neurology from January 2022 to November 2022.PD patients were divided into early group and advanced group according to the hoehn-yahr staging of PD.Cognitive impairment is classified as PD with mild cognitive impairment(PD-MCI)and PD with dementia(PDD)according to the diagnostic criteria established by the International Parkinson’s Disease Movement Disorders Society Task Force,and we combined the two appeal groups as PD with cognitive impairment(PD-CI)and the rest are PD with nomal cognition(PD-NC).We collected the general clinical information of the participants,and evaluated the patients with the Montreal Cognitive Assessment,the Mini-Mental State Examination,and the MDS Unified Parkinson’s Disease Rating Scale.All included subjects underwent 24-hour Holter monitoring.We analyzed and compared the general information and heart rate variability indicators of the control group,early group and advanced group.We also analyzed and compared PD-CI and PD-NC groups.Then we further explored the correlation between heart rate variability and other indicators in patients with Parkinson’s disease,and explored Influencing factors of disease severity and cognitive impairment.PD-CI and PD-NC groups also compared the same index.In addition,we also explored the correlation between heart rate variability and other indicators in patients with PD,as well as the influencing factors of disease severity and cognitive dysfunction.Result:1.There was no significant difference in gender and age between the early stage group,the advanced group and the control group(P>0.05),the education level,MOCA score,and MMSE score of the early group were not significantly different from those of the advanced group(P>0.05).The PD-CI group was older,had a longer course of disease,and had higher levodopa equivalent dose、UPDRSⅢ score than the PD-NC group(p<0.05),but a lower level of education than the PD-NC group(p<0.05).There was no statistically significant gender difference between the two groups.(P>0.05).2.SDNN,SDANN,SDNNindex,HF,VLF,LF,and triangle index all decreased when comparing the control,early,and advanced group,with significant differences(p<0.05).When compared between each group,there was no statistically significant difference between the control and early groups(p>0.05).Except for the HF,the control group and the early group decreased when compared with the advanced group,respectively.The difference was significant(p<0.05).3.SDNN,SDNNindex,LF,VLF,and triangle index were positively correlated with MMSE(p<0.05)and negatively correlated with UPDRSⅢ(p<0.05).SDNNindex,LF,VLF,and delta index were negatively correlated with disease duration(p<0.05).LF,VLF,and triangle index were negatively correlated with age(p<0.05).VLF was positively correlated with MOCA p<0.05).4.SDNN,SDNNindex,PNN50,LF,VLF,and delta index were all lower in the PD-CI group compared with the PD-NC group(P<0.05),all of which were significantly different.5.The high educational level(OR=0.758,95%CI 0.637-0.902,p=0.002)was a protective factor for cognitive function in Parkinson’s disease.Conclusion:1.Heart rate variability in Parkinson’s patients may correlate with the severity of the disease.Patients in the advanced group may show a significant decrease in HRV indicators,suggesting that cardiac autonomic dysfunction in Parkinson’s disease maybe more evident in patients with advanced stage.2.Heart rate variability may correlate with cognitive dysfunction in Parkinson’s disease;the decrease in heart rate variability indicators may lead to poorer cognitive function in patients.3.The older the patient with Parkinson’s disease,the longer the disease duration and the more pronounced the motor impairment,the more pronounced the decrease in heart rate variability and the poorer the cardiac autonomic function4.The high educational level is a protective factor against cognitive dysfunction in Parkinson’s disease...