Czopek-Rowinska Julia, de Bruin Eling D, Manser Patrick
Motor Control and Learning Group, Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland.
Department of Health, OST - Eastern Swiss University of Applied Sciences, St. Gallen, Switzerland.
Front Aging Neurosci. 2024 Dec 17;16:1498687. doi: 10.3389/fnagi.2024.1498687. eCollection 2024.
Mild neurocognitive disorder (mNCD) is recognized as an early stage of dementia and is gaining attention as a significant healthcare problem due to current demographic changes and increasing numbers of patients. Timely detection of mNCD provides an opportunity for early interventions that can potentially slow down or prevent cognitive decline. Heart rate variability (HRV) may be a promising measure, as it has been shown to be sensitive to cognitive impairment. However, there is currently no evidence regarding the diagnostic accuracy of HRV measurements in the context of the mNCD population. This study aimed to evaluate the diagnostic accuracy of vagally-mediated HRV (vm-HRV) as a screening tool for mNCD and to investigate the relationship between vm-HRV with executive functioning and depression in older adults who have mNCD.
We retrospectively analyzed data from healthy older adults (HOA) and individuals with a clinical diagnosis of mNCD with a biomarker-supported characterization of the etiology of mNCD. Diagnostic accuracy was evaluated using receiver operating characteristic curve analysis based on the area under the curve. Sensitivity and specificity were calculated based on the optimal threshold provided by Youden's Index. Multiple linear regression analyses were conducted to investigate the relationship between vm-HRV and executive functioning and depression.
This analysis included 42 HOA and 29 individuals with mNCD. The relative power of high frequency was found to be increased in individuals with mNCD. The greatest AUC calculated was 0.68 (with 95% CI: 0.56, 0.81) for the relative power of high frequency. AUCs for other vm-HRV parameters were between 0.53 and 0.61. No consistent correlations were found between vm-HRV and executive functioning or depression.
It appears that vm-HRV parameters alone are insufficient to reliably distinguish between HOA and older adults with mNCD. Additionally, the relationship between vm-HRV and executive functioning remains unclear and requires further investigation. Prospective studies that encompass a broad range of neurocognitive disorders, HRV measurements, neuroimaging, and multimodal approaches that consider a variety of functional domains affected in mNCD are warranted to further investigate the potential of vm-HRV as part of a multimodal screening tool for mNCD. These multimodal measures have the potential to improve the early detection of mNCD in the future.
轻度神经认知障碍（mNCD）被认为是痴呆症的早期阶段，由于当前人口结构的变化和患者数量的增加，它作为一个重大的医疗保健问题正日益受到关注。及时检测mNCD为早期干预提供了机会，这些干预措施有可能减缓或预防认知能力下降。心率变异性（HRV）可能是一个有前景的指标，因为它已被证明对认知障碍敏感。然而，目前尚无关于HRV测量在mNCD人群中的诊断准确性的证据。本研究旨在评估迷走神经介导的HRV（vm-HRV）作为mNCD筛查工具的诊断准确性，并调查mNCD老年患者中vm-HRV与执行功能和抑郁之间的关系。
我们回顾性分析了健康老年人（HOA）以及临床诊断为mNCD且有生物标志物支持的mNCD病因特征的个体的数据。使用基于曲线下面积的受试者工作特征曲线分析来评估诊断准确性。根据约登指数提供的最佳阈值计算敏感性和特异性。进行多元线性回归分析以研究vm-HRV与执行功能和抑郁之间的关系。
该分析纳入了42名HOA和29名mNCD患者。发现mNCD患者的高频相对功率增加。高频相对功率计算出的最大曲线下面积（AUC）为0.68（95%置信区间：0.56, 0.81）。其他vm-HRV参数的AUC在0.53至0.61之间。未发现vm-HRV与执行功能或抑郁之间存在一致的相关性。
单独的vm-HRV参数似乎不足以可靠地区分HOA和患有mNCD的老年人。此外，vm-HRV与执行功能之间的关系仍不明确，需要进一步研究。有必要开展前瞻性研究，涵盖广泛的神经认知障碍、HRV测量、神经影像学以及考虑mNCD中各种受影响功能领域的多模态方法，以进一步研究vm-HRV作为mNCD多模态筛查工具一部分的潜力。这些多模态措施有可能在未来改善mNCD的早期检测。
