Sergi Gabriele, Yekutieli Ziv, Meloni Mario, Bianchini Edoardo, Vivacqua Giorgio, Di Lazzaro Vincenzo, Marano Massimo
Fondazione Policlinico Universitario Campus Bio-Medico, Viale Alvaro del Portillo 200, 00128 Rome, Italy.
Research Unit of Geriatrics, Department of Medicine and Surgery, Università Campus Bio-Medico Di Roma, 00128 Rome, Italy.
Sensors (Basel). 2025 Sep 16;25(18):5756. doi: 10.3390/s25185756.
Autonomic dysfunction is a key non-motor feature of Parkinson's disease (PD) and may influence motor performance, particularly gait. While heart rate variability (HRV) has been associated with freezing of gait, its relationship with broader gait parameters remains unclear. The objective was to investigate correlations between resting-state HRV time-domain measures and spatiotemporal gait parameters during comfortable and fast walking in patients with idiopathic PD. Twenty-eight PD patients (mean age 68 ± 9 years) were evaluated at Campus Bio-Medico University Hospital. HRV was recorded at rest using the e-Sense pule™ portable sensor, including the Baevsky's Stress Index a measure increasing with sympathetic burden. Gait parameters were assessed via the 10 m Timed Up and Go (TUG) test using the Mon4t™ smartphone app at comfortable and fast pace. Clinical data included UPDRS III, MoCA, and disease characteristics. Gait metrics significantly changed between walking conditions. HRV parameters clustered separately from gait metrics but intersected with significant correlations. Higher Stress Index values, reflecting sympathetic dominance, were associated with poorer gait performance, including prolonged transition times, shorter steps, and increased variability ( < 0.001, r = 0.57-0.61). MoCA scores inversely correlated with the Stress Index (r = -0.52, = 0.004), linking cognitive and autonomic status. UPDRS III and MoCA were related to TUG metrics but not HRV. Time-domain HRV measures, particularly the Stress Index, are significantly associated with spatiotemporal gait features in PD, independent of gait speed. These findings suggest that impaired autonomic regulation contributes to functional mobility deficits in PD and supports the role of HRV as a biomarker in motor assessment.
自主神经功能障碍是帕金森病（PD）的一个关键非运动特征，可能会影响运动表现，尤其是步态。虽然心率变异性（HRV）与步态冻结有关，但其与更广泛的步态参数之间的关系仍不清楚。目的是研究特发性PD患者在舒适步行和快速步行时静息状态下HRV时域测量值与时空步态参数之间的相关性。28例PD患者（平均年龄68±9岁）在罗马生物医学大学校医院接受评估。使用e-Sense pule™便携式传感器在静息状态下记录HRV，包括Baevsky应激指数，该指数随交感神经负担增加而升高。使用Mon4t™智能手机应用程序通过10米定时起立行走（TUG）测试在舒适和快速步速下评估步态参数。临床数据包括统一帕金森病评定量表第三部分（UPDRS III）、蒙特利尔认知评估量表（MoCA）和疾病特征。步态指标在不同步行条件下有显著变化。HRV参数与步态指标分别聚类，但有显著相关性的交叉。较高的应激指数值反映交感神经占优势，与较差的步态表现相关，包括更长的过渡时间、更短的步长和更大的变异性（P<0.001，r = 0.57 - 0.61）。MoCA评分与应激指数呈负相关（r = -0.52，P = 0.004），将认知和自主神经状态联系起来。UPDRS III和MoCA与TUG指标相关，但与HRV无关。时域HRV测量值，尤其是应激指数，与PD患者的时空步态特征显著相关，与步态速度无关。这些发现表明，自主神经调节受损导致PD患者的功能移动性缺陷，并支持HRV作为运动评估生物标志物的作用。
