Association of Heart Rate Variability With Cognitive Performance: The Multi‐Ethnic Study of Atherosclerosis

Schaich, Christopher L.; Malaver, Diego; Chen, Haiying; Shaltout, Hossam A.; Hazzouri, Adina Zeki Al; Herrington, David M.; Hughes, Timothy M.

doi:10.1161/jaha.119.013827

Cited by 33 publications

(59 citation statements)

References 53 publications

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“…In accordance with the present results, higher SDNN was cross‐sectionally associated with better performance of working memory [ 87 ]. Regarding cognitive performance, a study reported that HRV, especially SDNN, pNN50, and RMSSD were significantly higher in high-performance individuals during medium and high-level chess problems relative to their low-performance counterparts [ 62 ].…”

Section: Discussionsupporting

confidence: 91%

Phasic heart rate variability and the association with cognitive performance: A cross-sectional study in a healthy population setting

et al. 2021

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Introduction Sympathovagal balance measured by heart rate variability is a core component of psychophysiological research. Through the close link of physiological and psychological aspects, often a reduced heart rate variability is associated with impaired cognitive function. A better understanding of the associations between cognitive and cardiovascular dysfunctions is necessary to prevent the manifestation of diseases. Therefore, this study investigated phasic heart rate variability using rest, anticipatory, stress, and recovery periods and the association with high and low cognitive performance in a generally healthy population setting. Methods 114 healthy individuals (40 males, 74 females) aged 20 to 70 participated in the cross-sectional study. The heart rate variability based on standard deviation of NN intervals (SDNN), and the root means square of successive differences (RMSSD), low frequency (LF), high frequency (HF) and LF/HF ratio and its association with high and low cognitive performance measured by the California Verbal Learning Task II were examined. Results The results of this study indicate that the paradigm was successful in producing stress and showed a significant association between phasic heart rate variability (SDNN) and verbal episodic memory performance, irrespective of age and sex. Discussion The results of this study suggest that a reduced heart rate variability is associated with reduced cognitive function regardless of age and sex and seem to be an early indicator of sympathovagal disbalance. Conclusion This leads to the conclusion that differences between high and low cognitive performance might show differences in heart rate variability at an early stage, where no diseases are yet manifest.

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Section: Discussionsupporting

confidence: 91%

Phasic heart rate variability and the association with cognitive performance: A cross-sectional study in a healthy population setting

et al. 2021

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“…Interestingly, a recent review of non-psychiatric patients presented evidence that, under resting conditions, HF-HRV is associated with greater activity in brain regions involved in working memory, executive functioning, decision making and socially driven interactions, including the right dorsolateral PFC (DLPFC), right superior frontal cortex, and anterior cingulate cortex 74 . Moreover, HRV parameters have been positively correlated with performance on tests of global cognitive functioning, processing speed and working memory 75 , and reduced HRV has been independently associated with abnormal PFC activity 76 and reduced regional cerebral blood flow 77 in healthy individuals. While no studies to date have investigated HRV in relation to mental processes such as attention and working memory in SCZ, there have been studies focused on the role of autonomic function in social cognition (see Supplementary Table 2 ).…”

Section: Implications Of Autonomic Dysfunction In Sczmentioning

confidence: 99%

Autonomic nervous system dysfunction in schizophrenia: impact on cognitive and metabolic health

et al. 2021

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Schizophrenia (SCZ) is a psychiatric disorder characterized by a wide range of positive, negative and cognitive symptoms, along with an increased risk of metabolic syndrome and cardiovascular disease that contribute to a 15–20-year reduced life expectancy. Autonomic dysfunction, in the form of increased sympathetic activity and decreased parasympathetic activity, is postulated to be implicated in SCZ and its treatment. The aim of this narrative review is to view SCZ through an autonomic lens and synthesize the evidence relating autonomic dysfunction to different domains of SCZ. Using various methods of assessing autonomic activity, autonomic dysfunction was found to be associated with multiple aspects of SCZ pathophysiology, including symptom severity, cognitive impairment, and the development of cardiometabolic comorbidities, such as metabolic syndrome and high BMI. The strongest association of low heart rate variability was noted among patients on antipsychotic treatment with high-affinity muscarinic antagonism (i.e., clozapine, olanzapine and quetiapine). The review will also suggest ways in which studying autonomic dysfunction can help reduce morbidity and mortality associated with SCZ and its treatment.

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“…Structural brain lesions, including (clinically unrecognized) brain infarcts, white matter lesions and microbleeds have been reported to contribute to cognitive dysfunction in AF patients [6,7]. Cardiac autonomic function (CAF) has been related to cognitive performance in sinus rhythm (SR) patients [8][9][10][11][12][13]. CAF can be quantified by means of heart rate variability (HRV) derived from Holter ECG but also from standard ECG recordings [14].…”

Section: Introductionmentioning

confidence: 99%

Cardiac autonomic function and cognitive performance in patients with atrial fibrillation

et al. 2021

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Background Atrial fibrillation (AF) is associated with loss of cognition and dementia. Cardiac autonomic dysfunction has been linked to cognitive decline. We aimed to investigate if reduced cardiac autonomic function (CAF) is associated with cognitive impairment in AF patients. Methods Patients with paroxysmal, persistent and permanent AF were enrolled from a multicenter cohort study if they had AF (“AF group”) or sinus rhythm (“SR group”) on a baseline 5 min ECG recording. Parameters quantifying CAF (heart rate variability triangular index (HRVI), mean heart rate (MHR), RMSSD, SDNN, total power and power in the VLF, LF, HF ranges) were calculated. We used the Montreal Cognitive Assessment (MoCA) to assess global cognitive function. Results 1685 AF patients with a mean age of 73 ± 8 years, 29% females, were included. MoCA score was 24.5 ± 3.2 in the AF group (N = 710 patients) and 25.4 ± 3.2 in the SR group (N = 975 patients). After adjusting for multiple confounders, lower HRVI was associated with lower MoCA scores, both in the SR group [β = 0.049; 95% confidence interval (CI) 0.016–0.081; p = 0.003] and in the AF group (β = 0.068; 95% CI 0.020–0.116; p = 0.006). In the AF group, higher MHR was associated with a poorer performance in the MoCA (β = − 0.008; 95% CI − 0.014 to − 0.002; p = 0.014). We found no convincing evidence of association for other CAF parameters with cognition. Conclusion Our data suggest that impaired CAF is associated with worse cognitive performance in patients with AF. Among standard HRV parameters, HRVI might be the most promising ECG index. Trial registration ClinicalTrials.gov Identifier: NCT02105844. Graphic abstract

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Association of Heart Rate Variability With Cognitive Performance: The Multi‐Ethnic Study of Atherosclerosis

Cited by 33 publications

References 53 publications

Phasic heart rate variability and the association with cognitive performance: A cross-sectional study in a healthy population setting

Phasic heart rate variability and the association with cognitive performance: A cross-sectional study in a healthy population setting

Autonomic nervous system dysfunction in schizophrenia: impact on cognitive and metabolic health

Cardiac autonomic function and cognitive performance in patients with atrial fibrillation

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