Heart rate variability and falls in Huntington’s disease

Terroba‐Chambi, Cinthia; Bruno, Verónica; Vigo, Daniel Eduardo; Merello, Marcelo

doi:10.1007/s10286-020-00669-2

Cited by 18 publications

(27 citation statements)

References 51 publications

(85 reference statements)

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“…Reduced cortical and subcortical blood flow and heart rate have been reported as examples of pathological abnormalities in HD hearts [ 85 , 86 , 87 , 88 ]. HD patients’ heart rate variability pattern is consistent with a higher sympathetic prevalence [ 89 ]. Further studies with HD animal models reaffirmed cardiac pathological events, such as variations in the heart rate and cardiac remodeling [ 90 , 91 , 92 ].…”

Section: Purines In Huntington’s Diseasementioning

confidence: 80%

Purine Nucleotides Metabolism and Signaling in Huntington’s Disease: Search for a Target for Novel Therapies

Tomczyk

Glaser

Słomińska

et al. 2021

IJMS

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Huntington’s disease (HD) is a multi-system disorder that is caused by expanded CAG repeats within the exon-1 of the huntingtin (HTT) gene that translate to the polyglutamine stretch in the HTT protein. HTT interacts with the proteins involved in gene transcription, endocytosis, and metabolism. HTT may also directly or indirectly affect purine metabolism and signaling. We aimed to review existing data and discuss the modulation of the purinergic system as a new therapeutic target in HD. Impaired intracellular nucleotide metabolism in the HD affected system (CNS, skeletal muscle and heart) may lead to extracellular accumulation of purine metabolites, its unusual catabolism, and modulation of purinergic signaling. The mechanisms of observed changes might be different in affected systems. Based on collected findings, compounds leading to purine and ATP pool reconstruction as well as purinergic receptor activity modulators, i.e., P2X7 receptor antagonists, may be applied for HD treatment.

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Section: Purines In Huntington’s Diseasementioning

confidence: 80%

Purine Nucleotides Metabolism and Signaling in Huntington’s Disease: Search for a Target for Novel Therapies

Tomczyk

Glaser

Słomińska

et al. 2021

IJMS

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“…It has been reported that being prone to falling is one of the strongest predictors of nursing home placement. 19 Falls and their resulting injuries are responsible for major health, social, and economic problems. A systematic review of the literature concluded that the incidence of falls in older persons follows a circadian variation.…”

Section: Search Methodologymentioning

confidence: 99%

“… 28–32 Different studies have used ANS evaluation and, in particular, heart rate variability (HRV) to detect and predict the risk of falling in various populations. 19 , 33 The identification of autonomic parameters as markers of risk of falling will help detect and monitor subjects prone to falling early on as well as allow for the implementation of preventive strategies. 34 , 35 There is no literature on the study of the circadian rhythm of the ANS, yet given the existing research on the subject and the fact that HRV is a fast, non-invasive, affordable and easily implemented technique, a 24hr HRV assessment presents and attractive and promising approach to the study of frailty and falls in older persons.…”

Section: Search Methodologymentioning

confidence: 99%

“…This association has not been thoroughly studied yet it represents and interesting approach since sleep-wake disturbances are potentially treatable and might reverse or prevent frailty progression. 18 In this line, the concept of "circadian reserve" is of increasing relevance. Similar to that of "cognitive reserve", it postulates that persons with healthier circadian rhythmicity cope with pathological insults better than those with low circadian reserve.…”

Section: Aging Circadian Rhythms and Fallsmentioning

confidence: 99%

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<p>Falls Risk, Circadian Rhythms and Melatonin: Current Perspectives</p>

Goswami¹,

Abulafia²,

Vigo³

et al. 2020

CIA

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Aging is associated with weakening of the circadian system. The circadian amplitude of most physiological variables is reduced, while the circadian phase becomes more labile and tends to occur earlier with advancing age. As the incidence of falls in older persons could follow circadian variations, a better understanding of conditions in which falls occur can lead to the implementation of countermeasures (such as adjusting the scheduling of hospital staff, or changing the timing of anti-hypertensive medication if falls are related to undesirable circadian patterns of blood pressure and/or heart rate). This includes knowing the times of the day, days of the week, and times of the year when falls are more likely to occur at home or in the hospital. Additionally, the links between aging processes and factors associated with an increased risk of developing autonomic dysfunction are well established. A strong association between heart rate variability indexes and aging has been shown. Circadian rhythms of autonomous nervous system activity may play important role for maintenance of orthostatic tolerance. Whether one is concerned with disease prediction and prevention or maintenance of healthy aging, the study of circadian rhythms and the broader time structure underlying physiopathology is helpful in terms of screening, early diagnosis and prognosis, as well as the timely institution of prophylactic and/or palliative/curative treatment. Timing the administration of such treatment as a function of circadian (and other) rhythms also could lead to reduction of falls in older persons. Finally, a prominent circadian rhythm characterizes melatonin, which peaks during the night. The circadian amplitude of melatonin decreases as a function of age, raising the questions whether such a decrease in the circadian amplitude of melatonin relates to a higher risk of falls and, if so, whether melatonin supplementation may be an effective countermeasure. This narrative review assesses the relationships between fall risk and the potential role circadian rhythms and melatonin play in mitigating this risk. We aim to provide healthcare workers adequate information about fall risk in older persons, including the potential role of the circadian rhythms and/or melatonin, as well as to lay foundations for future fall prevention interventional studies.

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“…While there is growing evidence that CAD can manifest in OH or symptoms of orthostatic intolerance/dizziness due to baroreflex dysfunction in MS (Racosta et al, 2015 ), its relationship with falls has not received much scrutiny. Cross-sectional studies have consistently reported that, compared to age-matched healthy controls, pwMS have reduced HRV and baroreflex function (Tombul et al, 2011 ; Shirbani et al, 2018 ), both of which have been found to predict falls in patient populations characterized by dysautonomia (Castaldo et al, 2017 ; Razjouyan et al, 2017 ; Terroba-Chambi et al, 2020 ; Zanotto et al, 2020 ). A direct biological mechanism linking baroreflex dysfunction and falls can be reasonably theorized.…”

Section: Relationship Between Cad and Fallsmentioning

confidence: 99%

Cardiovascular Autonomic Dysfunction and Falls in People With Multiple Sclerosis: Is There a Link? An Opinion Article

et al. 2020

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Heart rate variability and falls in Huntington’s disease

Abstract: The funding agencies did not have a role in the development of the study, analysis of data, and writing of the manuscript.

Cited by 18 publications

References 51 publications

Purine Nucleotides Metabolism and Signaling in Huntington’s Disease: Search for a Target for Novel Therapies

Purine Nucleotides Metabolism and Signaling in Huntington’s Disease: Search for a Target for Novel Therapies

<p>Falls Risk, Circadian Rhythms and Melatonin: Current Perspectives</p>

Cardiovascular Autonomic Dysfunction and Falls in People With Multiple Sclerosis: Is There a Link? An Opinion Article

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