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The Journals of Gerontology Series A: Biological Sciences and Medical Sciences Advance Access originally published online on July 30, 2009
The Journals of Gerontology Series A: Biological Sciences and Medical Sciences 2009 64A(12):1312-1315; doi:10.1093/gerona/glp105
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© The Author 2009. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org.

Cardiac Autonomic Dysfunction Is Associated With White Matter Lesions in Patients With Mild Cognitive Impairment

Samantha Galluzzi1, Franco Nicosia2, Cristina Geroldi1,3, Alberto Alicandri2, Matteo Bonetti4, Giuseppe Romanelli2, Roberto Zulli2 and Giovanni B. Frisoni1,3,5

1 Laboratory of Epidemiology, Neuroimaging and Telemedicine (LENITEM), IRCCS San Giovanni di Dio-Fatebenefratelli, Brescia, Italy
2 Institute of Internal Medicine, Department of Medical Sciences, University of Brescia, Italy
3 Psychogeriatric Unit, IRCCS San Giovanni di Dio-Fatebenefratelli, Brescia, Italy
4 Service of Neuroradiology, Istituto Clinico Città di Brescia, Italy
5 Associazione Fatebenefratelli per la Ricerca (AFaR), Rome, Italy

Address correspondence to Giovanni B. Frisoni, MD, Laboratory of Epidemiology Neuroimaging & Telemedicine (LENITEM), IRCCS San Giovanni di Dio FBF—The National Center for Research and Care of Alzheimer’s Disease, Via Pilastroni 4, 25125, Brescia, Italy. Email: gfrisoni{at}fatebenefratelli.it


  Abstract

Background: Cardiac autonomic dysfunction has been associated with cognitive impairment, but the underlying pathogenesis is complex and cerebral white matter lesions (WMLs) might be implicated.

Methods: Time and frequency heart rate variability (HRV) and visual rating of WMLs were carried out in 42 patients with mild cognitive impairment.

Results: After adjustment for relevant demographic and clinical characteristics, including left ventricular mass, reduced HRV indices of parasympathetic (root mean square of successive difference of RR intervals, RMSSD) and sympathetic modulation (low-frequency [LF] power) were associated with increased WML score (RMSSD: B –0.30, 95% CI –0.52 to –0.08, p = .01; LF: B –0.24, 95% CI –0.46 to –0.02, p = .05). In a multiple-adjusted model, RMSSD was the major independent predictor of WMLs (B –0.35, 95% CI –0.57 to –0.13, p = .002).

Conclusion: The evidence for an independent association of cardiac autonomic dysfunction with WMLs might suggest its role in the pathogenesis of WMLs.

Keywords Heart rate variability; Cardiac autonomic dysfunction; White matter lesions; Mild cognitive impairment

Received: August 29, 2008; Accepted: March 20, 2009

Decision Editor: Luigi Ferrucci, MD, PhD


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