Objective: To evaluate the relationship between the HRV and the risk of falling in HD patients.

Background: Huntington’s disease (HD) patients have a high prevalence of falls, on the other hand, autonomic nervous system dysfunction has been reported from early stages of the disease. However, there is lack of evidence regarding the relationship between heart rate variability (HRV) and falls in this population.

Method: Eighteen HD patients were assessed by short-term HRV analysis EKG were recorded during 5 minutes in resting and standing states. Time domain (MeanRR, SDNN, RMSSD), frequency domain (VLF, LF, HF, LF/HF) and non-linear (DFA α1, DFA α2 and SampEn) parameters were calculated. Data in each state and its difference between were analyzed. Additionally, data regarding falls, measurements of the risk of falling [Berg balance Scale (BBS), Timed-up go test (TUG), Tinetti mobility test (TMT)] and specific-diseases scales were collected.

Results: The prevalence of falls was 38.9% reporting at least one or no one fall (single faller) and 61.1% reporting two or more falls (recurrent fallers) in the past 12 months. There was no difference in age, gender, illness duration, number of CAG repetitions, total motor score (UHDRS-TMS), functional capacity (UHDRS-TFC) or any scale of risk of falling between groups. Recurrent fallers had significantly lower RMSSD in resting state (p=0.020), higher LF/HF ratio in both states (resting, p=0.011; standing, p=0.044) and higher DFA α1 in both states (resting, p = 0.027; standing, p=0.011). Patients classified with high risk of falling by BBS in resting state showed higher power of low frequency (p=0.044) and higher DFA α2 (p=0.011). Correlations were found in resting state between the RMSSD and [number of falls (r=-0.486, p=0.041), UHDRS-TMS (r=-0.408, p=0.030), BBS (r=0.049, p=0.470)] and LF/HF ratio and number of falls (r=0.539, p=0.021)). No significant differences were found between recurrent and single fallers for any blood pressure measures.

Conclusion: The observed HRV pattern is consistent with a higher sympathetic prevalence associated with a higher risk of falls. The short-term HRV assessment is a useful and rapid tool to assess the risk of falling in HD. The decrease of parasympathetic HRV values adequately identifies the high risk of falling, independently of orthostatic phenomena, in this specific population.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/usefulness-of-heart-rate-variability-to-identify-the-risk-of-falling-in-huntingtons-disease/