ORIGINAL RESEARCH article

Front. Aging Neurosci.

Sec. Parkinson’s Disease and Aging-related Movement Disorders

Volume 17 - 2025 | doi: 10.3389/fnagi.2025.1530240

Implications of Heart Rate Variability Measured using Wearable Electrocardiogram Devices in Diagnosing Parkinson's Disease and Its Association with Neuroimaging Biomarkers: A Case-Control Study

Provisionally accepted
Mincheol ParkMincheol Park1Sung-Woo KimSung-Woo Kim2Jin Yong HongJin Yong Hong3Sung ChoSung Cho4Junghwan ParkJunghwan Park4Erdenebayar UrtnasanErdenebayar Urtnasan3Min Seok BaekMin Seok Baek3*
  • 1Chung-Ang University Gwangmyeong Hospital, Gwangmyeonsi, Republic of Korea
  • 2Wonju Severance Christian Hospital, Wŏnju, Republic of Korea
  • 3Wonju College of Medicine, Yonsei University, Wonju, Gangwon, Republic of Korea
  • 4MEZOO, Wonju, Republic of Korea

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Introduction: Heart rate variability (HRV) reflects cardiac autonomic regulation, and reduced HRV is associated with Parkinson's disease (PD). However, studies regarding the implications of HRV measures for the clinical manifestations of PD have shown inconclusive results. We examined the relationship between HRV measures obtained via long-term monitoring using a wearable electrocardiogram (ECG) device and the diagnosis and clinical characteristics of PD.Methods: Seventeen controls and 20 patients with PD were prospectively enrolled. The HRV measures were recorded using a wearable ECG device for up to 72 h. Time-and frequency-domain measures were derived from the HRV analysis, and their association with PD diagnosis and clinical features was investigated. We investigated their association with neuroimaging biomarkers using magnetic resonance imaging to explore the underlying neural correlates.The diagnosis of PD was associated with several HRV measures, including a decreased standard deviation of N-N intervals, standard deviation of all heart rates, and low-frequency (LF) power. Among these HRV measures, only LF power was associated with clinical features of PD. LF power was positively correlated with the tremor sub-score (r = 0.500; p = 0.035) and negatively associated with the left (r = -0.598; p = 0.024) and right (r = -0.693; p = 0.006) cerebellar hemispheres in patients with PD.LF power may be used as a biomarker for tremor-associated pathophysiology of PD. Moreover, a wearable ECG device with its capability for long-term monitoring might be a promising tool for diagnosing PD.

Keywords: Parkinson's disease, Heart rate variability, Electrocardiography, Tremor, Cerebellum

Received: 16 Jan 2025; Accepted: 25 Apr 2025.

Copyright: © 2025 Park, Kim, Hong, Cho, Park, Urtnasan and Baek. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Min Seok Baek, Wonju College of Medicine, Yonsei University, Wonju, 26426, Gangwon, Republic of Korea

Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

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