Heart rate variability as a biomarker of functional outcomes in persons with acquired brain injury: Systematic review and meta-analysis

•Electrocardiograms and wearable devices were used to measure heart rate variability.•Persons with acquired brain injury indicated decreased heart rate variability.•Heart rate variability indices were correlated with functional outcomes.•These indices can be used as biomarkers of functions after acq...

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Published inNeuroscience and biobehavioral reviews Vol. 131; pp. 737 - 754
Main Authors Lee, Yejin, Walsh, Ryan J., Fong, Mandy W.M., Sykora, Marek, Doering, Michelle M., Wong, Alex W.K.
Format Journal Article
LanguageEnglish
Published United States Elsevier Ltd 01.12.2021
Subjects
Biomarker
Biomarkers
Brain Injuries
Emotions
Functional outcomes
Heart Rate - physiology
Heart rate variability
Humans
Meta-analysis
Outcome assessment (health care)
Stroke
Biomarker
Stroke
Functional outcomes
Heart rate variability
Brain injuries
Outcome assessment (health care)
Meta-analysis
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Summary:•Electrocardiograms and wearable devices were used to measure heart rate variability.•Persons with acquired brain injury indicated decreased heart rate variability.•Heart rate variability indices were correlated with functional outcomes.•These indices can be used as biomarkers of functions after acquired brain injury.•These indices enable precise monitoring of functions after acquired brain injury. This review aimed to quantify correlations between heart rate variability (HRV) and functional outcomes after acquired brain injury (ABI). We conducted a literature search from inception to January 2020 via electronic databases, using search terms with HRV, ABI, and functional outcomes. Meta-analyses included 16 studies with 906 persons with ABI. Results demonstrated significant associations: Low frequency (LF) (r = −0.28) and SDNN (r = −0.33) with neurological function; LF (r = −0.33), High frequency (HF) (r = −0.22), SDNN (r = −0.22), and RMSSD (r = −0.23) with emotional function; and LF (r = 0.34), HF (r = 0.41 to 0.43), SDNN (r = 0.43 to 0.51), and RMSSD (r = 0.46) with behavioral function. Results indicate that higher HRV is related to better neurological, emotional, and behavioral functions after ABI. In addition, persons with stroke showed lower HF (SMD = −0.50) and SDNN (SMD = −0.75) than healthy controls. The findings support the use of HRV as a biomarker to facilitate precise monitoring of post-ABI functions.
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Author contributions: AW and YL had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. AW, YL, and MF contributed to the conception and design of the study. YL, RW, and MD performed literature searches, organized the database, and performed reviews and statistical analyses. YL and AW interpreted the data. YL wrote the first draft of the manuscript. YL, RW, MF, MS, MD, and AW contributed to the critical revision of the manuscript for important intellectual content and approved the submitted version. AW obtained funding.
ISSN:0149-7634
1873-7528
DOI:10.1016/j.neubiorev.2021.10.004