Key result
Cerebral hemodynamics models accurately predict cognitive impairment in CSVD patients with AUCs up to ~0.92.
Why the study?
Cerebral small vessel disease is linked to cognitive impairment, prompting examination of how autonomic function and cerebral hemodynamics relate to cognitive function in these patients.
Are autonomic function and cerebral hemodynamics associated with cognitive impairment in patients with cerebral small vessel disease?
Cross-Sectional (n=206)
Are autonomic function and cerebral hemodynamics associated with cognitive impairment in patients with cerebral small vessel disease?
Impaired autonomic function (reduced HRV) and cerebral hemodynamic responses are significantly associated with cognitive dysfunction in cerebral small vessel disease, with CBFv-based models achieving high discriminative accuracy (AUC 0.917-0.924).
Cerebral hemodynamics discriminated cognitive impairment in CSVD; leaves open prospective validation and clinical utility.
BACKGROUND: Cerebral small vessel disease (CSVD) is linked to cognitive impairment. This study examined associations of autonomic function and cerebral hemodynamics with cognitive function in patients with CSVD. METHODS: In this cross-sectional study, patients with white matter hyperintensity and recent subcortical small infarction were recruited from January 2020 to March 2022. Cognitive function was assessed using education-adjusted Montreal Cognitive Assessment (MoCA), autonomic function using heart rate variability (HRV), and cerebral hemodynamics including cerebral autoregulation (CA), cerebrovascular reactivity, and neurovascular coupling (NVC). Logistic and linear regression and ROC analyses were performed. RESULTS: Among 206 patients (median age 63 years; 130 men), 167 (81.1%) had cognitive impairment. Patients with cognitive impairment showed reduced HRV and impaired cerebral hemodynamics, including dynamic CA and NVC. Mean Holding LF Phase and Mean Holding CBFv remained significantly associated with cognitive impairment in multivariable models. Hemodynamics-based models showed AUCs of 0.776-0.850 for LF Phase-based models and 0.917-0.924 for CBFv-based models. In sensitivity analyses excluding HFnu, Mean Holding CBFv remained significantly associated with cognitive impairment. CONCLUSIONS: Impaired autonomic function and cerebral hemodynamic responses may contribute to cognitive dysfunction in CSVD. Assessing parasympathetic function and cerebral hemodynamics may help identify cognitive impairment.
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Li et al. (2026) conducted a cross-sectional in Cerebral small vessel disease (CSVD) (n=206). Autonomic function (heart rate variability) and cerebral hemodynamics (cerebral autoregulation, cerebrovascular reactivity, neurovascular coupling) was evaluated on Cognitive impairment assessed using education-adjusted Montreal Cognitive Assessment (MoCA). Cerebral hemodynamics-based models predicted cognitive impairment (present in 81.1%) in CSVD patients with AUCs of 0.776-0.850 (LF Phase) and 0.917-0.924 (CBFv).
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