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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Bibliographic Details
Published in:Neuroscience and biobehavioral reviews 2021-12, Vol.131, p.737-754
Main Authors: Lee, Yejin, Walsh, Ryan J., Fong, Mandy W.M., Sykora, Marek, Doering, Michelle M., Wong, Alex W.K.
Format: Article
Language:English
Subjects:
Biomarker
Biomarkers
Brain Injuries
Emotions
Functional outcomes
Heart Rate - physiology
Heart rate variability
Humans
Meta-analysis
Outcome assessment (health care)
Stroke
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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.
ISSN:0149-7634
1873-7528
DOI:10.1016/j.neubiorev.2021.10.004