ArticleActa neurologica Belgica2026
Long-term HRV metrics may assist in differentiating between prolonged disorders of consciousness and emergence from minimally conscious state : a cross-sectional study.
Article in Acta neurologica Belgica, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveDiagnosing prolonged disorders of consciousness (DoC) remains a significant challenge in neurorehabilitation. Heart rate variability (HRV), a noninvasive measure of cardiac autonomic regulation, has been increasingly recognized as relevant to the mechanisms underlying consciousness. However, long-term HRV data in DoC patients remain scarce. This study aimed to investigate the relationship between long-term HRV metrics and the severity of consciousness impairment in patients with prolonged DoC.
methodsIn this cross-sectional study, 49 patients with prolonged DoC were enrolled. Each participant underwent five assessments using the Coma Recovery Scale-Revised (CRS-R) and one 24-hour electrocardiographic (ECG) monitoring session within one week of enrollment. Based on their highest CRS-R subscale scores, patients were categorized into three groups: unresponsive wakefulness syndrome (UWS, n = 17), minimally conscious state (MCS, n = 19), and emergence from MCS (EMCS, n = 13). HRV time-domain and frequency-domain indices were extracted from the 24-hour ECG recordings. Differences in HRV metrics among the consciousness groups were analyzed, and correlations between HRV parameters and CRS-R scores were examined.
resultsSignificant differences in HRV metrics were observed among the three consciousness groups (P < 0.05), including both time-domain indices (SDNN, SDANN, SDNN Index) and frequency-domain indices (HF, LF, VLF, ULF, and Total power). Furthermore, these HRV indices were significantly correlated with CRS-R scores (P < 0.05), indicating a strong association between autonomic function and the level of consciousness.
conclusionLong-term HRV monitoring reveals significantly greater heart rate variability in EMCS patients compared to those in UWS and MCS, highlighting its potential utility as a supplementary biomarker for assessing consciousness in patients with prolonged DoC.
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