Background. Cardiac autonomic dysfunction has been associated with cognitive impairment, but the underlying
pathogenesis is complex and cerebral white matter lesions (WMLs) might be implicated.
Methods. Time and frequency heart rate variability (HRV) and visual rating of WMLs were carried out in 42 patients
with mild cognitive impairment.
Results. After adjustment for relevant demographic and clinical characteristics, including left ventricular mass, reduced
HRV indices of parasympathetic (root mean square of successive difference of RR intervals, RMSSD) and sympathetic
modulation (low-frequency [LF] power) were associated with increased WML score (RMSSD: B − 0.30, 95%
CI − 0.52 to − 0.08, p = .01; LF: B − 0.24, 95% CI − 0.46 to − 0.02, p = .05). In a multiple-adjusted model, RMSSD was the
major independent predictor of WMLs ( B − 0.35, 95% CI − 0.57 to − 0.13, p = .002).
Conclusion. The evidence for an independent association of cardiac autonomic dysfunction with WMLs might
suggest its role in the pathogenesis of WMLs