Increased sympathetic and decreased parasympathetic cardiac innervation in patients with Alzheimer's disease.

To assess whether Alzheimer's disease affects the sympathetic and parasympathetic influences on the heart rate, we used power spectrum analysis of heart rate variability derived from simple body-surface electrocardiography. We calculated the energy ratio of low- to high-frequency bands. This ratio was significantly higher in patients with Alzheimer's disease than in normal controls (upright posture, 0.41 +/- 0.21 vs 0.23 +/- 0.08). The parasympathetically mediated baroreceptor activity reflected by the energy ratio of medium- to low- and high-frequency bands was significantly depressed in patients with Alzheimer's disease (upright posture, 0.12 +/- 0.02 vs 0.07 +/- 0.03; supine posture, 0.11 +/- 0.02 vs 0.085 +/- 0.025). Compared with normal volunteer controls, patients with Alzheimer's disease manifested a relatively hypersympathetic, hypoparasympathetic state.

[1]  D. Price,et al.  Topography of the Magnocellular Basal Forebrain System in Human Brain , 1984, Journal of neuropathology and experimental neurology.

[2]  E K Perry,et al.  Correlation of cholinergic abnormalities with senile plaques and mental test scores in senile dementia. , 1978, British medical journal.

[3]  J. Halter,et al.  Norepinephrine and MHPG levels in CSF and plasma in Alzheimer's disease. , 1984, Archives of general psychiatry.

[4]  L. Hersh,et al.  Neurofibrillary tangles in cholinergic pedunculopontine neurons in Alzheimer's disease , 1988, Annals of neurology.

[5]  R. Fieve,et al.  Cholinesterase activity and the manic depressive patients. , 1975, Diseases of the nervous system.

[6]  J Marshall,et al.  Cerebral blood flow in dementia. , 1975, Archives of neurology.

[7]  M. Folstein,et al.  Clinical diagnosis of Alzheimer's disease , 1984, Neurology.

[8]  B. W. Hyndman,et al.  Spontaneous Rhythms in Physiological Control Systems , 1971, Nature.

[9]  J. Coyle,et al.  Alzheimer disease: Evidence for selective loss of cholinergic neurons in the nucleus basalis , 1981, Annals of neurology.

[10]  S. Akselrod,et al.  Spectral analysis of heart rate fluctuations. A non-invasive, sensitive method for the early diagnosis of autonomic neuropathy in diabetes mellitus. , 1987, Journal of the autonomic nervous system.

[11]  R. Cohen,et al.  Power spectrum analysis of heart rate fluctuation: a quantitative probe of beat-to-beat cardiovascular control. , 1981, Science.

[12]  S Cerutti,et al.  The neural regulation of circulation explored in the frequency domain. , 1990, Journal of the autonomic nervous system.

[13]  M. Hamilton,et al.  Development of a rating scale for primary depressive illness. , 1967, The British journal of social and clinical psychology.

[14]  B. Chipperfield,et al.  DECREASED ERYTHROCYTE CHOLINESTERASE. ACTIVITY IN DEMENTIA , 1981, The Lancet.

[15]  S. Folstein,et al.  "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician. , 1975, Journal of psychiatric research.

[16]  M. Turiel,et al.  Power Spectral Analysis of Heart Rate and Arterial Pressure Variabilities as a Marker of Sympatho‐Vagal Interaction in Man and Conscious Dog , 1986, Circulation research.

[17]  R. Cohen,et al.  Hemodynamic regulation: investigation by spectral analysis. , 1985, The American journal of physiology.

[18]  J. Kessler Deficiency of a cholinergic differentiating factor in fibroblasts of patients with Alzheimer's disease , 1987, Annals of neurology.

[19]  Spectral analysis of short-term heart rate variability in diabetic patients. , 1990, Journal of the autonomic nervous system.

[20]  M. Mesulam,et al.  Atlas of cholinergic neurons in the forebrain and upper brainstem of the macaque based on monoclonal choline acetyltransferase immunohistochemistry and acetylcholinesterase histochemistry , 1984, Neuroscience.