Heart rate variability (HRV) abnormalities are potential early biomarkers in Parkinson’s disease (PD) but their relationship with central autonomic network (CAN) activity is not fully understood. We analyzed the synchronization between HRV and brain activity in 31 PD patients and 21 age-matched healthy controls using blood-oxygen-level-dependent (BOLD) signals from resting-state functional brain MRI and HRV metrics from finger plethysmography recorded for 7.40 min. We additionally quantified autonomic symptoms (SCOPA-AUT) and objective autonomic cardiovascular parameters (blood pressure and heart rate) during deep breathing, Valsalva, and head-up tilt, which were used to classify the clinical severity of dysautonomia. We evaluated HRV and BOLD signals synchronization (HRV-BOLD-sync) with Pearson lagged cross-correlations and Fisher’s statistics for combining window-length-dependent HRV-BOLD-Sync Maps and assessed their association with clinical dysautonomia. HRV-BOLD-sync was lower significantly in PD than in controls in various brain regions within CAN or in networks involved in autonomic modulation. Moreover, heart-brain synchronization index (HBSI), which quantifies heart-brain synchronization at a single-subject level, showed an inverse exposure–response relationship with dysautonomia severity, finding the lowest HBSI in patients with severe dysautonomia, followed by moderate, mild, and, lastly, controls. Importantly, HBSI was associated in PD, but not in controls, with Valsalva pressure recovery time (sympathetic), deep breathing E/I ratio (cardiovagal), and SCOPA-AUT. Our findings support the existence of heart-brain de-synchronization in PD with an impact on clinically relevant autonomic outcomes.

心率变异性 (HRV) 异常是帕金森病 (PD) 的潜在早期生物标志物，但它们与中枢自主神经网络 (CAN) 活动的关系尚不完全清楚。我们分析了 31 名 PD 患者和 21 名年龄匹配的健康对照者的 HRV 和大脑活动之间的同步性，使用来自静息状态功能性脑 MRI 的血氧水平依赖 (BOLD) 信号和来自记录 7.40 分钟的手指体积描记术的 HRV 指标。我们还量化了深呼吸、Valsalva 和抬头倾斜期间的自主神经症状 (SCOPA-AUT) 和客观自主心血管参数（血压和心率），用于对自主神经功能障碍的临床严重程度进行分类。我们评估了 HRV 和 BOLD 信号同步 (HRV-BOLD-sync) 与 Pearson 滞后互相关和 Fisher 的统计数据，以结合窗口长度相关的 HRV-BOLD-Sync Maps，并评估它们与临床自主神经功能障碍的关联。PD 患者的 HRV-BOLD 同步显着低于 CAN 内不同脑区或参与自主调节的网络中的对照。此外，在单个受试者水平上量化心脑同步的心脑同步指数 (HBSI) 显示出与自主神经功能障碍严重程度呈负相关的暴露-反应关系，发现重度自主神经功能障碍患者的 HBSI 最低，其次是中度、轻度，最后是控制。重要的是，HBSI 与 PD 相关，但与对照组无关，与 Valsalva 压力恢复时间（交感神经）、深呼吸 E/I 比（心脏）、和SCOPA-AUT。我们的研究结果支持 PD 中存在心脑去同步化，并影响临床相关的自主神经结果。