Assessing ageing, cognitive ability and freezing of gait in Parkinson's disease through integrated brain-heart network dynamics

Parkinsons Disease (PD) is a complex neurodegenerative disorder that manifests through systemic, large-scale physiological reorganizations. While research often focuses on region-specific neural changes, there is a growing need for multidomain approaches to capture the complexity of the disease and its clinical heterogeneity. This study proposes an analytical pipeline to evaluate Brain-Heart Interplay (BHI) as a novel systemic biomarker for neurodegeneration and healthy ageing. In this study we assessed BHI across three open-source datasets (EEG and ECG signals). We compared Healthy Young, Healthy Elderly, and PD patients in resting state to investigate the effects of ageing and cognitive performance. Additionally, we studied BHI trends in PD patients in the moment of freezing of gait (FOG). Methodologically, brain network organization was quantified using coherence-based EEG connectivity and graph theory, while heart activity was analyzed through Poincare plot-derived measures of cardiac autonomic activity. The coupling between these two systems was measured using the Maximal Information Coefficient to capture linear and non-linear dependencies between global cortical organization and cardiac autonomic outflow. The results demonstrate that BHI is a sensitive biomarker for detecting early multisystem dysfunction in both neurodegeneration and ageing. Furthermore, the identification of specific BHI trends during FOG onset suggests new opportunities for understanding the physiological mechanisms driving motor complications in PD. Our proposed pipeline provides a guiding tool for large-scale physiological assessment in clinical research. HighlightsO_LIWe propose a pipeline based on EEG-ECG to assess ageing and neurodegeneration C_LIO_LIBrain-heart networks detect systemic changes in ageing and early PD C_LIO_LIResting brain-heart networks relate to cognitive performance in early PD C_LIO_LISpecific brain-heart interaction clusters emerge during freezing of gait C_LIO_LIBrain-heart networks offer a promising tool to understand PDs symptomatology C_LI