Heart Rate Variability and Nonlinear Dynamics as Predictors of Autonomic Dysfunction Following Acute Cervical Spinal Cord Injury: Insights from Traumatic and Non-Traumatic Injuries in a Monocentric Cohort of 500 Patients

Background: Acute cervical spinal cord injury (cSCI) disrupts supraspinal regulation of sympathetic cardiovascular control, resulting in autonomic dysfunction. Heart rate variability (HRV), particularly when analyzed with nonlinear dynamic metrics, provides a sensitive index of integrative autonomic regulation. Objective: To evaluate linear and nonlinear HRV parameters as predictors of autonomic dysfunction in patients with acute cSCI, comparing traumatic vs. non-traumatic injuries and healthy controls. Methods: This monocentric prospective study included 500 patients with acute cSCI (