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Lory C, Kadlaskar G, McNally Keehn R, Francis AL, Keehn B. Brief Report: Reduced Heart Rate Variability in Children with Autism Spectrum Disorder. J Autism Dev Disord 2020; 50:4183-4190. [PMID: 32219633 DOI: 10.1007/s10803-020-04458-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Dysregulation of the autonomic nervous system (ANS), which can be indexed by heart rate variability (HRV), has been posited to contribute to core features of autism spectrum disorder (ASD). However, the relationship between ASD and HRV remains uncertain. We assessed tonic and phasic HRV of 21 children with ASD and 21 age- and IQ-matched typically developing (TD) children and examined (1) group differences in HRV and (2) associations between HRV and ASD symptomatology. Children with ASD showed significantly lower tonic HRV, but similar phasic HRV compared to TD children. Additionally, reduced tonic HRV was associated with atypical attentional responsivity in ASD. Our findings suggest ANS dysregulation is present in ASD and may contribute to atypical attentional responses to sensory stimulation.
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Affiliation(s)
- Catharine Lory
- Department of Educational Studies, Purdue University, 100 N University Street, West Lafayette, IN, 47907, USA.
| | - Girija Kadlaskar
- Department of Speech, Language, and Hearing Sciences, Purdue University, West Lafayette, IN, USA
| | - Rebecca McNally Keehn
- Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Alexander L Francis
- Department of Speech, Language, and Hearing Sciences, Purdue University, West Lafayette, IN, USA
| | - Brandon Keehn
- Department of Speech, Language, and Hearing Sciences, Purdue University, West Lafayette, IN, USA.,Department of Psychological Sciences, Purdue University, West Lafayette, IN, USA
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52
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Fedjajevs A, Groenendaal W, Agell C, Hermeling E. Platform for Analysis and Labeling of Medical Time Series. SENSORS (BASEL, SWITZERLAND) 2020; 20:E7302. [PMID: 33352643 PMCID: PMC7766988 DOI: 10.3390/s20247302] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 12/12/2020] [Accepted: 12/16/2020] [Indexed: 01/29/2023]
Abstract
Reliable and diverse labeled reference data are essential for the development of high-quality processing algorithms for medical signals, such as electrocardiogram (ECG) and photoplethysmogram (PPG). Here, we present the Platform for Analysis and Labeling of Medical time Series (PALMS) designed in Python. Its graphical user interface (GUI) facilitates three main types of manual annotations-(1) fiducials, e.g., R-peaks of ECG; (2) events with an adjustable duration, e.g., arrhythmic episodes; and (3) signal quality, e.g., data parts corrupted by motion artifacts. All annotations can be attributed to the same signal simultaneously in an ergonomic and user-friendly manner. Configuration for different data and annotation types is straightforward and flexible in order to use a wide range of data sources and to address many different use cases. Above all, configuration of PALMS allows plugging-in existing algorithms to display outcomes of automated processing, such as automatic R-peak detection, and to manually correct them where needed. This enables fast annotation and can be used to further improve algorithms. The GUI is currently complemented by ECG and PPG algorithms that detect characteristic points with high accuracy. The ECG algorithm reached 99% on the MIT/BIH arrhythmia database. The PPG algorithm was validated on two public databases with an F1-score above 98%. The GUI and optional algorithms result in an advanced software tool that allows the creation of diverse reference sets for existing datasets.
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Affiliation(s)
- Andrejs Fedjajevs
- Stichting Imec the Netherlands, 5656 AE Eindhoven, The Netherlands; (W.G.); (C.A.); (E.H.)
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53
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Oyelade T, Canciani G, Bottaro M, Zaccaria M, Formentin C, Moore K, Montagnese S, Mani AR. Heart Rate Turbulence Predicts Survival Independently From Severity of Liver Dysfunction in Patients With Cirrhosis. Front Physiol 2020; 11:602456. [PMID: 33362578 PMCID: PMC7755978 DOI: 10.3389/fphys.2020.602456] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 11/16/2020] [Indexed: 12/20/2022] Open
Abstract
Background Reduced heart rate variability (HRV) is an independent predictor of mortality in patients with cirrhosis. However, conventional HRV indices can only be interpreted in individuals with normal sinus rhythm. In patients with recurrent premature ventricular complexes (PVCs), the predictive capacity of conventional HRV indices is compromised. Heart Rate Turbulence (HRT) represents the biphasic change of the heart rate after PVCs. This study was aimed to define whether HRT parameters could predict mortality in cirrhotic patients. Materials and Methods 24 h electrocardiogram recordings were collected from 40 cirrhotic patients. Turbulence Onset was calculated as HRT indices. The enrolled patients were followed up for 12 months after the recruitment in relation to survival and/or transplantation. Results During the follow-up period, 21 patients (52.5%) survived, 12 patients (30%) died and 7 patients (17.5%) had liver transplantation. Turbulence Onset was found to be strongly linked with mortality on Cox regression (Hazard ratio = 1.351, p < 0.05). Moreover, Turbulence Onset predicted mortality independently of MELD and Child-Pugh's Score. Conclusion This study provides further evidence of autonomic dysfunction in cirrhosis and suggests that HRT is reliable alternative to HRV in patients with PVCs.
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Affiliation(s)
- Tope Oyelade
- Institute for Liver and Digestive Health, Division of Medicine, UCL, London, United Kingdom
| | - Gabriele Canciani
- Institute for Liver and Digestive Health, Division of Medicine, UCL, London, United Kingdom.,School of Medicine, Sapienza University of Rome, Rome, Italy
| | - Matteo Bottaro
- Department of Medicine, University of Padova, Padua, Italy
| | - Marta Zaccaria
- Institute for Liver and Digestive Health, Division of Medicine, UCL, London, United Kingdom
| | | | - Kevin Moore
- Institute for Liver and Digestive Health, Division of Medicine, UCL, London, United Kingdom
| | | | - Ali R Mani
- Institute for Liver and Digestive Health, Division of Medicine, UCL, London, United Kingdom
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Stewart J, Stewart P, Walker T, Gullapudi L, Eldehni MT, Selby NM, Taal MW. Application of the Lomb-Scargle Periodogram to InvestigateHeart Rate Variability during Haemodialysis. JOURNAL OF HEALTHCARE ENGINEERING 2020; 2020:8862074. [PMID: 33376586 PMCID: PMC7738214 DOI: 10.1155/2020/8862074] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 11/02/2020] [Accepted: 11/12/2020] [Indexed: 11/20/2022]
Abstract
Short-term cardiovascular compensatory responses to perturbations in the circulatory system caused by haemodialysis can be investigated by the spectral analysis of heart rate variability, thus providing an important variable for categorising individual patients' response, leading to a more personalised treatment. This is typically accomplished by resampling the irregular heart rate to generate an equidistant time series prior to spectral analysis, but resampling can further distort the data series whose interpretation can already be compromised by the presence of artefacts. The Lomb-Scargle periodogram provides a more direct method of spectral analysis as this method is specifically designed for large, irregularly sampled, and noisy datasets such as those obtained in clinical settings. However, guidelines for preprocessing patient data have been established in combination with equidistant time-series methods and their validity when used in combination with the Lomb-Scargle approach is missing from literature. This paper examines the effect of common preprocessing methods on the Lomb-Scargle power spectral density estimate using both real and synthetic heart rate data and will show that many common techniques for identifying and editing suspect data points, particularly interpolation and replacement, will distort the resulting power spectrum potentially misleading clinical interpretations of the results. Other methods are proposed and evaluated for use with the Lomb-Scargle approach leading to the main finding that suspicious data points should be excluded rather than edited, and where required, denoising of the heart rate signal can be reliably accomplished by empirical mode decomposition. Some additional methods were found to be particularly helpful when used in conjunction with the Lomb-Scargle periodogram, such as the use of a false alarm probability metric to establish whether spectral estimates are valid and help automate the assessment of valid heart rate records, potentially leading to greater use of this powerful technique in a clinical setting.
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Affiliation(s)
- Jill Stewart
- School of Health and Social Care, University of Derby, Derby, UK
| | - Paul Stewart
- School of Health and Social Care, University of Derby, Derby, UK
| | - Tom Walker
- School of Health and Social Care, University of Derby, Derby, UK
| | - Latha Gullapudi
- Centre for Kidney Research and Innovation, University of Nottingham, Derby, UK
| | | | - Nicholas M. Selby
- Centre for Kidney Research and Innovation, University of Nottingham, Derby, UK
- Renal Unit, Royal Derby Hospital, Derby, UK
| | - Maarten W. Taal
- Centre for Kidney Research and Innovation, University of Nottingham, Derby, UK
- Renal Unit, Royal Derby Hospital, Derby, UK
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Tseng VW, Costa JDR, Jung MF, Choudhury T. Using Smartphone Sensor Data to Assess Inhibitory Control in the Wild: Longitudinal Study. JMIR Mhealth Uhealth 2020; 8:e21703. [PMID: 33275106 PMCID: PMC7748963 DOI: 10.2196/21703] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 09/29/2020] [Accepted: 10/26/2020] [Indexed: 12/23/2022] Open
Abstract
Background Inhibitory control, or inhibition, is one of the core executive functions of humans. It contributes to our attention, performance, and physical and mental well-being. Our inhibitory control is modulated by various factors and therefore fluctuates over time. Being able to continuously and unobtrusively assess our inhibitory control and understand the mediating factors may allow us to design intelligent systems that help manage our inhibitory control and ultimately our well-being. Objective The aim of this study is to investigate whether we can assess individuals’ inhibitory control using an unobtrusive and scalable approach to identify digital markers that are predictive of changes in inhibitory control. Methods We developed InhibiSense, an app that passively collects the following information: users’ behaviors based on their phone use and sensor data, the ground truths of their inhibition control measured with stop-signal tasks (SSTs) and ecological momentary assessments (EMAs), and heart rate information transmitted from a wearable heart rate monitor (Polar H10). We conducted a 4-week in-the-wild study, where participants were asked to install InhibiSense on their phone and wear a Polar H10. We used generalized estimating equation (GEE) and gradient boosting tree models fitted with features extracted from participants’ phone use and sensor data to predict their stop-signal reaction time (SSRT), an objective metric used to measure an individual’s inhibitory control, and identify the predictive digital markers. Results A total of 12 participants completed the study, and 2189 EMAs and SST responses were collected. The results from the GEE models suggest that the top digital markers positively associated with an individual’s SSRT include phone use burstiness (P=.005), the mean duration between 2 consecutive phone use sessions (P=.02), the change rate of battery level when the phone was not charged (P=.04), and the frequency of incoming calls (P=.03). The top digital markers negatively associated with SSRT include the standard deviation of acceleration (P<.001), the frequency of short phone use sessions (P<.001), the mean duration of incoming calls (P<.001), the mean decibel level of ambient noise (P=.007), and the percentage of time in which the phone was connected to the internet through a mobile network (P=.001). No significant correlation between the participants’ objective and subjective measurement of inhibitory control was found. Conclusions We identified phone-based digital markers that were predictive of changes in inhibitory control and how they were positively or negatively associated with a person’s inhibitory control. The results of this study corroborate the findings of previous studies, which suggest that inhibitory control can be assessed continuously and unobtrusively in the wild. We discussed some potential applications of the system and how technological interventions can be designed to help manage inhibitory control.
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Affiliation(s)
- Vincent Ws Tseng
- Department of Information Science, Cornell University, New York, NY, United States
| | - Jean Dos Reis Costa
- DawnLight Technologies, Palo Alto, CA, United States.,Department of Information Science, Cornell University, Ithaca, NY, United States
| | - Malte F Jung
- Department of Information Science, Cornell University, Ithaca, NY, United States
| | - Tanzeem Choudhury
- Department of Information Science, Cornell University, New York, NY, United States
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56
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Silva LEV, Fazan R, Marin-Neto JA. PyBioS: A freeware computer software for analysis of cardiovascular signals. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2020; 197:105718. [PMID: 32866762 DOI: 10.1016/j.cmpb.2020.105718] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Accepted: 08/18/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND AND OBJECTIVE Several software applications have been proposed in the past years as computational tools for assessing biomedical signals. Many of them are focused on heart rate variability series only, with their strengths and limitations depending on the necessity of the user and the scope of the application. Here, we introduce new software, named PyBioS, intended for the analysis of cardiovascular signals, even though any type of biomedical signal can be used. PyBioS has some functionalities that differentiate it from the other software. METHODS PyBioS was developed in Python language with an intuitive, user-friendly graphical user interface. The basic steps for using PyBioS comprise the opening or creation (simulation) of signals, their visualization, preprocessing and analysis. Currently, PyBioS has 8 preprocessing tools and 15 analysis methods, the later providing more than 50 metrics for analysis of the signals' dynamics. RESULTS The possibility to create simulated signals and save the preprocessed signals is a strength of PyBioS. Besides, the software allows batch processing of files, making the analysis of a large amount of data easy and fast. Finally, PyBioS has plenty of analysis methods implemented, with the focus on nonlinear and complexity analysis of signals and time series. CONCLUSIONS Although PyBioS is not intended to overcome all the necessities from users, it has useful functionalities that may be helpful in many situations. Moreover, PyBioS is continuously under improvement and several simulated signals, tools and analysis methods are still to be implemented. Also, a new module is being implemented on it to provide machine learning algorithms for classification and regression of data extracted from the biomedical signals.
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Affiliation(s)
| | - Rubens Fazan
- Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil.
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57
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Stecyk JAW, Couturier CS, Abramochkin DV, Hall D, Arrant-Howell A, Kubly KL, Lockmann S, Logue K, Trueblood L, Swalling C, Pinard J, Vogt A. Cardiophysiological responses of the air-breathing Alaska blackfish to cold acclimation and chronic hypoxic submergence at 5°C. J Exp Biol 2020; 223:jeb225730. [PMID: 33020178 PMCID: PMC7687868 DOI: 10.1242/jeb.225730] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Accepted: 09/28/2020] [Indexed: 01/29/2023]
Abstract
The Alaska blackfish (Dallia pectoralis) remains active at cold temperatures when experiencing aquatic hypoxia without air access. To discern the cardiophysiological adjustments that permit this behaviour, we quantified the effect of acclimation from 15°C to 5°C in normoxia (15N and 5N fish), as well as chronic hypoxic submergence (6-8 weeks; ∼6.3-8.4 kPa; no air access) at 5°C (5H fish), on in vivo and spontaneous heart rate (fH), electrocardiogram, ventricular action potential (AP) shape and duration (APD), the background inward rectifier (IK1) and rapid delayed rectifier (IKr) K+ currents and ventricular gene expression of proteins involved in excitation-contraction coupling. In vivo fH was ∼50% slower in 5N than in 15N fish, but 5H fish did not display hypoxic bradycardia. Atypically, cold acclimation in normoxia did not induce shortening of APD or alter resting membrane potential. Rather, QT interval and APD were ∼2.6-fold longer in 5N than in 15N fish because outward IK1 and IKr were not upregulated in 5N fish. By contrast, chronic hypoxic submergence elicited a shortening of QT interval and APD, driven by an upregulation of IKr The altered electrophysiology of 5H fish was accompanied by increased gene expression of kcnh6 (3.5-fold; Kv11.2 of IKr), kcnj12 (7.4-fold; Kir2.2 of IK1) and kcnj14 (2.9-fold; Kir2.4 of IK1). 5H fish also exhibited a unique gene expression pattern that suggests modification of ventricular Ca2+ cycling. Overall, the findings reveal that Alaska blackfish exposed to chronic hypoxic submergence prioritize the continuation of cardiac performance to support an active lifestyle over reducing cardiac ATP demand.
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Affiliation(s)
- Jonathan A W Stecyk
- Department of Biological Sciences, University of Alaska Anchorage, Anchorage, AK 99508, USA
| | - Christine S Couturier
- Department of Biological Sciences, University of Alaska Anchorage, Anchorage, AK 99508, USA
| | - Denis V Abramochkin
- Department of Human and Animal Physiology, Lomonosov Moscow State University, 1-12 Leninskiye Gory, 119991 Moscow, Russia
- Ural Federal University, 19 Mira Street, 620002 Ekaterinburg, Russia
- Laboratory of Cardiac Physiology, Institute of Physiology of Kоmi Science Centre of the Ural Branch of the Russian Academy of Sciences, FRC Komi SC UB RAS, 50 Pervomayskaya Str., 167982 Syktyvkar, Komi Republic, Russia
| | - Diarmid Hall
- Department of Biological Sciences, University of Alaska Anchorage, Anchorage, AK 99508, USA
| | - Asia Arrant-Howell
- Department of Biological Sciences, University of Alaska Anchorage, Anchorage, AK 99508, USA
| | - Kerry L Kubly
- Department of Biological Sciences, University of Alaska Anchorage, Anchorage, AK 99508, USA
| | - Shyanne Lockmann
- Department of Biological Sciences, University of Alaska Anchorage, Anchorage, AK 99508, USA
| | - Kyle Logue
- Department of Biological Sciences, University of Alaska Anchorage, Anchorage, AK 99508, USA
| | - Lenett Trueblood
- Department of Biological Sciences, University of Alaska Anchorage, Anchorage, AK 99508, USA
| | - Connor Swalling
- Department of Biological Sciences, University of Alaska Anchorage, Anchorage, AK 99508, USA
| | - Jessica Pinard
- Department of Biological Sciences, University of Alaska Anchorage, Anchorage, AK 99508, USA
| | - Angela Vogt
- Department of Biological Sciences, University of Alaska Anchorage, Anchorage, AK 99508, USA
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Jacques T, Alves RA, Fadaei S, Barbosa F. Real-Time Psychophysiological and Writing Correlates of Expressive Writing. Exp Psychol 2020; 67:237-245. [PMID: 33111656 DOI: 10.1027/1618-3169/a000495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Concealing memories and emotions associated with a traumatic event seems to have negative effects on health. Re-enacting those events through writing is an opportunity to disclose such memories and emotions, and especially for emotion regulation. To study this, 57 university students were randomly assigned to one of two groups. They either completed an expressive writing or a neutral writing task. Real-time writing and psychophysiological data were recorded throughout the experiment to examine writing dynamics associated with emotion regulation and its psychophysiological correlates (electrodermal activity and electrocardiography measures). The results showed that the expressive group (EG) paused for longer than the control group (CG) denoting a positive and medium effect size ( η p 2 = .10 ) . Furthermore, during and after writing, the EG showed a higher low frequency/high frequency ratio than the CG, evidencing a positive and large effect size ( η p 2 = .22 ) . These real-time findings are interpreted as signs of emotion regulation happening during writing.
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Affiliation(s)
- Teresa Jacques
- Faculty of Psychology and Education Sciences, University of Porto, Portugal
| | - Rui A Alves
- Faculty of Psychology and Education Sciences, University of Porto, Portugal
| | - Setareh Fadaei
- Faculty of Psychology and Education Sciences, University of Porto, Portugal
| | - Fernando Barbosa
- Laboratory of Neuropsychophysiology, Faculty of Psychology and Education Sciences, University of Porto, Portugal
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Chiera M, Cerritelli F, Casini A, Barsotti N, Boschiero D, Cavigioli F, Corti CG, Manzotti A. Heart Rate Variability in the Perinatal Period: A Critical and Conceptual Review. Front Neurosci 2020; 14:561186. [PMID: 33071738 PMCID: PMC7544983 DOI: 10.3389/fnins.2020.561186] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Accepted: 08/28/2020] [Indexed: 12/18/2022] Open
Abstract
Neonatal intensive care units (NICUs) greatly expand the use of technology. There is a need to accurately diagnose discomfort, pain, and complications, such as sepsis, mainly before they occur. While specific treatments are possible, they are often time-consuming, invasive, or painful, with detrimental effects for the development of the infant. In the last 40 years, heart rate variability (HRV) has emerged as a non-invasive measurement to monitor newborns and infants, but it still is underused. Hence, the present paper aims to review the utility of HRV in neonatology and the instruments available to assess it, showing how HRV could be an innovative tool in the years to come. When continuously monitored, HRV could help assess the baby’s overall wellbeing and neurological development to detect stress-/pain-related behaviors or pathological conditions, such as respiratory distress syndrome and hyperbilirubinemia, to address when to perform procedures to reduce the baby’s stress/pain and interventions, such as therapeutic hypothermia, and to avoid severe complications, such as sepsis and necrotizing enterocolitis, thus reducing mortality. Based on literature and previous experiences, the first step to efficiently introduce HRV in the NICUs could consist in a monitoring system that uses photoplethysmography, which is low-cost and non-invasive, and displays one or a few metrics with good clinical utility. However, to fully harness HRV clinical potential and to greatly improve neonatal care, the monitoring systems will have to rely on modern bioinformatics (machine learning and artificial intelligence algorithms), which could easily integrate infant’s HRV metrics, vital signs, and especially past history, thus elaborating models capable to efficiently monitor and predict the infant’s clinical conditions. For this reason, hospitals and institutions will have to establish tight collaborations between the obstetric, neonatal, and pediatric departments: this way, healthcare would truly improve in every stage of the perinatal period (from conception to the first years of life), since information about patients’ health would flow freely among different professionals, and high-quality research could be performed integrating the data recorded in those departments.
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Affiliation(s)
- Marco Chiera
- Research and Assistance for Infants to Support Experience Lab, Foundation Center for Osteopathic Medicine Collaboration, Pescara, Italy.,Research Commission on Manual Therapies and Mind-Body Disciplines, Societ Italiana di Psico Neuro Endocrino Immunologia, Rome, Italy
| | - Francesco Cerritelli
- Research and Assistance for Infants to Support Experience Lab, Foundation Center for Osteopathic Medicine Collaboration, Pescara, Italy
| | - Alessandro Casini
- Research and Assistance for Infants to Support Experience Lab, Foundation Center for Osteopathic Medicine Collaboration, Pescara, Italy
| | - Nicola Barsotti
- Research and Assistance for Infants to Support Experience Lab, Foundation Center for Osteopathic Medicine Collaboration, Pescara, Italy.,Research Commission on Manual Therapies and Mind-Body Disciplines, Societ Italiana di Psico Neuro Endocrino Immunologia, Rome, Italy
| | | | - Francesco Cavigioli
- Neonatal Intensive Care Unit, "V. Buzzi" Children's Hospital, Azienda Socio Sanitaria Territoriale Fatebenefratelli-Sacco, Milan, Italy
| | - Carla G Corti
- Pediatric Cardiology Unit-Pediatric Department, Azienda Socio Sanitaria Territoriale Fatebenefratelli-Sacco, Milan, Italy
| | - Andrea Manzotti
- Research and Assistance for Infants to Support Experience Lab, Foundation Center for Osteopathic Medicine Collaboration, Pescara, Italy.,Neonatal Intensive Care Unit, "V. Buzzi" Children's Hospital, Azienda Socio Sanitaria Territoriale Fatebenefratelli-Sacco, Milan, Italy.,Research Department, SOMA, Istituto Osteopatia Milano, Milan, Italy
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Corbier C, Chouchou F, Roche F, Barthélémy JC, Pichot V. Causal analyses to study autonomic regulation during acute head-out water immersion, head-down tilt and supine position. Exp Physiol 2020; 105:1216-1222. [PMID: 32436624 DOI: 10.1113/ep088640] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Accepted: 05/18/2020] [Indexed: 11/08/2022]
Abstract
NEW FINDINGS What is the central question of this study? Can Granger causality analysis of R-R intervals, systolic blood pressure and respiration provide evidence for the different physiological mechanisms induced during thermoneutral water immersion, 6 deg head-down tilt and supine position tests that are not accessible using traditional heart rate variability and baroreflex methods? What is the main finding and its importance? The Granger analysis demonstrated a significant difference in the causal link from R-R intervals to respiration between water immersion and head-down tilt. The underlying physiological mechanism explaining this difference could be the variation in peripheral resistances. ABSTRACT Thermoneutral head-out water immersion (WI) and 6 deg head-down tilt (HDT) are used to simulate SCUBA diving, swimming and microgravity, because these models induce an increase in central blood volume. Standard methods to analyse autonomic regulation have demonstrated an increase in parasympathetic activity and baroreflex sensitivity during these experimental conditions. However, such methods are not adapted to quantify all closed-loop interactions involved in respiratory and cardiovascular regulation. To overcome this limitation, we used Granger causality analysis between R-R intervals (RR), systolic blood pressure (SBP) and respiration (RE) in eight young, healthy subjects, recorded during 30 min periods in the supine position, WI and HDT. For all experimental conditions, we found a bidirectional causal relationship between RE and RR and between RR and SBP, with a dominant direction from RR to SBP, and a unidirectional causality from RE to SBP. These causal relationships remained unchanged for the three experimental tests. Interestingly, there was a lower causal relationship from RR to RE during WI compared with HDT. This causal link from RR to RE could be modulated by peripheral resistances. These results highlight differences in cardiovascular regulation during WI and HDT and confirm that Granger causality might reveal physiological mechanisms not accessible with standard methods.
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Affiliation(s)
- Christophe Corbier
- Saint-Etienne Jean Monnet University, Roanne Technology University Institute, University of Lyon, LASPI (EA3059), Roanne, F-42334, France
| | - Florian Chouchou
- University of La Réunion, UFRSHE, IRISSE Laboratory (EA4075), Le Tampon, F-97430, France
| | - Frédéric Roche
- Saint-Etienne Jean Monnet University, CHU de Saint-Etienne, Department of Clinical and Exercise Physiology, University of Lyon, SNA-EPIS (EA4607), Saint-Etienne, F-42055, France
| | - Jean-Claude Barthélémy
- Saint-Etienne Jean Monnet University, CHU de Saint-Etienne, Department of Clinical and Exercise Physiology, University of Lyon, SNA-EPIS (EA4607), Saint-Etienne, F-42055, France
| | - Vincent Pichot
- Saint-Etienne Jean Monnet University, CHU de Saint-Etienne, Department of Clinical and Exercise Physiology, University of Lyon, SNA-EPIS (EA4607), Saint-Etienne, F-42055, France
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61
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Georgieva-Tsaneva G, Gospodinova E, Gospodinov M, Cheshmedzhiev K. Cardio-Diagnostic Assisting Computer System. Diagnostics (Basel) 2020; 10:diagnostics10050322. [PMID: 32438753 PMCID: PMC7277997 DOI: 10.3390/diagnostics10050322] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2020] [Revised: 05/07/2020] [Accepted: 05/13/2020] [Indexed: 12/29/2022] Open
Abstract
The mathematical analysis and the assessment of heart rate variability (HRV) based on computer systems can assist the diagnostic process with determining the cardiac status of patients. The new cardio-diagnostic assisting computer system created uses the classic Time-Domain, Frequency-Domain, and Time-Frequency analysis indices, as well as the nonlinear methods (Poincaré plot, Recurrence plot, Hurst R/S method, Detrended Fluctuation Analysis (DFA), Multi-Fractal DFA, Approximate Entropy and Sample Entropy). To test the feasibility of the software developed, 24-hour Holter recordings of four groups of people were analysed: healthy subjects and patients with arrhythmia, heart failure and syncope. Time-Domain (SDNN < 50 ms, SDANN < 100 ms, RMSSD < 17 ms) and Frequency-Domain (the spectrum of HRV in the LF < 550 ms2, and HF < 540 ms2) parameter values decreased in the cardiovascular disease groups compared to the control group as a result of lower HRV due to decreased parasympathetic and increased sympathetic activity. The results of the nonlinear analysis showed low values of (SD1 < 56 ms, SD2 < 110 ms) at Poincaré plot (Alpha < 90 ms) at DFA in patients with diseases. Significantly reducing these parameters are markers of cardiac dysfunction. The examined groups of patients showed an increase in the parameters (DET% > 95, REC% > 38, ENTR > 3.2) at the Recurrence plot. This is evidence of a pathological change in the regulation of heart rhythm. The system created can be useful in making the diagnosis by the cardiologist and in bringing greater accuracy and objectivity to the treatment.
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Duong HTH, Tadesse GA, Nhat PTH, Hao NV, Prince J, Duong TD, Kien TT, Nhat LTH, Tan LV, Pugh C, Loan HT, Chau NVV, Minh Yen L, Zhu T, Clifton D, Thwaites L. Heart Rate Variability as an Indicator of Autonomic Nervous System Disturbance in Tetanus. Am J Trop Med Hyg 2020; 102:403-407. [PMID: 31833471 PMCID: PMC7008337 DOI: 10.4269/ajtmh.19-0720] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Autonomic nervous system dysfunction (ANSD) is a significant cause of mortality in tetanus. Currently, diagnosis relies on nonspecific clinical signs. Heart rate variability (HRV) may indicate underlying autonomic nervous system activity and represents a potentially valuable noninvasive tool for ANSD diagnosis in tetanus. HRV was measured from three 5-minute electrocardiogram recordings during a 24-hour period in a cohort of patients with severe tetanus, all receiving mechanical ventilation. HRV measurements from all subjects—five with ANSD (Ablett Grade 4) and four patients without ANSD (Ablett Grade 3)—showed HRV was lower than reported ranges for healthy individuals. Comparing different severities of tetanus, raw data for both time and frequency measurements of HRV were reduced in those with ANSD compared with those without. Differences were statistically significant in all except root mean square SD, indicating HRV may be a valuable tool in ANSD diagnosis.
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Affiliation(s)
| | - Girmaw Abebe Tadesse
- Institute of Biomedical Engineering, University of Oxford, Oxford, United Kingdom
| | | | - Nguyen Van Hao
- University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam.,Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
| | - John Prince
- Institute of Biomedical Engineering, University of Oxford, Oxford, United Kingdom
| | - Tran Duc Duong
- Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
| | - Trịnh Trung Kien
- Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
| | | | - Le Van Tan
- Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
| | - Chris Pugh
- Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Huynh Thi Loan
- Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
| | | | - Lam Minh Yen
- Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
| | - Tingting Zhu
- Institute of Biomedical Engineering, University of Oxford, Oxford, United Kingdom
| | - David Clifton
- Institute of Biomedical Engineering, University of Oxford, Oxford, United Kingdom
| | - Louise Thwaites
- Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, United Kingdom.,Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
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63
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Tadesse GA, Zhu T, Le Nguyen Thanh N, Hung NT, Duong HTH, Khanh TH, Quang PV, Tran DD, Yen LM, Doorn RV, Hao NV, Prince J, Javed H, Kiyasseh D, Tan LV, Thwaites L, Clifton DA. Severity detection tool for patients with infectious disease. Healthc Technol Lett 2020; 7:45-50. [PMID: 32431851 PMCID: PMC7199289 DOI: 10.1049/htl.2019.0030] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Revised: 11/12/2019] [Accepted: 01/16/2020] [Indexed: 01/22/2023] Open
Abstract
Hand foot and mouth disease (HFMD) and tetanus are serious infectious diseases in low- and middle-income countries. Tetanus, in particular, has a high mortality rate and its treatment is resource-demanding. Furthermore, HFMD often affects a large number of infants and young children. As a result, its treatment consumes enormous healthcare resources, especially when outbreaks occur. Autonomic nervous system dysfunction (ANSD) is the main cause of death for both HFMD and tetanus patients. However, early detection of ANSD is a difficult and challenging problem. The authors aim to provide a proof-of-principle to detect the ANSD level automatically by applying machine learning techniques to physiological patient data, such as electrocardiogram waveforms, which can be collected using low-cost wearable sensors. Efficient features are extracted that encode variations in the waveforms in the time and frequency domains. The proposed approach is validated on multiple datasets of HFMD and tetanus patients in Vietnam. Results show that encouraging performance is achieved. Moreover, the proposed features are simple, more generalisable and outperformed the standard heart rate variability analysis. The proposed approach would facilitate both the diagnosis and treatment of infectious diseases in low- and middle-income countries, and thereby improve patient care.
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Affiliation(s)
- Girmaw Abebe Tadesse
- Institute of Biomedical Engineering, University of Oxford, Oxford, UK.,IBM Research
- Africa, Nairobi, Kenya
| | - Tingting Zhu
- Institute of Biomedical Engineering, University of Oxford, Oxford, UK
| | | | | | | | | | | | - Duc Duong Tran
- Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
| | - Lam Minh Yen
- Oxford Clinical Research Unit, Ho Chi Minh City, Vietnam
| | - Rogier Van Doorn
- Oxford University Clinical Research Unit, Hanoi, Vietnam.,Centre for Tropical Medicine and Global Health, Oxford University, UK
| | - Nguyen Van Hao
- Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
| | - John Prince
- Institute of Biomedical Engineering, University of Oxford, Oxford, UK
| | - Hamza Javed
- Institute of Biomedical Engineering, University of Oxford, Oxford, UK
| | - Dani Kiyasseh
- Institute of Biomedical Engineering, University of Oxford, Oxford, UK
| | - Le Van Tan
- Oxford Clinical Research Unit, Ho Chi Minh City, Vietnam
| | - Louise Thwaites
- Oxford Clinical Research Unit, Ho Chi Minh City, Vietnam.,Centre for Tropical Medicine and Global Health, Oxford University, UK
| | - David A Clifton
- Institute of Biomedical Engineering, University of Oxford, Oxford, UK
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64
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Fournié C, Bouscaren N, Dalleau G, Lenclume V, Mohr C, Zunic P, Cabrera Q, Verkindt C. Adapted physical activity and cardiac coherence in hematologic patients (APACCHE): study protocol for a randomized controlled trial. BMC Sports Sci Med Rehabil 2020; 12:18. [PMID: 32190333 PMCID: PMC7071585 DOI: 10.1186/s13102-020-00170-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Accepted: 03/05/2020] [Indexed: 12/22/2022]
Abstract
Background Hematologic malignancies and their treatments are recognized for their significant long-term adverse effects on health-related quality of life. As a part of cancer treatment, physical exercise is known to improve physical functioning, but there are still questions regarding its impact on psychological and emotional functioning. Nonetheless, heart rate variability biofeedback (HRVB) is recognized for its positive effects on autonomic nervous system balance and emotional self-regulation. The Adapted Physical Activity and Cardiac Coherence in Hematologic Patients (APACCHE) protocol is a randomized, controlled superiority trial designed to evaluate the effects of HRBV training combined with an adaptive physical activity (APA) program compared to APA alone on the post-treatment quality of life of adult hematologic patients. Methods Seventy patients aged 18–70 years, with various forms of hematological malignancies, in post-treatment remission within six months prior to beginning the study and who have been prescribed APA by a hematologist, will be randomly allocated in a 1:1 ratio to two 12-week treatment groups: HRVB + APA versus APA alone. APA sessions will consist of aerobic and resistance training for 1-h twice weekly. The HRVB training will consist of controlled breathing exercises with biofeedback of heart rate variability for 10 sessions and will include a daily home-based practice. The primary outcome will be to evaluate health-related quality of life (QLQ-C30, SF-36). The secondary outcomes will be to evaluate fatigue (MFI-20); anxiety and depression (HADS); clinical status with blood pressure, progression-free survival, overall survival, and body mass index; heart rate variability level and cardiac coherence score. All of these assessments will be evaluated initially (T1), 6 weeks after (T2), at the end of the 12 weeks (T3), and then at a 12-week post-intervention follow-up (T4). Discussion To our knowledge, this is the first protocol to investigate the additional value of HRVB on physical exercise. In addition, there has been no study previously published about HRVB in hematologic patients. We hypothesize that overall quality of life and psychological and physical functioning will be improved, potentially offering a better understanding of supportive cancer care in hematology and inferring new perspectives in psychophysiological research in cancer. Trial registration Current randomized controlled trial was registered 29 November 2017 on Clinical Trials.gov (NCT number: NCT03356171).
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Affiliation(s)
- Claire Fournié
- 1Laboratoire IRISSE EA4075, UFR des Sciences de l'Homme et de l'Environnement, Université de la Réunion, Le Tampon, La Réunion France
| | - Nicolas Bouscaren
- Centre d'Investigation Clinique, Inserm CIC 1410, CHU Sud Réunion, Saint-Pierre, La Réunion France
| | - Georges Dalleau
- 1Laboratoire IRISSE EA4075, UFR des Sciences de l'Homme et de l'Environnement, Université de la Réunion, Le Tampon, La Réunion France
| | - Victorine Lenclume
- Centre d'Investigation Clinique, Inserm CIC 1410, CHU Sud Réunion, Saint-Pierre, La Réunion France
| | - Catherine Mohr
- Service d'Hématologie Clinique, CHU Sud Réunion, Saint Pierre, La Réunion France
| | - Patricia Zunic
- Service d'Hématologie Clinique, CHU Sud Réunion, Saint Pierre, La Réunion France
| | - Quentin Cabrera
- Service d'Hématologie Clinique, CHU Sud Réunion, Saint Pierre, La Réunion France
| | - Chantal Verkindt
- 1Laboratoire IRISSE EA4075, UFR des Sciences de l'Homme et de l'Environnement, Université de la Réunion, Le Tampon, La Réunion France
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Ukraintseva Y, Liaukovich K, Saltykov K, Belov D, Nizhnik А. Selective slow-wave sleep suppression affects glucose tolerance and melatonin secretion. The role of sleep architecture. Sleep Med 2020; 67:171-183. [DOI: 10.1016/j.sleep.2019.11.1254] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Revised: 11/19/2019] [Accepted: 11/26/2019] [Indexed: 12/18/2022]
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66
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Bokov P, El Jurdi H, Denjoy I, Peiffer C, Medjahdi N, Holvoet L, Benkerrou M, Delclaux C. Salbutamol Worsens the Autonomic Nervous System Dysfunction of Children With Sickle Cell Disease. Front Physiol 2020; 11:31. [PMID: 32174840 PMCID: PMC7054439 DOI: 10.3389/fphys.2020.00031] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Accepted: 01/15/2020] [Indexed: 11/13/2022] Open
Abstract
Background Sickle cell disease (SCD) patients with asthma have an increased rate of vaso-occlusive crisis (VOC) and acute chest syndrome (ACS) episodes when compared to those without asthma. We hypothesized that either asthma diagnosis or bronchodilator treatment might aggravate SCD via their modulating effect on the autonomic nervous system (ANS). Methods Cross-sectional evaluation of heart rate variability (HRV) during pulmonary function tests, including salbutamol administration, in children with SCD receiving asthma treatment or not when compared to asthmatic children without SCD matched for ethnicity. Results SCD children with asthma (n = 30, median age of 12.9 years old) were characterized by a reduced FEV1/FVC ratio, an increased bronchodilator response, and a greater incidence of VOC and ACS when compared to SCD children without asthma (n = 30, 12.7 years). Children with asthma without SCD (n = 29, 11.4 years) were characterized by a higher exhaled NO fraction than SCD children. SCD children when compared to non-SCD children showed reduced HRV [total power, low (LF) and high (HF, vagal tone) frequencies], which was further worsened by salbutamol administration in all the groups: reduction in total power and HF with an increase in LF/HF ratio. After salbutamol, the LF/HF ratio of the SCD children was higher than that of the non-SCD children. The two groups of SCD children were similar, suggesting that asthma diagnosis per se did not modify ANS functions. Conclusion SCD children are characterized by impaired parasympathetic control and sympathetic overactivity that is worsened by salbutamol administration. Clinical Trial Registration www.ClinicalTrials.gov, identifier NCT04062409.
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Affiliation(s)
- Plamen Bokov
- Service de Physiologie Pédiatrique, AP-HP, Hôpital Robert Debré, Paris, France.,UMR 1141, Equipe NeoPhen, INSERM co-tutelle, Université de Paris, Paris, France
| | - Houmam El Jurdi
- Service de Physiologie Pédiatrique, AP-HP, Hôpital Robert Debré, Paris, France
| | - Isabelle Denjoy
- Service de Physiologie Pédiatrique, AP-HP, Hôpital Robert Debré, Paris, France
| | - Claudine Peiffer
- Service de Physiologie Pédiatrique, AP-HP, Hôpital Robert Debré, Paris, France
| | - Noria Medjahdi
- Service de Physiologie Pédiatrique, AP-HP, Hôpital Robert Debré, Paris, France
| | - Laurent Holvoet
- Service d'Hématologie Pédiatrique, AP-HP, Hôpital Robert Debré, Paris, France
| | - Malika Benkerrou
- Service d'Hématologie Pédiatrique, AP-HP, Hôpital Robert Debré, Paris, France
| | - Christophe Delclaux
- Service de Physiologie Pédiatrique, AP-HP, Hôpital Robert Debré, Paris, France.,UMR 1141, Equipe NeoPhen, INSERM co-tutelle, Université de Paris, Paris, France
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67
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Excoffier J, Pichot V, Cantais A, Mory O, Roche F, Patural H, Chouchou F. Autonomic Cardiac Reactivity to Painful Procedures Under Hypnosis in Pediatric Emergencies: A Feasibility Study. AMERICAN JOURNAL OF CLINICAL HYPNOSIS 2020; 62:267-281. [PMID: 31928519 DOI: 10.1080/00029157.2018.1564013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Pain sensation is characterized by abrupt changes in central nervous system activity producing autonomic reactivity. While clinical hypnosis has demonstrated its benefits for children in pain management, it is not clear whether hypnosis modulated autonomic pain response in children in clinical conditions. Here, we studied autonomic responses under hypnosis to sutures in pediatric emergencies. For that, 42 children (mean age: 6.5 years, range 1.5 to 13) were divided into two groups consecutively (hypnosis and control groups), according to their choice. Time-frequency analysis was applied on RR intervals (heart rate interbeat intervals, or RRI) to estimate parasympathetic reactivity based on high frequency power (HF) and the Analgesia Nociception Index (ANI®) and on sympathetic reactivity (low frequency power [LF]) and LF/HF ratio). We observed that RRI and LF/HF ratio varied according to suture and hypnosis (p < 0.05): RRI was higher and LF/HF ratio was lower during sutures in the hypnosis group in comparison to the control group whereas HF and ANI® increased only during hypnosis. To conclude, hypnosis in pediatric emergencies reduces sympathetic cardiac pain reactivity and could be a marker of pain relief under hypnosis, while parasympathetic activity seems to be a better marker of hypnosis.
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Affiliation(s)
| | | | | | | | | | | | - Florian Chouchou
- IRISSE Laboratory (EA4075), UFR SHE, University of La Réunion, Le Tampon, France
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68
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Autonomic cardiovascular adaptations to acute head-out water immersion, head-down tilt and supine position. Eur J Appl Physiol 2019; 120:337-347. [PMID: 31813043 DOI: 10.1007/s00421-019-04278-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2018] [Accepted: 11/30/2019] [Indexed: 01/21/2023]
Abstract
PURPOSE Thermoneutral head-out water immersion (WI) and 6° head-down tilt (HDT) have been considered as suitable models to increase central blood volume and simulate autonomic cardiovascular adaptations to microgravity, swimming or scuba diving. However, any differences in autonomic cardiovascular adaptations are still unclear. In this study, we hypothesized that WI induces a higher activation of arterial baroreceptors and the parasympathetic system. METHODS Ten healthy men underwent 30 min of WI, HDT, and a supine position (SP). RR intervals (RRI) and blood pressure (BP) were continuously monitored. High frequency power (HF), low frequency power (LF) and LF/HF ratio were calculated to study sympathetic and parasympathetic activities, and a spontaneous baroreflex method was used to study arterial baroreflex sensitivity (aBRS). Lung transfer of nitric oxide and carbon monoxide (TLNO/TLCO), vital capacity and alveolar volume (Vc/VA) were measured to study central blood redistribution. RESULTS We observed (1) a similar increase in RRI and decrease in BP; (2) a similar increase in HF power during all experimental conditions, whereas LF increased after; (3) a similar rise in aBRS; (4) a similar increase in Vc/VA and decrease in TLNO/TLCO in all experimental conditions. CONCLUSIONS These results showed a cardiac parasympathetic dominance to the same extent, underpinned by a similar arterial baroreflex activation during WI and HDT as well as control SP. Future studies may address their association with cold or hyperoxia to assess their ability to replicate autonomic cardiovascular adaptations to microgravity, swimming or scuba diving.
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69
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Moeyersons J, Amoni M, Van Huffel S, Willems R, Varon C. R-DECO: an open-source Matlab based graphical user interface for the detection and correction of R-peaks. PeerJ Comput Sci 2019; 5:e226. [PMID: 33816879 PMCID: PMC7924703 DOI: 10.7717/peerj-cs.226] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Accepted: 09/11/2019] [Indexed: 06/12/2023]
Abstract
Many of the existing electrocardiogram (ECG) toolboxes focus on the derivation of heart rate variability features from RR-intervals. By doing so, they assume correct detection of the QRS-complexes. However, it is highly likely that not all detections are correct. Therefore, it is recommended to visualize the actual R-peak positions in the ECG signal and allow manual adaptations. In this paper we present R-DECO, an easy-to-use graphical user interface (GUI) for the detection and correction of R-peaks. Within R-DECO, the R-peaks are detected by using a detection algorithm which uses an envelope-based procedure. This procedure flattens the ECG and enhances the QRS-complexes. The algorithm obtained an overall sensitivity of 99.60% and positive predictive value of 99.69% on the MIT/BIH arrhythmia database. Additionally, R-DECO includes support for several input data formats for ECG signals, three basic filters, the possibility to load other R-peak locations and intuitive methods to correct ectopic, wrong, or missed heartbeats. All functionalities can be accessed via the GUI and the analysis results can be exported as Matlab or Excel files. The software is publicly available. Through its easy-to-use GUI, R-DECO allows both clinicians and researchers to use all functionalities, without previous knowledge.
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Affiliation(s)
- Jonathan Moeyersons
- STADIUS Center for Dynamical Systems, Signal Processing and Data Analytics, Department of Electrical Engineering (ESAT), KU Leuven, Leuven, Belgium
| | - Matthew Amoni
- Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium
- Department of Cardiology, University Hospitals Leuven, Leuven, Belgium
| | - Sabine Van Huffel
- STADIUS Center for Dynamical Systems, Signal Processing and Data Analytics, Department of Electrical Engineering (ESAT), KU Leuven, Leuven, Belgium
| | - Rik Willems
- Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium
- Department of Cardiology, University Hospitals Leuven, Leuven, Belgium
| | - Carolina Varon
- STADIUS Center for Dynamical Systems, Signal Processing and Data Analytics, Department of Electrical Engineering (ESAT), KU Leuven, Leuven, Belgium
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70
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Determinants of Nocturnal Cardiovascular Variability and Heart Rate Arousal Response in Restless Legs Syndrome (RLS)/Periodic Limb Movements (PLMS). J Clin Med 2019; 8:jcm8101619. [PMID: 31590229 PMCID: PMC6832401 DOI: 10.3390/jcm8101619] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2019] [Revised: 09/24/2019] [Accepted: 09/25/2019] [Indexed: 12/23/2022] Open
Abstract
Recent studies have suggested that restless legs syndrome is associated with an increased prevalence of cardiovascular diseases mediated by sympathetic activation occurring during periodic limb movements. The aim of this study was to establish which factors affect the degree of sympathetic activation during the basal condition and during periodic limb movements that may contribute to increased vascular risk. Fifty untreated restless legs syndrome patients aged 62.6 ± 11.1 y, free of cardiovascular diseases, were examined. Heart rate variability was calculated during wakefulness and all sleep stages, during periods with and without periodic limb movements. Heart rate changes before and after periodic limb movement onset were analyzed to assess the arousal response to periodic limb movements. Both analyses took into account the effects of age, gender, periodic limb movement duration, periodic limb movement index, periodic limb movement interval and periodicity, and magnitude of muscular activity (electromyogram power). Compared to periods without periodic limb movements, a significant increase in sympathetic activity occurred in periods with periodic limb movements, independent of age, sex and periodic limb movement characteristics. Data obtained from the cardiac arousal response to periodic limb movements showed that electromyogram power is the factor affecting sympathetic tonus. These results suggest that other factors, such as electromyogram power and individual susceptibility, should be considered in the assessment of the vascular risk related to restless legs syndrome.
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71
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Berger M, Raffin J, Pichot V, Hupin D, Garet M, Labeix P, Costes F, Barthélémy JC, Roche F. Effect of exercise training on heart rate variability in patients with obstructive sleep apnea: A randomized controlled trial. Scand J Med Sci Sports 2019; 29:1254-1262. [PMID: 31050034 DOI: 10.1111/sms.13447] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Revised: 03/22/2019] [Accepted: 04/24/2019] [Indexed: 12/16/2022]
Abstract
While obstructive sleep apnea (OSA) increases chemoreflex, leading to an autonomic dysfunction in the long term, no studies have yet assessed the potential benefit of exercise on cardiac autonomic activity in these patients. The aim of this study was to evaluate potential improvement in cardiac autonomic function (CAF) measured through heart rate variability (HRV) after a 9-month physical activity program in patients with OSA. Seventy-four patients with moderate OSA, aged 40-80 years, were randomly assigned to an exercise group (n = 36, 3 × 1 h/wk) or a control group (n = 38) during 9 months. Linear and nonlinear HRV parameters were measured during night using a Holter ECG. After 9 months, mean R-R intervals increased in the exercise group without any changes in HRV parameters, while controls decreased global (standard deviation of normal-to-normal intervals, total power) and parasympathetic (root mean square successive difference of N-Ns, very low frequency, high frequency, and standard deviation of the instantaneous beat-to-beat variability) indices of HRV (P < 0.05 for all). Significant correlations with moderate effect size were found between changes in apnea severity and changes in R-R intervals (P < 0.05). Improvement in moderate-to-vigorous physical activity was also correlated to improvement in nocturnal oxygen parameters (P < 0.05). In conclusion, supervised community physical activity may prevent a decline in nighttime CAF observed in nontreated community-dwelling patients with moderate OSA over a 9-month period. Thus, beyond apnea-hypopnea index improvement, exercise may be cardioprotective in OSA patients through bradycardia, CAF preservation, and VO2peak increase.
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Affiliation(s)
- Mathieu Berger
- Laboratoire SNA-EPIS, EA 4607, Université de Lyon, Université Jean Monnet Saint-Etienne, Saint-Etienne, France.,Service de Physiologie Clinique et de l'Exercice, Centre Hospitalier Universitaire de Saint-Etienne, Saint-Etienne, France.,IRAPS, Fédération Française d'Éducation Physique et de Gymnastique Volontaire (FFEPGV), Montreuil, France
| | - Jérémy Raffin
- Laboratoire SNA-EPIS, EA 4607, Université de Lyon, Université Jean Monnet Saint-Etienne, Saint-Etienne, France.,Service de Physiologie Clinique et de l'Exercice, Centre Hospitalier Universitaire de Saint-Etienne, Saint-Etienne, France
| | - Vincent Pichot
- Laboratoire SNA-EPIS, EA 4607, Université de Lyon, Université Jean Monnet Saint-Etienne, Saint-Etienne, France.,Service de Physiologie Clinique et de l'Exercice, Centre Hospitalier Universitaire de Saint-Etienne, Saint-Etienne, France
| | - David Hupin
- Laboratoire SNA-EPIS, EA 4607, Université de Lyon, Université Jean Monnet Saint-Etienne, Saint-Etienne, France.,Service de Physiologie Clinique et de l'Exercice, Centre Hospitalier Universitaire de Saint-Etienne, Saint-Etienne, France
| | - Martin Garet
- Laboratoire SNA-EPIS, EA 4607, Université de Lyon, Université Jean Monnet Saint-Etienne, Saint-Etienne, France.,Service de Physiologie Clinique et de l'Exercice, Centre Hospitalier Universitaire de Saint-Etienne, Saint-Etienne, France
| | - Pierre Labeix
- Laboratoire SNA-EPIS, EA 4607, Université de Lyon, Université Jean Monnet Saint-Etienne, Saint-Etienne, France.,Service de Physiologie Clinique et de l'Exercice, Centre Hospitalier Universitaire de Saint-Etienne, Saint-Etienne, France
| | - Frédéric Costes
- Service de Physiologie de l'Exercice, Centre Hospitalier Universitaire Gabriel Montpied, Clermont-Ferrand, France
| | - Jean-Claude Barthélémy
- Laboratoire SNA-EPIS, EA 4607, Université de Lyon, Université Jean Monnet Saint-Etienne, Saint-Etienne, France.,Service de Physiologie Clinique et de l'Exercice, Centre Hospitalier Universitaire de Saint-Etienne, Saint-Etienne, France
| | - Frédéric Roche
- Laboratoire SNA-EPIS, EA 4607, Université de Lyon, Université Jean Monnet Saint-Etienne, Saint-Etienne, France.,Service de Physiologie Clinique et de l'Exercice, Centre Hospitalier Universitaire de Saint-Etienne, Saint-Etienne, France
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Autonomic maturation from birth to 2 years: normative values. Heliyon 2019; 5:e01300. [PMID: 30899829 PMCID: PMC6407160 DOI: 10.1016/j.heliyon.2019.e01300] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2018] [Revised: 02/03/2019] [Accepted: 02/27/2019] [Indexed: 01/11/2023] Open
Abstract
Background While heart rate variability (HRV) constitutes a relevant non-invasive tool to assess the autonomic nervous system (ANS) function with recognized diagnostic or therapeutic implications, there is still a lack of established data on maturation of autonomic control of heart rate during the first months of life. The Autonomic Baby Evaluation (AuBE) cohort was built to establish, the normal autonomic maturation profile from birth up to 2 years, in a healthy population of full-term newborns. Methods Heart rate variability analysis was carried out in 271 full-term newborns (mean gestational age 39 wGA + 5 days) from reliable polysomnographic recordings at 0 (n = 270) and 6 (n = 221) months and from a 24-hour ambulatory electrocardiogram (ECG) at 12 (n = 210), 18 (n = 197), and 24 (n = 190) months. Indices of HRV analysis were calculated through the ANSLabTools software. Results Indices are dissociated according a temporal, geometrical, frequency, Poincaré, empirical mode decomposition, fractal, Chaos and DC/AC and entropy analysis. Each index is presented for five different periods of time, 0, 6, 12, 18 and 24 months and with smoothed values in the 3rd, 10th, 50th, 90th and 97th percentiles. Data are also presented for the full cohort and individualized by sex to account for gender variability. Discussion & conclusion The physiological autonomic maturation profile from birth to 2 years in a healthy population of term neonates results in a fine-tuning autonomic maturation underlying progressively a new equilibrium and privileging the parasympathetic activity over the sympathetic activity.
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73
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Chouchou F, Mauguière F, Vallayer O, Catenoix H, Isnard J, Montavont A, Jung J, Pichot V, Rheims S, Mazzola L. How the insula speaks to the heart: Cardiac responses to insular stimulation in humans. Hum Brain Mapp 2019; 40:2611-2622. [PMID: 30815964 DOI: 10.1002/hbm.24548] [Citation(s) in RCA: 75] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2018] [Revised: 01/29/2019] [Accepted: 01/29/2019] [Indexed: 12/14/2022] Open
Abstract
Despite numerous studies suggesting the role of insular cortex in the control of autonomic activity, the exact location of cardiac motor regions remains controversial. We provide here a functional mapping of autonomic cardiac responses to intracortical stimulations of the human insula. The cardiac effects of 100 insular electrical stimulations into 47 epileptic patients were divided into tachycardia, bradycardia, and no cardiac response according to the magnitude of RR interval (RRI) reactivity. Sympathetic (low frequency, LF, and low to high frequency powers ratio, LF/HF ratio) and parasympathetic (high frequency power, HF) reactivity were studied using RRI analysis. Bradycardia was induced by 26 stimulations (26%) and tachycardia by 21 stimulations (21%). Right and left insular stimulations induced as often a bradycardia as a tachycardia. Tachycardia was accompanied by an increase in LF/HF ratio, suggesting an increase in sympathetic tone; while bradycardia seemed accompanied by an increase of parasympathetic tone reflected by an increase in HF. There was some left/right asymmetry in insular subregions where increased or decreased heart rates were produced after stimulation. However, spatial distribution of tachycardia responses predominated in the posterior insula, whereas bradycardia sites were more anterior in the median part of the insula. These findings seemed to indicate a posterior predominance of sympathetic control in the insula, whichever the side; whereas the parasympathetic control seemed more anterior. Dysfunction of these regions should be considered when modifications of cardiac activity occur during epileptic seizures and in cardiovascular diseases.
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Affiliation(s)
- Florian Chouchou
- IRISSE Laboratory (EA4075), UFR SHE, University of La Réunion, Le Tampon, France
| | - François Mauguière
- Department of Functional Neurology and Epileptology, Hospices Civils de Lyon, Université de Lyon, Lyon, France.,NeuroPain Lab, Lyon Neuroscience Research Centre, CRNL - INSERM U 1028/CNRS UMR 5292, University of Lyon, Lyon, France
| | - Ophélie Vallayer
- Neurology Department, University Hospital, Saint-Etienne, France
| | - Hélène Catenoix
- Department of Functional Neurology and Epileptology, Hospices Civils de Lyon, Université de Lyon, Lyon, France.,TIGER Lab, Lyon Neuroscience Research Centre, CRNL - INSERM U 1028/CNRS UMR 5292, University of Lyon, Lyon, France
| | - Jean Isnard
- Department of Functional Neurology and Epileptology, Hospices Civils de Lyon, Université de Lyon, Lyon, France.,NeuroPain Lab, Lyon Neuroscience Research Centre, CRNL - INSERM U 1028/CNRS UMR 5292, University of Lyon, Lyon, France
| | - Alexandra Montavont
- Department of Functional Neurology and Epileptology, Hospices Civils de Lyon, Université de Lyon, Lyon, France.,TIGER Lab, Lyon Neuroscience Research Centre, CRNL - INSERM U 1028/CNRS UMR 5292, University of Lyon, Lyon, France
| | - Julien Jung
- Department of Functional Neurology and Epileptology, Hospices Civils de Lyon, Université de Lyon, Lyon, France.,TIGER Lab, Lyon Neuroscience Research Centre, CRNL - INSERM U 1028/CNRS UMR 5292, University of Lyon, Lyon, France
| | - Vincent Pichot
- EA SNA-EPIS 4607, Department of Clinical and Exercise Physiology, University of Lyon, Jean Monnet University, Saint-Etienne, France
| | - Sylvain Rheims
- Department of Functional Neurology and Epileptology, Hospices Civils de Lyon, Université de Lyon, Lyon, France.,TIGER Lab, Lyon Neuroscience Research Centre, CRNL - INSERM U 1028/CNRS UMR 5292, University of Lyon, Lyon, France
| | - Laure Mazzola
- NeuroPain Lab, Lyon Neuroscience Research Centre, CRNL - INSERM U 1028/CNRS UMR 5292, University of Lyon, Lyon, France.,Neurology Department, University Hospital, Saint-Etienne, France
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74
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Lang M. Automatic Near Real-Time Outlier Detection and Correction in Cardiac Interbeat Interval Series for Heart Rate Variability Analysis: Singular Spectrum Analysis-Based Approach. JMIR BIOMEDICAL ENGINEERING 2019. [DOI: 10.2196/10740] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
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75
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Hidalgo-Muñoz AR, Béquet AJ, Astier-Juvenon M, Pépin G, Fort A, Jallais C, Tattegrain H, Gabaude C. Respiration and Heart Rate Modulation Due to Competing Cognitive Tasks While Driving. Front Hum Neurosci 2019; 12:525. [PMID: 30687043 PMCID: PMC6338053 DOI: 10.3389/fnhum.2018.00525] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Accepted: 12/12/2018] [Indexed: 12/29/2022] Open
Abstract
Research works on operator monitoring underline the benefit of taking into consideration several signal modalities to improve accuracy for an objective mental state diagnosis. Heart rate (HR) is one of the most utilized systemic measures to assess cognitive workload (CW), whereas, respiration parameters are hardly utilized. This study aims at verifying the contribution of analyzing respiratory signals to extract features to evaluate driver’s activity and CW variations in driving. Eighteen subjects participated in the study. The participants carried out two different cognitive tasks requiring different CW demands, a single task as well as a competing cognitive task realized while driving in a simulator. Our results confirm that both HR and breathing rate (BR) increase in driving and are sensitive to CW. However, HR and BR are differently modulated by the CW variations in driving. Specifically, HR is affected by both driving activity and CW, whereas, BR is suitable to evidence a variation of CW only when driving is not required. On the other hand, spectral features characterizing respiratory signal could be also used similarly to HR variability indices to detect high CW episodes. These results hint the use of respiration as an alternative to HR to monitor the driver mental state in autonomic vehicles in order to predict the available cognitive resources if the user has to take over the vehicle.
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76
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Montesinos L, Castaldo R, Cappuccio FP, Pecchia L. Day-to-day variations in sleep quality affect standing balance in healthy adults. Sci Rep 2018; 8:17504. [PMID: 30504839 PMCID: PMC6269497 DOI: 10.1038/s41598-018-36053-4] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Accepted: 11/10/2018] [Indexed: 11/23/2022] Open
Abstract
Acute sleep deprivation is known to affect human balance and posture control. However, the effects of variations in sleep quality and pattern over consecutive days have received less attention. This study investigated the associations between day-to-day variations in sleep quality and standing balance in healthy subjects. Twenty volunteers (12 females and 8 males; age: 28.8 ± 5.7 years, body mass index: 23.4 ± 3.4 kg/m2, resting heart rate: 63.1 ± 8.7 bpm) with no history of sleep disorders or balance impairments participated in the study. Sleep and balance were assessed over two consecutive days. Sleep quality variations were assessed using sleep diary, actigraphy and heart rate variability (HRV) measures. Sleep was monitored at home, using an unobtrusive wearable device. Balance was assessed in a gait lab using foot centre of pressure (COP) displacement during quiet standing. Subjects with a day-to-day deterioration in sleep quantity and quality (i.e., decreased duration and increased fragmentation, increased nocturnal activity and decreased HRV) exhibited significant changes in balance (i.e., larger COP area, amplitude and standard deviation). Conversely, subjects with no significant alterations in sleep quantity and quality showed no significant changes in COP displacements. These results confirmed our hypothesis that changes in sleep quality and pattern over consecutive days may affect balance.
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Affiliation(s)
- Luis Montesinos
- School of Engineering, University of Warwick, Coventry, United Kingdom
- Escuela de Ingenieria y Ciencias, Tecnologico de Monterrey, Mexico City, Mexico
| | - Rossana Castaldo
- School of Engineering, University of Warwick, Coventry, United Kingdom
- Institute of Advanced Study, University of Warwick, Coventry, United Kingdom
| | - Francesco P Cappuccio
- Warwick Medical School, University of Warwick, Coventry, United Kingdom
- University Hospitals Coventry & Warwickshire NHS Trust, Coventry, United Kingdom
| | - Leandro Pecchia
- School of Engineering, University of Warwick, Coventry, United Kingdom.
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77
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Fontolliet T, Pichot V, Bringard A, Fagoni N, Adami A, Tam E, Furlan R, Barthélémy JC, Ferretti G. TESTING THE VAGAL WITHDRAWAL HYPOTHESIS DURING LIGHT EXERCISE UNDER AUTONOMIC BLOCKADE: A HEART RATE VARIABILITY STUDY. J Appl Physiol (1985) 2018; 125:1804-1811. [PMID: 30307822 DOI: 10.1152/japplphysiol.00619.2018] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION We performed the first analysis of heart rate variability (HRV) at rest and exercise under full autonomic blockade on the same subjects, to test the conjecture that vagal tone withdrawal occurs at exercise onset. We hypothesized that, between rest and exercise: i) no differences in total power (PTOT) under parasympathetic blockade; ii) a PTOT fall under β1-sympathetic blockade; iii) no differences in Ptot under blockade of both ANS branches. METHODS 7 males (24±3 years) performed 5-min cycling (80W) supine, preceded by 5-min rest during control and with administration of atropine, metoprolol and atropine+metoprolol (double blockade). Heart rate and arterial blood pressure were continuously recorded. HRV and blood pressure variability were determined by power spectral analysis, and baroreflex sensitivity (BRS) by the sequence method. RESULTS At rest, PTOT and the powers of low (LF) and high (HF) frequency components of HRV were dramatically decreased in atropine and double blockade compared to control and metoprolol, with no effects on LF/HF ratio and on the normalised LF (LFnu) and HF (HFnu). At exercise, patterns were the same as at rest. Comparing exercise to rest, PTOT varied as hypothesized. For SAP and DAP, resting PTOT was the same in all conditions. At exercise, in all conditions, PTOT was lower than in control. BRS decreased under atropine and double blockade at rest, under control and metoprolol during exercise. CONCLUSIONS The results support the hypothesis that vagal suppression determined disappearance of HRV during exercise.
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Affiliation(s)
| | | | - Aurélien Bringard
- Department of Basic Neurosciences, University of Geneva, Switzerland, Switzerland
| | - Nazzareno Fagoni
- Dipartment of Kinesiology, College of Health Sciences, Universita di Brescia, Italy
| | - Alessandra Adami
- Department of Kinesiology, University of Rhode Island, Kingston, RI, USA, United States
| | - Enrico Tam
- Dipartimento di Scienze Neurologiche e del Movimento, Università di Verona, Italy
| | - Raffaello Furlan
- Division of Internal Medicine, Humanitas Clinical and Research Center, Rozzano Humanitas University, Italy
| | | | - Guido Ferretti
- University of Geneva, Switzerland, and of Brescia, Italy, Switzerland
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78
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Parasomnia versus epilepsy: An affair of the heart? Neurophysiol Clin 2018; 48:277-286. [DOI: 10.1016/j.neucli.2018.08.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Revised: 08/03/2018] [Accepted: 08/27/2018] [Indexed: 01/07/2023] Open
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79
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Berger C, Casagranda L, Pichot V, Trombert-Paviot B, Faure-Conter C, Freycon C, Isfan F, Guichard I, Durieu I, Garcin A, Roche F, Patural H. Dysautonomia in Childhood Cancer Survivors: A Widely Underestimated Risk. J Adolesc Young Adult Oncol 2018; 8:9-17. [PMID: 30136876 DOI: 10.1089/jayao.2018.0021] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
PURPOSE Survival rate of childhood cancers is now reaching 80% overall. However, early or late complications related to surgery, chemotherapy, and radiotherapy remain at a high rate and greatly increase the risk of late mortality. The objective of this study is to assess the autonomic nervous system (ANS) activity, measured through heart rate variability indices in childhood cancer survivors compared with healthy controls. METHODS This prospective study included 51 long-term childhood cancer survivors diagnosed before 15 years of age between 1987 and 1992 and controlled for age and sex with healthy volunteers. RESULTS We observed a significant increase in spontaneous heart rate (beats per minute) (67 ± 10 vs. 60 ± 10, p = 0.001), and all the studied parameters showed a significantly altered ANS activity in cases compared with healthy controls. In both groups, the main cofactors of dysautonomia (tobacco, drugs, cannabis, estro-progestative pills, alcohol, limited physical activity) were analyzed without any significant difference. The effect of cancer treatments received was not analyzed due to the small number of participants. CONCLUSION The results showed a significant ANS dysfunction in childhood cancer survivors compared with healthy controls and suggested the value of autonomic screening to underscore and possibly quantify the effect of the cancer treatments in a larger cohort. This evaluation could lead to the recommendation to increase physical activity, the most efficient way known to improve ANS activity, as already shown in other pathologies (breast cancer).
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Affiliation(s)
- Claire Berger
- 1 Department of Pediatric Hematology and Oncology Unit, University Hospital of Saint-Etienne, Saint-Etienne, France.,2 Childhood Cancer Registry of the Rhône-Alpes Region, University of Saint-Etienne, Saint-Etienne, France.,3 Department of Public Health and Medical Informatics, University of Saint-Etienne, Saint-Etienne, France.,4 Host Research Team EA4607 SNA-EPIS (Autonomic Nervous System, Epidemiology, Physiology, Exercise, and Health), Jean Monnet University of Saint-Etienne, PRES (Education and Research Cluster) Lyon, Saint-Etienne, France
| | - Léonie Casagranda
- 1 Department of Pediatric Hematology and Oncology Unit, University Hospital of Saint-Etienne, Saint-Etienne, France.,2 Childhood Cancer Registry of the Rhône-Alpes Region, University of Saint-Etienne, Saint-Etienne, France.,3 Department of Public Health and Medical Informatics, University of Saint-Etienne, Saint-Etienne, France.,4 Host Research Team EA4607 SNA-EPIS (Autonomic Nervous System, Epidemiology, Physiology, Exercise, and Health), Jean Monnet University of Saint-Etienne, PRES (Education and Research Cluster) Lyon, Saint-Etienne, France
| | - Vincent Pichot
- 4 Host Research Team EA4607 SNA-EPIS (Autonomic Nervous System, Epidemiology, Physiology, Exercise, and Health), Jean Monnet University of Saint-Etienne, PRES (Education and Research Cluster) Lyon, Saint-Etienne, France
| | - Béatrice Trombert-Paviot
- 2 Childhood Cancer Registry of the Rhône-Alpes Region, University of Saint-Etienne, Saint-Etienne, France.,3 Department of Public Health and Medical Informatics, University of Saint-Etienne, Saint-Etienne, France.,4 Host Research Team EA4607 SNA-EPIS (Autonomic Nervous System, Epidemiology, Physiology, Exercise, and Health), Jean Monnet University of Saint-Etienne, PRES (Education and Research Cluster) Lyon, Saint-Etienne, France
| | | | - Claire Freycon
- 6 Department of Pediatric Hematology and Oncology Unit, University Hospital of Grenoble, Grenoble, France
| | - Florentina Isfan
- 7 Department of Pediatric Hematology and Oncology Unit, University Hospital Estaing Clermont-Ferrand, Clermont-Ferrand, France
| | - Isabelle Guichard
- 8 Department of Internal Medicine Unit, University Hospital, Saint-Etienne, France
| | - Isabelle Durieu
- 9 Department of Internal Medicine and Vascular Pathology Unit, University Hospital of Lyon Sud, Pierre-Bénite, France
| | - Arnauld Garcin
- 4 Host Research Team EA4607 SNA-EPIS (Autonomic Nervous System, Epidemiology, Physiology, Exercise, and Health), Jean Monnet University of Saint-Etienne, PRES (Education and Research Cluster) Lyon, Saint-Etienne, France.,10 Department of Research and University Hospital, Saint-Etienne Cedex, France
| | - Fréderic Roche
- 4 Host Research Team EA4607 SNA-EPIS (Autonomic Nervous System, Epidemiology, Physiology, Exercise, and Health), Jean Monnet University of Saint-Etienne, PRES (Education and Research Cluster) Lyon, Saint-Etienne, France
| | - Hugues Patural
- 4 Host Research Team EA4607 SNA-EPIS (Autonomic Nervous System, Epidemiology, Physiology, Exercise, and Health), Jean Monnet University of Saint-Etienne, PRES (Education and Research Cluster) Lyon, Saint-Etienne, France.,11 Department of Pediatrics, University Hospital, Saint-Etienne Cedex, France
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80
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Hupin D, Pichot V, Berger M, Sforza E, Raffin J, Lietar C, Poyraz E, Maudoux D, Barthelemy JC, Roche F. Obstructive Sleep Apnea in Cardiac Rehabilitation Patients. J Clin Sleep Med 2018; 14:1119-1126. [PMID: 29991415 DOI: 10.5664/jcsm.7206] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2017] [Accepted: 03/01/2018] [Indexed: 12/17/2022]
Abstract
STUDY OBJECTIVES Although regular physical activity improves obstructive sleep apnea (OSA) in the general population, this finding has not been assessed in postmyocardial infarction (MI) patients in a rehabilitation setting (coronary artery disease, CAD). We aimed to determine whether cardiac rehabilitation may benefit post-MI patients in terms of OSA disease and associated autonomic nervous system (ANS) activity. METHODS Consecutive post-MI patients participating in the ambulatory cardiac rehabilitation program of St-Etienne University Hospital were included in this study. The apnea-hypopnea index calculated from electrocardiogram (ECG)-derived respiration (AHIEDR) was obtained through nocturnal Holter ECG recordings. According to AHIEDR, patients were classified as normal, mild, moderate, or severe OSA (< 5, 5-14, 15-29, ≥ 30, respectively). Physiological performance (peak VO2) was established via cardiopulmonary exercise testing. ANS activity was evaluated through spontaneous baroreflex sensibility as well as heart rate variability analysis. RESULTS Of the 105 patients with CAD and OSA included (95 men, 55.2 ± 12.4 years), 100 had at least 1 cardiovascular risk factor (98%) and 52 patients (50%) had an ANS dysfunction. Surprisingly, 68 of these patients with OSA (65%) were free of classical diurnal symptoms usually associated with sleep apnea. In response to cardiac rehabilitation, AHIEDR decreased significantly (-9.3 ± 9.5, P < .0001) only in patients with severe OSA, and the decrease was even greater when peak VO2 and baroreflex sensibility improved beyond 20% compared to basal values (-11.6 ± 9.1, P < .001). CONCLUSIONS Severe OSA in patients with CAD is significantly improved after 2 months of cardiopulmonary rehabilitation. Reviving ANS activity through physical activity might be a target for complementary therapy of OSA in patients with CAD.
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Affiliation(s)
- David Hupin
- EA SNA EPIS 4607, Autonomic Nervous System, University of Lyon, University Jean Monnet, Saint-Etienne, France.,Department of Clinical and Exercise Physiology, University Hospital of Saint-Etienne, France
| | - Vincent Pichot
- EA SNA EPIS 4607, Autonomic Nervous System, University of Lyon, University Jean Monnet, Saint-Etienne, France.,Department of Clinical and Exercise Physiology, University Hospital of Saint-Etienne, France
| | - Mathieu Berger
- Department of Clinical and Exercise Physiology, University Hospital of Saint-Etienne, France
| | - Emilia Sforza
- EA SNA EPIS 4607, Autonomic Nervous System, University of Lyon, University Jean Monnet, Saint-Etienne, France.,Department of Clinical and Exercise Physiology, University Hospital of Saint-Etienne, France
| | - Jérémy Raffin
- Department of Clinical and Exercise Physiology, University Hospital of Saint-Etienne, France
| | - Cécile Lietar
- Jacques Lisfranc Medical Faculty, University of Lyon, University Jean Monnet, Saint-Etienne, France
| | - Erkan Poyraz
- Jacques Lisfranc Medical Faculty, University of Lyon, University Jean Monnet, Saint-Etienne, France
| | - Delphine Maudoux
- EA SNA EPIS 4607, Autonomic Nervous System, University of Lyon, University Jean Monnet, Saint-Etienne, France.,Department of Clinical and Exercise Physiology, University Hospital of Saint-Etienne, France
| | - Jean-Claude Barthelemy
- EA SNA EPIS 4607, Autonomic Nervous System, University of Lyon, University Jean Monnet, Saint-Etienne, France.,Department of Clinical and Exercise Physiology, University Hospital of Saint-Etienne, France
| | - Frédéric Roche
- EA SNA EPIS 4607, Autonomic Nervous System, University of Lyon, University Jean Monnet, Saint-Etienne, France.,Department of Clinical and Exercise Physiology, University Hospital of Saint-Etienne, France
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81
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Fauchon C, Pichot V, Faillenot I, Pommier B, Garcia-Larrea L, Peyron R, Chouchou F. Contextual modulation of autonomic pain reactivity. Auton Neurosci 2018; 212:28-31. [PMID: 29778243 DOI: 10.1016/j.autneu.2018.04.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2017] [Revised: 02/02/2018] [Accepted: 04/07/2018] [Indexed: 01/19/2023]
Abstract
Although modulation of cardiac activity may be influenced by several factors, interaction between autonomic nociceptive responses and the high-level of cortical processes is not clearly understood. Here, we studied in 26 subjects whether empathetic or unempathetic contexts could interact with autonomic pain responses. RR intervals variability was used to approach parasympathetic and sympathetic responses to painful thermal stimulations, according to contexts evoked by experimenters' comments. We observed that unempathetic context increased sympathetic reactivity to comments and to painful stimulations without any parasympathetic change. These results show an interaction between context and nociceptive processes in cardiovascular control.
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Affiliation(s)
- Camille Fauchon
- Central Integration of Pain team (NeuroPain), Lyon Neuroscience Research Center, Inserm U1028, UCB Lyon 1, UJM, F-42023 Saint-Etienne, France.
| | - Vincent Pichot
- EA SNA-EPIS, Department of Clinical and Exercise Physiology, CHU de Saint-Etienne, F-42055 Saint-Etienne, France
| | - Isabelle Faillenot
- Central Integration of Pain team (NeuroPain), Lyon Neuroscience Research Center, Inserm U1028, UCB Lyon 1, UJM, F-42023 Saint-Etienne, France
| | - Benjamin Pommier
- Central Integration of Pain team (NeuroPain), Lyon Neuroscience Research Center, Inserm U1028, UCB Lyon 1, UJM, F-42023 Saint-Etienne, France
| | - Luis Garcia-Larrea
- Central Integration of Pain team (NeuroPain), Lyon Neuroscience Research Center, Inserm U1028, UCB Lyon 1, UJM, F-42023 Saint-Etienne, France
| | - Roland Peyron
- Central Integration of Pain team (NeuroPain), Lyon Neuroscience Research Center, Inserm U1028, UCB Lyon 1, UJM, F-42023 Saint-Etienne, France; Department of Neurology & Pain Center, CHU de Saint-Etienne, F-42055 Saint-Etienne, France
| | - Florian Chouchou
- Central Integration of Pain team (NeuroPain), Lyon Neuroscience Research Center, Inserm U1028, UCB Lyon 1, UJM, F-42023 Saint-Etienne, France; EA SNA-EPIS, Department of Clinical and Exercise Physiology, CHU de Saint-Etienne, F-42055 Saint-Etienne, France
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82
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Borg C, Chouchou F, Dayot-Gorlero J, Zimmerman P, Maudoux D, Laurent B, Michael GA. Pain and emotion as predictive factors of interoception in fibromyalgia. J Pain Res 2018; 11:823-835. [PMID: 29719416 PMCID: PMC5914549 DOI: 10.2147/jpr.s152012] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction This study investigated interoception in fibromyalgia (FM), a disorder characterized by chronic pain accompanied by mood deregulation. Based on observations on the relationship between somatosensory processing and pain in FM and considering the affective symptoms of this disorder, we tested in FM three dimensions of interoception: interoceptive accuracy (IA), interoceptive awareness (IAW) and interoceptive sensibility (IS). Materials and methods Twenty-one female FM patients (Mage = 50.3) and 21 female matched controls (Mage = 46.3) completed a heartbeat tracking task as an assessment of IA, rated confidence in their responses as a measure of IAW and completed the Multidimensional Assessment of Interoceptive Awareness as a measure of IS. Furthermore, they completed self-report scales that, according to a principal component analysis, targeted anxiety, emotional consciousness and pain-related affect and reactions. Results Multiple regression analyses showed that increased pain-related affect and reactions decrease IA in FM. When the results of each group were examined separately, such effect was found only in FM patients. On its turn, IS was predicted by emotional consciousness and pain-related affect and reactions, but these effects did not differ between FM and controls. Finally, none of the variables we used predicted IAW. Discussion Pain-related affect and reactions in FM patients can reduce their interoceptive ability. Our results help to better understand the integration between bodily signals and emotional processing in chronic pain.
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Affiliation(s)
- Céline Borg
- Neurology/Neuropsychology CMRR Unit, Hospital Nord, Saint-Priest-en-Jarez, France.,Department of Psychology, University of Lyon, Lyon, France.,Université de Lyon, Université Lyon 2, Laboratory EMC (EA 3082), Bron, France
| | - Florian Chouchou
- Central Integration of Pain (NeuroPain), Inserm U1028, UCB Lyon1, Saint-Etienne, France
| | - Jenny Dayot-Gorlero
- Université de Lyon, Université Lyon 2, Laboratory EMC (EA 3082), Bron, France
| | - Perrine Zimmerman
- Neurology/Neuropsychology CMRR Unit, Hospital Nord, Saint-Priest-en-Jarez, France
| | - Delphine Maudoux
- EA SNA-EPIS, Department of Clinical and Exercise Physiology, CHU de Saint-Etienne, Saint-Etienne, France
| | - Bernard Laurent
- Neurology/Neuropsychology CMRR Unit, Hospital Nord, Saint-Priest-en-Jarez, France.,Central Integration of Pain (NeuroPain), Inserm U1028, UCB Lyon1, Saint-Etienne, France
| | - George A Michael
- Université de Lyon, Université Lyon 2, Laboratory EMC (EA 3082), Bron, France
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83
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Cremillieux C, Makhlouf A, Pichot V, Trombert B, Patural H. Objective assessment of induced acute pain in neonatology with the Newborn Infant Parasympathetic Evaluation index. Eur J Pain 2018; 22:1071-1079. [DOI: 10.1002/ejp.1191] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/13/2018] [Indexed: 11/05/2022]
Affiliation(s)
- C. Cremillieux
- Department of Pediatric Medicine; Neonatal Intensive Care Unit; University Hospital of Saint-Etienne; France
| | - A. Makhlouf
- Department of Pediatric Medicine; Neonatal Intensive Care Unit; University Hospital of Saint-Etienne; France
| | - V. Pichot
- EA SNA-EPIS Research Laboratory; Jean Monnet University of Saint-Etienne; France
| | - B. Trombert
- Public Health and Medical Information Unit; University Hospital of Saint-Etienne; France
| | - H. Patural
- Department of Pediatric Medicine; Neonatal Intensive Care Unit; University Hospital of Saint-Etienne; France
- EA SNA-EPIS Research Laboratory; Jean Monnet University of Saint-Etienne; France
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Nano MM, Fonseca P, Vullings R, Aarts RM. Measures of cardiovascular autonomic activity in insomnia disorder: A systematic review. PLoS One 2017; 12:e0186716. [PMID: 29059210 PMCID: PMC5653329 DOI: 10.1371/journal.pone.0186716] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Accepted: 10/08/2017] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Insomnia disorder is a widespread sleep disorder with a prevalence of approximately 10%. Even though the link between insomnia and cardiovascular activity is not exactly clear, it is generally assumed that cardiovascular autonomic modifications could occur as a result of sleeplessness, or, alternatively, that autonomic alterations could be an expression of a hyper-arousal state. This review investigates whether cardiovascular measures are different between insomniacs and controls. METHODS Electronic databases were systematically searched, and 34 studies were identified. Heart rate variability features, the association of cardiac and EEG activity, physiologic complexity measures, and cardiovascular activity, assessed by measures such as pre-ejection time, blood pressure, and heart rate dynamics were studied. Given the heterogeneity of the studies, a narrative synthesis of the findings was performed. RESULTS This review study found overall differences in cardiovascular activity between insomniacs and controls in most of the observational studies (21/26), while the expression of cardiovascular regulation varied between the examined insomniac groups. All the studies that investigated the association of cardiac activity and EEG power reported an altered relation between autonomic activity and EEG parameters in insomniacs. CONCLUSION Autonomic regulation tends to be consistent between insomniacs, as long as they are grouped according to their respective phenotype, as shown in the insomnia subgroup with objectively short sleep duration. Our hypothesis is that these differences in the expression of cardiovascular activity could be explained by the heterogeneity of the disorder. Therefore, the determination of insomnia phenotypes, and the study of cardiovascular measures, rather than heart rate variability alone, will give more insight into the link between insomnia and cardiovascular regulation. This study suggests that cardiovascular activity differs between insomniacs and controls. These new findings are of interest to clinicians and researchers for a more accurate insomnia assessment, and the development of personalized technological solutions in insomnia.
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Affiliation(s)
- Marina-Marinela Nano
- Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
- Sleep Medicine Centre Kempenhaeghe, Heeze, The Netherlands
- Philips Research, High Tech Campus, Eindhoven, The Netherlands
| | - Pedro Fonseca
- Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
- Philips Research, High Tech Campus, Eindhoven, The Netherlands
| | - Rik Vullings
- Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Ronald M. Aarts
- Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
- Philips Research, High Tech Campus, Eindhoven, The Netherlands
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Fauchon C, Faillenot I, Perrin AM, Borg C, Pichot V, Chouchou F, Garcia-Larrea L, Peyron R. Does an observer's empathy influence my pain? Effect of perceived empathetic or unempathetic support on a pain test. Eur J Neurosci 2017; 46:2629-2637. [DOI: 10.1111/ejn.13701] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Revised: 07/12/2017] [Accepted: 08/01/2017] [Indexed: 01/10/2023]
Affiliation(s)
- C. Fauchon
- Central Integration of Pain (NeuroPain); Inserm U1028, UCB Lyon1, UJM; Saint-Etienne France
| | - I. Faillenot
- Central Integration of Pain (NeuroPain); Inserm U1028, UCB Lyon1, UJM; Saint-Etienne France
- Department of Neurology & Pain Center; CHU de Saint-Etienne; Saint-Etienne France
| | - A. M. Perrin
- Department of Neurology & Pain Center; CHU de Saint-Etienne; Saint-Etienne France
- Laboratory EMC (EA3082); University Lyon 2; Lyon-Bron France
| | - C. Borg
- Department of Neurology & Pain Center; CHU de Saint-Etienne; Saint-Etienne France
- Laboratory EMC (EA3082); University Lyon 2; Lyon-Bron France
| | - V. Pichot
- Department of Clinical and Exercise Physiology; EA SNA-EPIS; CHU de Saint-Etienne; Saint-Etienne France
| | - F. Chouchou
- Central Integration of Pain (NeuroPain); Inserm U1028, UCB Lyon1, UJM; Saint-Etienne France
| | - L. Garcia-Larrea
- Central Integration of Pain (NeuroPain); Inserm U1028, UCB Lyon1, UJM; Saint-Etienne France
| | - R. Peyron
- Central Integration of Pain (NeuroPain); Inserm U1028, UCB Lyon1, UJM; Saint-Etienne France
- Department of Neurology & Pain Center; CHU de Saint-Etienne; Saint-Etienne France
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86
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Chouchou F, Bouet R, Pichot V, Catenoix H, Mauguière F, Jung J. The neural bases of ictal tachycardia in temporal lobe seizures. Clin Neurophysiol 2017; 128:1810-1819. [PMID: 28709879 DOI: 10.1016/j.clinph.2017.06.033] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Revised: 05/03/2017] [Accepted: 06/02/2017] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Due to limited information from scalp electroencephalographic (EEG) recordings, brain areas driving changes in cardiac rhythm during Temporal lobe (TL) seizures are not clearly identified. Using stereotactic EEG (SEEG) recordings, we aimed at identifying which of the brain regions involved in autonomic control trigger ictal tachycardia. METHODS The neural activity of several mesial temporal lobe structures including amygdala, hippocampus, insula, and lateral temporal lobe recorded with SEEG were collected during 37 TL seizures in 9 patients, using indices based on High Frequency Activity (HFA). R-R intervals (RR) monitoring and time-frequency spectral analysis were performed to assess parasympathetic (High frequency power (HF)) and sympathetic (Low frequency/High frequency (LF/HF) ratio) reactivities. RESULTS Tachycardia was associated with a significant increase in LF/HF ratio and decrease in HF. Autonomic cardiac changes were accompanied by simultaneous SEEG signal changes with an increase in seizure-related HFA in anterior hippocampal formation and amygdala, but not in insula. CONCLUSION In our sample, TL seizures are thus accompanied by an early decrease in parasympathetic control of cardiac rhythm and by an increase of sympathetic tone, concomitant to seizure activity in anterior hippocampus and amygdala. SIGNIFICANCE These results support a pivotal role of hippocampus and amygdala in tachycardia occurring during TL seizures.
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Affiliation(s)
- Florian Chouchou
- NeuroPain Lab, Lyon Neuroscience Research Center - Inserm U 1028/CNRS UMR 5292, University of Lyon, France.
| | - Romain Bouet
- Dycog Lab, Lyon Neuroscience Research Center - Inserm U 1028/CNRS UMR 5292, University of Lyon, France
| | - Vincent Pichot
- Clinical Physiology Department, CHU Nord, Saint-Etienne, France; EA 4607 SNA-EPIS Lab, University of Jean Monnet, University of Lyon, Saint-Etienne, France
| | - Hélène Catenoix
- Epilepsy and Functional Neurology Department, Neurological Hospital Pierre Wertheimer, Hospices Civils de Lyon, Bron, France
| | - François Mauguière
- NeuroPain Lab, Lyon Neuroscience Research Center - Inserm U 1028/CNRS UMR 5292, University of Lyon, France; Epilepsy and Functional Neurology Department, Neurological Hospital Pierre Wertheimer, Hospices Civils de Lyon, Bron, France; Claude Bernard Lyon 1 University, Lyon, France
| | - Julien Jung
- Dycog Lab, Lyon Neuroscience Research Center - Inserm U 1028/CNRS UMR 5292, University of Lyon, France; Epilepsy and Functional Neurology Department, Neurological Hospital Pierre Wertheimer, Hospices Civils de Lyon, Bron, France
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87
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Ponganis PJ, McDonald BI, Tift MS, Williams CL. Heart rate regulation in diving sea lions: the vagus nerve rules. ACTA ACUST UNITED AC 2017; 220:1372-1381. [PMID: 28424310 DOI: 10.1242/jeb.146779] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Recent publications have emphasized the potential generation of morbid cardiac arrhythmias secondary to autonomic conflict in diving marine mammals. Such conflict, as typified by cardiovascular responses to cold water immersion in humans, has been proposed to result from exercise-related activation of cardiac sympathetic fibers to increase heart rate, combined with depth-related changes in parasympathetic tone to decrease heart rate. After reviewing the marine mammal literature and evaluating heart rate profiles of diving California sea lions (Zalophus californianus), we present an alternative interpretation of heart rate regulation that de-emphasizes the concept of autonomic conflict and the risk of morbid arrhythmias in marine mammals. We hypothesize that: (1) both the sympathetic cardiac accelerator fibers and the peripheral sympathetic vasomotor fibers are activated during dives even without exercise, and their activities are elevated at the lowest heart rates in a dive when vasoconstriction is maximal, (2) in diving animals, parasympathetic cardiac tone via the vagus nerve dominates over sympathetic cardiac tone during all phases of the dive, thus producing the bradycardia, (3) adjustment in vagal activity, which may be affected by many inputs, including exercise, is the primary regulator of heart rate and heart rate fluctuations during diving, and (4) heart beat fluctuations (benign arrhythmias) are common in marine mammals. Consistent with the literature and with these hypotheses, we believe that the generation of morbid arrhythmias because of exercise or stress during dives is unlikely in marine mammals.
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Affiliation(s)
- Paul J Ponganis
- Center for Marine Biotechnology & Biomedicine, Scripps Institution of Oceanography, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093-0204, USA
| | - Birgitte I McDonald
- Moss Landing Marine Laboratories, 8272 Moss Landing Road, Moss Landing, CA 95039, USA
| | - Michael S Tift
- Center for Marine Biotechnology & Biomedicine, Scripps Institution of Oceanography, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093-0204, USA
| | - Cassondra L Williams
- Center for Marine Biotechnology & Biomedicine, Scripps Institution of Oceanography, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093-0204, USA
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