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Dell’Acqua C, Mura F, Messerotti Benvenuti S, Patron E, Palomba D. Reduced heart rate variability and expressive suppression interact to prospectively predict COVID-19 pandemic-related post-traumatic stress symptoms. Sci Rep 2022; 12:21311. [PMID: 36494439 PMCID: PMC9734110 DOI: 10.1038/s41598-022-25915-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 12/07/2022] [Indexed: 12/13/2022] Open
Abstract
The COVID-19 pandemic is a unique period of stress that, in some cases, led to post-traumatic stress symptoms (PTSSs). Emotion regulation strategies are known to modulate the emotional response to stressful events. Expressive suppression (ES) is a maladaptive strategy related to the exacerbation of the physiological stress response. Heart rate variability (HRV), an index of cardiac autonomic balance strictly related to ES, was also shown to predict PTSSs. This was the first study to investigate whether the pre-pandemic ES use and resting-state HRV predicted pandemic-related PTSSs. Before the pandemic, 83 (58 females) university students completed the Emotion Regulation Questionnaire (ERQ), self-report measures of anxiety and depressive symptoms, and a three-minute resting-state electrocardiogram recording. After 12 months, 61 (45 females) participants completed a self-report measure of pandemic-related PTSSs and repeated the self-report psychological measures. Pre-pandemic anxiety symptoms prospectively predicted greater PTSSs. Moreover, a significant interaction between HRV and ES in predicting PTSSs emerged, whereby those who had higher levels of ES and reduced HRV showed higher PTSSs. These findings suggest that an integrated assessment of HRV and ES might be useful for identifying individuals who are more vulnerable to the development of PTSSs during crises.
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Affiliation(s)
- Carola Dell’Acqua
- grid.5608.b0000 0004 1757 3470Department of General Psychology, University of Padua, Via Venezia, 8, 35131 Padua, Italy ,grid.5608.b0000 0004 1757 3470Padova Neuroscience Center (PNC), University of Padua, Padua, Italy
| | - Francesca Mura
- grid.5608.b0000 0004 1757 3470Department of General Psychology, University of Padua, Via Venezia, 8, 35131 Padua, Italy ,grid.5608.b0000 0004 1757 3470Padova Neuroscience Center (PNC), University of Padua, Padua, Italy
| | - Simone Messerotti Benvenuti
- grid.5608.b0000 0004 1757 3470Department of General Psychology, University of Padua, Via Venezia, 8, 35131 Padua, Italy ,grid.5608.b0000 0004 1757 3470Padova Neuroscience Center (PNC), University of Padua, Padua, Italy ,grid.411474.30000 0004 1760 2630Hospital Psychology Unit, Padua University Hospital, Padua, Italy
| | - Elisabetta Patron
- grid.5608.b0000 0004 1757 3470Department of General Psychology, University of Padua, Via Venezia, 8, 35131 Padua, Italy
| | - Daniela Palomba
- grid.5608.b0000 0004 1757 3470Department of General Psychology, University of Padua, Via Venezia, 8, 35131 Padua, Italy ,grid.5608.b0000 0004 1757 3470Padova Neuroscience Center (PNC), University of Padua, Padua, Italy
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102
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Wu CS, Liao SC, Huang WL. Use of machine learning to diagnose somatic symptom disorder: Are the biomarkers beneficial for the diagnosis? World J Biol Psychiatry 2022:1-11. [PMID: 36408683 DOI: 10.1080/15622975.2022.2149853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVES We used machine learning to incorporate three types of biomarkers (respiratory sinus arrhythmia, RSA; skin conductance, SC; finger temperature, FT) for examining the performance of diagnosing somatic symptom disorder (SSD). METHODS We recruited 97 SSD subjects and 96 controls without psychiatric history or somatic distress. The values of RSA, SC and FT were recorded in three situations (resting state, under a cognitive task and under paced breathing) and compared for the two populations. We used machine learning to combine the biological signals and then applied receiver operating characteristic curve analysis to examine the performance of diagnosing SSD regarding the distinct indicators and situations. Subgroup analysis for subjects without depression/anxiety was also conducted. RESULTS FT was significantly different between SSD patients and controls, especially in the resting state and under paced breathing. However, the biomarkers (0.75-0.76) did not reveal an area under the curve (AUC) comparable with the psychological questionnaires (0.86). Combining the biological and psychological indicators gave a high AUC (0.86-0.92). When excluding individuals with depression/anxiety, combining three biomarkers (0.79-0.83) and adopting psychological questionnaires (0.78) revealed a similar AUC. CONCLUSIONS The performance of RSA/SC/FT was unsatisfactory for diagnosing SSD but became comparable when excluding comorbid depression/anxiety.
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Affiliation(s)
- Chi-Shin Wu
- National Center for Geriatrics and Welfare Research, National Health Research Institutes, Miaoli, Taiwan.,Department of Psychiatry, National Taiwan University Hospital Yunlin Branch, Yunlin, Taiwan
| | - Shih-Cheng Liao
- Department of Psychiatry, College of Medicine, National Taiwan University, Taipei, Taiwan.,Department of Psychiatry, National Taiwan University Hospital Hsin-Chu Branch, Hsin-Chu Hospital, Hsinchu, Taiwan
| | - Wei-Lieh Huang
- Department of Psychiatry, National Taiwan University Hospital Yunlin Branch, Yunlin, Taiwan.,Department of Psychiatry, College of Medicine, National Taiwan University, Taipei, Taiwan.,Cerebellar Research Center, National Taiwan University Hospital Yunlin Branch, Yunlin, Taiwan
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103
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Pagaduan JC, Chen YS, Fell JW, Xuan Wu SS. A preliminary systematic review and meta-analysis on the effects of heart rate variability biofeedback on heart rate variability and respiration of athletes. JOURNAL OF COMPLEMENTARY & INTEGRATIVE MEDICINE 2022; 19:817-826. [PMID: 34187114 DOI: 10.1515/jcim-2020-0528] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 06/18/2021] [Indexed: 06/13/2023]
Abstract
To date, there is no quantitative review examining the influence of heart rate variability biofeedback (HRV BFB) on the athlete population. Such an undertaking may provide valuable information on the autonomic and respiration responses of athletes when performing HRV BFB. Thus, purpose of this preliminary systematic review and meta-analysis on the effects of HRV BFB on HRV and respiration of athletes. Searches of Springerlink, SportDiscus, Web of Science, PROQUEST Academic Research Library, Google Scholar, and ScienceDirect were conducted for studies that met the following criteria: (1) experimental studies involving athletes that underwent randomized control trial; (2) availability of HRV BFB as a treatment compared with a control (CON)/placebo (PLA); (3) any pre and post HRV variable and/or breathing frequency as dependent variable/s; and, (4) peer-reviewed articles written in English. Four out of 660 studies involving 115 athletes (25 females and 90 males) ages 16-30 years old were assessed in this review. Preliminary findings suggest the promising ability of HRV BFB to improve respiratory mechanics in athlete population. More work is needed to determine the autonomic modulatory effect of HRV BFB in athletes.
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Affiliation(s)
- Jeffrey Cayaban Pagaduan
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Newnham, Tasmania, Australia
| | - Yung-Sheng Chen
- Department of Exercise and Health Sciences, University of Taipei, Taipei, Taiwan, ROC
| | - James William Fell
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Newnham, Tasmania, Australia
| | - Sam Shi Xuan Wu
- School of Health Sciences, Faculty of Health, Arts, and Design, Swinburne University, Melbourne, VIC, Australia
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104
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Korogod N, Skuza K, Bangerter G, Opsommer E. Physiological effects of Therapeutic Body Wraps in healthy volunteers: An observational study. Arch Psychiatr Nurs 2022; 41:114-123. [PMID: 36428039 DOI: 10.1016/j.apnu.2022.07.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 05/30/2022] [Accepted: 07/09/2022] [Indexed: 11/30/2022]
Abstract
INTRODUCTION The clinical management of severe anxiety is challenging. Along with specific medication, several nonpharmacological treatments exist, among which the Therapeutic Body Wraps (TBW). While TBW is clinically known to be efficient, the absence of objective physiological measurements raised some debates about its harmlessness. AIMS This observational study investigated TBW in healthy volunteers. METHODS Measurements were done in 26 participants, who experienced TBW, which consisted of tightly wrapping the body in one layer of wet cold sheets and several warm blankets. These were compared to 13 participants, who rested in supine position. RESULTS Our results showed increase in the trunk skin temperature by the end of TBW similar to rest. Somatosensory perception as assessed with quantitative sensory testing was stable after both TBW and rest. The heart and breath rates decreased both during TBW and rest. It was accompanied by increase in heart rate variability parameters and decrease in salivary cortisol levels. DISCUSSION Our data indicate anxiolytic effect of TBW in healthy participants. IMPLICATIONS FOR PRACTICE The TBW is harmless and might be used in patients, who are unable to relax by themselves and/or without anxiolytic medication. Further studies are necessary to investigate physiological response to TBW in clinical population.
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Affiliation(s)
- Natalya Korogod
- School of Health Sciences (HESAV), University of Applied Sciences and Arts Western Switzerland (HES-SO), Avenue de Beaumont 21, 1011 Lausanne, Switzerland.
| | - Krzysztof Skuza
- School of Health Sciences (HESAV), University of Applied Sciences and Arts Western Switzerland (HES-SO), Avenue de Beaumont 21, 1011 Lausanne, Switzerland
| | - Gilles Bangerter
- School of Health Sciences (HESAV), University of Applied Sciences and Arts Western Switzerland (HES-SO), Avenue de Beaumont 21, 1011 Lausanne, Switzerland
| | - Emmanuelle Opsommer
- School of Health Sciences (HESAV), University of Applied Sciences and Arts Western Switzerland (HES-SO), Avenue de Beaumont 21, 1011 Lausanne, Switzerland
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105
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Jarczok MN, Weimer K, Braun C, Williams DP, Thayer JF, Gündel HO, Balint EM. Heart rate variability in the prediction of mortality: A systematic review and meta-analysis of healthy and patient populations. Neurosci Biobehav Rev 2022; 143:104907. [DOI: 10.1016/j.neubiorev.2022.104907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 10/03/2022] [Accepted: 10/04/2022] [Indexed: 11/07/2022]
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Taylor PD, Gu H, Saunders H, Fiori F, Dalrymple KV, Sethupathi P, Yamanouchi L, Miller F, Jones B, Vieira MC, Singh C, Briley A, Seed PT, Pasupathy D, Santosh PJ, Groves AM, Sinha MD, Chowienczyk PJ, Poston L. Lifestyle intervention in obese pregnancy and cardiac remodelling in 3-year olds: children of the UPBEAT RCT. Int J Obes (Lond) 2022; 46:2145-2155. [PMID: 36224375 PMCID: PMC9678793 DOI: 10.1038/s41366-022-01210-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Revised: 07/20/2022] [Accepted: 08/05/2022] [Indexed: 11/08/2022]
Abstract
BACKGROUND/OBJECTIVES Obesity in pregnancy has been associated with increased childhood cardiometabolic risk and reduced life expectancy. The UK UPBEAT multicentre randomised control trial was a lifestyle intervention of diet and physical activity in pregnant women with obesity. We hypothesised that the 3-year-old children of women with obesity would have heightened cardiovascular risk compared to children of normal BMI women, and that the UPBEAT intervention would mitigate this risk. SUBJECTS/METHODS Children were recruited from one UPBEAT trial centre. Cardiovascular measures included blood pressure, echocardiographic assessment of cardiac function and dimensions, carotid intima-media thickness and heart rate variability (HRV) by electrocardiogram. RESULTS Compared to offspring of normal BMI women (n = 51), children of women with obesity from the trial standard care arm (n = 39) had evidence of cardiac remodelling including increased interventricular septum (IVS; mean difference 0.04 cm; 95% CI: 0.018 to 0.067), posterior wall (PW; 0.03 cm; 0.006 to 0.062) and relative wall thicknesses (RWT; 0.03 cm; 0.01 to 0.05) following adjustment. Randomisation of women with obesity to the intervention arm (n = 31) prevented this cardiac remodelling (intervention effect; mean difference IVS -0.03 cm (-0.05 to -0.008); PW -0.03 cm (-0.05 to -0.01); RWT -0.02 cm (-0.04 to -0.005)). Children of women with obesity (standard care arm) compared to women of normal BMI also had elevated minimum heart rate (7 bpm; 1.41 to 13.34) evidence of early diastolic dysfunction (e prime) and increased sympathetic nerve activity index by HRV analysis. CONCLUSIONS Maternal obesity was associated with left ventricular concentric remodelling in 3-year-old offspring. Absence of remodelling following the maternal intervention infers in utero origins of cardiac remodelling. CLINICAL TRIAL REGISTRY NAME AND REGISTRATION NUMBER The UPBEAT trial is registered with Current Controlled Trials, ISRCTN89971375.
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Affiliation(s)
- Paul D Taylor
- Department of Women & Children's Health, School of Life Course Sciences, King's College London, London, UK.
| | - Haotian Gu
- BHF Centre of Research Excellence, School of Cardiovascular Medicine and Sciences, King's College London, London, UK
| | - Hannah Saunders
- Department of Women & Children's Health, School of Life Course Sciences, King's College London, London, UK
| | - Federico Fiori
- Department of Child and Adolescent Psychiatry, IOPPN Kings College London, London, UK
| | - Kathryn V Dalrymple
- Department of Women & Children's Health, School of Life Course Sciences, King's College London, London, UK
| | - Priyanka Sethupathi
- Department of Women & Children's Health, School of Life Course Sciences, King's College London, London, UK
| | - Liana Yamanouchi
- Department of Women & Children's Health, School of Life Course Sciences, King's College London, London, UK
| | - Faith Miller
- Department of Women & Children's Health, School of Life Course Sciences, King's College London, London, UK
| | - Bethany Jones
- Department of Women & Children's Health, School of Life Course Sciences, King's College London, London, UK
| | - Matias C Vieira
- Department of Women & Children's Health, School of Life Course Sciences, King's College London, London, UK
| | - Claire Singh
- Department of Women & Children's Health, School of Life Course Sciences, King's College London, London, UK
| | - Annette Briley
- Department of Women & Children's Health, School of Life Course Sciences, King's College London, London, UK
| | - Paul T Seed
- Department of Women & Children's Health, School of Life Course Sciences, King's College London, London, UK
| | - Dharmintra Pasupathy
- Department of Women & Children's Health, School of Life Course Sciences, King's College London, London, UK
- Reproduction and Perinatal Centre, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Paramala J Santosh
- Department of Child and Adolescent Psychiatry, IOPPN Kings College London, London, UK
| | - Alan M Groves
- Department of Pediatrics, Division of Newborn Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Manish D Sinha
- Department of Women & Children's Health, School of Life Course Sciences, King's College London, London, UK
- BHF Centre of Research Excellence, School of Cardiovascular Medicine and Sciences, King's College London, London, UK
- Department of Paediatric Nephrology, Evelina London Children's Hospital, King's College London, Guy's and St Thomas NHS Foundation Trust, London, UK
| | - Philip J Chowienczyk
- BHF Centre of Research Excellence, School of Cardiovascular Medicine and Sciences, King's College London, London, UK
| | - Lucilla Poston
- Department of Women & Children's Health, School of Life Course Sciences, King's College London, London, UK
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Lu K, Sjörs Dahlman A, Karlsson J, Candefjord S. Detecting driver fatigue using heart rate variability: A systematic review. ACCIDENT; ANALYSIS AND PREVENTION 2022; 178:106830. [PMID: 36155280 DOI: 10.1016/j.aap.2022.106830] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 07/05/2022] [Accepted: 09/01/2022] [Indexed: 06/16/2023]
Abstract
Driver fatigue detection systems have potential to improve road safety by preventing crashes and saving lives. Conventional driver monitoring systems based on driving performance and facial features may be challenged by the application of automated driving systems. This limitation could potentially be overcome by monitoring systems based on physiological measurements. Heart rate variability (HRV) is a physiological marker of interest for detecting driver fatigue that can be measured during real life driving. This systematic review investigates the relationship between HRV measures and driver fatigue, as well as the performance of HRV based fatigue detection systems. With the applied eligibility criteria, 18 articles were identified in this review. Inconsistent results can be found within the studies that investigated differences of HRV measures between alert and fatigued drivers. For studies that developed HRV based fatigue detection systems, the detection performance showed a large variation, where the detection accuracy ranged from 44% to 100%. The inconsistency and variation of the results can be caused by differences in several key aspects in the study designs. Progress in this field is needed to determine the relationship between HRV and different fatigue causal factors and its connection to driver performance. To be deployed, HRV-based fatigue detection systems need to be thoroughly tested in real life conditions with good coverage of relevant driving scenarios and a sufficient number of participants.
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Affiliation(s)
- Ke Lu
- Department of Electrical Engineering, Chalmers University of Technology, Gothenburg, Sweden; SAFER Vehicle and Traffic Safety Centre, Chalmers University of Technology, Gothenburg, Sweden.
| | - Anna Sjörs Dahlman
- Department of Electrical Engineering, Chalmers University of Technology, Gothenburg, Sweden; SAFER Vehicle and Traffic Safety Centre, Chalmers University of Technology, Gothenburg, Sweden; Swedish National Road and Transport Research Institute (VTI), Linköping, Sweden
| | - Johan Karlsson
- SAFER Vehicle and Traffic Safety Centre, Chalmers University of Technology, Gothenburg, Sweden; Autoliv Research, Autoliv Development AB, Vårgårda, Sweden
| | - Stefan Candefjord
- Department of Electrical Engineering, Chalmers University of Technology, Gothenburg, Sweden; SAFER Vehicle and Traffic Safety Centre, Chalmers University of Technology, Gothenburg, Sweden
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108
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Cherifi F, Lefevre Arbogast S, Font J, Abdeddaim C, Becourt S, Penel N, Coquan E, Lequesne J, Gidron Y, Joly F. The promising prognostic value of vagal nerve activity at the initial management of ovarian cancer. Front Oncol 2022; 12:1049970. [PMID: 36523968 PMCID: PMC9745166 DOI: 10.3389/fonc.2022.1049970] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 11/08/2022] [Indexed: 12/24/2023] Open
Abstract
OBJECTIVE Identifying new modifiable prognostic markers is important for ovarian cancer (OC). Low parasympathic activity is associated with inflammation, oxidative stress and sympathetic nervous system activation. Previous studies reported that low vagal nerve activity, measured by low heart rate variability (HRV), may predict poor cancer prognosis. We aimed to examine the prognostic value of HRV in OC. METHODS This bicentric retrospective study included patients diagnosed with serous OC FIGO stage ≥IIB, between January 2015 and August 2019, with electrocardiograms (ECG) available around diagnosis. HRV was measured from ECG using the time domain parameter of standard deviation of all normal-to-normal heartbeat intervals (SDNN). Optimal SDNN cut-off was determined using the Youden index criteria of time-dependent ROC curves. We used multivariate cox proportional hazard models to investigate the association between HRV and overall survival (OS), while adjusting for well-known OC prognostic factors. RESULTS The 202 patients included were 65.7 years-old on average, 93% had stage FIGO IIIC/IV, 56% had complete surgical resection. Median OS was 38.6 months [95%CI:34.4-47.4]. The median SDNN was 11.1ms, with an optimal cut-off of 10ms to predict OS. OS was shorter for patients with low HRV compared to high HRV (26.4 vs 45.1 months; p<0.001). In multivariate analysis, HRV remained an independent prognostic factor with a two-fold higher risk of death among patients with low SDNN compared to those with high SDNN (HR=2.03, 95%CI=1.35-3.06, p<0.001). CONCLUSION Low HRV, was associated with worse OS in OC patients, supporting previous studies on the prognostic role of HRV in cancer. If replicated in prospective studies, vagal nerve activity may be a new therapeutic target in OC.
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Affiliation(s)
- François Cherifi
- Department of Medical Oncology, Centre François Baclesse, Caen, France
- Department of Clinical Research, Centre Francois Baclesse, Caen, France
| | - Sophie Lefevre Arbogast
- Department of Clinical Research, Centre Francois Baclesse, Caen, France
- Normandie Université, UNICAEN, Institut National de la Santé et de la Recherche Médicale (Inserm) U1086, ANTICIPE, Caen, France
| | - Jonaz Font
- Department of Cardiology, Centre Hospitalier Universitaire de Caen, Caen, France
| | - Cyril Abdeddaim
- Department of Medical Oncology, Centre Oscar Lambret, Lille, France
| | | | - Nicolas Penel
- Department of Medical Oncology, Centre Oscar Lambret, Lille, France
| | - Elodie Coquan
- Department of Medical Oncology, Centre François Baclesse, Caen, France
- Department of Clinical Research, Centre Francois Baclesse, Caen, France
| | - Justine Lequesne
- Department of Clinical Research, Centre Francois Baclesse, Caen, France
| | - Yori Gidron
- Department of Nursing, Faculty of Health Sciences, Haifa University, Haifa, Israel
| | - Florence Joly
- Department of Medical Oncology, Centre François Baclesse, Caen, France
- Normandie Université, UNICAEN, Institut National de la Santé et de la Recherche Médicale (Inserm) U1086, ANTICIPE, Caen, France
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Smirl JD, Peacock D, Burma JS, Wright AD, Bouliane KJ, Dierijck J, van Donkelaar P. Repetitive bout of controlled soccer heading does not alter heart rate variability metrics: A preliminary investigation. Front Neurol 2022; 13:980938. [PMID: 36504654 PMCID: PMC9732532 DOI: 10.3389/fneur.2022.980938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 11/09/2022] [Indexed: 11/27/2022] Open
Abstract
Objectives There is elevated unease regarding how repetitive head impacts, such as those associated with soccer heading, contribute to alterations in brain function. This study examined the extent heart rate variability (HRV) and cardiac baroreceptor sensitivity (BRS) metrics are altered immediately following an acute bout of soccer heading. Methods Seven male elite soccer players (24.1 ± 1.5 years) completed 40 successful soccer headers in 20-min. The headers were performed under controlled circumstances using a soccer ball launcher located 25 meters away and using an initial ball velocity of 77.5 ± 3.7 km/h (heading condition). An accelerometer (xPatch) on the right mastoid process quantified linear/rotational head accelerations. Participants also completed sham (body contact) and control (non-contact) sessions. A three-lead ECG and finger photoplethysmography characterized short-term spontaneous HRV/cardiac BRS, before and after each condition. The SCAT3 indexed symptom scores pre-post exposures to all three conditions. Results During the heading condition, cumulative linear and rotational accelerations experienced were 1,574 ± 97.9 g and 313,761 ± 23,966 rad/s2, respectively. Heart rate trended toward an increase from pre- to post-heading (p = 0.063), however HRV metrics in the time-domain (ps > 0.260) and frequency-domain (ps > 0.327) as well as cardiac BRS (ps > 0.144) were not significantly changed following all three conditions. Following the heading condition, SCAT3 symptom severity increased (p = 0.030) with a trend for symptom score augmentation (p = 0.078) compared to control and sham. Conclusion Whereas, symptoms as measured by the SCAT3 were induced following an acute bout of controlled soccer heading, these preliminary findings indicate they were not accompanied by alterations to autonomic function. Ultimately, this demonstrates further research is needed to understand the physiological underpinnings of alterations in brain function occurring immediately after a bout of soccer heading and how these may, over time, contribute to long-term neurological impairments.
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Affiliation(s)
- Jonathan David Smirl
- Concussion Research Lab, University of British Columbia, Kelowna, BC, Canada,Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada,Sport Injury Prevention Research Centre, University of Calgary, Calgary, AB, Canada,Human Performance Laboratory, University of Calgary, Calgary, AB, Canada,Faculty of Medicine, Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada,Integrated Concussion Research Program, University of Calgary, Calgary, AB, Canada,Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada,Libin Cardiovascular Institute, University of Calgary, Calgary, AB, Canada,*Correspondence: Jonathan David Smirl
| | - Dakota Peacock
- Southern Medical Program, University of British Columbia, Kelowna, BC, Canada,Division of Neurology, Department of Pediatrics, BC Children's Hospital, Vancouver, BC, Canada
| | - Joel Stephen Burma
- Concussion Research Lab, University of British Columbia, Kelowna, BC, Canada,Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada,Sport Injury Prevention Research Centre, University of Calgary, Calgary, AB, Canada,Human Performance Laboratory, University of Calgary, Calgary, AB, Canada,Faculty of Medicine, Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada,Integrated Concussion Research Program, University of Calgary, Calgary, AB, Canada,Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada,Libin Cardiovascular Institute, University of Calgary, Calgary, AB, Canada
| | - Alexander D. Wright
- Concussion Research Lab, University of British Columbia, Kelowna, BC, Canada,Southern Medical Program, University of British Columbia, Kelowna, BC, Canada,University of British Columbia, Vancouver, BC, Canada,Experimental Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Kevin J. Bouliane
- Concussion Research Lab, University of British Columbia, Kelowna, BC, Canada
| | - Jill Dierijck
- Concussion Research Lab, University of British Columbia, Kelowna, BC, Canada,School of Physiotherapy, Faculty of Health, Dalhousie University, Halifax, NS, Canada
| | - Paul van Donkelaar
- Concussion Research Lab, University of British Columbia, Kelowna, BC, Canada
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Chen H, Comnick C, Norman GJ, Caplan DJ, Jin XX, Fillingim RB. Triad Multisystem Phenotype with High-risk for Developing Temporomandibular Disorders- Characteristics and Potential Pathophysiology Results from the OPPERA Dataset. Pain 2022; 164:1027-1038. [PMID: 36661844 DOI: 10.1097/j.pain.0000000000002797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 09/20/2022] [Indexed: 01/21/2023]
Abstract
ABSTRACT A multisystem phenotype with the Triad of bodily pain, psychological distress, and sleep disturbance was found to have high risk for developing initial onset of painful temporomandibular disorders (TMDs) in the multicenter Orofacial Pain: Prospective Evaluation and Risk Assessment (OPPERA) dataset. In this study, we systemically examined phenotypic characteristics and explored potential pathophysiology in quantitative sensory testing (QST) and autonomic nervous system (ANS) domains in this multisystem Triad phenotype. Secondary analysis was performed on 1199 non-Triad and 154 Triad TMD-free OPPERA enrollees at baseline. Results indicate that prior to developing TMDs, the Triad phenotype demonstrated both orofacial and systemic signs and symptoms that can only be captured through multisystem assessment. In addition, we found significantly lower resting heart rate variability and higher resting heart rate in the Triad phenotype as compared to the non-Triad group. However, pain sensitivity measured by QST was not different between groups. These findings highlight the importance of whole-person multisystem assessment at the stage prior to developing complex pain conditions such as TMDs, and suggest that, in addition to a "tissue damage monitor", pain should be considered in a broader context, such as a component within a "distress monitoring system" at the whole-person level when multisystem issues co-present. Therefore, the presence or absence of multisystem issues may carry critical information when searching for disease mechanisms and developing mechanism-based intervention and prevention strategies for TMDs and related pain conditions. Cardiovascular autonomic function should be further researched when multisystem issues co-present prior to developing TMDs.
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Affiliation(s)
- Hong Chen
- the University of Iowa College of Dentistry, Department of Preventive and Community Dentistry
| | - Carissa Comnick
- University of Iowa College of Dentistry, Division of Biostatistics & Computational Biology and University of Iowa College of Public Health, Department of Biostatistics
| | | | - Daniel J Caplan
- the University of Iowa College of Dentistry, Department of Preventive and Community Dentistry
| | - Xie Xian Jin
- University of Iowa College of Dentistry, Division of Biostatistics & Computational Biology and University of Iowa College of Public Health, Department of Biostatistics
| | - Roger B Fillingim
- University of Florida College of Dentistry, Department of Community Dentistry and Behavioral Science
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Neuromodulation Applied to Diseases: The Case of HRV Biofeedback. J Clin Med 2022; 11:jcm11195927. [PMID: 36233794 PMCID: PMC9571900 DOI: 10.3390/jcm11195927] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 09/26/2022] [Accepted: 09/28/2022] [Indexed: 12/02/2022] Open
Abstract
The vagus or “wandering” nerve is the main branch of the parasympathetic nervous system (PNS), innervating most internal organs crucial for health. Activity of the vagus nerve can be non-invasively indexed by heart-rate variability parameters (HRV). Specific HRV parameters predict less all-cause mortality, lower risk of and better prognosis after myocardial infarctions, and better survival in cancer. A non-invasive manner for self-activating the vagus is achieved by performing a slow-paced breathing technique while receiving visual feedback of one’s HRV, called HRV-biofeedback (HRV-B). This article narratively reviews the biological mechanisms underlying the role of vagal activity and vagally mediated HRV in hypertension, diabetes, coronary heart disease (CHD), cancer, pain, and dementia. After searching the literature for HRV-B intervention studies in each condition, we report the effects of HRV-B on clinical outcomes in these health conditions, while evaluating the methodological quality of these studies. Generally, the levels of evidence for the benefits of HRV-B is high in CHD, pain, and hypertension, moderate in cancer, and poor in diabetes and dementia. Limitations and future research directions are discussed.
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112
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Huang WL, Cheng YC, Liao SC. A simple version of resting-state heart rate variability interpretation for patients with affective disorders: A four-pattern perspective. Kaohsiung J Med Sci 2022; 38:1123-1132. [PMID: 36177817 DOI: 10.1002/kjm2.12600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 08/30/2022] [Accepted: 08/31/2022] [Indexed: 11/08/2022] Open
Abstract
Heart rate variability (HRV) is often considered as a biomarker reflecting well-being, but the clinical meaning of short-term resting-state HRV is not sufficiently defined. We assume that combining several common HRV indices as "HRV patterns" and using the patterns for screening purposes are meaningful approaches. Resting-state 5-min HRV data of 424 subjects were analyzed. Four of the most commonly used HRV indices were considered: standard deviation of normal-to-normal RR intervals, low-frequency power, high-frequency power and the ratio of low-frequency to high-frequency power. According to these indices, four HRV patterns were defined: normal pattern, low HRV pattern, relatively high sympathetic pattern, and relatively high vagal pattern. The associations between the demographics, lifestyles, personality traits, psychological states, and HRV patterns were explored: the low HRV pattern was positively associated with age, body mass index, and depression; the relatively high sympathetic pattern was positively associated with age and negatively associated with exercise habit; and the relatively high vagal pattern was negatively associated with having a steady job and novelty seeking. The pattern perspective may provide a convenient and evidence-based way to interpret resting-state HRV for patients with affective disorders.
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Affiliation(s)
- Wei-Lieh Huang
- Department of Psychiatry, National Taiwan University Hospital Yunlin Branch, Yunlin, Taiwan.,Department of Psychiatry, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Ying-Chih Cheng
- Department of Psychiatry, China Medical University Hsinchu Hospital, China Medical University, Hsinchu, Taiwan.,Department of Public Health and Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan.,Research Center of Big Data and Meta-analysis, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Shih-Cheng Liao
- Department of Psychiatry, College of Medicine, National Taiwan University, Taipei, Taiwan.,Department of Psychiatry, National Taiwan University Hospital Hsin-Chu Branch, Hsin-Chu Hospital, Hsinchu, Taiwan
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113
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Nicolini P, Lucchi T, Abbate C, Inglese S, Tomasini E, Mari D, Rossi PD, Vicenzi M. Autonomic function predicts cognitive decline in mild cognitive impairment: Evidence from power spectral analysis of heart rate variability in a longitudinal study. Front Aging Neurosci 2022; 14:886023. [PMID: 36185491 PMCID: PMC9520613 DOI: 10.3389/fnagi.2022.886023] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 08/25/2022] [Indexed: 11/13/2022] Open
Abstract
Background Despite the emerging clinical relevance of heart rate variability (HRV) as a potential biomarker of cognitive decline and as a candidate target for intervention, there is a dearth of research on the prospective relationship between HRV and cognitive change. In particular, no study has addressed this issue in subjects with a diagnosis of cognitive status including cognitive impairment. Objective To investigate HRV as a predictor of cognitive decline in subjects with normal cognition (NC) or Mild Cognitive Impairment (MCI). Specifically, we tested the literature-based hypothesis that the HRV response to different physical challenges would predict decline in different cognitive domains. Methods This longitudinal study represents the approximately 3-year follow-up of a previous cross-sectional study enrolling 80 older outpatients (aged ≥ 65). At baseline, power spectral analysis of HRV was performed on five-minute electrocardiographic recordings at rest and during a sympathetic (active standing) and a parasympathetic (paced breathing) challenge. We focused on normalized HRV measures [normalized low frequency power (LFn) and the low frequency to high frequency power ratio (LF/HF)] and on their dynamic response from rest to challenge (Δ HRV). Extensive neuropsychological testing was used to diagnose cognitive status at baseline and to evaluate cognitive change over the follow-up via annualized changes in cognitive Z-scores. The association between Δ HRV and cognitive change was explored by means of linear regression, unadjusted and adjusted for potential confounders. Results In subjects diagnosed with MCI at baseline a greater response to a sympathetic challenge predicted a greater decline in episodic memory [adjusted model: Δ LFn, standardized regression coefficient (β) = −0.528, p = 0.019; Δ LF/HF, β = −0.643, p = 0.001] whereas a greater response to a parasympathetic challenge predicted a lesser decline in executive functioning (adjusted model: Δ LFn, β = −0.716, p < 0.001; Δ LF/HF, β = −0.935, p < 0.001). Conclusion Our findings provide novel insight into the link between HRV and cognition in MCI. They contribute to a better understanding of the heart-brain connection, but will require replication in larger cohorts.
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Affiliation(s)
- Paola Nicolini
- Geriatric Unit, Internal Medicine Department, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
- *Correspondence: Paola Nicolini,
| | - Tiziano Lucchi
- Geriatric Unit, Internal Medicine Department, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Carlo Abbate
- Geriatric Unit, Internal Medicine Department, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
- IRCCS Fondazione Don Carlo Gnocchi, Milan, Italy
| | - Silvia Inglese
- Geriatric Unit, Internal Medicine Department, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Emanuele Tomasini
- Geriatric Unit, Internal Medicine Department, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
- IRCCS Fondazione Don Carlo Gnocchi, Milan, Italy
| | - Daniela Mari
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Paolo D. Rossi
- Geriatric Unit, Internal Medicine Department, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Marco Vicenzi
- Dyspnea Lab, Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
- Cardiovascular Disease Unit, Internal Medicine Department, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
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114
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Liboriussen CH, Andersen SS, Andersen SS, Jensen MK, Jochumsen M, Kristensen S. Investigating the Dose-Response Relationship between Deep Breathing and Heart Rate Variability in Healthy Participants and Across-Days Reliability in Patients with Rheumatoid Arthritis and Systemic Lupus Erythematosus. SENSORS (BASEL, SWITZERLAND) 2022; 22:s22186849. [PMID: 36146198 PMCID: PMC9503478 DOI: 10.3390/s22186849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 09/06/2022] [Accepted: 09/07/2022] [Indexed: 05/09/2023]
Abstract
Rheumatoid Arthritis (RA) and Systemic Lupus Erythematosus (SLE) are associated with autonomic dysfunction, potentially through reduced vagus nerve tone. Vagus nerve stimulation has been proposed as an anti-inflammatory treatment, and it can be performed through deep breathing (DB) exercises. In this study, the dose-response relationship between DB exercises and heart rate variability (HRV) was investigated in healthy participants and reliability across days in patients with RA and SLE. On three separate days, 41 healthy participants performed DB for: 5, 15, or 30 min. On two separate days, 52 RA or SLE patients performed DB with the dose associated with the highest HRV increase in healthy participants. The HRV was estimated from ECG-recordings recorded prior and post the DB exercises. Increases in dose led to larger HRV-responses. Thirty minutes led to the largest HRV-response. In the RA and SLE patients, this dose increased the HRV-parameters consistently across the two days, indicating reliability. DB increases HRV in healthy participants and RA or SLE patients, which indicates stimulation of the vagus nerve. Of the tested durations, 30 min of DB was the optimal period of stimulation. A potential anti-inflammatory effect of DB exercises should be investigated in future studies.
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Affiliation(s)
| | | | | | | | - Mads Jochumsen
- Department of Health Science and Technology, Aalborg University, 9220 Aalborg, Denmark
- Correspondence:
| | - Salome Kristensen
- Department of Rheumatology, Aalborg University Hospital, 9000 Aalborg, Denmark
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115
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Ellingson CJ, Singh J, Ellingson CA, Sirant LW, Krätzig GP, Dorsch KD, Piskorski J, Neary JP. Alterations in Baroreflex Sensitivity and Blood Pressure Variability Following Sport-Related Concussion. Life (Basel) 2022; 12:life12091400. [PMID: 36143435 PMCID: PMC9500648 DOI: 10.3390/life12091400] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 08/23/2022] [Accepted: 09/06/2022] [Indexed: 11/24/2022] Open
Abstract
Current methods to diagnose concussions are subjective and difficult to confirm. A variety of physiological biomarkers have been reported, but with conflicting results. This study assessed heart rate variability (HRV), spontaneous baroreflex sensitivity (BRS), and systolic blood pressure variability (BPV) in concussed athletes. The assessment consisted of a 5-min seated rest followed by a 5-min (0.1 Hz) controlled breathing protocol. Thirty participants completed baseline assessments. The protocol was repeated during the post-injury acute phase (days one to five). Total (p = 0.02) and low-frequency (p = 0.009) BPV spectral power were significantly decreased during the acute phase of concussion. BRS down-sequence (p = 0.036) and up-sequence (p = 0.05) were significantly increased in the acute phase of concussion, with a trend towards an increased BRS pooled (p = 0.06). Significant decreases in HRV were also found. Acute concussion resulted in altered BRS and BPV dynamics compared to baseline. These findings highlight objective physiological parameters that could aid concussion diagnosis and return-to-play protocols.
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Affiliation(s)
- Chase J. Ellingson
- Faculty of Kinesiology & Health Studies, University of Regina, 3737 Wascana Parkway, Regina, SK S4S 0A2, Canada
| | - Jyotpal Singh
- Faculty of Kinesiology & Health Studies, University of Regina, 3737 Wascana Parkway, Regina, SK S4S 0A2, Canada
| | - Cody A. Ellingson
- Faculty of Kinesiology & Health Studies, University of Regina, 3737 Wascana Parkway, Regina, SK S4S 0A2, Canada
| | - Luke W. Sirant
- College of Medicine, University of Manitoba, 66 Chancellors Cir, Winnipeg, MB R3T 2N2, Canada
| | - Gregory P. Krätzig
- Department of Psychology, University of Regina, 3737 Wascana Parkway, Regina, SK S4S 0A2, Canada
| | - Kim D. Dorsch
- Faculty of Kinesiology & Health Studies, University of Regina, 3737 Wascana Parkway, Regina, SK S4S 0A2, Canada
| | - Jaroslaw Piskorski
- Institute of Physics, University of Zielona Góra, Licealna 9, 65-417 Zielona Góra, Poland
| | - J. Patrick Neary
- Faculty of Kinesiology & Health Studies, University of Regina, 3737 Wascana Parkway, Regina, SK S4S 0A2, Canada
- Correspondence: ; Tel.: +1-306-585-4844
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116
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Huwiler S, Carro Dominguez M, Huwyler S, Kiener L, Stich FM, Sala R, Aziri F, Trippel A, Schmied C, Huber R, Wenderoth N, Lustenberger C. Effects of auditory sleep modulation approaches on brain oscillatory and cardiovascular dynamics. Sleep 2022; 45:6632997. [PMID: 35793672 PMCID: PMC9453626 DOI: 10.1093/sleep/zsac155] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 06/01/2022] [Indexed: 11/14/2022] Open
Abstract
Abstract
Slow waves, the hallmark feature of deep nonrapid eye movement sleep, do potentially drive restorative effects of sleep on brain and body functions. Sleep modulation techniques to elucidate the functional role of slow waves thus have gained large interest. Auditory slow wave stimulation is a promising tool; however, directly comparing auditory stimulation approaches within a night and analyzing induced dynamic brain and cardiovascular effects are yet missing. Here, we tested various auditory stimulation approaches in a windowed, 10 s ON (stimulations) followed by 10 s OFF (no stimulations), within-night stimulation design and compared them to a SHAM control condition. We report the results of three studies and a total of 51 included nights and found a large and global increase in slow-wave activity (SWA) in the stimulation window compared to SHAM. Furthermore, slow-wave dynamics were most pronouncedly increased at the start of the stimulation and declined across the stimulation window. Beyond the changes in brain oscillations, we observed, for some conditions, a significant increase in the mean interval between two heartbeats within a stimulation window, indicating a slowing of the heart rate, and increased heart rate variability derived parasympathetic activity. Those cardiovascular changes were positively correlated with the change in SWA, and thus, our findings provide insight into the potential of auditory slow wave enhancement to modulate cardiovascular restorative conditions during sleep. However, future studies need to investigate whether the potentially increased restorative capacity through slow-wave enhancements translates into a more rested cardiovascular system on a subsequent day.
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Affiliation(s)
- Stephanie Huwiler
- Department of Health Sciences and Technology, Neural Control of Movement Lab, Institute of Human Movement Sciences and Sport, ETH Zurich, Zurich, Switzerland
| | - Manuel Carro Dominguez
- Department of Health Sciences and Technology, Neural Control of Movement Lab, Institute of Human Movement Sciences and Sport, ETH Zurich, Zurich, Switzerland
| | - Silja Huwyler
- Department of Health Sciences and Technology, Neural Control of Movement Lab, Institute of Human Movement Sciences and Sport, ETH Zurich, Zurich, Switzerland
| | - Luca Kiener
- Department of Health Sciences and Technology, Neural Control of Movement Lab, Institute of Human Movement Sciences and Sport, ETH Zurich, Zurich, Switzerland
| | - Fabia M Stich
- Department of Health Sciences and Technology, Neural Control of Movement Lab, Institute of Human Movement Sciences and Sport, ETH Zurich, Zurich, Switzerland
| | - Rossella Sala
- Department of Health Sciences and Technology, Neural Control of Movement Lab, Institute of Human Movement Sciences and Sport, ETH Zurich, Zurich, Switzerland
| | - Florent Aziri
- Department of Health Sciences and Technology, Neural Control of Movement Lab, Institute of Human Movement Sciences and Sport, ETH Zurich, Zurich, Switzerland
| | - Anna Trippel
- Department of Health Sciences and Technology, Neural Control of Movement Lab, Institute of Human Movement Sciences and Sport, ETH Zurich, Zurich, Switzerland
| | - Christian Schmied
- Department of Cardiology, University Heart Center Zurich, University of Zurich, Zurich, Switzerland
| | - Reto Huber
- Center of Competence Sleep and Health Zurich, University of Zurich, Zurich, Switzerland
- Neuroscience Center Zurich (ZNZ), University of Zurich, ETH Zurich, Zurich, Switzerland
- Child Development Centre, University Children’s Hospital, University of Zurich, Zurich, Switzerland
- Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Nicole Wenderoth
- Department of Health Sciences and Technology, Neural Control of Movement Lab, Institute of Human Movement Sciences and Sport, ETH Zurich, Zurich, Switzerland
- Neuroscience Center Zurich (ZNZ), University of Zurich, ETH Zurich, Zurich, Switzerland
- Future Health Technologies, Singapore-ETH Center, Campus for Research Excellence and Technological Enterprise (CREATE), Singapore, Singapore
| | - Caroline Lustenberger
- Corresponding author. Caroline Lustenberger, Department of Health Sciences and Technology, Neural Control of Movement Lab, ETH Zurich, Zurich, 8092, Switzerland.
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117
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Cherry M, Khatir Z, Khan A, Bissell M. The impact of 4D-Flow MRI spatial resolution on patient-specific CFD simulations of the thoracic aorta. Sci Rep 2022; 12:15128. [PMID: 36068322 PMCID: PMC9448751 DOI: 10.1038/s41598-022-19347-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 08/29/2022] [Indexed: 11/29/2022] Open
Abstract
Magnetic Resonance Imaging (MRI) is considered the gold standard of medical imaging technologies as it allows for accurate imaging of blood vessels. 4-Dimensional Flow Magnetic Resonance Imaging (4D-Flow MRI) is built on conventional MRI, and provides flow data in the three vector directions and a time resolved magnitude data set. As such it can be used to retrospectively calculate haemodynamic parameters of interest, such as Wall Shear Stress (WSS). However, multiple studies have indicated that a significant limitation of the imaging technique is the spatiotemporal resolution that is currently available. Recent advances have proposed and successfully integrated 4D-Flow MRI imaging techniques with Computational Fluid Dynamics (CFD) to produce patient-specific simulations that have the potential to aid in treatments,surgical decision making, and risk stratification. However, the consequences of using insufficient 4D-Flow MRI spatial resolutions on any patient-specific CFD simulations is currently unclear, despite being a recognised limitation. The research presented in this study aims to quantify the inaccuracies in patient-specific 4D-Flow MRI based CFD simulations that can be attributed to insufficient spatial resolutions when acquiring 4D-Flow MRI data. For this research, a patient has undergone four 4D-Flow MRI scans acquired at various isotropic spatial resolutions and patient-specific CFD simulations have subsequently been run using geometry and velocity data produced from each scan. It was found that compared to CFD simulations based on a \documentclass[12pt]{minimal}
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\begin{document}$$1.5\,{\text {mm}} \times 1.5\,{\text {mm}} \times 1.5\,{\text {mm}}$$\end{document}1.5mm×1.5mm×1.5mm, using a spatial resolution of \documentclass[12pt]{minimal}
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\begin{document}$$4\,{\text {mm}} \times 4\,{\text {mm}} \times 4\,{\text {mm}}$$\end{document}4mm×4mm×4mm substantially underestimated the maximum velocity magnitude at peak systole by \documentclass[12pt]{minimal}
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\begin{document}$$110.55\%$$\end{document}110.55%. The impacts of 4D-Flow MRI spatial resolution on WSS calculated from CFD simulations have been investigated and it has been shown that WSS is underestimated in CFD simulations that are based on a coarse 4D-Flow MRI spatial resolution. The authors have concluded that a minimum 4D-Flow MRI spatial resolution of \documentclass[12pt]{minimal}
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\begin{document}$$1.5\,{\text {mm}} \times 1.5\,{\text {mm}} \times 1.5\,{\text {mm}}$$\end{document}1.5mm×1.5mm×1.5mm must be used when acquiring 4D-Flow MRI data to perform patient-specific CFD simulations. A coarser spatial resolution will produce substantial differences within the flow field and geometry.
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Affiliation(s)
- Molly Cherry
- CDT in Fluid Dynamics, School of Computing, University of Leeds, Leeds, LS2 9JT, UK.
| | - Zinedine Khatir
- School of Engineering and the Built Environment, Birmingham City University, Birmingham, B4 7XG, UK.,School of Mechanical Engineering, University of Leeds, Leeds, LS2 9JT, UK
| | - Amirul Khan
- School of Civil Engineering, University of Leeds, Leeds, LS2 9JT, UK
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118
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Peng H, Oikawa S, Inai Y, Maeda S, Akama T. Effects of lung volume and trigeminal nerve stimulation on diving response in breath-hold divers and non-divers. Respir Physiol Neurobiol 2022; 303:103918. [PMID: 35550439 DOI: 10.1016/j.resp.2022.103918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 04/21/2022] [Accepted: 05/05/2022] [Indexed: 10/18/2022]
Abstract
PURPOSE This study investigated the effects of lung volume and trigeminal nerve stimulation (TS) on diving responses in breath-hold divers (BHDs) and non-divers (NDs). METHODS Eight BHDs and nine NDs performed four breath-hold trials at different lung volumes, with or without TS, and one trial of TS. Haemodynamic parameters and electrocardiograms were measured for each trial. RESULTS During the TS trial, the total peripheral resistance increased more in BHDs. Breath-hold performed at total lung capacity showed a more pronounced decrease in stroke volume and cardiac output in BHDs. The decrease in heart rate and increase in total peripheral resistance were more pronounced in BHDs when breath-holding was performed with TS. CONCLUSION The more pronounced diving response in BHDs was attributed to the greater increase in total peripheral resistance caused by TS. Furthermore, the lower stroke volume and cardiac output in BH performed at total lung capacity could also cause a more pronounced diving response in BHDs.
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Affiliation(s)
- Heng Peng
- Graduate School of Sport Sciences, Waseda University, 2-579-15 Mikajima, Tokorozawa-city, Saitama 359-1192, Japan.
| | - Satoshi Oikawa
- Faculty of Sport Sciences, Waseda University, 2-579-15 Mikajima, Tokorozawa-city, Saitama 359-1192, Japan
| | - Yuto Inai
- Graduate School of Sport Sciences, Waseda University, 2-579-15 Mikajima, Tokorozawa-city, Saitama 359-1192, Japan
| | - Seiji Maeda
- Faculty of Sport Sciences, Waseda University, 2-579-15 Mikajima, Tokorozawa-city, Saitama 359-1192, Japan
| | - Takao Akama
- Faculty of Sport Sciences, Waseda University, 2-579-15 Mikajima, Tokorozawa-city, Saitama 359-1192, Japan
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119
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Huang CC, Liang CS, Chu HT, Chang HA, Yeh TC. Intermittent theta burst stimulation for the treatment of autonomic dysfunction and depressive symptoms in dementia with Lewy bodies. Asian J Psychiatr 2022; 75:103212. [PMID: 35905514 DOI: 10.1016/j.ajp.2022.103212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 07/01/2022] [Accepted: 07/14/2022] [Indexed: 12/01/2022]
Abstract
Dementia with Lewy bodies (DLB) is one of the most prevalent forms of neurodegenerative dementia, second to Alzheimer's disease, and autonomic abnormalities and depressive symptoms are common. There are currently no cures or treatments with evidence of disease-modifying effects for DLB, and the treatment for the amelioration of targeted symptoms is challenging due to the risk of side effects and drug-drug interactions. In the present case, we report a female elder with DLB suffering from poor tolerance to the adverse events of numerous approaches. Following intermittent theta burst stimulation (iTBS), the autonomic abnormalities and depressive symptoms remarkably improved without significant side effects.
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Affiliation(s)
- Chih-Chung Huang
- Department of Psychiatry, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan.
| | - Chih-Sung Liang
- Department of Psychiatry, Beitou Branch, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan.
| | - Hsuan-Te Chu
- Department of Psychiatry, Beitou Branch, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan.
| | - Hsin-An Chang
- Department of Psychiatry, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan
| | - Ta-Chuan Yeh
- Department of Psychiatry, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan.
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120
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Huang WL, Ko LC, Liao SC. The association between heart rate variability and skin conductance: a correlation analysis in healthy individuals and patients with somatic symptom disorder comorbid with depression and anxiety. J Int Med Res 2022; 50:3000605221127104. [PMID: 36177841 PMCID: PMC9528031 DOI: 10.1177/03000605221127104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Objective To investigate the correlations between heart rate variability (HRV) and skin conductance (SC) in two populations under three different situations. Methods This cross-sectional study enrolled patients with somatic symptom disorder comorbid with depression and anxiety and healthy individuals without a psychiatric history. The biological signals were measured under three conditions: resting state, during a cognitive task and during paced breathing. Pearson’s correlation analysis and the generalized estimating equation were used to examine the correlations between SC and HRV in the two populations under the three situations. Results The study enrolled 97 patients with somatic symptom disorder comorbid with depression and anxiety and 96 healthy individuals. In healthy individuals, the ratio of low-frequency power to high frequency power (LF/HF) and normalized LF (LF%) were significantly correlated with SC in the resting state and during a cognitive task, but the correlation coefficients were low level. In patients with somatic symptom disorder comorbid with depression and anxiety, LF/HF and LF% did not show significant correlations with SC under any situation. Conclusions The two different populations and three situations might have affected the significance of the LF/HF-SC and LF%-SC correlations. The generally low correlations indicate that LF/HF and LF% cannot fully reflect the sympathetic cholinergic activity represented by SC.
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Affiliation(s)
- Wei-Lieh Huang
- Department of Psychiatry, National Taiwan University Hospital Yunlin Branch, Yunlin.,Department of Psychiatry, College of Medicine, National Taiwan University, Taipei.,Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei
| | - Li-Chin Ko
- Department of Neurology, National Taiwan University Hospital, Taipei
| | - Shih-Cheng Liao
- Department of Psychiatry, College of Medicine, National Taiwan University, Taipei.,Department of Psychiatry, National Taiwan University Hospital Hsin-Chu Branch, Hsin-Chu Hospital, Hsin-Chu City
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121
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Coulter H, Donnelly M, Mallett J, Kernohan WG. Heart Rate Variability Biofeedback to Treat Anxiety in Young People With Autism Spectrum Disorder: Findings From a Home-Based Pilot Study. JMIR Form Res 2022; 6:e37994. [PMID: 36018712 PMCID: PMC9463620 DOI: 10.2196/37994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 06/24/2022] [Accepted: 06/30/2022] [Indexed: 12/04/2022] Open
Abstract
Background People with autism spectrum disorder (ASD) frequently experience high levels of anxiety. Despite this, many clinical settings do not provide specialist ASD mental health services, and demand for professional support frequently outstrips supply. Across many sectors of health, investigators have explored digital health solutions to mitigate demand and extend the reach of professional practice beyond traditional clinical settings. Objective This critical appraisal and pilot feasibility study examines heart rate variability (HRV) biofeedback as an approach to help young people with ASD to manage anxiety symptoms outside of formal settings. The aim is to explore the use of portable biofeedback devices to manage anxiety, while also highlighting the risks and benefits of this approach with this population. Methods We assessed the feasibility of using home-based HRV biofeedback for self-management of anxiety in young people with ASD. We adopted coproduction, involving people with ASD, to facilitate development of the study design. Next, a separate pilot with 20 participants with ASD (n=16, 80% male participants and n=4, 20% female participants, aged 13-24 years; IQ>70) assessed adoption and acceptability of HRV biofeedback devices for home use over a 12-week period. Data were collected from both carers and participants through questionnaires and interviews; participants also provided single-lead electrocardiogram recordings as well as daily reports through smartphone on adoption and use of their device. Results Pre-post participant questionnaires indicated a significant reduction in anxiety in children (t6=2.55; P=.04; Cohen d=0.99) as well as adults (t7=3.95; P=.006; Cohen d=0.54). Participant age was significantly negatively correlated with all HRV variables at baseline, namely high-frequency heart rate variability (HF-HRV: P=.02), the root mean square of successive differences in normal heartbeat contractions (RMSSD: P=.02) and the variability of normal-to-normal interbeat intervals (SDNN: P=.04). At follow-up, only SDNN was significantly negatively correlated with age (P=.05). Levels of ASD symptoms were positively correlated with heart rate both before (P=.04) and after the intervention (P=.01). The majority (311/474, 65.6%) of reports from participants indicated that the devices helped when used. Difficulties with the use of some devices and problems with home testing of HRV were noted. These initial findings are discussed within the context of the strengths and challenges of remotely delivering a biofeedback intervention for people with ASD. Conclusions HRV biofeedback devices have shown promise in this pilot study. There is now a need for larger evaluation of biofeedback to determine which delivery methods achieve the greatest effect for people with ASD. Trial Registration ClinicalTrials.gov NCT04955093; https://clinicaltrials.gov/ct2/show/NCT04955093
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Affiliation(s)
- Helen Coulter
- South Eastern Health and Social Care Trust, County Down, United Kingdom
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Correlation between impaired hemodynamic response and cardiopulmonary fitness in middle-aged type 2 diabetes mellitus patients: a case-control study. Eur J Appl Physiol 2022; 122:2295-2303. [PMID: 35859047 DOI: 10.1007/s00421-022-05008-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 07/08/2022] [Indexed: 11/03/2022]
Abstract
PURPOSE Impaired cardiorespiratory fitness (CRF) is a predictor of mortality in patients with type 2 diabetes mellitus (T2DM). It is still not known how the exercise hemodynamic response correlates with CRF. The purpose was to assess the correlation between hemodynamic changes and CRF in middle-aged patients with T2DM. METHODS After 1:1 matching by age and sex, 139 T2DM patients and 139 non-T2DM controls who completed the exercise treadmill test were included. Maximal aerobic capacity (VO2max), exercise-induced changes in heart rate (ΔHR), systolic blood pressure (ΔSBP), diastolic blood pressure (ΔDBP), and rate-pressure product (ΔRPP) were measured. HRR1 was calculated as the maximum heart rate minus the heart rate after 1 min of rest. RESULTS Compared to the control population, T2DM patients had decreased ΔHR (87 (77, 97) v 93 (84, 104) bpm, p < 0.05), ΔRPP (3833.64 ± 1670.34 v 4381.16 ± 1587.78 bpm∙mmHg, p < 0.05), HRR1 (21 (14, 27) v 21 (17, 27) bpm, p < 0.05), and VO2max (32.76 ± 5.63 v 34.68 ± 5.70 ml/kg/min, p < 0.05). Multiple linear regression analysis showed that ΔHR and HRR1, yielded a positive correlation with VO2max in T2DM patients (β = 0.325, P < 0.001; β = 0.173, P = 0.01). CONCLUSION The presence of impaired hemodynamic response and VO2max in middle-aged T2DM patients and the association of impaired ΔHR, HRR1, and VO2max may indicate a physiological pathway of impaired CRF, and our results support the need for cardiorespiratory screening and individualized treatment of middle-aged T2DM patients.
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Nonimprovement in Chronic Fatigue Syndrome: Relation to Activity Patterns, Uplifts and Hassles, and Autonomic Dysfunction. Psychosom Med 2022; 84:669-678. [PMID: 35420586 PMCID: PMC9271593 DOI: 10.1097/psy.0000000000001082] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To test a model of nonimprovement in chronic fatigue syndrome (CFS) using self-report activity patterns (e.g., "push-crash"), uplifts and hassles, and a biological measure of cardiac autonomic function. Activity pattern impacts on symptoms and objective measures of autonomic and physical activity were also examined. METHODS This prospective study in CFS collected all data remotely, including 6 months of weekly web diaries that recorded symptom ratings, activity patterns, and hassles and uplifts. In addition, 6 months of weekly heart monitoring and 3 months of daily waking actigraphy data were collected. Improvement or nonimprovement status was assessed using semistructured interviews at the 6-month follow-up. RESULTS A total of 148 individuals (87.2% female) were enrolled, and 12.2% were lost to follow-up. Participants reporting nonimprovement ( n = 92), as compared with improvement ( n = 38), showed greater autonomic dysfunction (lower heart rate variability, group difference = 5.93 [SE = 2.73] milliseconds; p = .032) and lower mean intensity of behavioral uplifts (group difference = 0.14 [SE = 0.16]; p = .043), but no significant differences in any activity pattern, including push-crash, limiting activity, and healthy pacing. CONCLUSIONS This study provided evidence for linking patient-reported nonimprovement to a biological variable indexing autonomic dysfunction and a behavioral measure indicating a deficit in psychological uplifts. These findings suggest a possible marker of illness trajectory that could potentially advance the biomedical underpinnings of CFS.Trial Registration:ClinicalTrials.gov ID: NCT02948556.
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Cheng YC, Su MI, Liu CW, Huang YC, Huang WL. Heart rate variability in patients with anxiety disorders: A systematic review and meta-analysis. Psychiatry Clin Neurosci 2022; 76:292-302. [PMID: 35340102 DOI: 10.1111/pcn.13356] [Citation(s) in RCA: 41] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Revised: 03/10/2022] [Accepted: 03/21/2022] [Indexed: 11/28/2022]
Abstract
AIMS Patients with anxiety disorders (AD) have been found to have lower heart rate variability (HRV) than healthy individuals in some studies, but this was inconsistent. Furthermore, the influence of distinct diagnoses, study design, and demographic factors on the results was not comprehensively examined. METHODS We gathered studies comparing HRV in patients with AD and in healthy controls. The parasympathetic activity in the hierarchical order principle was adopted in the main analysis. We adopted the random effects model to calculate the standardized mean difference. RESULTS Of the 7805 screened studies, 99 were included in the quantitative analysis, with a total of 4897 AD patients and 5559 controls finally entered the meta-analysis. AD patients had a significantly lower resting-state HRV for parasympathetic activity compared to control (Hedges' g = -0.3897). For the diagnostic subgroup analysis relative to the controls, resting-state HRV was significantly lower in post-traumatic stress disorder, panic disorder, generalized anxiety disorder, and social anxiety disorder patients. HRV reactivity (all reactivity data, data on physiological challenge, and psychological challenge) did not show significant inter-group differences between AD patients and healthy subjects. CONCLUSIONS The results supported that patients with AD had significantly lower resting-state HRV than the healthy population, but no alterations were found for HRV reactivity.
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Affiliation(s)
- Ying-Chih Cheng
- Department of Psychiatry, China Medical University Hsinchu Hospital, China Medical University, Hsinchu, Taiwan.,Department of Public Health and Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan.,Research Center of Big Data and Meta-analysis, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Min-I Su
- Division of Cardiology, Department of Internal Medicine, Taitung MacKay Memorial Hospital, Taitung, Taiwan.,Department of Medicine, MacKay Medical College, New Taipei City, Taiwan
| | - Cheng-Wei Liu
- Department of Internal Medicine, Tri-Service General Hospital Songshan Branch, National Defense Medical Center, Taipei, Taiwan.,Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Yu-Chen Huang
- Research Center of Big Data and Meta-analysis, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.,Department of Dermatology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.,Department of Dermatology, School of Medicine and College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Wei-Lieh Huang
- Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan.,Department of Psychiatry, National Taiwan University Hospital Yunlin Branch, Yunlin, Taiwan.,Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan.,Department of Psychiatry, College of Medicine, National Taiwan University, Taipei, Taiwan.,Cerebellar Research Center, National Taiwan University Hospital Yunlin Branch, Yunlin, Taiwan
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125
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Akbarzadeh A, Akbarzadeh F, Kazemi B. Simultaneous beat-to-beat heart rate and systolic blood pressure variability in patients with and without neurally mediated syncope. J Cardiovasc Thorac Res 2022; 14:108-115. [PMID: 35935387 PMCID: PMC9339730 DOI: 10.34172/jcvtr.2022.18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 04/29/2022] [Indexed: 11/09/2022] Open
Abstract
Introduction: Autonomic changes play an essential role in the genesis of neurally mediated syncope (NMS). The aim of this study was to compare the changes of the autonomic nervous system (ANS) by measuring spectral indices of beat-to-beat systolic blood pressure and heart rate variability (SBPV and HRV) in ranges of low frequency (LF), high frequency (HF), and the LF/HF ratio during head-up tilt test (HUTT) in patients with and without a syncope response.
Methods: In this case-control study of 46 patients with a suspected history of unexplained syncope, data were recorded separately during the typical three phases of HUTT. Patients who developed syncope were designated as the case group and the rest as the control group. Results: Thirty one patients experienced syncope during HUTT. Resting HRV and SBPV indices were significantly lower in cases than controls. After tilting in the syncope group, both HF and LF powers of SBPV showed a significant and gradual decrease. LF/HF in HRV increased in both groups similarly during the test but in SBPV, mainly driven by oscilations in its LF power, it increased significantly more during the first two phases of the test in syncope patients only to paradoxically decrease during active tilt (P< 0.001). Conclusion: Our findings show an abnormal autonomic function in patients with syncope, both at rest and tilting. Fluctuations of spectral indices of beat-to-beat SBPV, a potential noval index of pure sympathetic activity, show an exaggerated response during tilt and its withdrawal before syncope.
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Affiliation(s)
| | - Fariborz Akbarzadeh
- Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Babak Kazemi
- Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
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Ludwig RJ, Welch MG. Wired to Connect: The Autonomic Socioemotional Reflex Arc. Front Psychol 2022; 13:841207. [PMID: 35814106 PMCID: PMC9268160 DOI: 10.3389/fpsyg.2022.841207] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 04/04/2022] [Indexed: 01/10/2023] Open
Abstract
We have previously proposed that mothers and infants co-regulate one another’s autonomic state through an autonomic conditioning mechanism, which starts during gestation and results in the formation of autonomic socioemotional reflexes (ASRs) following birth. Theoretically, autonomic physiology associated with the ASR should correlate concomitantly with behaviors of mother and infant, although the neuronal pathway by which this phenomenon occurs has not been elucidated. In this paper, we consider the neuronal pathway by which sensory stimuli between a mother and her baby/child affect the physiology and emotional behavior of each. We divide our paper into two parts. In the first part, to gain perspective on current theories on the subject, we conduct a 500-year narrative history of scientific investigations into the human nervous system and theories that describe the neuronal pathway between sensory stimulus and emotional behavior. We then review inconsistencies between several currently accepted theories and recent data. In the second part, we lay out a new theory of emotions that describes how sensory stimuli between mother and baby unconsciously control the behavior and physiology of both. We present a theory of mother/infant emotion based on a set of assumptions fundamentally different from current theories. Briefly, we propose that mother/infant sensory stimuli trigger conditional autonomic socioemotional reflexes (ASRs), which drive cardiac function and behavior without the benefit of the thalamus, amygdala or cortex. We hold that the ASR is shaped by an evolutionarily conserved autonomic learning mechanism (i.e., functional Pavlovian conditioning) that forms between mother and fetus during gestation and continues following birth. We highlight our own and others research findings over the past 15 years that support our contention that mother/infant socioemotional behavior is driven by mutual autonomic state plasticity, as opposed to cortical trait plasticity. We review a novel assessment tool designed to measure the behaviors associated with the ASR phenomenon. Finally, we discuss the significance of our theory for the treatment of mothers and infants with socioemotional disorders.
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Affiliation(s)
- Robert J. Ludwig
- Department of Pediatrics, Columbia University Irving Medical Center, New York, NY, United States
- *Correspondence: Robert J. Ludwig,
| | - Martha G. Welch
- Department of Pediatrics, Columbia University Irving Medical Center, New York, NY, United States
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, United States
- Department of Anatomy and Cell Biology, Columbia University Irving Medical Center, New York, NY, United States
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Heart rate variability in hypothyroid patients: A systematic review and meta-analysis. PLoS One 2022; 17:e0269277. [PMID: 35657799 PMCID: PMC9165841 DOI: 10.1371/journal.pone.0269277] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Accepted: 05/17/2022] [Indexed: 11/19/2022] Open
Abstract
Introduction
Hypothyroidism may be associated with changes in the autonomic regulation of the cardiovascular system, which may have clinical implications.
Objective
To conduct a systematic review and meta-analysis on the impact of hypothyroidism on HRV.
Materials and methods
PubMed, Cochrane, Embase and Google Scholar were searched until 20 August 2021 for articles reporting HRV parameters in untreated hypothyroidism and healthy controls. Random-effects meta-analysis were stratified by degree of hypothyroidism for each HRV parameters: RR intervals (or normal to normal-NN intervals), SDNN (standard deviation of RR intervals), RMSSD (square root of the mean difference of successive RR intervals), pNN50 (percentage of RR intervals with >50ms variation), total power (TP), LFnu (low-frequency normalized unit), HFnu (high-frequency), VLF (very low frequency), and LF/HF ratio.
Results
We included 17 studies with 11438 patients: 1163 hypothyroid patients and 10275 healthy controls. There was a decrease in SDNN (effect size = -1.27, 95% CI -1.72 to -0.83), RMSSD (-1.66, -2.32 to -1.00), pNN50 (-1.41, -1.98 to -0.84), TP (-1.55, -2.1 to -1.00), HFnu (-1.21, -1.78 to -0.63) with an increase in LFnu (1.14, 0.63 to 1.66) and LF/HF ratio (1.26, 0.71 to 1.81) (p <0.001). HRV alteration increased with severity of hypothyroidism.
Conclusions
Hypothyroidism is associated with a decreased HRV, that may be explained by molecular mechanisms involving catecholamines and by the effect of TSH on HRV. The increased sympathetic and decreased parasympathetic activity may have clinical implications.
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Riveros-Rivera A, Penzel T, Gunga HC, Opatz O, Paul F, Klug L, Boschmann M, Mähler A. Hypoxia Differentially Affects Healthy Men and Women During a Daytime Nap With a Dose-Response Relationship: a Randomized, Cross-Over Pilot Study. Front Physiol 2022; 13:899636. [PMID: 35685284 PMCID: PMC9171024 DOI: 10.3389/fphys.2022.899636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 04/18/2022] [Indexed: 11/13/2022] Open
Abstract
Context: The use of daytime napping as a countermeasure in sleep disturbances has been recommended but its physiological evaluation at high altitude is limited. Objective: To evaluate the neuroendocrine response to hypoxic stress during a daytime nap and its cognitive impact. Design, Subject, and Setting: Randomized, single-blind, three period cross-over pilot study conducted with 15 healthy lowlander subjects (8 women) with a mean (SD) age of 29(6) years (Clinicaltrials identifier: NCT04146857, https://clinicaltrials.gov/ct2/show/NCT04146857?cond=napping&draw=3&rank=12). Interventions: Volunteers underwent a polysomnography, hematological and cognitive evaluation around a 90 min midday nap, being allocated to a randomized sequence of three conditions: normobaric normoxia (NN), normobaric hypoxia at FiO2 14.7% (NH15) and 12.5% (NH13), with a washout period of 1 week between conditions. Results: Primary outcome was the interbeat period measured by the RR interval with electrocardiogram. Compared to normobaric normoxia, RR during napping was shortened by 57 and 206 ms under NH15 and NH13 conditions, respectively (p < 0.001). Sympathetic predominance was evident by heart rate variability analysis and increased epinephrine levels. Concomitantly, there were significant changes in endocrine parameters such as erythropoietin (∼6 UI/L) and cortisol (∼100 nmol/L) (NH13 vs. NN, p < 0.001). Cognitive evaluation revealed changes in the color-word Stroop test. Additionally, although sleep efficiency was preserved, polysomnography showed lesser deep sleep and REM sleep, and periodic breathing, predominantly in men. Conclusion: Although napping in simulated altitude does not appear to significantly affect cognitive performance, sex-dependent changes in cardiac autonomic modulation and respiratory pattern should be considered before napping is prescribed as a countermeasure.
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Affiliation(s)
- Alain Riveros-Rivera
- Center for Space Medicine and Extreme Environments Berlin, Institute of Physiology, Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
- Department of Physiological Sciences, Faculty of Medicine, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Thomas Penzel
- Interdisciplinary Center of Sleep Medicine, Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Hanns-Christian Gunga
- Center for Space Medicine and Extreme Environments Berlin, Institute of Physiology, Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Oliver Opatz
- Center for Space Medicine and Extreme Environments Berlin, Institute of Physiology, Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Friedemann Paul
- Experimental and Clinical Research Center, A Cooperation Between the Max-Delbrück Center for Molecular Medicine in the Helmholtz Association and Charité Universitätsmedizin Berlin, Berlin, Germany
- Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Experimental and Clinical Research Center, Berlin, Germany
- Max Delbrück Center for Molecular Medicine in the Helmholtz Association (MDC), Berlin, Germany
| | - Lars Klug
- Experimental and Clinical Research Center, A Cooperation Between the Max-Delbrück Center for Molecular Medicine in the Helmholtz Association and Charité Universitätsmedizin Berlin, Berlin, Germany
- Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Experimental and Clinical Research Center, Berlin, Germany
- Max Delbrück Center for Molecular Medicine in the Helmholtz Association (MDC), Berlin, Germany
| | - Michael Boschmann
- Experimental and Clinical Research Center, A Cooperation Between the Max-Delbrück Center for Molecular Medicine in the Helmholtz Association and Charité Universitätsmedizin Berlin, Berlin, Germany
- Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Experimental and Clinical Research Center, Berlin, Germany
- Max Delbrück Center for Molecular Medicine in the Helmholtz Association (MDC), Berlin, Germany
| | - Anja Mähler
- Experimental and Clinical Research Center, A Cooperation Between the Max-Delbrück Center for Molecular Medicine in the Helmholtz Association and Charité Universitätsmedizin Berlin, Berlin, Germany
- Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Experimental and Clinical Research Center, Berlin, Germany
- Max Delbrück Center for Molecular Medicine in the Helmholtz Association (MDC), Berlin, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Berlin, Germany
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Dynamics of parasympathetic activity in violent incarcerated offenders before, during, and in recovery from an emotional inhibition task. Sci Rep 2022; 12:7126. [PMID: 35504982 PMCID: PMC9065157 DOI: 10.1038/s41598-022-10872-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 04/11/2022] [Indexed: 11/08/2022] Open
Abstract
Dynamics of the autonomic nervous system (ANS) are hypothesized to play a role in the emergence of interpersonal violence. In the present study, we examined continuous activities of the inhibitory parasympathetic pathway of the ANS through the root mean square of successive differences between normal heartbeats (RMSSD) in 22 male offenders who committed interpersonal violence and 24 matched controls from the general population across three successive phases: resting baseline, while performing an emotional Go/No-Go task, and post-task recovery. Results showed that across the three phases, the offender group presented lower RMSSD at baseline (pFDR = .003; Cohen's d = - 1.11), but similar levels during the task, attributed to a significant increase in their RMSSD level (pFDR = .027, Cohen's d = - 1.26). During recovery, while no distinction between the two groups was found, both groups showed signs of recovering toward baseline values. These findings suggest that violent incarcerated offenders can flexibly engage parasympathetic resources to meet environmental challenges. This underscores the necessity of considering parasympathetic dynamics and its respective mobilization/flexibility to better understand ANS profiles underlying interpersonal violence as well as its potential utility in designing more tailored interventions.
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Finding a rhythm: Relating ultra-short-term heart rate variability measures in healthy young adults during rest, exercise, and recovery. Auton Neurosci 2022; 239:102953. [DOI: 10.1016/j.autneu.2022.102953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 02/01/2022] [Accepted: 02/04/2022] [Indexed: 11/20/2022]
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131
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Stockfelt L, Xu Y, Gudmundsson A, Rissler J, Isaxon C, Brunskog J, Pagels J, Nilsson PT, Berglund M, Barregard L, Bohgard M, Albin M, Hagerman I, Wierzbicka A. A controlled chamber study of effects of exposure to diesel exhaust particles and noise on heart rate variability and endothelial function. Inhal Toxicol 2022; 34:159-170. [PMID: 35475948 DOI: 10.1080/08958378.2022.2065388] [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: 11/05/2022]
Abstract
BACKGROUND Adverse cardiovascular effects are associated with both diesel exhaust and road traffic noise, but these exposures are hard to disentangle epidemiologically. We used an experimental setup to evaluate the impact of diesel exhaust particles and traffic noise, alone and combined, on intermediary outcomes related to the autonomic nervous system and increased cardiovascular risk. METHODS In a controlled chamber 18 healthy adults were exposed to four scenarios in a randomized cross-over fashion. Each exposure scenario consisted of either filtered (clean) air or diesel engine exhaust (particle mass concentrations around 300 µg/m3), and either low (46 dB(A)) or high (75 dB(A)) levels of traffic noise for 3 h at rest. ECG was recorded for 10-min periods before and during each exposure type, and frequency-domain heart rate variability (HRV) computed. Endothelial dysfunction and arterial stiffness were assessed after each exposure using EndoPAT 2000. RESULTS Compared to control exposure, HRV in the high frequency band decreased during exposure to diesel exhaust, both alone and combined with noise, but not during noise exposure only. These differences were more pronounced in women. We observed no synergistic effects of combined exposure, and no significant differences between exposure scenarios for other HRV indices, endothelial function or arterial stiffness. CONCLUSION Three-hour exposure to diesel exhaust, but not noise, was associated with decreased HRV in the high frequency band. This indicates activation of irritant receptor-mediated autonomic reflexes, a possible mechanism for the cardiovascular risks of diesel exposure. There was no effect on endothelial dysfunction or arterial stiffness after exposure.
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Affiliation(s)
- Leo Stockfelt
- Occupational and Environmental Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Occupational and Environmental Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Yiyi Xu
- Occupational and Environmental Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Occupational and Environmental Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Anders Gudmundsson
- Ergonomics and Aerosol Technology, Department of Design Sciences, Lund University, Lund, Sweden
| | - Jenny Rissler
- Ergonomics and Aerosol Technology, Department of Design Sciences, Lund University, Lund, Sweden.,Bioeconomy and Health, RISE Research Institutes of Sweden, Lund, Sweden
| | - Christina Isaxon
- Ergonomics and Aerosol Technology, Department of Design Sciences, Lund University, Lund, Sweden
| | - Jonas Brunskog
- Department of Electrical Engineering, Technical University of Denmark, Kongens Lyngby, Denmark
| | - Joakim Pagels
- Ergonomics and Aerosol Technology, Department of Design Sciences, Lund University, Lund, Sweden
| | - Patrik T Nilsson
- Ergonomics and Aerosol Technology, Department of Design Sciences, Lund University, Lund, Sweden
| | - Margareta Berglund
- Department of Cardiology, Karolinska Institute, Karolinska University Hospital, Huddinge, Sweden
| | - Lars Barregard
- Department of Occupational and Environmental Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Mats Bohgard
- Ergonomics and Aerosol Technology, Department of Design Sciences, Lund University, Lund, Sweden
| | - Maria Albin
- Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden.,Unit of Occupational Medicine, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Inger Hagerman
- Department of Cardiology, Karolinska Institute, Karolinska University Hospital, Huddinge, Sweden
| | - Aneta Wierzbicka
- Ergonomics and Aerosol Technology, Department of Design Sciences, Lund University, Lund, Sweden
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Heart Rate Variability during Auricular Acupressure at Heart Point in Healthy Volunteers: A Pilot Study. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:1019029. [PMID: 35509626 PMCID: PMC9060987 DOI: 10.1155/2022/1019029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 03/14/2022] [Accepted: 03/24/2022] [Indexed: 11/18/2022]
Abstract
Heart rate variability (HRV) is the variation in time between each heartbeat. Increasing HRV may contribute to improving autonomic nervous system dysfunctions. Acupuncture stimulation through the vagus plexus in the ear is considered as a method that can improve HRV. In this pilot study, we examined 114 healthy volunteers at the Faculty of Traditional Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, from January to May 2020. During a 20-minute interval, participants were stimulated two times at the acupoint in the left ear with Semen seed. The heart rate and HRV values were monitored before, during, and after acupressure every 5 minutes. When we compared the experimental group with the control group, HRV significantly increased in the stage of ear-stimulated acupressure compared with the stage before and after the auricular acupressure (p=0.01, p=0.04, p=0.04 and p=0.02) and the difference was not statistically significant compared with the phase of nonstimulated (p=0.15, p=0.28). The changes in other values including SDNN (standard deviation of the average NN), RMSSD (root mean square of successive RR interval differences), LF (low-frequency power), and HF (high-frequency power) in all stages were not statistically significant (p=>0.05) between groups. Based on the results, we can determine the increase in HRV when conducting auricular acupressure with stimulation at the heart acupoint on the left ear. This leads to a direction in further studies for clinical application for patients with autonomic nervous disorder.
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133
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Stampas A, Malesovas C, Burke M, Farooq S, Singh M, Korupolu R, Li S. Exploring 5-minute heart rate variability in spinal cord injury during acute inpatient rehabilitation. J Spinal Cord Med 2022; 46:450-457. [PMID: 35353022 PMCID: PMC10114963 DOI: 10.1080/10790268.2022.2052621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
UNLABELLED To explore the use of 5-minute heart rate variability (HRV) during inpatient rehabilitation in the acute phase of traumatic spinal cord injury (SCI). Longitudinal observational study. Acute inpatient rehabilitation (AIR). 10 patients with acute traumatic SCI. 5-minute HRV supine recordings twice daily on three different days per patient. HRV values were evaluated (1) within a single day (Early versus Late); (2) across the inpatient admission (initial, mid, and discharge); (3) by SCI phenotypes and by clinical outcomes (ex. pressure injuries (PI)). Patients had an average age of 38 years, 80% male, and 40% with tetraplegia. There were no HRV differences between Early and Late recordings, across the inpatient admission, demographics, or SCI phenotype. However, improvement in neurologic exam was accompanied by increased parasympathetic tone (mean RR increased by 172 ms SD 61, P = .005). Patients with PI demonstrated lower sympathetic (SNS) activity (decreased LF by 472 ms2 SD 240, P = .049) and lower PNS activity (decreased RMSSD by 1.2 ms SD 0.5, P = .02), compared to no PI. Comparisons to uninjured reference values and chronic SCI suggest a changing autonomic nervous system (ANS) from uninjured to acute to chronic as measured by HRV. CONCLUSIONS This preliminary evidence suggests HRV in acute SCI is stable across time and day during inpatient rehabilitation and may be correlated to clinical sequalae of ANS dysfunction and neurologic recovery. Comparisons to published work suggest that HRV may measure the progression in the ANS from acute to chronic phase after SCI.
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Affiliation(s)
- Argyrios Stampas
- UTHealth McGovern Medical School, Houston, TX, USA.,Department of PM&R, UTHealth McGovern Medical School, New York, NY, USA
| | | | | | | | - Mani Singh
- Dept. of Rehabilitation and Regenerative Medicine, Columbia University Irving Medical Center, New York, NY, USA
| | - Radha Korupolu
- UTHealth McGovern Medical School, Houston, TX, USA.,Department of PM&R, UTHealth McGovern Medical School, New York, NY, USA
| | - Sheng Li
- UTHealth McGovern Medical School, Houston, TX, USA.,Department of PM&R, UTHealth McGovern Medical School, New York, NY, USA
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134
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Kirk PA, Davidson Bryan A, Garfinkel SN, Robinson OJ. RapidHRV: an open-source toolbox for extracting heart rate and heart rate variability. PeerJ 2022; 10:e13147. [PMID: 35345583 PMCID: PMC8957280 DOI: 10.7717/peerj.13147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 03/01/2022] [Indexed: 01/12/2023] Open
Abstract
Heart rate and heart rate variability have enabled insight into a myriad of psychophysiological phenomena. There is now an influx of research attempting using these metrics within both laboratory settings (typically derived through electrocardiography or pulse oximetry) and ecologically-rich contexts (via wearable photoplethysmography, i.e., smartwatches). However, these signals can be prone to artifacts and a low signal to noise ratio, which traditionally are detected and removed through visual inspection. Here, we developed an open-source Python package, RapidHRV, dedicated to the preprocessing, analysis, and visualization of heart rate and heart rate variability. Each of these modules can be executed with one line of code and includes automated cleaning. In simulated data, RapidHRV demonstrated excellent recovery of heart rate across most levels of noise (>=10 dB) and moderate-to-excellent recovery of heart rate variability even at relatively low signal to noise ratios (>=20 dB) and sampling rates (>=20 Hz). Validation in real datasets shows good-to-excellent recovery of heart rate and heart rate variability in electrocardiography and finger photoplethysmography recordings. Validation in wrist photoplethysmography demonstrated RapidHRV estimations were sensitive to heart rate and its variability under low motion conditions, but estimates were less stable under higher movement settings.
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Affiliation(s)
- Peter A. Kirk
- Institute of Cognitive Neuroscience, University College London, University of London, London, United Kingdom,Experimental Psychology, University College London, University of London, London, United Kingdom
| | | | - Sarah N. Garfinkel
- Institute of Cognitive Neuroscience, University College London, University of London, London, United Kingdom
| | - Oliver J. Robinson
- Institute of Cognitive Neuroscience, University College London, University of London, London, United Kingdom,Clinical, Educational and Health Psychology, University College London, University of London, London, United Kingdom
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135
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Ishii M, Ishiyama G, Ishiyama A, Kato Y, Mochizuki F, Ito Y. Relationship Between the Onset of Ménière's Disease and Sympathetic Hyperactivity. Front Neurol 2022; 13:804777. [PMID: 35370896 PMCID: PMC8970286 DOI: 10.3389/fneur.2022.804777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 02/21/2022] [Indexed: 12/03/2022] Open
Abstract
Objective The pathogenesis of Ménière's disease is still largely unknown; however, it is known to be strongly associated with stress. Excessive stress can cause hyperactivity of the sympathetic autonomic nervous system. With the aim of understanding changes in sympathetic hyperactivity before and after Ménière's disease, we compared autonomic nervous function in patients in a stable phase of Ménière's disease and that in healthy adults. We also gathered data over about 10 years on autonomic nervous function immediately before a Ménière's attack. Study Design Prospective study. Patients Autonomic nervous function was analyzed in 129 patients in a stable phase of Ménière's disease 31 healthy adult volunteers. In nine patients, autonomic nervous function was also measured immediately before and after treatment of a vertigo attack. Main Outcome Measure Power spectrum analysis of heart rate variability (HRV) of EEG/ECG and an infrared electronic pupillometer were used. Sympathetic and parasympathetic nervous function was measured. Results There were no statistically significant differences in autonomic nervous function determined by HRV and electronic pupillometry between patients in a stable phase of Ménière's disease and healthy adults. Sympathetic function as measured by electronic pupillometry parameters VD and T5 showed no difference between the affected and unaffected sides in the baseline data measured in the stable phase (VD: affected side is 31.02 ± 6.16 mm/sec, unaffected side is 29.25 ± 5.73 mm/sec; T5: affected side is 3.37 ± 0.43 msec, unaffected side is 3.25 ± 0.39 msec). In contrast, all nine patients whose HRV data had been obtained just before an attack showed marked suppression of the parasympathetic nervous system and activation of the sympathetic nervous system. Electronic pupillometry also revealed an overactivation of the sympathetic nervous system on the affected side, just before the attacks. Analysis of sequential changes after the onset of an attack revealed that overactivation on the affected side was reduced after treatment, and no difference between affected and unaffected sides was observed 3 days after treatment. Conclusion Detailed analysis of autonomic nervous function showed that immediately before an attack of Ménière's disease, the sympathetic nervous system on the affected side was strongly overactivated.
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Affiliation(s)
- Masanori Ishii
- Department of Otorhinolaryngology, Japan Community Health Care Organization (JCHO) Tokyo Shinjuku Medical Center, Tokyo, Japan
- Department of Otorhinolaryngology and Head & Neck Surgery, The Jikei University School of Medicine, Tokyo, Japan
- *Correspondence: Masanori Ishii
| | - Gail Ishiyama
- Department of Neurology, David Geffen School of Medicine at UCLA, Los Angeles, CA, United States
| | - Akira Ishiyama
- Department of Head & Neck Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA, United States
| | - Yujin Kato
- Department of Otorhinolaryngology and Head & Neck Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Fumihiro Mochizuki
- Department of Otorhinolaryngology, St. Marianna University School of Medicine, Kanagawa, Japan
| | - Yusuke Ito
- Department of Otorhinolaryngology, St. Marianna University School of Medicine, Kanagawa, Japan
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136
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A New Approach for Evaluation of Cardiovascular Fitness and Cardiac Responses to Maximal Exercise Test in Master Runners: A Cross-Sectional Study. J Clin Med 2022; 11:jcm11061648. [PMID: 35329974 PMCID: PMC8955590 DOI: 10.3390/jcm11061648] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 03/06/2022] [Accepted: 03/08/2022] [Indexed: 01/08/2023] Open
Abstract
The aim of this study was to analyze the cardiac autonomic function at rest, at maximum exercise, and in recovery after exercise and to determine sex-specific and age-specific values for resting heart rate (RHR), hear rate (HR)-peak, HR recovery (HRR), and HR variability at rest in master runners. Fifty endurance runners (21 women) participated in this study (43.28 ± 5.25 years). The subjects came from different athletic clubs in Andalusia (Spain), and the testing protocol was performed in-season. A 3-km running test was performed and the cardiovascular response was monitored. Regarding sex, no significant differences were found regarding cardiovascular autonomic function at rest, during exercise, and following maximal exercise, only at rest, the standard deviation of all R-R intervals and low frequency values displayed significantly (p < 0.05) lower scores in women. 46% of athletes showed an RHR < 60 bpm. Additionally, HR-peak showed a significant correlation with age (r = −0.369; p = 0.009) and HRR5min (r = 0.476, p = 0.001). Also, endurance performance was inversely associated with obesity traits and cardiometabolic risk factors. In summary, age, sex, fitness, or anthropometrics characteristics did not show a relevant influence on cardiovascular autonomic modulation in master runners. However, the 3-km performance displayed a significant negative association with several factors of cardiometabolic risk.
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137
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Lawrence DW. Heart rate (HR) and heart rate variability (HRV) response to inhaled N, N-dimethyltryptamine (N, N-DMT): A case report. JOURNAL OF PSYCHEDELIC STUDIES 2022. [DOI: 10.1556/2054.2022.00178] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Abstract
Background
N, N-Dimethyltryptamine (N, N-DMT) is a naturally occurring tryptamine-based alkaloid and classic psychedelic. The potent psychoactive properties of N, N-DMT are mediated by serotonin 2A (5-HT2A) receptor agonism. There are limited investigations into the physiologic effects of inhaled N, N-DMT, despite this being one of the most common routes of administration. Heart rate variability (HRV) is an emergent non-invasive marker of cardiac autonomic nervous system (ANS) regulation and reductions in HRV have been negatively associated with multiple health outcomes.
Methods
A case is described with a brief review of supportive findings.
Results
Heart rate (HR) and HRV responses following three naturalistic inhaled N, N-DMT experiences were documented in a healthy 31-year-old male. Acute transient elevations in HR immediately following N, N-DMT administration and a pronounced elevation in the average daily HRV one-day following the experiences were observed. The duration of experience shortened across the three experiences despite similar N, N-DMT doses.
Conclusion
These findings offer preliminary evidence into the effect of inhaled N, N-DMT on HR and HRV. Given the emergent understanding of reductions in HRV as a hazardous marker of stress, psychiatric conditions, and mental health outcomes, further research into the effects of psychedelics on HRV is warranted.
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Affiliation(s)
- David Wyndham Lawrence
- Faculty of Medicine, University of Toronto, Toronto, Canada
- Mount Sinai Hospital, Sinai Health System, Toronto, Canada
- Faculty of Kinesiology & Physical Education, University of Toronto, Toronto, Canada
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138
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Ashaie SA, Engel S, Cherney LR. Test-retest reliability of heart-rate variability metrics in individuals with aphasia. Neuropsychol Rehabil 2022; 33:646-661. [PMID: 35179091 DOI: 10.1080/09602011.2022.2037438] [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: 10/19/2022]
Abstract
Individuals with aphasia may have impairments in cognition, higher incidences of depression, and a variety of post-stroke functional impairments. However, evaluating these issues is challenging since most assessments require some degree of linguistic processing and task instructions are often verbal. Heart rate variability has shown to be an objective marker for cognitive functioning in neurologically healthy individuals, depression and post-stroke depression, and post-stroke functional impairments. However, before the utility of heart rate variability is established in persons with aphasia, its test-retest reliability needs to be established. The purpose of this study was to assess test-retest reliability of heart rate variability metrics in persons with aphasia. Heart rate variability was recorded at rest while in a sitting position in twenty-one persons with aphasia at two time points. Heart rate variability metrics were mostly moderately reliable. The majority of participants had resting heart rate variability parasympathetic and sympathetic indexes similar to those of neurologically healthy individuals. Further research is needed to establish the test-retest reliability of heart rate variability metrics in different postures and breathing conditions in persons with aphasia.
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Affiliation(s)
- Sameer A Ashaie
- Center for Aphasia Research and Treatment, Shirley Ryan AbilityLab, Chicago, IL, USA.,Shirley Ryan Affective and Emotion Rehabilitation Lab, Shirley Ryan AbilityLab, Chicago, IL, USA.,Physical Medicine and Rehabilitation, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Samantha Engel
- Center for Aphasia Research and Treatment, Shirley Ryan AbilityLab, Chicago, IL, USA
| | - Leora R Cherney
- Center for Aphasia Research and Treatment, Shirley Ryan AbilityLab, Chicago, IL, USA.,Physical Medicine and Rehabilitation, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.,Communication Sciences and Disorders, Northwestern University, Evanston, IL, USA
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139
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Mercier LJ, Batycky J, Campbell C, Schneider K, Smirl J, Debert CT. Autonomic dysfunction in adults following mild traumatic brain injury: A systematic review. NeuroRehabilitation 2022; 50:3-32. [PMID: 35068421 DOI: 10.3233/nre-210243] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND Increasing evidence suggests autonomic nervous system (ANS) dysfunction may occur following mild traumatic brain injury (mTBI). Measures of heart rate, heart rate variability, blood pressure and baroreceptor sensitivity can be used to evaluate ANS dysfunction following mTBI. OBJECTIVE Summarize the evidence for ANS dysfunction in adults following mTBI. METHODS A search of Embase, MEDLINE, Cochrane Central Register, PsycINFO, CINAHL and SPORTDiscus databases was conducted. Search topics included: mTBI and ANS. Identified abstracts were independently reviewed by 2 reviewers followed by full text screening. Risk of bias was assessed using a modified SIGN checklist. A structured synthesis was performed. RESULTS Thirty-nine studies (combined 1,467 participants diagnosed with mTBI) evaluating ANS function were included. ANS function was evaluated under various conditions including: rest, during exertion, cold pressor test, Valsalva maneuver, using face cooling and eyeball pressure paradigms. Short-term or ultra-short-term recordings were most common. The majority of studies (28/39) were rated as "unacceptable" for quality of evidence. CONCLUSIONS Altered parameters of ANS function have been reported in multiple conditions following mTBI, both acutely and in the post-acute/chronic stages of recovery. However, due to methodological limitations, conclusions regarding the severity and timing of ANS dysfunction following mTBI cannot be drawn.
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Affiliation(s)
- Leah J Mercier
- Department of Clinical Neurosciences, Division of Physical Medicine and Rehabilitation, University of Caglary, Calgary, AB, Canada
| | - Julia Batycky
- Department of Clinical Neurosciences, Division of Physical Medicine and Rehabilitation, University of Caglary, Calgary, AB, Canada
| | - Christina Campbell
- Department of Clinical Neurosciences, Division of Physical Medicine and Rehabilitation, University of Caglary, Calgary, AB, Canada
| | - Kathryn Schneider
- Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada.,Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada.,Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada.,Sport Medicine Centre, Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada
| | - Jonathan Smirl
- Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada.,Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada.,Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada.,Sport Medicine Centre, Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada.,Cerebrovascular Concussion Laboratory, Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada.,Libin Cardiovascular Institute of Alberta, Univeristy of Calgary, Calgary, AB, Canada
| | - Chantel T Debert
- Department of Clinical Neurosciences, Division of Physical Medicine and Rehabilitation, University of Caglary, Calgary, AB, Canada.,Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada.,Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada
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140
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Kvadsheim E, Fasmer OB, Fasmer EE, R. Hauge E, Thayer JF, Osnes B, Haavik J, Koenig J, Adolfsdottir S, Plessen KJ, Sørensen L. Innovative approaches in investigating
inter‐beat
intervals: Graph theoretical method suggests altered autonomic functioning in adolescents with
ADHD. Psychophysiology 2022; 59:e14005. [DOI: 10.1111/psyp.14005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 11/05/2021] [Accepted: 12/30/2021] [Indexed: 11/28/2022]
Affiliation(s)
| | - Ole Bernt Fasmer
- Department of Clinical Medicine University of Bergen Bergen Norway
- Division of Psychiatry Haukeland University Hospital Bergen Norway
| | | | - Erik R. Hauge
- Division of Psychiatry Haukeland University Hospital Bergen Norway
| | - Julian F. Thayer
- Department of Psychological Science University of California, Irvine Irvine California United States
| | - Berge Osnes
- Department of Biological and Medical Psychology University of Bergen Bergen Norway
- Bjørgvin District Psychiatric Centre Haukeland University Hospital Bergen Norway
| | - Jan Haavik
- Division of Psychiatry Haukeland University Hospital Bergen Norway
- Department of Biomedicine University of Bergen Bergen Norway
| | - Julian Koenig
- Faculty of Medicine, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy University Hospital Cologne, University of Cologne Cologne Germany
| | - Steinunn Adolfsdottir
- Department of Biological and Medical Psychology University of Bergen Bergen Norway
- Department of Visual Impairments Statped ‐ National Service for Special Needs Education Bergen Norway
| | - Kerstin Jessica Plessen
- Division of Child and Adolescent Psychiatry, Department of Psychiatry Lausanne University Hospital, University of Lausanne Lausanne Switzerland
| | - Lin Sørensen
- Department of Biological and Medical Psychology University of Bergen Bergen Norway
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141
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Honkalampi K, Kupari S, Järvelin-Pasanen S, Saaranen T, Vauhkonen A, Räsänen K, Härmä M, Lindholm H, Perkiö-Mäkelä M, Tarvainen MP, Oksanen T. The association between chronotype and sleep quality among female home care workers performing shift work. Chronobiol Int 2022; 39:747-756. [PMID: 35114874 DOI: 10.1080/07420528.2022.2033256] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
There is a scarcity of evidence on the association between shift work, sleeping parameters, heart rate variability (HRV), and chronotype, i.e., morningness and eveningness. The aims of this study were to 1) compare participants with different chronotypes (morning (M), evening (E), or neither (N)) in terms of their total sleep time, sleep efficiency, and HRV parameters, taking their age into account, and 2) examine whether self-reported work-related stress, the length of the working career and years performing shift work affect this association. The participants of the study were home care workers working in two shifts in one municipality in Eastern Finland (N = 395). Of these, 52 females (mean age 42.78 y, SD 12.92 y) completed the study questionnaire and participated in physiological measurements. Several sleep-related parameters were assessed (total sleep time, sleep efficiency, number of awakenings, and length of awakening) and indices of autonomic nervous system based on HRV were calculated. The participants worked in two shifts: a morning shift (7:00-15:00 h) and an evening shift (14:00-21:30 h). All these parameters were assessed during the night before the first work shift (N1), the night before the second work shift (N2), the night before the final work shift (N3), and the night before the first day off work (N4). According to the results, 21.2% of the participants were M-types, 17.3% were E-types, and 61.5% were N-types. On average, the participants had been in working life for 18.8 years and performing shift work for 13.7 years. On night N3, E-types had a significantly shorter total sleep time and spent less time in bed compared to M- and N-types. The total sleep time of M-type and N-type participants was on average 66 minutes and 82 minutes longer, respectively, when compared to E-types on night N3. There were no statistically significant differences in actigraphy-based sleep quality parameters between M-, N-, and E-types on nights N1, N2, and N4. Our results together indicate that M- and N-type individuals may have better sleep quality than E-types, which was also reflected in HRV parameters. Further research with longitudinal study design and workplace interventions is needed to determine how the chronotype can be optimally and individually utilized to improve the health and well-being of morning-type and evening-type people. This is particularly important for both younger and older workers entering the workforce to support healthier and longer working lives.
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Affiliation(s)
- Kirsi Honkalampi
- School of Educational Sciences and Psychology, Philosophical Faculty, University of Eastern Finland, Joensuu, Finland
| | - Saana Kupari
- Department of Applied Physics, Faculty of Science and Forestry, University of Eastern Finland, Kuopio, Finland
| | | | - Terhi Saaranen
- Department of Nursing Science, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
| | - Anneli Vauhkonen
- Department of Nursing Science, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
| | - Kimmo Räsänen
- Institute of Public Health and Clinical Nutrition, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
| | - Mikko Härmä
- Research and Service Centre of Occupational Health, Finnish Institute of Occupational Health, Helsinki, Finland
| | - Harri Lindholm
- School of Medicine, Institute of Biomedicine, University of Eastern Finland, Kuopio, Finland
| | - Merja Perkiö-Mäkelä
- Institute of Public Health and Clinical Nutrition, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
| | - Mika P Tarvainen
- Department of Applied Physics, Faculty of Science and Forestry, University of Eastern Finland, Kuopio, Finland.,Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, Kuopio Finland
| | - Tuula Oksanen
- Institute of Public Health and Clinical Nutrition, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
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142
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Estévez-González AJ, Pérez-Ruiz M, Cobo-Vicente F, Donadio MVF, Larumbe-Zabala E. Effects of Physical Training on Heart Rate Variability in Children and Adolescents with Chronic Diseases: A Systematic Review and Meta-analysis. Int J Sports Med 2022; 43:679-686. [PMID: 35108729 DOI: 10.1055/a-1524-2421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
This study analyzed the effects of physical training programs on heart rate variability, as a measure of sympathovagal balance, in children and adolescents with chronic diseases. Relevant articles were systematically searched in Pubmed, Science Direct, Web of Science, Scopus, Google Scholar and Embase scientific databases. We performed a meta-analysis using an inverse variance heterogeneity model. Effect size calculation was based on the standardized mean differences between pre- and post-intervention assessments, assuring at least a single-group repeated-measures model for each extracted group. Ten studies (252 participants) were included, seven in obese subjects, two in type-1 diabetes, and one in cerebral palsy. When time-domain variables were analyzed, exercise was found to moderately increase RMSSD (SMD=0.478; 95%CI: 0.227 to 0.729; p<0.001), SDNN (SMD=0.367; 95%CI: 0.139 to 0.595; p=0.002) and pNN50 (SMD=0.817; 95%CI: 0.139 to 0.595; p=0.002). As for frequency-domain variables, exercise presented a moderate increasing effect on HF (SMD=0.512; 95%CI: 0.240 to 0.783; p<0.001), a negligible effect for LF (SMD=0.077; 95%CI: -0.259 to 0.412; p<0.001) and a non-significant reduction for LF/HF (SMD=-0.519; 95%CI: -1.162 to 0.124; p=0.114). In conclusion, physical training programs are able to modulate heart rate variability in children and adolescents with chronic diseases, affecting mainly the time-domain variables.
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Affiliation(s)
| | - Margarita Pérez-Ruiz
- Faculty of Sport Sciences, Universidad Europea de Madrid Campus de Villaviciosa de Odón, Madrid, Spain
| | - Fernando Cobo-Vicente
- Faculty of Sport Sciences, Universidad Europea de Madrid Campus de Villaviciosa de Odón, Madrid, Spain
| | - Márcio Vinícius Fagundes Donadio
- Laboratory of Pediatric Physical Activity, Infant Center, PUCRS, Porto Alegre, Brazil. Visiting Professor (2019-2020), Universidad Europea de Madrid, Madrid, Spain
| | - Eneko Larumbe-Zabala
- Faculty of Sport Sciences, Universidad Europea de Madrid Campus de Villaviciosa de Odón, Madrid, Spain
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143
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Heart rate variability and cardiac autonomic functions in post-COVID period. J Interv Card Electrophysiol 2022; 63:715-721. [PMID: 35106678 PMCID: PMC8806134 DOI: 10.1007/s10840-022-01138-8] [Citation(s) in RCA: 58] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 01/25/2022] [Indexed: 12/28/2022]
Abstract
Background The heart rate variability (HRV) is a non-invasive, objective and validated method for the assessment of autonomic nervous system. Although acute manifestations of COVID-19 were widely researched, long-term sequela of COVID-19 are still unknown. This study aimed to analyze autonomic function using HRV indices in the post-COVID period that may have a potential to enlighten symptoms of COVID long-haulers. Methods The 24-h ambulatory electrocardiography (ECG) recordings obtained >12 weeks after the diagnosis of COVID-19 were compared with age–gender-matched healthy controls. Patients who used drugs or had comorbidities that affect HRV and who were hospitalized with severe COVID-19 were excluded from the study. Results Time domain indices of HRV analysis (standard deviation of normal RR intervals in 24 h (SDNN 24 h) and root mean square of successive RR interval differences (RMSSD)) were significantly higher in post-COVID patients (p < 0.05 for all). Among frequency domain indices, high frequency and low frequency/high frequency ratio was significantly higher in post-COVID patients (p = 0.037 and p = 0.010, respectively). SDNN >60 ms [36 (60.0%) vs. 12 (36.4%), p = 0.028)] and RMSSD >40 ms [31 (51.7%) vs. 7 (21.2%), p = 0.003)] were more prevalent in post-COVID patients. Logistic regression models were created to evaluate parasympathetic overtone in terms of SDNN >60 ms and RMSSD >40 ms. After covariate adjustment, post-COVID patients were more likely to have SDNN >60 msn (OR: 2.4, 95% CI:1.2–12.8) and RMSSD >40 ms (OR: 2.5, 95% CI: 1.4–9.2). Conclusion This study revealed parasympathetic overtone and increased HRV in patients with history of COVID-19. This may explain the unresolved orthostatic symptoms occurring in post-COVID period which may be associated with autonomic imbalance. Supplementary Information The online version contains supplementary material available at 10.1007/s10840-022-01138-8.
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144
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Herhaus B, Siepmann M, Kahaly GJ, Conrad R, Petrowski K. Effect of a Biofeedback Intervention on Heart Rate Variability in Individuals With Panic Disorder: A Randomized Controlled Trial. Psychosom Med 2022; 84:199-209. [PMID: 34654028 DOI: 10.1097/psy.0000000000001031] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Some individuals with panic disorder (PD) display reduced heart rate variability (HRV), which may result in an increased risk of cardiovascular mortality. Heart rate variability-biofeedback (HRV-BF) training has been shown to improve the modulation of the autonomic activity. Therefore, this randomized controlled trial was conducted to investigate the effect of a 4-week HRV-BF intervention in individuals with PD. HRV-BF training improved the modulation of the autonomic activity. Therefore, with this randomized controlled trial, we aimed to investigate the effect of a 4-week HRV-BF intervention in people with PD. METHODS Thirty-six women and 16 men with PD (mean age = 35.85 [15.60] years) were randomly allocated either to HRV-BF with 0.1-Hz breathing as intervention group or to HRV-Sham-BF as active control group. HRV-BF was performed for 4 weeks, whereas HRV was measured both during a short-term resting condition and during a paced breathing condition before and after intervention. RESULTS HRV-BF with 0.1-Hz breathing increased HRV and reduced panic symptoms in individuals with PD. HRV-BF with 0.1-Hz breathing demonstrated an increase in the time and frequency domain parameters of HRV during the short-term resting condition (ΔPost-Pre root mean square successive differences: 5.87 [14.03] milliseconds; ΔPost-Pre standard deviation of all NN intervals: 11.63 [17.06] milliseconds; ΔPost-Pre total power: 464.88 [1825.47] milliseconds2; ΔPost-Pre power in low-frequency range 0.04-0.15 Hz: 312.73 [592.71] milliseconds2), a decrease in the heart rate during the paced breathing condition (ΔPost-Pre: -5.87 [9.14] beats/min), and a decrease in the Panic and Agoraphobia Scale (ΔPost-Pre: -3.64 [6.30]). There was no intervention effect in the HRV-Sham-BF group. CONCLUSIONS HRV-BF as a noninvasive and nonpharmacological treatment seems to be an important intervention option to improve reduced HRV and decrease panic symptoms in individuals with PD. Future studies are needed to establish whether these effects translate to reductions in the risk of cardiovascular disease in PD.
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Affiliation(s)
- Benedict Herhaus
- From the Medical Psychology and Medical Sociology (Herhaus, Petrowski), University Medical Center of the Johannes Gutenberg University Mainz, Mainz; Clinic for Psychotherapy and Psychosomatic Medicine (Siepmann), University Hospital Carl Gustav Carus, Technical University Dresden, Dresden; Department of Medicine I (Kahaly), Johannes Gutenberg University Medical Center, Mainz; and Department of Psychosomatic Medicine und Psychotherapy (Conrad), University Hospital Bonn, Bonn, Germany
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Nam EC, Chun KJ, Won JY, Kim JW, Lee WH. The differences between daytime and night-time heart rate variability may usefully predict the apnea-hypopnea index in patients with obstructive sleep apnea. J Clin Sleep Med 2022; 18:1557-1563. [PMID: 35088710 DOI: 10.5664/jcsm.9912] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES The association between daytime/night-time heart rate variability (HRV) and the apnea-hypopnea index (AHI) remains unclear. We sought a relationship between AHI and the daytime-to night-time HRV ratio as measured by 24-h Holter monitoring in patients with obstructive sleep apnea (OSA). METHODS We prospectively enrolled 66 patients who visited our sleep clinic complaining of habitual snoring or sleep apnea. All underwent 24-h Holter monitoring (to measure HRV) combined with full-night polysomnography (PSG). Sixty-two met our enrolment criteria. We evaluated the associations between HRV frequency domains and the PSG indices. We also considered medical histories and anthropometric data. RESULTS The night-time very low frequency (VLF), low frequency (LF), and high frequency (HF) HRVs were significantly higher than the daytime values. On correlation analysis, the day/night VLF (r = 0.550, p < 0.001), LF (r = 0.556, p < 0.001), and HF (r = 0.303, p = 0.017) HRVs were significantly related to the AHI. Of the day/night HRV ratios, the VLF (p for trend = 0.003) and LF (p for trend = 0.013) ratios decreased significantly by OSA severity. Multivariable analysis showed that the day/night VLF (β = 16.387, p < 0.001) and day/night LF (β = 25.248, p < 0.001) were independently (and significantly) associated with the AHI. CONCLUSIONS Twenty-four-hour Holter monitoring may usefully predict AHI. The day/night VLF and day/night LF ratios tended to decrease by OSA severity and were independently associated with the AHI.
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Affiliation(s)
- Eui-Cheol Nam
- Departments of Otolaryngology, Kangwon National University Hospital, College of Medicine, Kangwon National University, Chuncheon, Korea
| | - Kwang Jin Chun
- Division of Cardiology, Department of Internal Medicine, Kangwon National University Hospital, College of Medicine, Kangwon National University, Chuncheon, Korea
| | - Jun Yeon Won
- Departments of Otolaryngology, Kangwon National University Hospital, College of Medicine, Kangwon National University, Chuncheon, Korea
| | - Jeong-Whun Kim
- Department of Otorhinolaryngology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Woo Hyun Lee
- Departments of Otolaryngology, Kangwon National University Hospital, College of Medicine, Kangwon National University, Chuncheon, Korea
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Palix J, Abu-Akel A, Moulin V, Abbiati M, Gasser J, Hasler C, Marcot D, Mohr C, Dan-Glauser E. The Utility of Physiological Measures in Assessing the Empathic Skills of Incarcerated Violent Offenders. INTERNATIONAL JOURNAL OF OFFENDER THERAPY AND COMPARATIVE CRIMINOLOGY 2022; 66:98-122. [PMID: 33567952 PMCID: PMC8609505 DOI: 10.1177/0306624x21994056] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Since lack of empathy is an important indicator of violent behaviors, researchers need consistent and valid measures. This study evaluated the practical significance of a potential physiological correlate of empathy compared to a traditional self-report questionnaire in 18 male violent offenders and 21 general population controls. Empathy skills were assessed with the Interpersonal Reactivity Index (IRI) questionnaire. Heart-Rate Variability (HRV) was assessed with an electrocardiogram. The RMSSD (Root Mean Square of the Successive beat-to-beat Differences), an HRV index implicated in social cognition, was calculated. There were no group differences in IRI scores. However, RMSSD was lower in the offender group. Positive correlations between RMSSD and IRI subscales were found for controls only. We conclude that psychometric measures of empathy do not discriminate incarcerated violent offenders, and that the incorporation of psychophysiological measures, such as HRV, could be an avenue for forensic research on empathy to establish translatable evidence-based information.
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Affiliation(s)
- Julie Palix
- Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Ahmad Abu-Akel
- Institute of Psychology, University of Lausanne, Switzerland
| | - Valérie Moulin
- Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Milena Abbiati
- Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Jacques Gasser
- Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | | | | | - Christine Mohr
- Institute of Psychology, University of Lausanne, Switzerland
| | - Elise Dan-Glauser
- Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
- Institute of Psychology, University of Lausanne, Switzerland
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Lahens NF, Rahman M, Cohen JB, Cohen DL, Chen J, Weir MR, Feldman HI, Grant GR, Townsend RR, Skarke C, Study Investigators* ATCRIC. Time-specific associations of wearable sensor-based cardiovascular and behavioral readouts with disease phenotypes in the outpatient setting of the Chronic Renal Insufficiency Cohort. Digit Health 2022; 8:20552076221107903. [PMID: 35746950 PMCID: PMC9210076 DOI: 10.1177/20552076221107903] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 05/30/2022] [Indexed: 11/15/2022] Open
Abstract
Patients with chronic kidney disease are at risk of developing cardiovascular disease. To facilitate out-of-clinic evaluation, we piloted wearable device-based analysis of heart rate variability and behavioral readouts in patients with chronic kidney disease from the Chronic Renal Insufficiency Cohort and controls (n = 49). Time-specific partitioning of heart rate variability readouts confirm higher parasympathetic nervous activity during the night (mean RR at night 14.4 ± 1.9 ms vs. 12.8 ± 2.1 ms during active hours; n = 47, analysis of variance (ANOVA) q = 0.001). The α2 long-term fluctuations in the detrended fluctuation analysis, a parameter predictive of cardiovascular mortality, significantly differentiated between diabetic and nondiabetic patients (prominent at night with 0.58 ± 0.2 vs. 0.45 ± 0.12, respectively, adj. p = 0.004). Both diabetic and nondiabetic chronic kidney disease patients showed loss of rhythmic organization compared to controls, with diabetic chronic kidney disease patients exhibiting deconsolidation of peak phases between their activity and standard deviation of interbeat intervals rhythms (mean phase difference chronic kidney disease 8.3 h, chronic kidney disease/type 2 diabetes mellitus 4 h, controls 6.8 h). This work provides a roadmap toward deriving actionable clinical insights from the data collected by wearable devices outside of highly controlled clinical environments.
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Affiliation(s)
- Nicholas F. Lahens
- Institute for Translational Medicine and Therapeutics (ITMAT), University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
- Department of Systems Pharmacology and Translational Therapeutics, University of Pennsylvania Perelman School of Medicine, Philadelphia,
PA, USA
| | - Mahboob Rahman
- University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH, USA
| | - Jordana B. Cohen
- Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
- Department of Biostatistics and Epidemiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Debbie L. Cohen
- Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Jing Chen
- Department of Medicine, Tulane University School of Medicine, New Orleans, LA, USA
| | - Matthew R. Weir
- Division of Nephrology, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Harold I. Feldman
- Department of Biostatistics and Epidemiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Gregory R. Grant
- Institute for Translational Medicine and Therapeutics (ITMAT), University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
- Department of Genetics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Raymond R. Townsend
- Institute for Translational Medicine and Therapeutics (ITMAT), University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
- Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Carsten Skarke
- Institute for Translational Medicine and Therapeutics (ITMAT), University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
- Department of Systems Pharmacology and Translational Therapeutics, University of Pennsylvania Perelman School of Medicine, Philadelphia,
PA, USA
- Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
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Latremouille S, Lam J, Shalish W, Sant'Anna G. Neonatal heart rate variability: a contemporary scoping review of analysis methods and clinical applications. BMJ Open 2021; 11:e055209. [PMID: 34933863 PMCID: PMC8710426 DOI: 10.1136/bmjopen-2021-055209] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Neonatal heart rate variability (HRV) is widely used as a research tool. However, HRV calculation methods are highly variable making it difficult for comparisons between studies. OBJECTIVES To describe the different types of investigations where neonatal HRV was used, study characteristics, and types of analyses performed. ELIGIBILITY CRITERIA Human neonates ≤1 month of corrected age. SOURCES OF EVIDENCE A protocol and search strategy of the literature was developed in collaboration with the McGill University Health Center's librarians and articles were obtained from searches in the Biosis, Cochrane, Embase, Medline and Web of Science databases published between 1 January 2000 and 1 July 2020. CHARTING METHODS A single reviewer screened for eligibility and data were extracted from the included articles. Information collected included the study characteristics and population, type of HRV analysis used (time domain, frequency domain, non-linear, heart rate characteristics (HRC) parameters) and clinical applications (physiological and pathological conditions, responses to various stimuli and outcome prediction). RESULTS Of the 286 articles included, 171 (60%) were small single centre studies (sample size <50) performed on term infants (n=136). There were 138 different types of investigations reported: physiological investigations (n=162), responses to various stimuli (n=136), pathological conditions (n=109) and outcome predictor (n=30). Frequency domain analyses were used in 210 articles (73%), followed by time domain (n=139), non-linear methods (n=74) or HRC analyses (n=25). Additionally, over 60 different measures of HRV were reported; in the frequency domain analyses alone there were 29 different ranges used for the low frequency band and 46 for the high frequency band. CONCLUSIONS Neonatal HRV has been used in diverse types of investigations with significant lack of consistency in analysis methods applied. Specific guidelines for HRV analyses in neonates are needed to allow for comparisons between studies.
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Affiliation(s)
- Samantha Latremouille
- Division of Experimental Medicine, McGill University Health Centre, Montreal, Québec, Canada
| | - Justin Lam
- Medicine, Griffith University, Nathan, Queensland, Australia
| | - Wissam Shalish
- Division of Neonatology, McGill University Health Center, Montreal, Québec, Canada
| | - Guilherme Sant'Anna
- Division of Neonatology, McGill University Health Center, Montreal, Québec, Canada
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Mallick MK, Biser S, Haridas A, Umesh V, Tönsing O, Yari IA, Ollenschläger M, Heckel M, Ostgathe C, Kluge F, Eskofier B, Steigleder T. Improving Dyspnoea Symptom Control of Patients in Palliative Care Using a Smart Patch-A Proof of Concept Study. Front Digit Health 2021; 3:765867. [PMID: 34913047 PMCID: PMC8666503 DOI: 10.3389/fdgth.2021.765867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Accepted: 11/01/2021] [Indexed: 11/13/2022] Open
Abstract
The world of healthcare constantly aims to improve the lives of people while nurturing their health and comfort. Digital health and wearable technologies are aimed at making this possible. However, there are numerous factors that need to be addressed such as aging, disabilities, and health hazards. These factors are intensified in palliative care (PC) patients and limited hospital capacities make it challenging for health care providers (HCP) to handle the crisis. One of the most common symptoms reported by PC patients with severe conditions is dyspnoea. Monitoring devices with sufficient comfort could improve symptom control of patients with dyspnoea in PC. In this article, we discuss the proof-of-concept study to investigate a smart patch (SP), which monitors the pulmonary parameters: (a) breathing rate (BR) and inspiration to expiration ratio (I:E); markers for distress: (b) heart rate (HR) and heart rate variability (HRV), and (c) transmits real-time data securely to an adaptable user interface, primarily geared for palliative HCP but scalable to specific needs. The concept is verified by measuring and analyzing physiological signals from different electrode positions on the chest and comparing the results achieved with the gold standard Task Force Monitor (TFM).
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Affiliation(s)
- Mostafa Kamal Mallick
- Machine Learning and Data Analytics Lab, Department Artificial Intelligence in Biomedical Engineering (AIBE), Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Sarah Biser
- Machine Learning and Data Analytics Lab, Department Artificial Intelligence in Biomedical Engineering (AIBE), Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Aathira Haridas
- Machine Learning and Data Analytics Lab, Department Artificial Intelligence in Biomedical Engineering (AIBE), Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Vaishnavi Umesh
- Machine Learning and Data Analytics Lab, Department Artificial Intelligence in Biomedical Engineering (AIBE), Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Olaf Tönsing
- Machine Learning and Data Analytics Lab, Department Artificial Intelligence in Biomedical Engineering (AIBE), Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Imrana Abdullahi Yari
- Machine Learning and Data Analytics Lab, Department Artificial Intelligence in Biomedical Engineering (AIBE), Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Malte Ollenschläger
- Machine Learning and Data Analytics Lab, Department Artificial Intelligence in Biomedical Engineering (AIBE), Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Maria Heckel
- Department of Palliative Medicine, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Christoph Ostgathe
- Department of Palliative Medicine, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Felix Kluge
- Machine Learning and Data Analytics Lab, Department Artificial Intelligence in Biomedical Engineering (AIBE), Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Bjoern Eskofier
- Machine Learning and Data Analytics Lab, Department Artificial Intelligence in Biomedical Engineering (AIBE), Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Tobias Steigleder
- Department of Palliative Medicine, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
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Orthopaedic Surgeon Physiological Indicators of Strain as Measured by a Wearable Fitness Device. J Am Acad Orthop Surg 2021; 29:e1378-e1386. [PMID: 33999882 DOI: 10.5435/jaaos-d-21-00078] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 04/21/2021] [Indexed: 02/01/2023] Open
Abstract
INTRODUCTION Symptoms of stress, depression, and burnout are prevalent in medicine, adversely affecting physician performance. We investigated real-time measurements of physiological strain in orthopaedic resident and faculty surgeon volunteers and identified potential daily stressors. METHODS We performed a prospective blinded cohort pilot study in our academic orthopaedic department. Physicians used a wearable fitness device for 12 weeks to objectively measure heart rate variability (HRV), a documented parameter of overall well-being. Baseline burnout levels were assessed using the Maslach Burnout Inventory questionnaire. Daily surveys inquiring on work responsibilities (clinic, operating room [OR], or "other") were correlated with physiological parameters of strain. Descriptive statistics and linear mixed effects modeling were used to evaluate bivariate relationships. RESULTS Of the 21 participating surgeons, 9 faculty and 12 residents, there was a response rate of 95.2% for the initial burnout survey. Daily surveys were completed for 63.8% (54.9 ± 22.3 days) of the total collection window, and surgeons wore the device for 83.2% of the study (71.6 ± 25.0 days). Residents trended toward lower personal accomplishment and greater psychological detachment on the Maslach Burnout Inventory, with 5 surgeons including 1 faculty surgeon (11.1%) and 4 resident surgeons (33.3%) found to have negatively trending HRV throughout the study period demonstrating higher physiological strain. Time in the OR led to increased next-day HRV (y-intercept = 47.39; B = 4.90; 95% confidence interval, 2.14-7.66; P < 0.001), indicative of lower physiological strain. An increase in device-reported sleep from a surgeon's baseline resulted in a significant increase in next-day HRV (y-intercept = 50.46; B = 0.64; 95% confidence interval, 0.11-1.17; P = 0.02). DISCUSSION Orthopaedic residents, more than faculty, had physiologic findings suggestive of burnout. Time in the OR and increased sleep improved physiological strain parameters. Real-time biometric measurements can identify those at risk of burnout and in need of well-being interventions. LEVEL OF EVIDENCE Level III.
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