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Pichot V, Corbier C, Chouchou F, Barthélémy JC, Roche F. CVRanalysis: a free software for analyzing cardiac, vascular and respiratory interactions. Front Physiol 2024; 14:1224440. [PMID: 38250656 PMCID: PMC10797906 DOI: 10.3389/fphys.2023.1224440] [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: 05/17/2023] [Accepted: 12/13/2023] [Indexed: 01/23/2024] Open
Abstract
Introduction: Simultaneous beat-to-beat R-R intervals, blood pressure and respiration signals are routinely analyzed for the evaluation of autonomic cardiovascular and cardiorespiratory regulations for research or clinical purposes. The more recognized analyses are i) heart rate variability and cardiac coherence, which provides an evaluation of autonomic nervous system activity and more particularly parasympathetic and sympathetic autonomic arms; ii) blood pressure variability which is mainly linked to sympathetic modulation and myogenic vascular function; iii) baroreflex sensitivity; iv) time-frequency analyses to identify fast modifications of autonomic activity; and more recently, v) time and frequency domain Granger causality analyses were introduced for assessing bidirectional causal links between each considered signal, thus allowing the scrutiny of many physiological regulatory mechanisms. Methods: These analyses are commonly applied in various populations and conditions, including mortality and morbidity predictions, cardiac and respiratory rehabilitation, training and overtraining, diabetes, autonomic status of newborns, anesthesia, or neurophysiological studies. Results: We developed CVRanalysis, a free software to analyze cardiac, vascular and respiratory interactions, with a friendly graphical interface designed to meet laboratory requirements. The main strength of CVRanalysis resides in its wide scope of applications: recordings can arise from beat-to-beat preprocessed data (R-R, systolic, diastolic and mean blood pressure, respiration) or raw data (ECG, continuous blood pressure and respiratory waveforms). It has several tools for beat detection and correction, as well as setting of specific areas or events. In addition to the wide possibility of analyses cited above, the interface is also designed for easy study of large cohorts, including batch mode signal processing to avoid running repetitive operations. Results are displayed as figures or saved in text files that are easily employable in statistical softwares. Conclusion: CVRanalysis is freely available at this website: anslabtools.univ-st-etienne.fr. It has been developed using MATLAB® and works on Windows 64-bit operating systems. The software is a standalone application avoiding to have programming skills and to install MATLAB. The aims of this paper area are to describe the physiological, research and clinical contexts of CVRanalysis, to introduce the methodological approach of the different techniques used, and to show an overview of the software with the aid of screenshots.
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Affiliation(s)
- Vincent Pichot
- SAINBIOSE U1059, Inserm, Saint-Etienne Jean-Monnet University, Clinical Physiology and Exercise, CHU of Saint-Etienne, Saint-Etienne, France
| | - Christophe Corbier
- LASPI EA3059, Saint-Etienne Jean-Monnet University, Roanne Technology University Institute, Roanne, France
| | - Florian Chouchou
- IRISSE EA4075, UFR SHE, University of La Réunion, Le Tampon, France
| | - Jean-Claude Barthélémy
- SAINBIOSE U1059, Inserm, Saint-Etienne Jean-Monnet University, Clinical Physiology and Exercise, CHU of Saint-Etienne, Saint-Etienne, France
| | - Frédéric Roche
- SAINBIOSE U1059, Inserm, Saint-Etienne Jean-Monnet University, Clinical Physiology and Exercise, CHU of Saint-Etienne, Saint-Etienne, France
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Roche F, Pichot V, Mouhli-Gasmi L, Monier M, Barthélémy JC, Berger M, Celle S, Chouchou F. Anatomy and physiology of the autonomic nervous system: Implication on the choice of diagnostic/monitoring tools in 2023. Rev Neurol (Paris) 2024; 180:42-52. [PMID: 38176987 DOI: 10.1016/j.neurol.2023.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Revised: 12/18/2023] [Accepted: 12/20/2023] [Indexed: 01/06/2024]
Abstract
The autonomic nervous system (ANS) harmoniously regulates all internal organic functions (heart rate, blood pressure, vasomotion, digestive tract motility, endocrinal secretions) and adapts them to the needs. It's the control of so-called vegetative functions, which allows homeostasis but also allostasis of our body. ANS is divided into two systems often understood as antagonistic and complementary: the sympathetic and the parasympathetic systems. However, we currently know of many situations of co-activation of the two systems. Long seen as acting through "reflex" control loops passing through the integration of peripheral information and the efferent response to the peripheral organ, more recent electrophysiological and brain functional imaging knowledge has been able to identify the essential role of the central autonomic network. This element complicates the understanding of the responses of the reflex loops classically used to identify and quantify dysautonomia. Finding the "ANS" tools best suited for the clinician in their daily practice is a challenge that we will attempt to address in this work.
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Affiliation(s)
- F Roche
- Clinical Physiology, Saint-Étienne University Hospital, Saint-Étienne, France; Inserm U1059 Sainbiose, Jean-Monnet University, Saint-Étienne, France.
| | - V Pichot
- Clinical Physiology, Saint-Étienne University Hospital, Saint-Étienne, France; Inserm U1059 Sainbiose, Jean-Monnet University, Saint-Étienne, France
| | - L Mouhli-Gasmi
- Clinical Physiology, Saint-Étienne University Hospital, Saint-Étienne, France
| | - M Monier
- Clinical Physiology, Saint-Étienne University Hospital, Saint-Étienne, France
| | - J-C Barthélémy
- Clinical Physiology, Saint-Étienne University Hospital, Saint-Étienne, France; Inserm U1059 Sainbiose, Jean-Monnet University, Saint-Étienne, France
| | - M Berger
- Clinical Physiology, Saint-Étienne University Hospital, Saint-Étienne, France; Inserm U1059 Sainbiose, Jean-Monnet University, Saint-Étienne, France
| | - S Celle
- Clinical Physiology, Saint-Étienne University Hospital, Saint-Étienne, France; Inserm U1059 Sainbiose, Jean-Monnet University, Saint-Étienne, France
| | - F Chouchou
- IRISSE EA4075, STAPS Department, La Reunion University, Le Tampon, France
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Sandoval Ortega RA, Renard M, Cohen MX, Nevian T. Interactive effects of pain and arousal state on heart rate and cortical activity in the mouse anterior cingulate and somatosensory cortices. NEUROBIOLOGY OF PAIN (CAMBRIDGE, MASS.) 2024; 15:100157. [PMID: 38764613 PMCID: PMC11099324 DOI: 10.1016/j.ynpai.2024.100157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 04/22/2024] [Accepted: 04/22/2024] [Indexed: 05/21/2024]
Abstract
Sensory disconnection is a hallmark of sleep, yet the cortex retains some ability to process sensory information. Acute noxious stimulation during sleep increases the heart rate and the likelihood of awakening, indicating that certain mechanisms for pain sensing and processing remain active. However, processing of somatosensory information, including pain, during sleep remains underexplored. To assess somatosensation in natural sleep, we simultaneously recorded heart rate and local field potentials in the anterior cingulate (ACC) and somatosensory (S1) cortices of naïve, adult male mice, while applying noxious and non-noxious stimuli to their hind paws throughout their sleep-wake cycle. Noxious stimuli evoked stronger heart rate increases in both wake and non-rapid eye movement sleep (NREMS), and resulted in larger awakening probability in NREMS, as compared to non-noxious stimulation, suggesting differential processing of noxious and non-noxious information during sleep. Somatosensory information differentially reached S1 and ACC in sleep, eliciting complex transient and sustained responses in the delta, alpha, and gamma frequency bands as well as somatosensory evoked potentials. These dynamics depended on sleep state, the behavioral response to the stimulation and stimulation intensity (non-noxious vs. noxious). Furthermore, we found a correlation of the heart rate with the gamma band in S1 in the absence of a reaction in wake and sleep for noxious stimulation. These findings confirm that somatosensory information, including nociception, is sensed and processed during sleep even in the absence of a behavioral response.
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Affiliation(s)
| | - Margot Renard
- Neuronal Plasticity Group, Department of Physiology, University of Bern, Bühlplatz 5, 3012 Bern, Switzerland
| | - Michael X. Cohen
- Synchronization in Neural Systems Lab, Donders Centre for Medical Neuroscience, Radboud University Medical Center, Houtlaan 4, 6525 XZ Nijmegen, the Netherlands
| | - Thomas Nevian
- Neuronal Plasticity Group, Department of Physiology, University of Bern, Bühlplatz 5, 3012 Bern, Switzerland
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El Youssef N, Marchi A, Bartolomei F, Bonini F, Lambert I. Sleep and epilepsy: A clinical and pathophysiological overview. Rev Neurol (Paris) 2023; 179:687-702. [PMID: 37598088 DOI: 10.1016/j.neurol.2023.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 07/28/2023] [Accepted: 07/29/2023] [Indexed: 08/21/2023]
Abstract
The interaction between sleep and epilepsy is complex. A better understanding of the mechanisms linking sleep and epilepsy appears increasingly important as it may improve diagnosis and therapeutic strategies in patients with epilepsy. In this narrative review, we aim to (i) provide an overview of the physiological and pathophysiological processes linking sleep and epilepsy; (ii) present common sleep disorders in patients with epilepsy; (iii) discuss how sleep and sleep disorders should be considered in new therapeutic approaches to epilepsy such as neurostimulation; and (iv) present the overall nocturnal manifestations and differential diagnosis between epileptic seizures and parasomnia.
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Affiliation(s)
- N El Youssef
- AP-HM, Timone hospital, Sleep Unit, Epileptology and Cerebral Rhythmology, Marseille, France
| | - A Marchi
- AP-HM, Timone hospital, Sleep Unit, Epileptology and Cerebral Rhythmology, Marseille, France
| | - F Bartolomei
- AP-HM, Timone hospital, Sleep Unit, Epileptology and Cerebral Rhythmology, Marseille, France; Aix-Marseille University, Inserm, Inst Neurosci Syst (INS), Marseille, France
| | - F Bonini
- AP-HM, Timone hospital, Sleep Unit, Epileptology and Cerebral Rhythmology, Marseille, France; Aix-Marseille University, Inserm, Inst Neurosci Syst (INS), Marseille, France
| | - I Lambert
- AP-HM, Timone hospital, Sleep Unit, Epileptology and Cerebral Rhythmology, Marseille, France; Aix-Marseille University, Inserm, Inst Neurosci Syst (INS), Marseille, France.
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Ruf SP, Hetterich L, Mazurak N, Rometsch C, Jurjut AM, Ott S, Herrmann-Werner A, Zipfel S, Stengel A. Mirror Therapy in Patients with Somatoform Pain Disorders-A Pilot Study. Behav Sci (Basel) 2023; 13:bs13050432. [PMID: 37232669 DOI: 10.3390/bs13050432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 05/12/2023] [Accepted: 05/18/2023] [Indexed: 05/27/2023] Open
Abstract
Patients with chronic pain report reduced quality of life and high symptom burden while often responding insufficiently to treatment options. Mirror therapy has been proven to be effective in treating phantom limb pain and other conditions such as CRPS. This study was designed to investigate the efficacy of mirror therapy in patients with somatoform pain disorders on symptom severity and associated physiological parameters. Fifteen patients with persistent somatoform pain disorder (F45.40) or chronic pain disorder with somatic and psychological factors (F45.41) participated and received four weeks of tablet-based mirror therapy. Symptom severity was measured with established questionnaires, and their thermal detection, pain thresholds, and heart rate variability (HRV) were also assessed. After mirror therapy, pain intensity was reduced (z = -2.878, p = 0.004), and pain thresholds for cold stimuli were also diminished, i.e., the subjects became more sensitive to cold stimuli (z = -2.040, p = 0.041). In addition, a reduction of absolute power in the low-frequency band of HRV (t(13) = 2.536, p = 0.025) was detected. These findings indicate that this intervention may reduce pain intensity and modulate associated physiological parameters. As these results are limited by several factors, e.g., a small sample size and no control group, they should be validated in further studies investigating this novel intervention in these patients.
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Affiliation(s)
- Steffen Philipp Ruf
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Osianderstr. 5, 72076 Tübingen, Germany
| | - Larissa Hetterich
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Osianderstr. 5, 72076 Tübingen, Germany
| | - Nazar Mazurak
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Osianderstr. 5, 72076 Tübingen, Germany
| | - Caroline Rometsch
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Osianderstr. 5, 72076 Tübingen, Germany
- Department of Experimental and Clinical Medicine, University of Florence, Largo Brambilla 3, 50134 Firenze, Italy
| | - Anna-Maria Jurjut
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Osianderstr. 5, 72076 Tübingen, Germany
| | - Stephan Ott
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Osianderstr. 5, 72076 Tübingen, Germany
- Institute of Occupational, Social and Environmental Medicine with Outpatient Clinic, Friedrich-Alexander-Universität Erlangen-Nürnberg, Henkestr. 9-11, 91054 Erlangen, Germany
| | - Anne Herrmann-Werner
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Osianderstr. 5, 72076 Tübingen, Germany
- TIME (Tübingen Institute for Medical Education), Medical Faculty Tübingen, Elfriede-Aulhorn-Str. 10, 72076 Tübingen, Germany
| | - Stephan Zipfel
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Osianderstr. 5, 72076 Tübingen, Germany
| | - Andreas Stengel
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Osianderstr. 5, 72076 Tübingen, Germany
- Charité Center for Internal Medicine and Dermatology, Department for Psychosomatic Medicine, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, 12203 Berlin, Germany
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Mourad F, Giudice A, Maritati G, Maselli F, Kranenburg R, Taylor A, Kerry R, Hutting N. A guide to identify cervical autonomic dysfunctions (and associated conditions) in patients with musculoskeletal disorders in physical therapy practice. Braz J Phys Ther 2023; 27:100495. [PMID: 37075598 DOI: 10.1016/j.bjpt.2023.100495] [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: 01/27/2022] [Revised: 09/24/2022] [Accepted: 03/06/2023] [Indexed: 04/21/2023] Open
Abstract
BACKGROUND Differential diagnosis is a hot topic in physical therapy, especially for those working in a direct access setting dealing with neck pain and its associated disorders. All international guidelines agree in recommending to first rule out non-musculoskeletal pathologies as the cause of signs and symptoms in the patient. Although the autonomic nervous system (ANS) has a crucial role and is also involved in pain conditions, coverage of it in neuroscience textbooks and educational programmes is limited and most healthcare professionals are unfamiliar with it. Although autonomic conditions are benign in nature, they are clinically of great importance as they may be a 'red flag' warning of an injury along the sympathetic pathway. Therefore, sound knowledge of the ANS system is essential for clinicians. OBJECTIVE To develop physical therapists' knowledge of and confidence in understanding cervical ANS function and dysfunction, thus enhancing clinical reasoning skills and the pattern recognition process, and performing and interpreting objective examinations. METHODS This master class provides an introductory guide and essential knowledge to facilitate clinicians to understand cervical autonomic dysfunctions and their clinical evaluation. The optimal referral method is also handled. CONCLUSIONS Gaining knowledge and understanding of the ANS, its function, its dysfunction, and the related clinical manifestations is likely to lead to a decision-making process driven by 'science and conscience'. This will empower physical therapists to be aware of subtle clues that may be offered by patients during the interview and history intake leading to the appropriate physical examination and triage.
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Affiliation(s)
- Firas Mourad
- Department of Physical Therapy, LUNEX International University of Health, Exercise and Sports, Differdange, Luxembourg; Luxembourg Health & Sport Sciences Research Institute A.s.b.l., Differdange, Luxembourg
| | - Andrea Giudice
- Department of Physical Therapy, Poliambulatorio Physio Power, Brescia, Italy
| | - Giorgio Maritati
- Department of Physical Therapy, Poliambulatorio Physio Power, Brescia, Italy
| | - Filippo Maselli
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy; Sovrintendenza Sanitaria Regionale Puglia INAIL, Bari, Italy
| | - Rik Kranenburg
- Healthy Ageing, Allied Health Care and Nursing Research Group, Hanze University of Applied Sciences, Groningen, the Netherlands
| | - Alan Taylor
- Faculty of Medicine and Health Sciences, School of Health Sciences, University of Nottingham, UK
| | - Roger Kerry
- Faculty of Medicine and Health Sciences, School of Health Sciences, University of Nottingham, UK
| | - Nathan Hutting
- Department of Occupation and Health, School of Organisation and Development, HAN University of Applied Sciences, Nijmegen, the Netherlands.
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Forte G, Troisi G, Pazzaglia M, Pascalis VD, Casagrande M. Heart Rate Variability and Pain: A Systematic Review. Brain Sci 2022; 12:brainsci12020153. [PMID: 35203917 PMCID: PMC8870705 DOI: 10.3390/brainsci12020153] [Citation(s) in RCA: 58] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 01/20/2022] [Accepted: 01/21/2022] [Indexed: 02/04/2023] Open
Abstract
Background and Objective: Heart rate variability (HRV) as an index of the autonomic nervous system appears to be related to reactivity to experimental pain stimuli. HRV could better explain the contributions of sympathetic and parasympathetic activity response to nociceptive stimulation. The aim of this study was to systematically review and synthesize the current evidence on HRV in relation to the experience of pain in experimental tasks. Databases and Data Treatment: Studies indexed in the PubMed, PsycINFO, MEDLINE, WebOfScience, and Scopus databases were reviewed for eligibility. Studies on the autonomic response (i.e., HRV) to experimentally induced pain in healthy adults were included. Different methods of pain induction were considered (e.g., thermal, pressure, and electrical). Data were synthesized considering the association between HRV and both pain induction and subjective measures of pain. Results: Seventy-one studies were included. The results underline significant change in both the sympathetic and parasympathetic autonomic nervous systems during the painful stimulation independent of the pain induction method. The autonomic reaction to pain could be affected by several factors, such as sex, age, body mass index, breathing patterns, the intensity of the stimulation, and the affective state. Moreover, an association between the autonomic nervous system and the subjective experience of pain was found. Higher parasympathetic activity was associated with better self-regulation capacities and, accordingly, a higher pain inhibition capacity. Conclusions: HRV appears to be a helpful marker to evaluate nociceptive response in experimentally induced pain. Future studies are also needed in clinical samples to understand better the interindividual changes of autonomic response due to pain stimuli.
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Affiliation(s)
- Giuseppe Forte
- Department of Psychology, “Sapienza” University of Rome, 00185 Rome, Italy; (M.P.); (V.D.P.)
- Body and Action Lab, IRCCS Fondazione Santa Lucia, Via Ardeatina 306, 00179 Rome, Italy
- Correspondence: (G.F.); (M.C.)
| | - Giovanna Troisi
- Department of Clinical and Dynamic Psychology and Health Studies, “Sapienza” University of Rome, 00185 Rome, Italy;
| | - Mariella Pazzaglia
- Department of Psychology, “Sapienza” University of Rome, 00185 Rome, Italy; (M.P.); (V.D.P.)
- Body and Action Lab, IRCCS Fondazione Santa Lucia, Via Ardeatina 306, 00179 Rome, Italy
| | - Vilfredo De Pascalis
- Department of Psychology, “Sapienza” University of Rome, 00185 Rome, Italy; (M.P.); (V.D.P.)
| | - Maria Casagrande
- Department of Clinical and Dynamic Psychology and Health Studies, “Sapienza” University of Rome, 00185 Rome, Italy;
- Correspondence: (G.F.); (M.C.)
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Li F, Jackson T. Psychophysiological correlates of pain resilience in anticipating, experiencing, and recovering from pain. Psychophysiology 2021; 59:e13962. [PMID: 34716607 DOI: 10.1111/psyp.13962] [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: 03/17/2021] [Revised: 10/09/2021] [Accepted: 10/14/2021] [Indexed: 11/29/2022]
Abstract
Although researchers have documented behavioral and brain structure correlates of pain resilience, associated physiological responses have received little consideration. In this study, we assessed psychophysiological differences between high (HPR), moderate (MPR), and low (LPR) pain resilience subgroups during anticipation, experiencing, and recovery from laboratory pain. In an initial pain anticipation task, participants (79 women, 32 man) viewed visual cues to signal possible mild or intense shocks prior to receiving these shocks. Subsequently, in a pain recovery task, participants received uncued mild and intense shocks. Subjective appraisals were assessed during each task in tandem with continuous recording of skin conductance level (SCL), heart rate variability (HRV), and corrugator electromyography (cEMG). On physiological indexes, HPR subgroup members displayed significantly lower SCL than MPR and LPR subgroups did during anticipation and experiencing of pain while no resilience group effects were found for HRV or cEMG. During pain recovery, HPR and LPR subgroups displayed weaker SCL than the MPR subgroup did in the immediate aftermath of shock. However, HPR members continued to display lower SCL than other groups did over an extended recovery period. On self-report measures, the LPR subgroup reported higher levels of anticipatory anxiety and expected pain than HPR and MPR subgroups did during the pain anticipation task. Together, results suggested higher pain resilience is characterized, in part, by comparatively reduced SCL during the course of anticipating, experiencing and recovering from painful shock.
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Affiliation(s)
- Fenghua Li
- Key Laboratory of Cognition & Personality, Southwest University, Chongqing, China
| | - Todd Jackson
- Key Laboratory of Cognition & Personality, Southwest University, Chongqing, China.,Department of Psychology, University of Macau, Taipa, Macau S.A.R., China
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Excoffier J, Pichot V, Cantais A, Mory O, Roche F, Patural H, Chouchou F. Autonomic Cardiac Reactivity to Painful Procedures Under Hypnosis in Pediatric Emergencies: A Feasibility Study. AMERICAN JOURNAL OF CLINICAL HYPNOSIS 2020; 62:267-281. [PMID: 31928519 DOI: 10.1080/00029157.2018.1564013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Pain sensation is characterized by abrupt changes in central nervous system activity producing autonomic reactivity. While clinical hypnosis has demonstrated its benefits for children in pain management, it is not clear whether hypnosis modulated autonomic pain response in children in clinical conditions. Here, we studied autonomic responses under hypnosis to sutures in pediatric emergencies. For that, 42 children (mean age: 6.5 years, range 1.5 to 13) were divided into two groups consecutively (hypnosis and control groups), according to their choice. Time-frequency analysis was applied on RR intervals (heart rate interbeat intervals, or RRI) to estimate parasympathetic reactivity based on high frequency power (HF) and the Analgesia Nociception Index (ANI®) and on sympathetic reactivity (low frequency power [LF]) and LF/HF ratio). We observed that RRI and LF/HF ratio varied according to suture and hypnosis (p < 0.05): RRI was higher and LF/HF ratio was lower during sutures in the hypnosis group in comparison to the control group whereas HF and ANI® increased only during hypnosis. To conclude, hypnosis in pediatric emergencies reduces sympathetic cardiac pain reactivity and could be a marker of pain relief under hypnosis, while parasympathetic activity seems to be a better marker of hypnosis.
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Affiliation(s)
| | | | | | | | | | | | - Florian Chouchou
- IRISSE Laboratory (EA4075), UFR SHE, University of La Réunion, Le Tampon, France
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Lee IS, Necka EA, Atlas LY. Distinguishing pain from nociception, salience, and arousal: How autonomic nervous system activity can improve neuroimaging tests of specificity. Neuroimage 2020; 204:116254. [PMID: 31604122 PMCID: PMC6911655 DOI: 10.1016/j.neuroimage.2019.116254] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2019] [Revised: 10/04/2019] [Accepted: 10/07/2019] [Indexed: 12/16/2022] Open
Abstract
Pain is a subjective, multidimensional experience that is distinct from nociception. A large body of work has focused on whether pain processing is supported by specific, dedicated brain circuits. Despite advances in human neuroscience and neuroimaging analysis, dissociating acute pain from other sensations has been challenging since both pain and non-pain stimuli evoke salience and arousal responses throughout the body and in overlapping brain circuits. In this review, we discuss these challenges and propose that brain-body interactions in pain can be leveraged in order to improve tests for pain specificity. We review brain and bodily responses to pain and nociception and extant efforts toward identifying pain-specific brain networks. We propose that autonomic nervous system activity should be used as a surrogate measure of salience and arousal to improve these efforts and enable researchers to parse out pain-specific responses in the brain, and demonstrate the feasibility of this approach using example fMRI data from a thermal pain paradigm. This new approach will improve the accuracy and specificity of functional neuroimaging analyses and help to overcome current difficulties in assessing pain specific responses in the human brain.
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Affiliation(s)
- In-Seon Lee
- National Center for Complementary and Integrative Health, National Institutes of Health, Bethesda, MD, USA
| | - Elizabeth A Necka
- National Center for Complementary and Integrative Health, National Institutes of Health, Bethesda, MD, USA
| | - Lauren Y Atlas
- National Center for Complementary and Integrative Health, National Institutes of Health, Bethesda, MD, USA; National Institute on Drug Abuse, National Institutes of Health, Baltimore, MD, USA; National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA.
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11
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Chouchou F, Mauguière F, Vallayer O, Catenoix H, Isnard J, Montavont A, Jung J, Pichot V, Rheims S, Mazzola L. How the insula speaks to the heart: Cardiac responses to insular stimulation in humans. Hum Brain Mapp 2019; 40:2611-2622. [PMID: 30815964 DOI: 10.1002/hbm.24548] [Citation(s) in RCA: 75] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2018] [Revised: 01/29/2019] [Accepted: 01/29/2019] [Indexed: 12/14/2022] Open
Abstract
Despite numerous studies suggesting the role of insular cortex in the control of autonomic activity, the exact location of cardiac motor regions remains controversial. We provide here a functional mapping of autonomic cardiac responses to intracortical stimulations of the human insula. The cardiac effects of 100 insular electrical stimulations into 47 epileptic patients were divided into tachycardia, bradycardia, and no cardiac response according to the magnitude of RR interval (RRI) reactivity. Sympathetic (low frequency, LF, and low to high frequency powers ratio, LF/HF ratio) and parasympathetic (high frequency power, HF) reactivity were studied using RRI analysis. Bradycardia was induced by 26 stimulations (26%) and tachycardia by 21 stimulations (21%). Right and left insular stimulations induced as often a bradycardia as a tachycardia. Tachycardia was accompanied by an increase in LF/HF ratio, suggesting an increase in sympathetic tone; while bradycardia seemed accompanied by an increase of parasympathetic tone reflected by an increase in HF. There was some left/right asymmetry in insular subregions where increased or decreased heart rates were produced after stimulation. However, spatial distribution of tachycardia responses predominated in the posterior insula, whereas bradycardia sites were more anterior in the median part of the insula. These findings seemed to indicate a posterior predominance of sympathetic control in the insula, whichever the side; whereas the parasympathetic control seemed more anterior. Dysfunction of these regions should be considered when modifications of cardiac activity occur during epileptic seizures and in cardiovascular diseases.
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Affiliation(s)
- Florian Chouchou
- IRISSE Laboratory (EA4075), UFR SHE, University of La Réunion, Le Tampon, France
| | - François Mauguière
- Department of Functional Neurology and Epileptology, Hospices Civils de Lyon, Université de Lyon, Lyon, France.,NeuroPain Lab, Lyon Neuroscience Research Centre, CRNL - INSERM U 1028/CNRS UMR 5292, University of Lyon, Lyon, France
| | - Ophélie Vallayer
- Neurology Department, University Hospital, Saint-Etienne, France
| | - Hélène Catenoix
- Department of Functional Neurology and Epileptology, Hospices Civils de Lyon, Université de Lyon, Lyon, France.,TIGER Lab, Lyon Neuroscience Research Centre, CRNL - INSERM U 1028/CNRS UMR 5292, University of Lyon, Lyon, France
| | - Jean Isnard
- Department of Functional Neurology and Epileptology, Hospices Civils de Lyon, Université de Lyon, Lyon, France.,NeuroPain Lab, Lyon Neuroscience Research Centre, CRNL - INSERM U 1028/CNRS UMR 5292, University of Lyon, Lyon, France
| | - Alexandra Montavont
- Department of Functional Neurology and Epileptology, Hospices Civils de Lyon, Université de Lyon, Lyon, France.,TIGER Lab, Lyon Neuroscience Research Centre, CRNL - INSERM U 1028/CNRS UMR 5292, University of Lyon, Lyon, France
| | - Julien Jung
- Department of Functional Neurology and Epileptology, Hospices Civils de Lyon, Université de Lyon, Lyon, France.,TIGER Lab, Lyon Neuroscience Research Centre, CRNL - INSERM U 1028/CNRS UMR 5292, University of Lyon, Lyon, France
| | - Vincent Pichot
- EA SNA-EPIS 4607, Department of Clinical and Exercise Physiology, University of Lyon, Jean Monnet University, Saint-Etienne, France
| | - Sylvain Rheims
- Department of Functional Neurology and Epileptology, Hospices Civils de Lyon, Université de Lyon, Lyon, France.,TIGER Lab, Lyon Neuroscience Research Centre, CRNL - INSERM U 1028/CNRS UMR 5292, University of Lyon, Lyon, France
| | - Laure Mazzola
- NeuroPain Lab, Lyon Neuroscience Research Centre, CRNL - INSERM U 1028/CNRS UMR 5292, University of Lyon, Lyon, France.,Neurology Department, University Hospital, Saint-Etienne, France
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12
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Kitagawa Y, Kimura K, Yoshida S. Spectral Analysis of Heart Rate Variability during Trigger Point Acupuncture. Acupunct Med 2018; 32:273-8. [DOI: 10.1136/acupmed-2013-010440] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Objectives To clarify changes in the cardiovascular autonomic nervous system function due to trigger point acupuncture, we evaluated differences in responses between acupuncture at trigger points and those at other sites using spectral analysis of heart rate variability. Methods Subjects were 35 healthy men. Before measurements began the subjects were assigned to a trigger point acupuncture or control group based on the presence/absence of referred pain on applying pressure to a taut band within the right tibialis anterior muscle. The measurements were conducted in a room with a temperature of 25°C, with subjects in a long sitting position after 10 min rest. Acupuncture needles were retained for 10 min at two sites on the right tibialis anterior muscle. ECG was performed simultaneously with measurements of blood pressure and the respiratory cycle. Based on the R–R interval on the ECG, frequency analysis was performed, low-frequency (LF) and high-frequency (HF) components were extracted and the ratio of LF to HF components (LF/HF) was evaluated. Results The trigger point acupuncture group showed a transient decrease in heart rate and an increase in the HF component but no significant changes in LF/HF. In the control group, no significant changes were observed in heart rate, the HF component or LF/HF. There were no consistent changes in systolic or diastolic blood pressure in either group. Conclusions These data suggest that acupuncture stimulation of trigger points of the tibialis anterior muscle transiently increases parasympathetic nerve activity.
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Affiliation(s)
- Yoji Kitagawa
- Department of Health Sciences, Kansai University of Health Sciences, Osaka, Japan
| | - Kenichi Kimura
- Department of Health Sciences, Kansai University of Health Sciences, Osaka, Japan
| | - Sohei Yoshida
- Department of Health Sciences, Kansai University of Health Sciences, Osaka, Japan
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13
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Parasomnia versus epilepsy: An affair of the heart? Neurophysiol Clin 2018; 48:277-286. [DOI: 10.1016/j.neucli.2018.08.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Revised: 08/03/2018] [Accepted: 08/27/2018] [Indexed: 01/07/2023] Open
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14
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Champéroux P, Fesler P, Judé S, Richard S, Le Guennec JY, Thireau J. High-frequency autonomic modulation: a new model for analysis of autonomic cardiac control. Br J Pharmacol 2018; 175:3131-3143. [PMID: 29723392 PMCID: PMC6031873 DOI: 10.1111/bph.14354] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Revised: 04/18/2018] [Accepted: 04/24/2018] [Indexed: 12/19/2022] Open
Abstract
Background and Purpose Increase in high‐frequency beat‐to‐beat heart rate oscillations by torsadogenic hERG blockers appears to be associated with signs of parasympathetic and sympathetic co‐activation which cannot be assessed directly using classic methods of heart rate variability analysis. The present work aimed to find a translational model that would allow this particular state of the autonomic control of heart rate to be assessed. Experimental Approach High‐frequency heart rate and heart period oscillations were analysed within discrete 10 s intervals in a cohort of 200 healthy human subjects. Results were compared to data collected in non‐human primates and beagle dogs during pharmacological challenges and torsadogenic hERG blockers exposure, in 127 genotyped LQT1 patients on/off β‐blocker treatment and in subgroups of smoking and non‐smoking subjects. Key Results Three states of autonomic modulation, S1 (parasympathetic predominance) to S3 (reciprocal parasympathetic withdrawal/sympathetic activation), were differentiated to build a new model of heart rate variability referred to as high‐frequency autonomic modulation. The S2 state corresponded to a specific state during which both parasympathetic and sympathetic systems were coexisting or co‐activated. S2 oscillations were proportionally increased by torsadogenic hERG‐blocking drugs, whereas smoking caused an increase in S3 oscillations. Conclusions and Implications The combined analysis of the magnitude of high‐frequency heart rate and high‐frequency heart period oscillations allows a refined assessment of heart rate autonomic modulation applicable to long‐term ECG recordings and offers new approaches to assessment of the risk of sudden death both in terms of underlying mechanisms and sensitivity.
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Affiliation(s)
| | - Pierre Fesler
- Department of Internal Medicine, Hopital Lapeyronie, Montpellier, France.,Laboratoire PHYMEDEXP,INSERM U1046, CNRS UMR 9214, Université de Montpellier, CHU Arnaud de Villeneuve, Montpellier Cedex 05, 34295, France
| | - Sebastien Judé
- Centre de Recherches Biologiques, CERB, Baugy, 18800, France
| | - Serge Richard
- Centre de Recherches Biologiques, CERB, Baugy, 18800, France
| | - Jean-Yves Le Guennec
- Laboratoire PHYMEDEXP,INSERM U1046, CNRS UMR 9214, Université de Montpellier, CHU Arnaud de Villeneuve, Montpellier Cedex 05, 34295, France
| | - Jérôme Thireau
- Laboratoire PHYMEDEXP,INSERM U1046, CNRS UMR 9214, Université de Montpellier, CHU Arnaud de Villeneuve, Montpellier Cedex 05, 34295, France
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15
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Fauchon C, Pichot V, Faillenot I, Pommier B, Garcia-Larrea L, Peyron R, Chouchou F. Contextual modulation of autonomic pain reactivity. Auton Neurosci 2018; 212:28-31. [PMID: 29778243 DOI: 10.1016/j.autneu.2018.04.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2017] [Revised: 02/02/2018] [Accepted: 04/07/2018] [Indexed: 01/19/2023]
Abstract
Although modulation of cardiac activity may be influenced by several factors, interaction between autonomic nociceptive responses and the high-level of cortical processes is not clearly understood. Here, we studied in 26 subjects whether empathetic or unempathetic contexts could interact with autonomic pain responses. RR intervals variability was used to approach parasympathetic and sympathetic responses to painful thermal stimulations, according to contexts evoked by experimenters' comments. We observed that unempathetic context increased sympathetic reactivity to comments and to painful stimulations without any parasympathetic change. These results show an interaction between context and nociceptive processes in cardiovascular control.
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Affiliation(s)
- Camille Fauchon
- Central Integration of Pain team (NeuroPain), Lyon Neuroscience Research Center, Inserm U1028, UCB Lyon 1, UJM, F-42023 Saint-Etienne, France.
| | - Vincent Pichot
- EA SNA-EPIS, Department of Clinical and Exercise Physiology, CHU de Saint-Etienne, F-42055 Saint-Etienne, France
| | - Isabelle Faillenot
- Central Integration of Pain team (NeuroPain), Lyon Neuroscience Research Center, Inserm U1028, UCB Lyon 1, UJM, F-42023 Saint-Etienne, France
| | - Benjamin Pommier
- Central Integration of Pain team (NeuroPain), Lyon Neuroscience Research Center, Inserm U1028, UCB Lyon 1, UJM, F-42023 Saint-Etienne, France
| | - Luis Garcia-Larrea
- Central Integration of Pain team (NeuroPain), Lyon Neuroscience Research Center, Inserm U1028, UCB Lyon 1, UJM, F-42023 Saint-Etienne, France
| | - Roland Peyron
- Central Integration of Pain team (NeuroPain), Lyon Neuroscience Research Center, Inserm U1028, UCB Lyon 1, UJM, F-42023 Saint-Etienne, France; Department of Neurology & Pain Center, CHU de Saint-Etienne, F-42055 Saint-Etienne, France
| | - Florian Chouchou
- Central Integration of Pain team (NeuroPain), Lyon Neuroscience Research Center, Inserm U1028, UCB Lyon 1, UJM, F-42023 Saint-Etienne, France; EA SNA-EPIS, Department of Clinical and Exercise Physiology, CHU de Saint-Etienne, F-42055 Saint-Etienne, France
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16
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Tzabazis A, Eisenried A, Yeomans DC, Hyatt MIV. Wavelet analysis of heart rate variability: Impact of wavelet selection. Biomed Signal Process Control 2018. [DOI: 10.1016/j.bspc.2017.09.027] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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17
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The Role of Sleep in Learning Placebo Effects. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2018; 139:321-355. [DOI: 10.1016/bs.irn.2018.07.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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18
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Fauchon C, Faillenot I, Perrin AM, Borg C, Pichot V, Chouchou F, Garcia-Larrea L, Peyron R. Does an observer's empathy influence my pain? Effect of perceived empathetic or unempathetic support on a pain test. Eur J Neurosci 2017; 46:2629-2637. [DOI: 10.1111/ejn.13701] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Revised: 07/12/2017] [Accepted: 08/01/2017] [Indexed: 01/10/2023]
Affiliation(s)
- C. Fauchon
- Central Integration of Pain (NeuroPain); Inserm U1028, UCB Lyon1, UJM; Saint-Etienne France
| | - I. Faillenot
- Central Integration of Pain (NeuroPain); Inserm U1028, UCB Lyon1, UJM; Saint-Etienne France
- Department of Neurology & Pain Center; CHU de Saint-Etienne; Saint-Etienne France
| | - A. M. Perrin
- Department of Neurology & Pain Center; CHU de Saint-Etienne; Saint-Etienne France
- Laboratory EMC (EA3082); University Lyon 2; Lyon-Bron France
| | - C. Borg
- Department of Neurology & Pain Center; CHU de Saint-Etienne; Saint-Etienne France
- Laboratory EMC (EA3082); University Lyon 2; Lyon-Bron France
| | - V. Pichot
- Department of Clinical and Exercise Physiology; EA SNA-EPIS; CHU de Saint-Etienne; Saint-Etienne France
| | - F. Chouchou
- Central Integration of Pain (NeuroPain); Inserm U1028, UCB Lyon1, UJM; Saint-Etienne France
| | - L. Garcia-Larrea
- Central Integration of Pain (NeuroPain); Inserm U1028, UCB Lyon1, UJM; Saint-Etienne France
| | - R. Peyron
- Central Integration of Pain (NeuroPain); Inserm U1028, UCB Lyon1, UJM; Saint-Etienne France
- Department of Neurology & Pain Center; CHU de Saint-Etienne; Saint-Etienne France
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19
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Chouchou F, Bouet R, Pichot V, Catenoix H, Mauguière F, Jung J. The neural bases of ictal tachycardia in temporal lobe seizures. Clin Neurophysiol 2017; 128:1810-1819. [PMID: 28709879 DOI: 10.1016/j.clinph.2017.06.033] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Revised: 05/03/2017] [Accepted: 06/02/2017] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Due to limited information from scalp electroencephalographic (EEG) recordings, brain areas driving changes in cardiac rhythm during Temporal lobe (TL) seizures are not clearly identified. Using stereotactic EEG (SEEG) recordings, we aimed at identifying which of the brain regions involved in autonomic control trigger ictal tachycardia. METHODS The neural activity of several mesial temporal lobe structures including amygdala, hippocampus, insula, and lateral temporal lobe recorded with SEEG were collected during 37 TL seizures in 9 patients, using indices based on High Frequency Activity (HFA). R-R intervals (RR) monitoring and time-frequency spectral analysis were performed to assess parasympathetic (High frequency power (HF)) and sympathetic (Low frequency/High frequency (LF/HF) ratio) reactivities. RESULTS Tachycardia was associated with a significant increase in LF/HF ratio and decrease in HF. Autonomic cardiac changes were accompanied by simultaneous SEEG signal changes with an increase in seizure-related HFA in anterior hippocampal formation and amygdala, but not in insula. CONCLUSION In our sample, TL seizures are thus accompanied by an early decrease in parasympathetic control of cardiac rhythm and by an increase of sympathetic tone, concomitant to seizure activity in anterior hippocampus and amygdala. SIGNIFICANCE These results support a pivotal role of hippocampus and amygdala in tachycardia occurring during TL seizures.
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Affiliation(s)
- Florian Chouchou
- NeuroPain Lab, Lyon Neuroscience Research Center - Inserm U 1028/CNRS UMR 5292, University of Lyon, France.
| | - Romain Bouet
- Dycog Lab, Lyon Neuroscience Research Center - Inserm U 1028/CNRS UMR 5292, University of Lyon, France
| | - Vincent Pichot
- Clinical Physiology Department, CHU Nord, Saint-Etienne, France; EA 4607 SNA-EPIS Lab, University of Jean Monnet, University of Lyon, Saint-Etienne, France
| | - Hélène Catenoix
- Epilepsy and Functional Neurology Department, Neurological Hospital Pierre Wertheimer, Hospices Civils de Lyon, Bron, France
| | - François Mauguière
- NeuroPain Lab, Lyon Neuroscience Research Center - Inserm U 1028/CNRS UMR 5292, University of Lyon, France; Epilepsy and Functional Neurology Department, Neurological Hospital Pierre Wertheimer, Hospices Civils de Lyon, Bron, France; Claude Bernard Lyon 1 University, Lyon, France
| | - Julien Jung
- Dycog Lab, Lyon Neuroscience Research Center - Inserm U 1028/CNRS UMR 5292, University of Lyon, France; Epilepsy and Functional Neurology Department, Neurological Hospital Pierre Wertheimer, Hospices Civils de Lyon, Bron, France
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20
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Pain, opioids, and sleep: implications for restless legs syndrome treatment. Sleep Med 2017; 31:78-85. [DOI: 10.1016/j.sleep.2016.09.017] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Revised: 09/27/2016] [Accepted: 09/29/2016] [Indexed: 12/31/2022]
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21
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Pichot V, Roche F, Celle S, Barthélémy JC, Chouchou F. HRVanalysis: A Free Software for Analyzing Cardiac Autonomic Activity. Front Physiol 2016; 7:557. [PMID: 27920726 PMCID: PMC5118625 DOI: 10.3389/fphys.2016.00557] [Citation(s) in RCA: 83] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Accepted: 11/04/2016] [Indexed: 11/13/2022] Open
Abstract
Since the pioneering studies of the 1960s, heart rate variability (HRV) has become an increasingly used non-invasive tool for examining cardiac autonomic functions and dysfunctions in various populations and conditions. Many calculation methods have been developed to address these issues, each with their strengths and weaknesses. Although, its interpretation may remain difficult, this technique provides, from a non-invasive approach, reliable physiological information that was previously inaccessible, in many fields including death and health prediction, training and overtraining, cardiac and respiratory rehabilitation, sleep-disordered breathing, large cohort follow-ups, children's autonomic status, anesthesia, or neurophysiological studies. In this context, we developed HRVanalysis, a software to analyse HRV, used and improved for over 20 years and, thus, designed to meet laboratory requirements. The main strength of HRVanalysis is its wide application scope. In addition to standard analysis over short and long periods of RR intervals, the software allows time-frequency analysis using wavelet transform as well as analysis of autonomic nervous system status on surrounding scored events and on preselected labeled areas. Moreover, the interface is designed for easy study of large cohorts, including batch mode signal processing to avoid running repetitive operations. Results are displayed as figures or saved in TXT files directly employable in statistical softwares. Recordings can arise from RR or EKG files of different types such as cardiofrequencemeters, holters EKG, polygraphs, and data acquisition systems. HRVanalysis can be downloaded freely from the Web page at: https://anslabtools.univ-st-etienne.frHRVanalysis is meticulously maintained and developed for in-house laboratory use. In this article, after a brief description of the context, we present an overall view of HRV analysis and we describe the methodological approach of the different techniques provided by the software.
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Affiliation(s)
- Vincent Pichot
- EA SNA-EPIS 4607, Department of Clinical and Exercise Physiology, University of Lyon, Jean Monnet University Saint-Etienne, France
| | - Frédéric Roche
- EA SNA-EPIS 4607, Department of Clinical and Exercise Physiology, University of Lyon, Jean Monnet University Saint-Etienne, France
| | - Sébastien Celle
- EA SNA-EPIS 4607, Department of Clinical and Exercise Physiology, University of Lyon, Jean Monnet University Saint-Etienne, France
| | - Jean-Claude Barthélémy
- EA SNA-EPIS 4607, Department of Clinical and Exercise Physiology, University of Lyon, Jean Monnet University Saint-Etienne, France
| | - Florian Chouchou
- NeuroPain Unit, Lyon Neuroscience Research Centre, Institut National de la Santé et de la Recherche Médicale U 1028/Centre National de la Recherche Scientifique UMR 5292, University of Lyon Lyon, France
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22
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23
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Peter-Derex L, Magnin M, Bastuji H. Heterogeneity of arousals in human sleep: A stereo-electroencephalographic study. Neuroimage 2015. [DOI: 10.1016/j.neuroimage.2015.07.057] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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24
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Claude L, Chouchou F, Prados G, Castro M, De Blay B, Perchet C, García-Larrea L, Mazza S, Bastuji H. Sleep spindles and human cortical nociception: a surface and intracerebral electrophysiological study. J Physiol 2015; 593:4995-5008. [PMID: 26377229 DOI: 10.1113/jp270941] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2015] [Accepted: 08/23/2015] [Indexed: 01/05/2023] Open
Abstract
KEY POINTS Sleep spindle are usually considered to play a major role in inhibiting sensory inputs. Using nociceptive stimuli in humans, we tested the effect of spindles on behavioural, autonomic and cortical responses in two experiments using surface and intracerebral electroencephalographic recordings. We found that sleep spindles do not prevent arousal reactions to nociceptive stimuli and that autonomic reactivity to nociceptive inputs is not modulated by spindle activity. Moreover, neither the surface sensory, nor the insular evoked responses were modulated by the spindle, as detected at the surface or within the thalamus. The present study comprises the first investigation of the effect of spindles on nociceptive information processing and the results obtained challenge the classical inhibitory effect of spindles. ABSTRACT Responsiveness to environmental stimuli declines during sleep, and sleep spindles are often considered to play a major role in inhibiting sensory inputs. In the present study, we tested the effect of spindles on behavioural, autonomic and cortical responses to pain, in two experiments assessing surface and intracerebral responses to thermo-nociceptive laser stimuli during the all-night N2 sleep stage. The percentage of arousals remained unchanged as a result of the presence of spindles. Neither cortical nociceptive responses, nor autonomic cardiovascular reactivity were depressed when elicited within a spindle. These results could be replicated in human intracerebral recordings, where sleep spindle activity in the posterior thalamus failed to depress the thalamocortical nociceptive transmission, as measured by sensory responses within the posterior insula. Hence, the assumed inhibitory effect of spindles on sensory inputs may not apply to the nociceptive system, possibly as a result of the specificity of spinothalamic pathways and the crucial role of nociceptive information for homeostasis. Intriguingly, a late scalp response commonly considered to reflect high-order stimulus processing (the 'P3' potential) was significantly enhanced during spindling, suggesting a possible spindle-driven facilitation, rather than attenuation, of cortical nociception.
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Affiliation(s)
- Léa Claude
- Central Integration of Pain (NeuroPain) Lab - Neuroscience Research Center, INSERM U1028, CNRS UMR5292, Lyon, France
| | - Florian Chouchou
- Central Integration of Pain (NeuroPain) Lab - Neuroscience Research Center, INSERM U1028, CNRS UMR5292, Lyon, France
| | - Germán Prados
- Central Integration of Pain (NeuroPain) Lab - Neuroscience Research Center, INSERM U1028, CNRS UMR5292, Lyon, France
| | - Maïté Castro
- Central Integration of Pain (NeuroPain) Lab - Neuroscience Research Center, INSERM U1028, CNRS UMR5292, Lyon, France
| | - Barbara De Blay
- Central Integration of Pain (NeuroPain) Lab - Neuroscience Research Center, INSERM U1028, CNRS UMR5292, Lyon, France
| | - Caroline Perchet
- Central Integration of Pain (NeuroPain) Lab - Neuroscience Research Center, INSERM U1028, CNRS UMR5292, Lyon, France
| | - Luis García-Larrea
- Central Integration of Pain (NeuroPain) Lab - Neuroscience Research Center, INSERM U1028, CNRS UMR5292, Lyon, France
| | - Stéphanie Mazza
- Université Lumière Lyon 2, Laboratoire d'Etude des Mécanismes Cognitifs (EMC), Bron, France
| | - Hélène Bastuji
- Central Integration of Pain (NeuroPain) Lab - Neuroscience Research Center, INSERM U1028, CNRS UMR5292, Lyon, France.,Unité d'Hypnologie, Service de Neurologie Fonctionnelle et d'Épileptologie, Hôpital Neurologique, Hospices Civils de Lyon, Bron, France
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25
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Krenk L, Sørensen GL, Kehlet H, Jennum P. Heart rate response during sleep in elderly patients after fast-track hip and knee arthroplasty. Sleep Biol Rhythms 2015. [DOI: 10.1111/sbr.12108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Lene Krenk
- Section of Surgical Pathophysiology; Rigshospitalet; Copenhagen Denmark
- The Lundbeck Centre for fast-track Hip and Knee Arthroplasty; Copenhagen Denmark
| | - Gertrud Laura Sørensen
- The Danish Centre for Sleep Medicine; Department of Clinical Neurophysiology, Glostrup Hospital, and Centre for Healthy Ageing; Faculty of Health; University of Copenhagen; Copenhagen Denmark
| | - Henrik Kehlet
- Section of Surgical Pathophysiology; Rigshospitalet; Copenhagen Denmark
- The Lundbeck Centre for fast-track Hip and Knee Arthroplasty; Copenhagen Denmark
| | - Poul Jennum
- The Danish Centre for Sleep Medicine; Department of Clinical Neurophysiology, Glostrup Hospital, and Centre for Healthy Ageing; Faculty of Health; University of Copenhagen; Copenhagen Denmark
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26
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Pickering ME, Chapurlat R, Kocher L, Peter-Derex L. Sleep Disturbances and Osteoarthritis. Pain Pract 2015; 16:237-44. [PMID: 25639339 DOI: 10.1111/papr.12271] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2014] [Revised: 10/06/2014] [Accepted: 11/02/2014] [Indexed: 02/06/2023]
Abstract
Sleep disturbances are particularly troublesome in patients with painful rheumatic disease. This article reviews the literature specifically published on sleep disturbances in osteoarthritis, a prevalent pathology and leading cause of disability. Several aspects of the relationship between sleep and osteoarthritis are discussed, including epidemiology, pathophysiological hypotheses, and treatment outcomes. Sleep is of central importance in the well-being of patients and should systematically be assessed in patients with osteoarthritis. When needed, a specific treatment of sleep disorders should be associated with an optimal management of pain to achieve synergistic improvements in quality of life. More large-scale studies are needed to identify predictive factors of sleep impairment in osteoarthritis.
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Affiliation(s)
| | - Roland Chapurlat
- Rheumatology Department, Hôpital E Herriot, Lyon, France.,Clinical Research, INSERM UMR 1033, Lyon, France.,University Lyon 1, Lyon, France
| | - Laurence Kocher
- Neurology and Sleep Department, Hôpital Lyon Sud, Lyon, France
| | - Laure Peter-Derex
- University Lyon 1, Lyon, France.,Neurology and Sleep Department, Hôpital Lyon Sud, Lyon, France.,"Neuropain" Team, INSERM U1028/5292, Centre de Recherche en Neurosciences, Lyon, France
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27
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Chouchou F, Desseilles M. Heart rate variability: a tool to explore the sleeping brain? Front Neurosci 2014; 8:402. [PMID: 25565936 PMCID: PMC4263095 DOI: 10.3389/fnins.2014.00402] [Citation(s) in RCA: 95] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2014] [Accepted: 11/19/2014] [Indexed: 12/17/2022] Open
Abstract
Sleep is divided into two main sleep stages: (1) non-rapid eye movement sleep (non-REMS), characterized among others by reduced global brain activity; and (2) rapid eye movement sleep (REMS), characterized by global brain activity similar to that of wakefulness. Results of heart rate variability (HRV) analysis, which is widely used to explore autonomic modulation, have revealed higher parasympathetic tone during normal non-REMS and a shift toward sympathetic predominance during normal REMS. Moreover, HRV analysis combined with brain imaging has identified close connectivity between autonomic cardiac modulation and activity in brain areas such as the amygdala and insular cortex during REMS, but no connectivity between brain and cardiac activity during non-REMS. There is also some evidence for an association between HRV and dream intensity and emotionality. Following some technical considerations, this review addresses how brain activity during sleep contributes to changes in autonomic cardiac activity, organized into three parts: (1) the knowledge on autonomic cardiac control, (2) differences in brain and autonomic activity between non-REMS and REMS, and (3) the potential of HRV analysis to explore the sleeping brain, and the implications for psychiatric disorders.
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Affiliation(s)
- Florian Chouchou
- NeuroPain Unit, Lyon Neuroscience Research Centre, CRNL - INSERM U 1028/CNRS UMR 5292, University of Lyon France ; Department of Psychology, University of Namur Namur, Belgium
| | - Martin Desseilles
- Department of Psychology, University of Namur Namur, Belgium ; Cyclotron Research Centre, University of Liège Liège, Belgium
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28
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Crawford-Achour E, Roche F, Pichot V, Celle S, Barthélémy JC, Chouchou F. Sleep-related autonomic overactivity in a general elderly population and its relationship to cardiovascular regulation. Heart Vessels 2014; 31:46-51. [PMID: 25150588 DOI: 10.1007/s00380-014-0573-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2014] [Accepted: 08/15/2014] [Indexed: 11/25/2022]
Abstract
Alteration in cardiac autonomic activity during sleep is a common feature of sleep disorders. Diurnal sympathetic overactivity is a possible consequence and could contribute to future cardiovascular complications. The aim of this study is to assess the relationship between cardiac autonomic activity during sleep and diurnal autonomic cardiovascular control. In a large cohort (n = 1011) of subjects aged 65 years old (± 0.4) free of cardiac and cerebrovascular events and of sleep-related breathing disorders, we evaluated (cross-sectional study) the prevalence of unexpected alteration in sleep-related autonomic overactivity according to the presence of a cyclical nocturnal heart rate variability [quantified using the relative power spectral density of the very low-frequency band of the heart rate increment (VLFi%) from ECG Holter monitoring]. We tested its relationship with diurnal ambulatory blood pressure and spontaneous baroreflex sensitivity (sBRS). An abnormal cardiac autonomic activity during sleep was retained in 34.4% of this population according to a VLFi% >4. Using multiple logistic regression analysis, the severity of the autonomic alteration was mainly correlated after adjustment with lower sBRS (p = 0.01; OR: 0.94; 95% CI: 0.90-0.98). Diurnal baroreflex control alteration is associated with sleep-related autonomic overactivity elderly. Such alteration may contribute to the increased incidence of cardiovascular complications in sleep disorders.
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Affiliation(s)
- Emilie Crawford-Achour
- Service de Gériatrie et Gérontologie, CHU Saint-Etienne, Université Jean Monnet, Saint-Etienne PRES de Lyon, France
| | - Frédéric Roche
- Faculté de Médecine Jacques Lisfranc, Service de Physiologie et de l'Exercice, EA 4607 SNA EPIS, CHU Nord, Université Jean Monnet, Saint-Etienne PRES de Lyon, France.
- , CHU Nord, Niveau 6, EFCR, 42055, Saint-Etienne Cedex 2, France.
| | - Vincent Pichot
- Faculté de Médecine Jacques Lisfranc, Service de Physiologie et de l'Exercice, EA 4607 SNA EPIS, CHU Nord, Université Jean Monnet, Saint-Etienne PRES de Lyon, France
| | - Sébastien Celle
- Faculté de Médecine Jacques Lisfranc, Service de Physiologie et de l'Exercice, EA 4607 SNA EPIS, CHU Nord, Université Jean Monnet, Saint-Etienne PRES de Lyon, France
| | - Jean-Claude Barthélémy
- Faculté de Médecine Jacques Lisfranc, Service de Physiologie et de l'Exercice, EA 4607 SNA EPIS, CHU Nord, Université Jean Monnet, Saint-Etienne PRES de Lyon, France
| | - Florian Chouchou
- Faculté de Médecine Jacques Lisfranc, Service de Physiologie et de l'Exercice, EA 4607 SNA EPIS, CHU Nord, Université Jean Monnet, Saint-Etienne PRES de Lyon, France
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Chouchou F, Khoury S, Chauny JM, Denis R, Lavigne GJ. Postoperative sleep disruptions: A potential catalyst of acute pain? Sleep Med Rev 2014; 18:273-82. [DOI: 10.1016/j.smrv.2013.07.002] [Citation(s) in RCA: 65] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2013] [Revised: 07/08/2013] [Accepted: 07/09/2013] [Indexed: 12/29/2022]
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Abstract
The relationship between sleep and migraine headaches is complex. Changes in sleep patterns can trigger migraine attacks, and sleep disorders may be associated with increased migraine frequency. Furthermore, migraine patients and their doctors very consistently report that sleep relieves already established migraine attacks. Herein we will try to answer the question, "Why does sleep stop migraine?" Since evidence for this relationship is largely based on empirical clinical observation, we will not provide a clinical review of the association. Instead, we will focus on the pathophysiology of migraine attacks and its intersections with sleep biology.
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Chouchou F, Pichot V, Barthélémy JC, Bastuji H, Roche F. Cardiac sympathetic modulation in response to apneas/hypopneas through heart rate variability analysis. PLoS One 2014; 9:e86434. [PMID: 24466093 PMCID: PMC3899280 DOI: 10.1371/journal.pone.0086434] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2013] [Accepted: 12/12/2013] [Indexed: 11/18/2022] Open
Abstract
Autonomic dysfunction is recognized to contribute to cardiovascular consequences in obstructive sleep apnea/hypopnea syndrome (OSAHS) patients who present predominant cardiovascular sympathetic activity that persists during wakefulness. Here, we examined 1) the factors that influence sympathetic cardiac modulation in response to apneas/hypopneas; and 2) the influence of autonomic activity during apneas/hypopneas on CA. Sixteen OSAHS patients underwent in-hospital polysomnography. RR interval (RR) and RR spectral analysis using wavelet transform were used to study parasympathetic (high frequency power: HF(WV)) and sympathetic (low frequency power: LF(WV) and LF(WV)/HF(WV) ratio) activity before and after apnea/hypopnea termination. Autonomic cardiac modulations were compared according to sleep stage, apnea/hypopnea type and duration, arterial oxygen saturation, and presence of CA. At apnea/hypopnea termination, RR decreased (p<0.001) while LF(WV) (p = 0.001) and LF(WV)/HF(WV) ratio (p = 0.001) increased. Only RR and LF(WV)/HF(WV) ratio changes were higher when apneas/hypopneas produced CA (p = 0.030 and p = 0.035, respectively) or deep hypoxia (p = 0.023 and p = 0.046, respectively). Multivariate statistical analysis showed that elevated LF(WV) (p = 0.006) and LF(WV)/HF(WV) ratio (p = 0.029) during apneas/hypopneas were independently related to higher CA occurrence. Both the arousal and hypoxia processes may contribute to sympathetic cardiovascular overactivity by recurrent cardiac sympathetic modulation in response to apneas/hypopneas. Sympathetic overactivity also may play an important role in the acute central response to apneas/hypopneas, and in the sleep fragmentation.
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Affiliation(s)
- Florian Chouchou
- Service de Physiologie Clinique, Pole NOL, CHU Nord, Saint-Etienne, France
- EA 4607 SNA-EPIS, Université Jean Monnet, PRES de Lyon, Saint-Etienne, France
- * E-mail:
| | - Vincent Pichot
- Service de Physiologie Clinique, Pole NOL, CHU Nord, Saint-Etienne, France
- EA 4607 SNA-EPIS, Université Jean Monnet, PRES de Lyon, Saint-Etienne, France
| | | | - Hélène Bastuji
- Unité NeuroPain, Centre de recherche en Neurosciences de Lyon, INSERM U1028 CNRS UMR5292, Lyon, France
| | - Frédéric Roche
- Service de Physiologie Clinique, Pole NOL, CHU Nord, Saint-Etienne, France
- EA 4607 SNA-EPIS, Université Jean Monnet, PRES de Lyon, Saint-Etienne, France
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Erratum to: Why does Sleep Stop Migraine? Curr Pain Headache Rep 2014. [DOI: 10.1007/s11916-013-0390-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Hallman DM, Ekman AH, Lyskov E. Changes in physical activity and heart rate variability in chronic neck–shoulder pain: monitoring during work and leisure time. Int Arch Occup Environ Health 2013; 87:735-44. [DOI: 10.1007/s00420-013-0917-2] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2013] [Accepted: 10/15/2013] [Indexed: 11/24/2022]
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Koenig J, Jarczok M, Ellis R, Hillecke T, Thayer J. Heart rate variability and experimentally induced pain in healthy adults: A systematic review. Eur J Pain 2013; 18:301-14. [DOI: 10.1002/j.1532-2149.2013.00379.x] [Citation(s) in RCA: 124] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/20/2013] [Indexed: 12/30/2022]
Affiliation(s)
- J. Koenig
- School of Therapeutic Sciences; SRH University; Heidelberg Germany
| | - M.N. Jarczok
- Mannheim Institute of Public Health; Social and Preventive Medicine; Mannheim Medical Faculty; Heidelberg University; Mannheim Germany
| | - R.J. Ellis
- Department of Neurology; Beth Israel Deaconess Medical Center and Harvard Medical School; Boston USA
| | - T.K. Hillecke
- School of Therapeutic Sciences; SRH University; Heidelberg Germany
| | - J.F. Thayer
- Department of Psychology; The Ohio State University; Columbus USA
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Abstract
Painful diabetic polyneuropathy (PDPN) is generally considered a variant of diabetic polyneuropathy (DPN) but the identification of distinctive aspects that characterize painful compared with painless DPN has however been addressed in many studies, mainly with the purpose of better understanding the mechanisms of neuropathic pain in the scenario of peripheral nerve damage of DPN, of determining risk markers for pain development, and also of recognizing who might respond to treatments. This review is aimed at examining available literature dealing with the issue of similarities and differences between painful and painless DPN in an attempt to respond to the question of whether painful and painless DPN are the same disease or not and to address the conundrum of why some people develop the insensate variety of DPN whilst others experience distressing pain. Thus, from the perspective of comparing painful with painless forms of DPN, this review considers the clinical correlates of PDPN, its distinctive framework of symptoms, signs, and nerve functional and structural abnormalities, the question of large and small fiber involvement, the peripheral pain mechanisms, the central processing of pain and some new insights into the pathogenesis of pain in peripheral polyneuropathies and PDPN.
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Affiliation(s)
- Vincenza Spallone
- Endocrinology, Department of Systems Medicine, University of Tor Vergata, Via Montpellier 1, 00133, Rome, Italy.
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Chouchou F, Pichot V, Pépin J, Tamisier R, Celle S, Maudoux D, Garcin A, Lévy P, Barthélémy J, Roche F. Sympathetic overactivity due to sleep fragmentation is associated with elevated diurnal systolic blood pressure in healthy elderly subjects: the PROOF-SYNAPSE study. Eur Heart J 2013; 34:2122-31, 2131a. [DOI: 10.1093/eurheartj/eht208] [Citation(s) in RCA: 87] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
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Mazza S, Magnin M, Bastuji H. Pain and sleep: From reaction to action. Neurophysiol Clin 2012; 42:337-44. [DOI: 10.1016/j.neucli.2012.05.003] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2011] [Revised: 05/29/2012] [Accepted: 05/31/2012] [Indexed: 12/19/2022] Open
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Physiologic autonomic arousal heralds motor manifestations of seizures in nocturnal frontal lobe epilepsy: Implications for pathophysiology. Sleep Med 2012; 13:252-62. [DOI: 10.1016/j.sleep.2011.11.007] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2011] [Revised: 10/25/2011] [Accepted: 11/11/2011] [Indexed: 11/23/2022]
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Bastuji H, Mazza S, Perchet C, Frot M, Mauguière F, Magnin M, Garcia-Larrea L. Filtering the reality: functional dissociation of lateral and medial pain systems during sleep in humans. Hum Brain Mapp 2011; 33:2638-49. [PMID: 21922606 DOI: 10.1002/hbm.21390] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2011] [Revised: 05/17/2011] [Accepted: 05/31/2011] [Indexed: 11/11/2022] Open
Abstract
Behavioral reactions to sensory stimuli during sleep are scarce despite preservation of sizeable cortical responses. To further understand such dissociation, we recorded intracortical field potentials to painful laser pulses in humans during waking and all-night sleep. Recordings were obtained from the three cortical structures receiving 95% of the spinothalamic cortical input in primates, namely the parietal operculum, posterior insula, and mid-anterior cingulate cortex. The dynamics of responses during sleep differed among cortical sites. In sleep Stage 2, evoked potential amplitudes were similarly attenuated relative to waking in all three cortical regions. During paradoxical, or rapid eye movements (REM), sleep, opercular and insular potentials remained stable in comparison with Stage 2, whereas the responses from mid-anterior cingulate abated drastically, and decreasing below background noise in half of the subjects. Thus, while the lateral operculo-insular system subserving sensory analysis of somatic stimuli remained active during paradoxical-REM sleep, mid-anterior cingulate processes related to orienting and avoidance behavior were suppressed. Dissociation between sensory and orienting-motor networks might explain why nociceptive stimuli can be either neglected or incorporated into dreams without awakening the subject.
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Affiliation(s)
- Hélène Bastuji
- Central Integration of Pain Lab-Lyon Neuroscience Research Center, INSERM, U1028, CNRS, UMR5292, Bron, F-69677, France.
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