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Quigley KS, Gianaros PJ, Norman GJ, Jennings JR, Berntson GG, de Geus EJC. Publication guidelines for human heart rate and heart rate variability studies in psychophysiology-Part 1: Physiological underpinnings and foundations of measurement. Psychophysiology 2024:e14604. [PMID: 38873876 DOI: 10.1111/psyp.14604] [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: 05/11/2022] [Revised: 12/22/2023] [Accepted: 04/04/2024] [Indexed: 06/15/2024]
Abstract
This Committee Report provides methodological, interpretive, and reporting guidance for researchers who use measures of heart rate (HR) and heart rate variability (HRV) in psychophysiological research. We provide brief summaries of best practices in measuring HR and HRV via electrocardiographic and photoplethysmographic signals in laboratory, field (ambulatory), and brain-imaging contexts to address research questions incorporating measures of HR and HRV. The Report emphasizes evidence for the strengths and weaknesses of different recording and derivation methods for measures of HR and HRV. Along with this guidance, the Report reviews what is known about the origin of the heartbeat and its neural control, including factors that produce and influence HRV metrics. The Report concludes with checklists to guide authors in study design and analysis considerations, as well as guidance on the reporting of key methodological details and characteristics of the samples under study. It is expected that rigorous and transparent recording and reporting of HR and HRV measures will strengthen inferences across the many applications of these metrics in psychophysiology. The prior Committee Reports on HR and HRV are several decades old. Since their appearance, technologies for human cardiac and vascular monitoring in laboratory and daily life (i.e., ambulatory) contexts have greatly expanded. This Committee Report was prepared for the Society for Psychophysiological Research to provide updated methodological and interpretive guidance, as well as to summarize best practices for reporting HR and HRV studies in humans.
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Affiliation(s)
- Karen S Quigley
- Department of Psychology, Northeastern University, Boston, Massachusetts, USA
| | - Peter J Gianaros
- Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Greg J Norman
- Department of Psychology, The University of Chicago, Chicago, Illinois, USA
| | - J Richard Jennings
- Department of Psychiatry & Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Gary G Berntson
- Department of Psychology & Psychiatry, The Ohio State University, Columbus, Ohio, USA
| | - Eco J C de Geus
- Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
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2
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Mather M. The emotion paradox in the aging body and brain. Ann N Y Acad Sci 2024; 1536:13-41. [PMID: 38676452 DOI: 10.1111/nyas.15138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2024]
Abstract
With age, parasympathetic activity decreases, while sympathetic activity increases. Thus, the typical older adult has low heart rate variability (HRV) and high noradrenaline levels. Younger adults with this physiological profile tend to be unhappy and stressed. Yet, with age, emotional experience tends to improve. Why does older adults' emotional well-being not suffer as their HRV decreases? To address this apparent paradox, I present the autonomic compensation model. In this model, failing organs, the initial phases of Alzheimer's pathology, and other age-related diseases trigger noradrenergic hyperactivity. To compensate, older brains increase autonomic regulatory activity in the pregenual prefrontal cortex (PFC). Age-related declines in nerve conduction reduce the ability of the pregenual PFC to reduce hyperactive noradrenergic activity and increase peripheral HRV. But these pregenual PFC autonomic compensation efforts have a significant impact in the brain, where they bias processing in favor of stimuli that tend to increase parasympathetic activity (e.g., stimuli that increase feelings of safety) and against stimuli that tend to increase sympathetic activity (e.g., threatening stimuli). In summary, the autonomic compensation model posits that age-related chronic sympathetic/noradrenergic hyperactivity stimulates regulatory attempts that have the side effect of enhancing emotional well-being.
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Affiliation(s)
- Mara Mather
- Leonard Davis School of Gerontology, Department of Psychology, and Department of Biomedical Engineering, University of Southern California, Los Angeles, California, USA
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Plappert F, Engström G, Platonov PG, Wallman M, Sandberg F. ECG-based estimation of respiration-induced autonomic modulation of AV nodal conduction during atrial fibrillation. Front Physiol 2024; 15:1281343. [PMID: 38779321 PMCID: PMC11110927 DOI: 10.3389/fphys.2024.1281343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 04/08/2024] [Indexed: 05/25/2024] Open
Abstract
Introduction: Information about autonomic nervous system (ANS) activity may offer insights about atrial fibrillation (AF) progression and support personalized AF treatment but is not easily accessible from the ECG. In this study, we propose a new approach for ECG-based assessment of respiratory modulation in atrioventricular (AV) nodal refractory period and conduction delay. Methods: A 1-dimensional convolutional neural network (1D-CNN) was trained to estimate respiratory modulation of AV nodal conduction properties from 1-minute segments of RR series, respiration signals, and atrial fibrillatory rates (AFR) using synthetic data that replicates clinical ECG-derived data. The synthetic data were generated using a network model of the AV node and 4 million unique model parameter sets. The 1D-CNN was then used to analyze respiratory modulation in clinical deep breathing test data of 28 patients in AF, where an ECG-derived respiration signal was extracted using a novel approach based on periodic component analysis. Results: We demonstrated using synthetic data that the 1D-CNN can estimate the respiratory modulation from RR series alone with a Pearson sample correlation of r = 0.805 and that the addition of either respiration signal (r = 0.830), AFR (r = 0.837), or both (r = 0.855) improves the estimation. Discussion: Initial results from analysis of ECG data suggest that our proposed estimate of respiration-induced autonomic modulation, a resp, is reproducible and sufficiently sensitive to monitor changes and detect individual differences. However, further studies are needed to verify the reproducibility, sensitivity, and clinical significance of a resp.
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Affiliation(s)
- Felix Plappert
- Department of Biomedical Engineering, Lund University, Lund, Sweden
| | - Gunnar Engström
- Department of Clinical Sciences, Cardiovascular Research–Epidemiology, Malmö, Sweden
| | - Pyotr G. Platonov
- Department of Cardiology, Clinical Sciences, Lund University, Lund, Sweden
| | - Mikael Wallman
- Fraunhofer-Chalmers Centre, Department of Systems and Data Analysis, Gothenburg, Sweden
| | - Frida Sandberg
- Department of Biomedical Engineering, Lund University, Lund, Sweden
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Thompson N, Ravagli E, Mastitskaya S, Challita R, Hadaya J, Iacoviello F, Shah Idil A, Shearing PR, Ajijola OA, Ardell JL, Shivkumar K, Holder D, Aristovich K. Anatomical and functional organization of cardiac fibers in the porcine cervical vagus nerve allows spatially selective efferent neuromodulation. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.01.09.574861. [PMID: 38260584 PMCID: PMC10802425 DOI: 10.1101/2024.01.09.574861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/24/2024]
Abstract
Cardiac disease progression reflects the dynamic interaction between adversely remodeled neurohumoral control systems and an abnormal cardiac substrate. Vagal nerve stimulation (VNS) is an attractive neuromodulatory option to dampen this dynamic interaction; however, it is limited by off-target effects. Spatially-selective VNS (sVNS) offers a promising solution to induce cardioprotection while mitigating off-target effects by specifically targeting pre-ganglionic parasympathetic efferent cardiac fibers. This approach also has the potential to enhance therapeutic outcomes by eliminating time-consuming titration required for optimal VNS. Recent studies have demonstrated the independent modulation of breathing rate, heart rate, and laryngeal contraction through sVNS. However, the spatial organization of afferent and efferent cardiac-related fibers within the vagus nerve remains unexplored. By using trial-and-error sVNS in vivo in combination with ex vivo micro-computed tomography fascicle tracing, we show the significant spatial separation of cardiac afferent and efferent fibers (179±55° SD microCT, p<0.05 and 200±137° SD, p<0.05 sVNS - degrees of separation across a cross-section of nerve) at the mid-cervical level. We also show that cardiac afferent fibers are located in proximity to pulmonary fibers consistent with recent findings of cardiopulmonary convergent neurons and circuits. We demonstrate the ability of sVNS to selectively elicit desired scalable heart rate decrease without stimulating afferent-related reflexes. By elucidating the spatial organization of cardiac-related fibers within the vagus nerve, our findings pave the way for more targeted neuromodulation, thereby reducing off-target effects and eliminating the need for titration. This, in turn, will enhance the precision and efficacy of VNS therapy in treating cardiac pathology, allowing for improved therapeutic efficacy.
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Affiliation(s)
- Nicole Thompson
- EIT and Neurophysiology Research Group, Department of Medical Physics and Biomedical Engineering, University College London, London, United Kingdom
| | - Enrico Ravagli
- EIT and Neurophysiology Research Group, Department of Medical Physics and Biomedical Engineering, University College London, London, United Kingdom
| | - Svetlana Mastitskaya
- EIT and Neurophysiology Research Group, Department of Medical Physics and Biomedical Engineering, University College London, London, United Kingdom
| | - Ronald Challita
- UCLA Cardiac Arrhythmia Center and Neurocardiology Research Program of Excellence, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Joseph Hadaya
- UCLA Cardiac Arrhythmia Center and Neurocardiology Research Program of Excellence, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Francesco Iacoviello
- Electrochemical Innovation Lab, Department of Chemical Engineering, University College London, London, United Kingdom
| | - Ahmad Shah Idil
- EIT and Neurophysiology Research Group, Department of Medical Physics and Biomedical Engineering, University College London, London, United Kingdom
| | - Paul R. Shearing
- Electrochemical Innovation Lab, Department of Chemical Engineering, University College London, London, United Kingdom
| | - Olujimi A. Ajijola
- UCLA Cardiac Arrhythmia Center and Neurocardiology Research Program of Excellence, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Jeffrey L. Ardell
- UCLA Cardiac Arrhythmia Center and Neurocardiology Research Program of Excellence, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Kalyanam Shivkumar
- UCLA Cardiac Arrhythmia Center and Neurocardiology Research Program of Excellence, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - David Holder
- EIT and Neurophysiology Research Group, Department of Medical Physics and Biomedical Engineering, University College London, London, United Kingdom
| | - Kirill Aristovich
- EIT and Neurophysiology Research Group, Department of Medical Physics and Biomedical Engineering, University College London, London, United Kingdom
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Lim J, Zoss PA, Powley TL, Lee H, Ward MP. A flexible, thin-film microchannel electrode array device for selective subdiaphragmatic vagus nerve recording. MICROSYSTEMS & NANOENGINEERING 2024; 10:16. [PMID: 38264708 PMCID: PMC10803373 DOI: 10.1038/s41378-023-00637-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 10/18/2023] [Accepted: 11/17/2023] [Indexed: 01/25/2024]
Abstract
The vagus nerve (VN) plays an important role in regulating physiological conditions in the gastrointestinal (GI) tract by communicating via the parasympathetic pathway to the enteric nervous system (ENS). However, the lack of knowledge in the neurophysiology of the VN and GI tract limits the development of advanced treatments for autonomic dysfunctions related to the VN. To better understand the complicated underlying mechanisms of the VN-GI tract neurophysiology, it is necessary to use an advanced device enabled by microfabrication technologies. Among several candidates including intraneural probe array and extraneural cuff electrodes, microchannel electrode array devices can be used to interface with smaller numbers of nerve fibers by securing them in the separate channel structures. Previous microchannel electrode array devices to interface teased nerve structures are relatively bulky with thickness around 200 µm. The thick design can potentially harm the delicate tissue structures, including the nerve itself. In this paper, we present a flexible thin film based microchannel electrode array device (thickness: 11.5 µm) that can interface with one of the subdiaphragmatic nerve branches of the VN in a rat. We demonstrated recording evoked compound action potentials (ECAP) from a transected nerve ending that has multiple nerve fibers. Moreover, our analysis confirmed that the signals are from C-fibers that are critical in regulating autonomic neurophysiology in the GI tract.
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Affiliation(s)
- Jongcheon Lim
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN USA
- Birck Nanotechnology Center, Purdue University, West Lafayette, IN USA
- Center for Implantable Devices, Purdue University, West Lafayette, IN USA
| | - Peter A. Zoss
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN USA
| | - Terry L. Powley
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN USA
- Department of Psychological Sciences, Purdue University, West Lafayette, IN USA
- Purdue Institute of Integrative Neuroscience, Purdue University, West Lafayette, IN USA
| | - Hyowon Lee
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN USA
- Birck Nanotechnology Center, Purdue University, West Lafayette, IN USA
- Center for Implantable Devices, Purdue University, West Lafayette, IN USA
| | - Matthew P. Ward
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN USA
- Indiana University School of Medicine, Indianapolis, IN USA
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Vallone F, Dushpanova A, Leali M, Strauss I, Agnesi F, Zinno C, Casieri V, Carrozzo A, Bernini F, Terlizzi D, Carpaneto J, Micera S, Lionetti V. Left cardiac vagotomy rapidly reduces contralateral cardiac vagal electrical activity in anesthetized Göttingen minipigs. Int J Cardiol 2024; 394:131349. [PMID: 37689397 DOI: 10.1016/j.ijcard.2023.131349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 08/14/2023] [Accepted: 09/05/2023] [Indexed: 09/11/2023]
Abstract
BACKGROUND The impact of acute unilateral injury on spontaneous electrical activity in both vagus nerves at the heart level is poorly understood. We investigated the immediate neuroelectrical response after right or left cardiac vagal nerve transection (VNTx) by recording spiking activity of each heart vagus nerve (VN). METHODS Fourteen male Göttingen minipigs underwent sternotomy. Multi-electrode cuffs were implanted below the cut level to record vagal electroneurographic signals during electrocardiographic and hemodynamic monitoring, before and immediately after cardiac VNTx (left: L-cut, n = 6; right: R-cut, n = 8). RESULTS Left cardiac VNTx significantly reduced multi-unit electrical activity (MUA) firing rate in the vagal stump (-30.7% vs pre-cut) and intact right VN (-21.8% vs pre-cut) at the heart level, without affecting heart rate, heart rate variability, or hemodynamics. In contrast, right cardiac VNTx did not acutely alter MUA in either VN but slightly increased (p < 0.022) the root mean square of successive RR interval differences (rMSSD), an index of parasympathetic outflow, without affecting hemodynamics. CONCLUSIONS Our study reveals an early left-lateralized pattern in vagal spiking activity following unilateral cardiac vagotomy. These findings enhance understanding of the neuroelectrical response to vagal injury and provide insights into preserving vagal outflow after unilateral cardiac vagotomy. Importantly, monitoring spiking activity of the cardiac right VN may predict onset of left vagal pathway injury, which is detrimental to cardiac patients and can occur as a complication of catheter ablation for atrial fibrillation.
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Affiliation(s)
- Fabio Vallone
- BioRobotics Institute, Department of Excellence in Robotics & AI, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Anar Dushpanova
- Unit of Translational Critical Care Medicine, Laboratory of Basic and Applied Medical Sciences, Interdisciplinary Research Center "Health Science," Scuola Superiore Sant'Anna, Pisa, Italy; Al-Farabi Kazakh National University, Almaty, Kazakhstan
| | - Marco Leali
- Unit of Translational Critical Care Medicine, Laboratory of Basic and Applied Medical Sciences, Interdisciplinary Research Center "Health Science," Scuola Superiore Sant'Anna, Pisa, Italy
| | - Ivo Strauss
- Institut für Mikrosystemtechnik, University of Freiburg, IMTEK, Freiburg, Germany
| | - Filippo Agnesi
- BioRobotics Institute, Department of Excellence in Robotics & AI, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Ciro Zinno
- BioRobotics Institute, Department of Excellence in Robotics & AI, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Valentina Casieri
- Unit of Translational Critical Care Medicine, Laboratory of Basic and Applied Medical Sciences, Interdisciplinary Research Center "Health Science," Scuola Superiore Sant'Anna, Pisa, Italy
| | - Alessandro Carrozzo
- Unit of Translational Critical Care Medicine, Laboratory of Basic and Applied Medical Sciences, Interdisciplinary Research Center "Health Science," Scuola Superiore Sant'Anna, Pisa, Italy; Department of Cardiac Surgery, ICLAS, GVM Care & Research, Rapallo, Italy
| | | | | | - Jacopo Carpaneto
- BioRobotics Institute, Department of Excellence in Robotics & AI, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Silvestro Micera
- BioRobotics Institute, Department of Excellence in Robotics & AI, Scuola Superiore Sant'Anna, Pisa, Italy; Bertarelli Foundation Chair in Translational NeuroEngineering, Centre for Neuroprosthetics and Institute of Bioengineering, École Polytechnique Fédérale de Lausanne, Lausanne, Switzerland.
| | - Vincenzo Lionetti
- Unit of Translational Critical Care Medicine, Laboratory of Basic and Applied Medical Sciences, Interdisciplinary Research Center "Health Science," Scuola Superiore Sant'Anna, Pisa, Italy; BioMedLab, Scuola Superiore Sant'Anna, Pisa, Italy; Fondazione Toscana "G. Monasterio", Pisa, Italy.
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Güemes Gonzalez A, Carnicer-Lombarte A, Hilton S, Malliaras G. A multivariate physiological model of vagus nerve signalling during metabolic challenges in anaesthetised rats for diabetes treatment. J Neural Eng 2023; 20:056033. [PMID: 37757803 DOI: 10.1088/1741-2552/acfdcd] [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: 04/05/2023] [Accepted: 09/27/2023] [Indexed: 09/29/2023]
Abstract
Objective.This study aims to develop a comprehensive decoding framework to create a multivariate physiological model of vagus nerve transmission that reveals the complex interactions between the nervous and metabolic systems.Approach.Vagus nerve activity was recorded in female Sprague-Dawley rats using gold hook microwires implanted around the left cervical vagus nerve. The rats were divided into three experimental cohorts (intact nerve, ligation nerve for recording afferent activation, and ligation for recording efferent activation) and metabolic challenges were administered to change glucose levels while recording the nerve activity. The decoding methodology involved various techniques, including continuous wavelet transformation, extraction of breathing rate (BR), and correlation of neural metrics with physiological signals.Main results.Decrease in glucose level was consistently negatively correlated with an increase in the firing activity of the intact vagus nerve that was found to be conveyed by both afferent and efferent pathways, with the afferent response being more similar to the one on the intact nerve. A larger variability was observed in the sensory and motor responses to hyperglycaemia. A novel strategy to extract the BR over time based on inter-burst-interval is also presented. The vagus afferent was found to encode breathing information through amplitude and firing rate modulation. Modulations of the signal amplitude were also observed due to changes in heart rate in the intact and efferent recordings, highlighting the parasympathetic control of the heart.Significance.The analytical framework presented in this study provides an integrative understanding that considers the relationship between metabolic, cardiac, and breathing signals and contributes to the development of a multivariable physiological model for the transmission of vagus nerve signals. This work progresses toward the development of closed-loop neuro-metabolic therapeutic systems for diabetes.
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Affiliation(s)
- Amparo Güemes Gonzalez
- Electrical Engineering Division, Department of Engineering, University of Cambridge, Cambridge, CB3 0FA, United Kingdom
| | - Alejandro Carnicer-Lombarte
- Electrical Engineering Division, Department of Engineering, University of Cambridge, Cambridge, CB3 0FA, United Kingdom
| | - Sam Hilton
- Electrical Engineering Division, Department of Engineering, University of Cambridge, Cambridge, CB3 0FA, United Kingdom
| | - George Malliaras
- Electrical Engineering Division, Department of Engineering, University of Cambridge, Cambridge, CB3 0FA, United Kingdom
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Hughes GW, Moore JP, Lord RN. Barosensory vessel mechanics and the vascular sympathetic baroreflex: Impact on blood pressure homeostasis. Exp Physiol 2023; 108:1245-1249. [PMID: 37031381 PMCID: PMC10988470 DOI: 10.1113/ep089686] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 03/09/2023] [Indexed: 04/10/2023]
Abstract
NEW FINDINGS What is the topic of this review? We review barosensory vessel mechanics and their role in blood pressure regulation across the lifespan. What advances does it highlight? In young normotensive men, aortic unloading mechanics contribute to the resting operating point of the vascular sympathetic baroreflex; however, with advancing age, this contribution is removed. This suggests that barosensory vessel unloading mechanics are not driving the well-documented age-related increase in resting muscle sympathetic nerve activity. ABSTRACT An age-associated increase in arterial blood pressure is evident for apparently healthy humans. This is frequently attributed to stiffening of the central arteries and a concurrent increase in sympathetic outflow, potentially mediated by a reduced ability of the baroreceptive vessels to distend. This is supported, in part, by a reduced mechanical component of the vascular sympathetic baroreflex (i.e., a reduction in distension for a given pressure). Previous characterization of the mechanical component has assessed only carotid artery distension; however, evidence suggests that both the aortic and carotid baroreflexes are integral to blood pressure regulation. In addition, given that baroreceptors are located in the vessel wall, the change in wall tension, comprising diameter, pressure and vessel wall thickness, and the mechanics of this change might provide a better index of the baroreceptor stimulus than the previous method used to characterize the mechanical component that relies on diameter alone. This brief review summarizes the data using this new method of assessing barosensory vessel mechanics and their influence on the vascular sympathetic baroreflex across the lifespan.
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Affiliation(s)
- Guto W. Hughes
- School of Human and Behavioural SciencesBangor UniversityBangorUK
| | | | - Rachel N. Lord
- Centre for Activity, Health and Wellbeing ResearchCardiff Metropolitan UniversityCardiffUK
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Shanks J, Pachen M, Chang JWH, George B, Ramchandra R. Cardiac Vagal Nerve Activity Increases During Exercise to Enhance Coronary Blood Flow. Circ Res 2023; 133:559-571. [PMID: 37641938 DOI: 10.1161/circresaha.123.323017] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 08/17/2023] [Indexed: 08/31/2023]
Abstract
BACKGROUND The phrase complete vagal withdrawal is often used when discussing autonomic control of the heart during exercise. However, more recent studies have challenged this assumption. We hypothesized that cardiac vagal activity increases during exercise and maintains cardiac function via transmitters other than acetylcholine. METHODS Chronic direct recordings of cardiac vagal nerve activity, cardiac output, coronary artery blood flow, and heart rate were recorded in conscious adult sheep during whole-body treadmill exercise. Cardiac innervation of the left cardiac vagal branch was confirmed with lipophilic tracer dyes (DiO). Sheep were exercised with pharmacological blockers of acetylcholine (atropine, 250 mg), VIP (vasoactive intestinal peptide; [4Cl-D-Phe6,Leu17]VIP 25 µg), or saline control, randomized on different days. In a subset of sheep, the left cardiac vagal branch was denervated. RESULTS Neural innervation from the cardiac vagal branch is seen at major cardiac ganglionic plexi, and within the fat pads associated with the coronary arteries. Directly recorded cardiac vagal nerve activity increased during exercise. Left cardiac vagal branch denervation attenuated the maximum changes in coronary artery blood flow (maximum exercise, control: 63.5±5.9 mL/min, n=8; cardiac vagal denervated: 32.7±5.6 mL/min, n=6, P=2.5×10-7), cardiac output, and heart rate during exercise. Atropine did not affect any cardiac parameters during exercise, but VIP antagonism significantly reduced coronary artery blood flow during exercise to a similar level to vagal denervation. CONCLUSIONS Our study demonstrates that cardiac vagal nerve activity actually increases and is crucial for maintaining cardiac function during exercise. Furthermore, our findings show the dynamic modulation of coronary artery blood flow during exercise is mediated by VIP.
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Affiliation(s)
- Julia Shanks
- Manaaki Manawa - The Centre for Heart Research, Department of Physiology, University of Auckland, Grafton, New Zealand
| | - Mridula Pachen
- Manaaki Manawa - The Centre for Heart Research, Department of Physiology, University of Auckland, Grafton, New Zealand
| | - Joshua W-H Chang
- Manaaki Manawa - The Centre for Heart Research, Department of Physiology, University of Auckland, Grafton, New Zealand
| | - Bindu George
- Manaaki Manawa - The Centre for Heart Research, Department of Physiology, University of Auckland, Grafton, New Zealand
| | - Rohit Ramchandra
- Manaaki Manawa - The Centre for Heart Research, Department of Physiology, University of Auckland, Grafton, New Zealand
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Hamaoka T, Leuenberger UA, Kronfli A, Gao Z, Blaha C, Luck JC, Dalton P, Sinoway LI, Cui J. Effect of Cyclooxygenase Inhibition on Peripheral Venous Distension Reflex in Healthy Humans. Hypertension 2023; 80:1102-1109. [PMID: 36942572 PMCID: PMC10133193 DOI: 10.1161/hypertensionaha.122.20506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 03/07/2023] [Indexed: 03/23/2023]
Abstract
BACKGROUND Peripheral venous distension evokes a pressor reflex (venous distension reflex). Afferent group III and IV nerves innervating veins are suggested as the afferent arm of the venous distension reflex. Prostaglandins stimulate/sensitize group III/IV nerves. We hypothesized that inhibition of prostaglandin synthesis by local cyclooxygenase blockade would attenuate the muscle sympathetic nerve activity (MSNA) and blood pressure responses to venous distension. METHODS Nineteen healthy volunteers (age, 27±5 years) participated in the study with 2 visits. To induce venous distension, a volume of solution (saline alone or 9 mg ketorolac tromethamine in saline) was infused into the vein in the antecubital fossa of an arterially occluded forearm. During the procedure, beat-by-beat heart rate, blood pressure and MSNA were recorded simultaneously. The vein size was measured with ultrasound. RESULTS In both visits, the venous distension procedure significantly increased blood pressure, heart rate, and MSNA (all, P<0.05). The increase in mean arterial pressure and MSNA in the ketorolac visit was significantly lower than in the control visit (∆ mean arterial pressure, 7.0±6.2 versus 13.8±7.7 mm Hg; ∆MSNA, 6.0±7.1 versus 14.8±7.7 bursts/min; both, P<0.05). The increase in vein size induced by the infusion was not different between visits. CONCLUSIONS The presented data show that cyclooxygenase blockade attenuates the responses in MSNA and blood pressure to peripheral venous distension reflex. The results suggest that cyclooxygenase products play a key role in evoking afferent activation responsible for the venous distension reflex.
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Affiliation(s)
- Takuto Hamaoka
- Penn State Heart and Vascular Institute, Pennsylvania State University College of Medicine, Hershey, PA 17033
| | - Urs A. Leuenberger
- Penn State Heart and Vascular Institute, Pennsylvania State University College of Medicine, Hershey, PA 17033
| | - Anthony Kronfli
- Penn State Heart and Vascular Institute, Pennsylvania State University College of Medicine, Hershey, PA 17033
| | - Zhaohui Gao
- Penn State Heart and Vascular Institute, Pennsylvania State University College of Medicine, Hershey, PA 17033
| | - Cheryl Blaha
- Penn State Heart and Vascular Institute, Pennsylvania State University College of Medicine, Hershey, PA 17033
| | - Jonathan Carter Luck
- Penn State Heart and Vascular Institute, Pennsylvania State University College of Medicine, Hershey, PA 17033
| | - Paul Dalton
- Penn State Heart and Vascular Institute, Pennsylvania State University College of Medicine, Hershey, PA 17033
| | - Lawrence I. Sinoway
- Penn State Heart and Vascular Institute, Pennsylvania State University College of Medicine, Hershey, PA 17033
| | - Jian Cui
- Penn State Heart and Vascular Institute, Pennsylvania State University College of Medicine, Hershey, PA 17033
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Wang J, Zhao H, Shi K, Wang M. Treatment of insomnia based on the mechanism of pathophysiology by acupuncture combined with herbal medicine: A review. Medicine (Baltimore) 2023; 102:e33213. [PMID: 36930068 PMCID: PMC10019201 DOI: 10.1097/md.0000000000033213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 02/15/2023] [Indexed: 03/18/2023] Open
Abstract
Insomnia is a sleep disorder which severely affects patients mood, quality of life and social functioning, serves as a trigger or risk factor to a variety of diseases such as depression, cardiovascular and cerebrovascular diseases, obesity and diabetes, and even increases the risk of suicide, and has become an increasingly widespread concern worldwide. Considerable research on insomnia has been conducted in modern medicine in recent years and encouraging results have been achieved in the fields of genetics and neurobiology. Unfortunately, however, the pathogenesis of insomnia remains elusive to modern medicine, and pharmacological treatment of insomnia has been regarded as conventional. However, in the course of treatment, pharmacological treatment itself is increasingly being questioned due to potential dependence and drug resistance and is now being replaced by cognitive behavior therapy as the first-line treatment. As an important component of complementary and alternative medicine, traditional Chinese medicine, especially non-pharmacological treatment methods such as acupuncture, is gaining increasing attention worldwide. In this article, we discuss the combination of traditional Chinese medicine, acupuncture, and medicine to treat insomnia based on neurobiology in the context of modern medicine.
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Affiliation(s)
- Jie Wang
- Department of Pain, Datong Hospital of Traditional Chinese Medicine, Shanxi Province, Datong, China
| | - Haishen Zhao
- Department of Rehabilitation, Luchaogang Community Health Service Center, Pudong New District, Shanghai, China
| | - Kejun Shi
- Department of Rehabilitation, Luchaogang Community Health Service Center, Pudong New District, Shanghai, China
| | - Manya Wang
- Department of Rehabilitation, Luchaogang Community Health Service Center, Pudong New District, Shanghai, China
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12
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Smith D, Miller R, Lee JB. Can vagus nerve recordings shed light on autonomic dysfunction in spinal cord injury? J Physiol 2022; 600:4973-4975. [PMID: 36254576 DOI: 10.1113/jp283815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 10/14/2022] [Indexed: 01/05/2023] Open
Affiliation(s)
- Donovan Smith
- Departments of Physiology and Pharmacology, Cardiac Sciences, Clinical Neurosciences, Biomedical Engineering, Libin Cardiovascular Institute, Hotchkiss Brain Institute, RESTORE.network, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Ryan Miller
- Departments of Physiology and Pharmacology, Cardiac Sciences, Clinical Neurosciences, Biomedical Engineering, Libin Cardiovascular Institute, Hotchkiss Brain Institute, RESTORE.network, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Jordan B Lee
- Departments of Physiology and Pharmacology, Cardiac Sciences, Clinical Neurosciences, Biomedical Engineering, Libin Cardiovascular Institute, Hotchkiss Brain Institute, RESTORE.network, Cumming School of Medicine, University of Calgary, Calgary, Canada
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13
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Iannarelli NJ, Vos NG, Gibson AJ. 'History doesn't repeat itself, but it often rhymes': Have coincidental microneurographic recordings yet again illuminated human sympathetic neurocirculatory control? J Physiol 2022; 600:4261-4263. [PMID: 36047532 DOI: 10.1113/jp283593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Affiliation(s)
- Nathaniel J Iannarelli
- Sympathetic Neurocirculatory Regulation Laboratory, Department of Kinesiology, Faculty of Applied Health Sciences, Brock University, St. Catharines, ON, Canada.,Human Hemodynamics Laboratory, Department of Health Sciences, Faculty of Applied Health Sciences, Brock University, St. Catharines, ON, Canada
| | - Naomi G Vos
- Sympathetic Neurocirculatory Regulation Laboratory, Department of Kinesiology, Faculty of Applied Health Sciences, Brock University, St. Catharines, ON, Canada.,Human Hemodynamics Laboratory, Department of Health Sciences, Faculty of Applied Health Sciences, Brock University, St. Catharines, ON, Canada
| | - Alexander J Gibson
- Sympathetic Neurocirculatory Regulation Laboratory, Department of Kinesiology, Faculty of Applied Health Sciences, Brock University, St. Catharines, ON, Canada
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14
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Pollina L, Vallone F, Ottaviani MM, Strauss I, Carlucci L, Recchia FA, Micera S, Moccia S. A lightweight learning-based decoding algorithm for intraneural vagus nerve activity classification in pigs. J Neural Eng 2022; 19. [PMID: 35896098 DOI: 10.1088/1741-2552/ac84ab] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 07/27/2022] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Bioelectronic medicine is an emerging field that aims at developing closed-loop neuromodulation protocols for the autonomic nervous system (ANS) to treat a wide range of disorders. When designing a closed-loop protocol for real time modulation of the ANS, the computational execution time and the memory and power demands of the decoding step are important factors to consider. In the context of cardiovascular and respiratory diseases, these requirements may partially explain why closed-loop clinical neuromodulation protocols that adapt stimulation parameters on patient's clinical characteristics are currently missing. APPROACH Here, we developed a lightweight learning-based decoder for the classification of cardiovascular and respiratory functional challenges from neural signals acquired through intraneural electrodes implanted in the cervical vagus nerve (VN) of 5 anaesthetized pigs. Our algorithm is based on signal temporal windowing, 9 handcrafted features, and Random Forest (RF) model for classification. Temporal windowing ranging from 50 ms to 1 sec, compatible in duration with cardio-respiratory dynamics, was applied to the data in order to mimic a pseudo real-time scenario. MAIN RESULTS We were able to achieve high balanced accuracy (BA) values over the whole range of temporal windowing duration. We identified 500 ms as the optimal temporal windowing duration for both BA values and computational execution time processing, achieving more than 86% for BA and a computational execution time of only ∼6.8 ms. Our algorithm outperformed in terms of balanced accuracy and computational execution time a state of the art decoding algorithm tested on the same dataset [1]. We found that RF outperformed other machine learning models such as Support Vector Machines, K-Nearest Neighbors, and Multi-Layer Perceptrons. SIGNIFICANCE Our approach could represent an important step towards the implementation of a closed-loop neuromodulation protocol relying on a single intraneural interface able to perform real-time decoding tasks and selective modulation of the VN.
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Affiliation(s)
- Leonardo Pollina
- Sant'Anna School of Advanced Studies, P.za Martiri della Liberta', 33, Pisa, 56127, ITALY
| | - Fabio Vallone
- Sant'Anna School of Advanced Studies, P.za Martiri della Liberta', 33, Pisa, 56127, ITALY
| | - Matteo M Ottaviani
- Scuola Superiore Sant'Anna, Istituto di Scienze Della Vita (ISV), P.za Martiri della Liberta', 33, Pisa, 56127, ITALY
| | - Ivo Strauss
- Scuola Superiore Sant'Anna, P.za Martiri della Libertà 33, Pisa, 56127, ITALY
| | - Lucia Carlucci
- Scuola Superiore Sant'Anna, Istituto di Scienze Della Vita (ISV), P.zza Martiri della Libertà 33, Pisa, 56127, ITALY
| | - Fabio A Recchia
- Scuola Superiore Sant'Anna, Istituto di Scienze Della Vita (ISV), P.za Martiri della Libertà 33, Pisa, 56127, ITALY
| | - Silvestro Micera
- Scuola Superiore Sant'Anna, P.za Martiri della Liberta', 33, Pisa, Toscana, 56127, ITALY
| | - Sara Moccia
- Scuola Superiore Sant'Anna, P.za Martiri della Liberta', 33, Pisa, 56127, ITALY
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15
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Szeghy RE, Stute NL. Sticking your neck out for science. J Physiol 2022; 600:3651-3652. [PMID: 35836333 DOI: 10.1113/jp283306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Accepted: 07/12/2022] [Indexed: 11/08/2022] Open
Affiliation(s)
- Rachel E Szeghy
- Exercise Respiratory and Physiology Lab, Department of Health & Exercise Science, Appalachian State University, Boone, NC
| | - Nina L Stute
- Signature Tracking for Optimized Nutrition and Training Lab, Air Force Research Labs, Wright Patterson Air Force Base, Dayton, OH
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16
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Spiesshoefer J, Regmi B, Ottaviani MM, Kahles F, Giannoni A, Borrelli C, Passino C, Macefield V, Dreher M. Sympathetic and Vagal Nerve Activity in COPD: Pathophysiology, Presumed Determinants and Underappreciated Therapeutic Potential. Front Physiol 2022; 13:919422. [PMID: 35845993 PMCID: PMC9281604 DOI: 10.3389/fphys.2022.919422] [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: 04/13/2022] [Accepted: 06/02/2022] [Indexed: 11/13/2022] Open
Abstract
This article explains the comprehensive state of the art assessment of sympathetic (SNA) and vagal nerve activity recordings in humans and highlights the precise mechanisms mediating increased SNA and its corresponding presumed clinical determinants and therapeutic potential in the context of chronic obstructive pulmonary disease (COPD). It is known that patients with COPD exhibit increased muscle sympathetic nerve activity (MSNA), as measured directly using intraneural microelectrodes—the gold standard for evaluation of sympathetic outflow. However, the underlying physiological mechanisms responsible for the sympathoexcitation in COPD and its clinical relevance are less well understood. This may be related to the absence of a systematic approach to measure the increase in sympathetic activity and the lack of a comprehensive approach to assess the underlying mechanisms by which MSNA increases. The nature of sympathoexcitation can be dissected by distinguishing the heart rate increasing properties (heart rate and blood pressure variability) from the vasoconstrictive drive to the peripheral vasculature (measurement of catecholamines and MSNA) (Graphical Abstract Figure 1). Invasive assessment of MSNA to the point of single unit recordings with analysis of single postganglionic sympathetic firing, and hence SNA drive to the peripheral vasculature, is the gold standard for quantification of SNA in humans but is only available in a few centres worldwide because it is costly, time consuming and requires a high level of training. A broad picture of the underlying pathophysiological determinants of the increase in sympathetic outflow in COPD can only be determined if a combination of these tools are used. Various factors potentially determine SNA in COPD (Graphical Abstract Figure 1): Obstructive sleep apnoea (OSA) is highly prevalent in COPD, and leads to repeated bouts of upper airway obstructions with hypoxemia, causing repetitive arousals. This probably produces ongoing sympathoexcitation in the awake state, likely in the “blue bloater” phenotype, resulting in persistent vasoconstriction. Other variables likely describe a subset of COPD patients with increase of sympathetic drive to the heart, clinically likely in the “pink puffer” phenotype. Pharmacological treatment options of increased SNA in COPD could comprise beta blocker therapy. However, as opposed to systolic heart failure a similar beneficial effect of beta blocker therapy in COPD patients has not been shown. The point is made that although MSNA is undoubtedly increased in COPD (probably independently from concomitant cardiovascular disease), studies designed to determine clinical improvements during specific treatment will only be successful if they include adequate patient selection and translational state of the art assessment of SNA. This would ideally include intraneural recordings of MSNA and—as a future perspective—vagal nerve activity all of which should ideally be assessed both in the upright and in the supine position to also determine baroreflex function.
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Affiliation(s)
- Jens Spiesshoefer
- Department of Pneumology and Intensive Care Medicine, University Hospital RWTH Aachen, Aachen, Germany
- Institute of Life Sciences, Scuola Superiore Sant’Anna, Pisa, Italy
- *Correspondence: Jens Spiesshoefer, , orcid.org/0000-0001-8205-1749
| | - Binaya Regmi
- Department of Pneumology and Intensive Care Medicine, University Hospital RWTH Aachen, Aachen, Germany
| | | | - Florian Kahles
- Department of Cardiology and Vascular Medicine, University Hospital RWTH Aachen, Aachen, Germany
| | - Alberto Giannoni
- Institute of Life Sciences, Scuola Superiore Sant’Anna, Pisa, Italy
| | - Chiara Borrelli
- Institute of Life Sciences, Scuola Superiore Sant’Anna, Pisa, Italy
| | - Claudio Passino
- Institute of Life Sciences, Scuola Superiore Sant’Anna, Pisa, Italy
| | - Vaughan Macefield
- Human Autonomic Neurophysiology Laboratory, Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
- Department of Anatomy and Physiology, University of Melbourne, Melbourne, VIC, Australia
| | - Michael Dreher
- Department of Pneumology and Intensive Care Medicine, University Hospital RWTH Aachen, Aachen, Germany
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17
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Joyner MJ, Klassen SA. Embracing a curiosity-driven approach in the microneurographic exploration of the human vagus nerves. J Physiol 2022; 600:3009-3010. [PMID: 35621702 DOI: 10.1113/jp283281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 05/25/2022] [Indexed: 11/08/2022] Open
Affiliation(s)
- Michael J Joyner
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, United States
| | - Stephen A Klassen
- Department of Kinesiology, Faculty of Applied Health Sciences, Brock University, St. Catharines, Ontario, Canada
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