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Siciliano RE, Anderson AS, Gruhn MA, Henry LM, Vreeland AJ, Watson KH, Ciriegio AE, Liu Q, Ebert J, Kuhn T, Cole DA, Compas BE. Momentary autonomic engagement during parent-adolescent conflict: Coping as a moderator of associations with emotions. Psychophysiology 2024:e14666. [PMID: 39118277 DOI: 10.1111/psyp.14666] [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: 11/26/2023] [Revised: 07/24/2024] [Accepted: 07/29/2024] [Indexed: 08/10/2024]
Abstract
Regulatory efforts are hypothesized to affect associations between emotions and physiology (i.e., concordance) to facilitate adaptive functioning. Assessing the role of coping on physiological-emotional concordance during ecologically relevant scenarios can elucidate whether concordance can serve as a biomarker of risk or resilience. The present study assessed self-reported coping as a moderator of minute-to-minute associations between autonomic nervous system activity and emotions (i.e., physiological-emotional concordance) in caregivers (N = 97) and adolescents (N = 97; ages 10-15) during a dyadic conflict task. Models included physiological variables (sympathetic, skin conductance level [SCL]; and parasympathetic, respiratory sinus arrhythmia [RSA]) and their interaction (SCL × RSA) as predictors of emotions, with coping variables as moderators. Caregivers' use of primary control coping (e.g., problem solving and emotional expression) and secondary control coping (e.g., cognitive reappraisal and acceptance) use in response to family stress predicted more positive emotional experiences during the laboratory conflict task. Adolescents' use of secondary control coping moderated the SCL-emotion association, such that increases in momentary SCL were associated with more positive emotion ratings for youth reporting higher secondary control coping. For youth who report more adaptive trait-level coping skills, momentary changes in SCL may reflect active engagement and attentiveness to facilitate more positive emotional experiences. Findings advance our understanding of the interrelationships between physiological responses and psychological experiences during relevant, interactive scenarios. Autonomic responses are differentially related to affective states depending on the coping strategies that adolescents employ, suggesting that concordance may be associated with intervention targets (i.e., coping skills).
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Affiliation(s)
- Rachel E Siciliano
- Department of Psychology and Human Development, Vanderbilt University, Nashville, Tennessee, USA
| | - Allegra S Anderson
- Department of Psychology and Human Development, Vanderbilt University, Nashville, Tennessee, USA
| | - Meredith A Gruhn
- Department of Psychology and Human Development, Vanderbilt University, Nashville, Tennessee, USA
| | - Lauren M Henry
- Department of Psychology and Human Development, Vanderbilt University, Nashville, Tennessee, USA
| | - Allison J Vreeland
- Department of Psychology and Human Development, Vanderbilt University, Nashville, Tennessee, USA
| | - Kelly H Watson
- Department of Psychology and Human Development, Vanderbilt University, Nashville, Tennessee, USA
| | - Abagail E Ciriegio
- Department of Psychology and Human Development, Vanderbilt University, Nashville, Tennessee, USA
| | - Qimin Liu
- Department of Psychological and Brain Sciences, Boston University, Boston, Massachusetts, USA
| | - Jon Ebert
- Department of Psychiatry, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Tarah Kuhn
- Department of Psychiatry, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - David A Cole
- Department of Psychology and Human Development, Vanderbilt University, Nashville, Tennessee, USA
| | - Bruce E Compas
- Department of Psychology and Human Development, Vanderbilt University, Nashville, Tennessee, USA
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Stoupi NA, Weijs ML, Imbach L, Lenggenhager B. Heartbeat-evoked potentials following voluntary hyperventilation in epilepsy patients: respiratory influences on cardiac interoception. Front Neurosci 2024; 18:1391437. [PMID: 39035777 PMCID: PMC11259972 DOI: 10.3389/fnins.2024.1391437] [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: 02/26/2024] [Accepted: 06/12/2024] [Indexed: 07/23/2024] Open
Abstract
Introduction Current evidence indicates a modulating role of respiratory processes in cardiac interoception, yet whether altered breathing patterns influence heartbeat-evoked potentials (HEP) remains inconclusive. Methods Here, we examined the effects of voluntary hyperventilation (VH) as part of a clinical routine examination on scalp-recorded HEPs in epilepsy patients (N = 80). Results Using cluster-based permutation analyses, HEP amplitudes were compared across pre-VH and post-VH conditions within young and elderly subgroups, as well as for the total sample. No differences in the HEP were detected for younger participants or across the full sample, while an increased late HEP during pre-VH compared to post-VH was fond in the senior group, denoting decreased cardiac interoceptive processing after hyperventilation. Discussion The present study, thus, provides initial evidence of breathing-related HEP modulations in elderly epilepsy patients, emphasizing the potential of HEP as an interoceptive neural marker that could partially extend to the representation of pulmonary signaling. We speculate that aberrant CO2-chemosensing, coupled with disturbances in autonomic regulation, might constitute the underlying pathophysiological mechanism behind the obtained effect. Available databases involving patient records of routine VH assessment may constitute a valuable asset in disentangling the interplay of cardiac and ventilatory interoceptive information in various patient groups, providing thorough clinical data to parse, as well as increased statistical power and estimates of effects with higher precision through large-scale studies.
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Affiliation(s)
- Niovi A Stoupi
- Department of Psychology, University of Zurich, Zürich, Switzerland
| | - Marieke L Weijs
- Department of Psychology, University of Zurich, Zürich, Switzerland
| | - Lukas Imbach
- Department of Neurology, University Hospital of Zurich, Zürich, Switzerland
- Swiss Epilepsy Center, Klinik Lengg, Zürich, Switzerland
- Zurich Neuroscience Center, University of Zurich and ETH Zurich, Zürich, Switzerland
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Kim M, Tsouris N, Lung BE, Miskiewicz M, Wang KE, Komatsu DE, Wang ED. Cumulative effect of chronic dehydration and age on postoperative complications after total shoulder arthroplasty. JSES Int 2024; 8:491-499. [PMID: 38707563 PMCID: PMC11064703 DOI: 10.1016/j.jseint.2023.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/07/2024] Open
Abstract
Background Dehydration is a modifiable risk factor that should be optimized prior to all surgical procedures. The aim of this study was to determine the effects of dehydration on postoperative complications following total shoulder arthroplasty (TSA). Methods The American College of Surgeons National Surgical Quality Improvement database was queried for all patients who underwent TSA between 2015 and 2019 and a total of 16,993 patients were included in this study. The study population was subsequently classified into 3 categories: 8498 (50.0%) nondehydrated patients with blood urea nitrogen/creatinine (BUN/Cr) < 20, 4908 (28.9%) moderately dehydrated patients with 20 ≤ BUN/Cr ≤ 25, and 3587 (21.1%) severely dehydrated patients with 25 < BUN/Cr. A subgroup analysis involving only elderly patients aged > 65 years and normalized gender-adjusted Cr values was also performed. Postoperative complications within 30 days of the TSA were collected. Multivariate logistic regression analysis was conducted to explore the correlation between dehydration and postoperative complications. Results Adjusted multivariate logistic regression analysis showed that the severely dehydrated cohort had a greater risk of postoperative transfusion, mortality, nonhome discharge, and increased length of stay (all P < .05). The moderately dehydrated cohort had a greater risk of wound dehiscence (P = .044). Among the elderly, severely dehydrated patients had a greater risk of cardiac complications, postoperative transfusion, mortality, nonhome discharge, and increased length of stay (all P < .05). Finally, the elderly moderately dehydrated cohort had a greater risk of postoperative transfusion and nonhome discharge (all P < .05). Conclusion BUN/Cr ratio is an important preoperative diagnostic tool to identify at-risk dehydrated patients. Providers should optimize dehydration to prevent complications, decrease costs, and improve discharge planning.
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Affiliation(s)
- Matthew Kim
- Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA
| | - Nicholas Tsouris
- Department of Orthopaedics and Rehabilitation, Stony Brook University, Stony Brook, NY, USA
| | | | - Michael Miskiewicz
- Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA
| | - Katherine E. Wang
- Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA
| | - David E. Komatsu
- Department of Orthopaedics and Rehabilitation, Stony Brook University, Stony Brook, NY, USA
| | - Edward D. Wang
- Department of Orthopaedics and Rehabilitation, Stony Brook University, Stony Brook, NY, USA
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Sangeetha RP, Chakrabarti D, Sriganesh K, Mahendranath M, Sathyaprabha TN, Srinivas D. Prevalence and predictors of preoperative cardiac autonomic dysfunction among elective neurosurgical patients: A prospective observational study. Indian J Anaesth 2024; 68:380-386. [PMID: 38586253 PMCID: PMC10993939 DOI: 10.4103/ija.ija_722_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 01/24/2024] [Accepted: 01/26/2024] [Indexed: 04/09/2024] Open
Abstract
Background and Aims The autonomic nervous system (ANS) is cardinal for systemic homeostasis. Autonomic dysfunction is prevalent in as high as 65% of patients presenting for cardiac surgery in the Indian scenario. Pre-existing cardiac autonomic dysfunction (CAD) in surgical patients can accentuate perioperative haemodynamic fluctuations during stressful intraoperative events, predispose to adverse cardiac events, and contribute to morbidity and mortality. The prevalence and predictors of CAD in the elective neurosurgical population are unknown in the Indian scenario. The current study was conducted to bridge this knowledge gap. Methods In this single-centre prospective observational study conducted at a tertiary care neurosciences centre, among 400 consenting adult patients of either gender, between 18 and 80 years of age, undergoing elective neurosurgery, the preoperative ANS function at the bedside was assessed as the primary outcome measure. The ANS status was evaluated using ANSiscope™-derived indices of heart rate variability. The diagnosis of CAD was made when the ANS index exceeded a threshold of 13.5. Data regarding predictors of CAD were collected from patient records as the secondary outcome measure. Statistical analysis was done using the R software. A P-value of <0.05 was considered statistically significant. Results The prevalence of preoperative CAD in our study population was 79.7% (319/400 patients). None of the demographic and baseline clinical characteristics we studied predicted CAD in our study. Conclusion We observed a significant prevalence of preoperative CAD among elective neurosurgical patients. None of the parameters we evaluated predicted CAD in our study.
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Affiliation(s)
- RP Sangeetha
- Department of Neuroanesthesia and Neurocritical Care, NIMHANS, Bangalore, Karnataka, India
| | - Dhritiman Chakrabarti
- Department of Neuroanesthesia and Neurocritical Care, NIMHANS, Bangalore, Karnataka, India
| | - Kamath Sriganesh
- Department of Neuroanesthesia and Neurocritical Care, NIMHANS, Bangalore, Karnataka, India
| | - Musumur Mahendranath
- Department of Neuroanesthesia and Neurocritical Care, NIMHANS, Bangalore, Karnataka, India
| | - TN Sathyaprabha
- Department of Neurophysiology, NIMHANS, Bangalore, Karnataka, India
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Alrosan AZ, Heilat GB, Alrosan K, Aleikish AA, Rabbaa AN, Shakhatreh AM, Alshalout EM, Al Momany EM. Autonomic brain functioning and age-related health concerns. Curr Res Physiol 2024; 7:100123. [PMID: 38510918 PMCID: PMC10950753 DOI: 10.1016/j.crphys.2024.100123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 03/02/2024] [Accepted: 03/04/2024] [Indexed: 03/22/2024] Open
Abstract
The autonomic nervous system (ANS) regulates involuntary bodily functions such as blood pressure, heart rate, breathing, and digestion, in addition to controlling motivation and behavior. In older adults, the ANS is dysregulated, which changes the ability of the ANS to respond to physiological signals, regulate cardiovascular autonomic functionality, diminish gastric motility, and exacerbate sleep problems. For example, a decrease in heart rate variability, or the variation in the interval between heartbeats, is one of the most well-known alterations in the ANS associated with health issues, including cardiovascular diseases and cognitive decline. The inability to perform fundamental activities of daily living and compromising the physiological reactivity or motivational responses of older adults to moving toward or away from specific environmental stimuli are significant negative consequences of chronic and geriatric conditions that pose grave threats to autonomy, health, and well-being. The most updated research has investigated the associations between the action responsiveness of older adults and the maintenance of their physiological and physical health or the development of mental and physical health problems. Once autonomic dysfunction may significantly influence the development of different age-related diseases, including ischemic stroke, cardiovascular disease, and autoimmune diseases, this review aimed to assess the relationship between aging and autonomic functions. The review explored how motivational responses, physiological reactivity, cognitive processes, and lifelong developmental changes associated with aging impact the ANS and contribute to the emergence of health problems.
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Affiliation(s)
- Amjad Z. Alrosan
- Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmaceutical Sciences, The Hashemite University, Zarqa, 13133, Jordan
| | - Ghaith B. Heilat
- Department of General Surgery and Urology, Faculty of Medicine, The Jordan University of Science and Technology, Irbid, 22110, Jordan
| | - Khaled Alrosan
- Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmaceutical Sciences, The Hashemite University, Zarqa, 13133, Jordan
| | - Abrar A. Aleikish
- Master of Pharmacology, Department of Pharmacology, Faculty of Medicine, The Jordan University of Science and Technology, Irbid, 22110, Jordan
| | - Aya N. Rabbaa
- Faculty of Pharmaceutical Sciences, The Hashemite University, Zarqa, 13133, Jordan
| | - Aseel M. Shakhatreh
- Department of Biochemistry and Molecular Biology, Faculty of Medicine, The Jordan University of Science and Technology, Irbid, 22110, Jordan
| | - Ehab M. Alshalout
- Faculty of Pharmaceutical Sciences, The Hashemite University, Zarqa, 13133, Jordan
| | - Enaam M.A. Al Momany
- Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmaceutical Sciences, The Hashemite University, Zarqa, 13133, Jordan
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Giunta S, Xia S, Pelliccioni G, Olivieri F. Autonomic nervous system imbalance during aging contributes to impair endogenous anti-inflammaging strategies. GeroScience 2024; 46:113-127. [PMID: 37821752 PMCID: PMC10828245 DOI: 10.1007/s11357-023-00947-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 09/13/2023] [Indexed: 10/13/2023] Open
Abstract
Inflammaging refers to the age-related low grade, sterile, chronic, systemic, and long-lasting subclinical, proinflammatory status, currently recognized as the main risk factor for development and progression of the most common age-related diseases (ARDs). Extensive investigations were focused on a plethora of proinflammatory stimuli that can fuel inflammaging, underestimating and partly neglecting important endogenous anti-inflammaging mechanisms that could play a crucial role in such age-related proinflammatory state. Studies on autonomic nervous system (ANS) functions during aging highlighted an imbalance toward an overactive sympathetic nervous system (SNS) tone, promoting proinflammatory conditions, and a diminished parasympathetic nervous system (PNS) activity, playing anti-inflammatory effects mediated by the so called cholinergic anti-inflammatory pathway (CAP). At the molecular level, CAP is characterized by signals communicated via the vagus nerve (with the possible involvement of the splenic nerves) through acetylcholine release to downregulate the inflammatory actions of macrophages, key players of inflammaging. Notably, decreased vagal function and increased burden of activated/senescent macrophages (macrophaging) probably precede the development of several age-related risk factors and diseases, while increased vagal function and reduced macrophaging could be associated with relevant reduction of risk profiles. Hypothalamic-pituitary-adrenal axis (HPA axis) is another pathway related to ANS promoting some anti-inflammatory response mainly through increased cortisol levels. In this perspective review, we highlighted that CAP and HPA, representing broadly "anti-inflammaging" mechanisms, have a reduced efficacy and lose effectiveness in aged people, a phenomenon that could contribute to fuel inflammaging. In this framework, strategies aimed to re-balance PNS/SNS activities could be explored to modulate systemic inflammaging especially at an early subclinical stage, thus increasing the chances to reach the extreme limit of human lifespan in healthy status.
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Affiliation(s)
- Sergio Giunta
- Casa Di Cura Prof. Nobili (Gruppo Garofalo (GHC)), Castiglione Dei Pepoli, Bologna, Italy
| | - Shijin Xia
- Department of Geriatrics, Shanghai Institute of Geriatrics, Huadong Hospital, Fudan University, Shanghai, China
| | | | - Fabiola Olivieri
- Department of Clinical and Molecular Sciences, DISCLIMO, Università Politecnica Delle Marche, Via Tronto 10/A, 60126, Ancona, Italy.
- Clinical Laboratory and Molecular Diagnostic, IRCCS INRCA, Ancona, Italy.
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Mujaddadi A, Zaki S, M Noohu M, Naqvi IH, Veqar Z. Predictors of Cardiac Autonomic Dysfunction in Obesity-Related Hypertension. High Blood Press Cardiovasc Prev 2024; 31:77-91. [PMID: 38345729 DOI: 10.1007/s40292-024-00623-7] [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: 09/20/2023] [Accepted: 01/04/2024] [Indexed: 03/12/2024] Open
Abstract
INTRODUCTION Cardiac Autonomic Dysfunction (CAD) is an overlooked cardiovascular risk factor in individuals with obesity-related hypertension. Despite its clinical significance, there is a notable lack of clarity regarding the pathophysiological correlates involved in its onset and progression. AIM The present study aimed to identify potential predictors of CAD in obesity-related hypertension. METHODS A total of 72 participants (34 men and 38 women) were enrolled. Comprehensive evaluations were conducted, including cardiac autonomic function assessments, body composition estimation and biochemical analysis. Participants were categorized as CAD-positive or CAD-negative based on Ewing's criteria for autonomic dysfunction. Univariate logistic regression analysis was performed to identify potential predictors for CAD. Multivariate logistic regression models were further constructed by adjusting clinically relevant covariates to identify independent predictors of CAD. RESULTS Multivariate logistic regression analysis revealed that resting heart rate (HRrest), (odds ratio, confidence interval: 0.85, 0.78-0.93; p = 0.001) and percentage body fat (BF%), (odds ratio, confidence interval: 0.78, 0.64-0.96; p = 0.018) were significant independent predictors of CAD. Receiver Operating Characteristic curve analysis depicted optimal cut-off values for HRrest and BF% as > 74.1 bpm and > 33.6%, respectively. Multicolinearity analysis showed variance inflation factors (VIF) below the cautionary threshold of 3. CONCLUSIONS The HRrest and BF% emerged as significant independent predictors of CAD in obesity-related hypertension. Therapeutic strategies should target HRrest < 74.1 bpm and BF% < 33.6% to mitigate CAD risk in this population. Future trials are required to establish causal relationships and may consider additional confounding variables in obesity-related hypertension.
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Affiliation(s)
- Aqsa Mujaddadi
- Centre for Physiotherapy and Rehabilitation Sciences, Jamia Millia Islamia (A Central University), New Delhi, 110025, India
| | - Saima Zaki
- Centre for Physiotherapy and Rehabilitation Sciences, Jamia Millia Islamia (A Central University), New Delhi, 110025, India
| | - Majumi M Noohu
- Centre for Physiotherapy and Rehabilitation Sciences, Jamia Millia Islamia (A Central University), New Delhi, 110025, India
| | - Irshad Husain Naqvi
- Centre for Physiotherapy and Rehabilitation Sciences, Jamia Millia Islamia (A Central University), New Delhi, 110025, India
- Dr. M.A. Ansari Health Centre, Jamia Millia Islamia (A Central University), New Delhi, 110025, India
| | - Zubia Veqar
- Centre for Physiotherapy and Rehabilitation Sciences, Jamia Millia Islamia (A Central University), New Delhi, 110025, India.
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Seo MW, Park TY, Jung H. Sex Differences in Heart Rate Variability and Vascular Function Following High-Intensity Interval Training in Young Adults. J Hum Kinet 2024; 90:89-100. [PMID: 38380301 PMCID: PMC10875700 DOI: 10.5114/jhk/170964] [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: 03/27/2023] [Accepted: 07/24/2023] [Indexed: 02/22/2024] Open
Abstract
High-intensityintervaltraining (HIIT) issuperiortoothertrainingstrategies in both male andfemalehealthyindividuals. Understanding sex-specificdifferences in cardiac auto-regulation maycontributetothe optimal trainingstrategiesfor HIIT. The presentstudyaimedtoidentifysexdifferences in heart rate variability (HRV) andvascularfunctionfollowing HIIT in youngadults. Twenty-fourphysicallyactiveyoung male andfemaleadults (M: 12, F: 12, age: 19.5 yr, BMI: 22.1 kg·m-2) volunteeredtoparticipate in thestudy. Participantsperformed 10 boutsof HIIT including 20 s of high-intensitycycling at 115-130% Wmaxfollowedby 100 s ofrecovery. The cardiac auto-regulationsincluding HRV andvascularfunctionweremeasured at five different time points. The R-R interval, rMSSD, and SDNN wererecoveredfaster in malesthan in females after 15 min of HIIT. Thereweresexdifferences in theautonomicnervoussystemwhereln LF andln HF activitiesalongwithsympathovagalbalance (ln LF/HF) weregreater in femalescomparedwithmalesimmediatelyand 15 min after HIIT. However, nosignificantdifferences in bloodpressureand brachial-ankle pulse wavevelocitywereobservedbetween male andfemaleparticipants. Overall, HRV was moreactivated in femalesthan in malesfollowing HIIT, but theacuteresponse in vascularfunction was not different betweensexes. In futurestudies, sex-specificadaptationsofcardiacautoregulationfollowingrepeated HIIT mayneedtobeperformed.
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Affiliation(s)
- Myong-Won Seo
- Department of Exercise Science, David B. Falk College of Sport and Human Dynamics, Syracuse University, Syracuse, NY, USA
| | - Tae-Young Park
- Department of Physical Education, Graduate School, Kyung Hee University, Yoingin-si, Gyeonggi-do, Republic of Korea
| | - HyunChul Jung
- Sports Science Research Center, Kyung Hee University, Yongin-si, Gyeonggi-do, Republic of Korea
- Department of Sports Coaching, College of Physical Education, Kyung Hee University, Yoinin-si, Gyeonggi-do, Republic of Korea
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Alyahya AI, Charman SJ, Okwose NC, Fuller AS, Eggett C, Luke P, Bailey K, MacGowan GA, Jakovljevic DG. Heart rate variability and haemodynamic function in individuals with hypertrophic cardiomyopathy. Clin Physiol Funct Imaging 2023; 43:421-430. [PMID: 37293795 DOI: 10.1111/cpf.12840] [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: 01/15/2023] [Revised: 05/26/2023] [Accepted: 06/07/2023] [Indexed: 06/10/2023]
Abstract
OBJECTIVES Heart rate variability (HRV) is a measure of cardiac autonomic function. This study: (1) evaluated the differences in HRV and haemodynamic function between individuals with hypertrophic cardiomyopathy (HCM) and healthy controls, and (2) determined the relationship between HRV and haemodynamic variables in individuals with HCM. METHODS Twenty-eight individuals with HCM (n = 7, females; age 54 ± 15 years; body mass index: 29 ± 5 kg/m2 ) and 28 matched healthy individuals (n = 7 females; age 54 ± 16 years; body mass index: 29 ± 5 kg/m2 ) completed 5-min HRV and haemodynamic measurements under resting (supine) conditions using bioimpedance technology. Frequency domain HRV measures (absolute and normalized low-frequency power (LF), high-frequency power (HF) and LF/HF ratio) and RR interval were recorded. RESULTS Individuals with HCM demonstrated higher vagal activity (i.e., absolute unit of HF power (7.40 ± 2.50 vs. 6.03 ± 1.35 ms2 , p = 0.01) but lower RR interval (914 ± 178 vs. 1014 ± 168 ms, p = 0.03) compared to controls. Stroke volume (SV) index and cardiac index were lower in HCM compared with healthy individuals (SV, 33 ± 9 vs. 43 ± 7 ml/beat/m², p < 0.01; cardiac index,2.33 ± 0.42 vs. 3.57 ± 0.82 L/min/m2 , p < 0.01), but total peripheral resistance (TPR) was higher in HCM (3468 ± 1027 vs. 2953 ± 1050 dyn·s·m2 cm-5 , p = 0.03). HF power was significantly related to SV (r = -0.46, p < 0.01) and TPR (r = 0.28, p < 0.05) in HCM. CONCLUSIONS Short-term frequency domain indices of HRV provide a feasible approach to assess autonomic function in individuals with HCM. Vagal activity, represented by HF power, is increased, and associated with peripheral resistance in individuals with HCM.
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Affiliation(s)
- Alaa I Alyahya
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
- Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
- Department of Cardiac Technology, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, Dammam, Kingdom of Saudi Arabia
| | - Sarah J Charman
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
- Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Nduka C Okwose
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
- Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
- Research Centre for Health and Life Sciences, Institute for Health and Wellbeing, Faculty of Health and Life Sciences, Coventry University, and University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK
| | - Amy S Fuller
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
- Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Christopher Eggett
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
- Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Peter Luke
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
- Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Kristian Bailey
- Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Guy A MacGowan
- Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
- Biosciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Djordje G Jakovljevic
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
- Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
- Research Centre for Health and Life Sciences, Institute for Health and Wellbeing, Faculty of Health and Life Sciences, Coventry University, and University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK
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The Relationship Between Health-Related Quality of Life and Lower-Extremity Visuomotor Reaction Time in Young Adult Women Following Ankle Sprain. J Sport Rehabil 2023; 32:433-439. [PMID: 36848899 DOI: 10.1123/jsr.2022-0199] [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: 05/25/2022] [Revised: 12/08/2022] [Accepted: 12/13/2022] [Indexed: 03/01/2023]
Abstract
CONTEXT Many individuals who sustain a lateral ankle sprain (LAS) fail to return to prior activity due to residual symptoms; and report elevated levels of injury-related fear, decreased function, and decreased health-related quality of life (HRQOL). Additionally, individuals with history of LAS exhibit deficits in neurocognitive functional measures like visuomotor reaction time (VMRT), which contributes to worse patient-reported outcome scores. The aim of this study was to examine the relationship between HRQOL and lower-extremity (LE) VMRT in individuals with LAS history. DESIGN Cross-sectional. METHODS Young adult female volunteers with history of LAS (n = 22; age = 24 [3.5] y; height = 163.1 [9.8] cm; mass = 65.1 [11.5] kg; and time since last LAS = 67.8 [50.5] mo) completed HRQOL outcomes including the following: (1) Tampa Scale of Kinesiophobia-11, (2) Fear-Avoidance Beliefs Questionnaire, (3) Penn State Worry Questionnaire, (4) modified Disablement in the Physically Active Scale, and (5) Foot and Ankle Disability Index (FADI). Additionally, participants completed a LE-VMRT task by responding to a visual stimulus using their foot to deactivate light sensors. Participants completed trials bilaterally. Separate Spearman rho correlations were performed to assess the relationship between patient-reported outcomes assessing constructs of HRQOL and LE-VRMT bilaterally. Significance was set at P < .05. RESULTS There was a strong, significant negative correlation between FADI-Activities of Daily Living (ρ = -.68; P = .002) and FADI-Sport (ρ = -.76; P = .001) scores and injured limb LE-VMRT; moderate, significant negative correlations between the uninjured limb LE-VMRT and FADI-Activities of Daily Living (ρ = -.60; P = .01) and FADI-Sport (ρ = -.60; P = .01) scores; and moderate, significant positive correlations between the injured limb LE-VMRT and modified Disablement in the Physically Active Scale-Physical Summary Component (ρ = .52; P = .01) and modified Disablement in the Physically Active Scale-Total (ρ = .54; P = .02) scores. All other correlations were not statistically significant. CONCLUSIONS Young adult women with history of LAS demonstrated an association between self-reported constructs of HRQOL and LE-VMRT. As LE-VMRT is a modifiable injury risk factor, future studies should examine the effectiveness of interventions designed to improve LE-VMRT and the impact on self-reported HRQOL.
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11
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Lee CK, Lee JH, Ha MS. Comparison of the Effects of Aerobic versus Resistance Exercise on the Autonomic Nervous System in Middle-Aged Women: A Randomized Controlled Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159156. [PMID: 35954510 PMCID: PMC9368650 DOI: 10.3390/ijerph19159156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 07/22/2022] [Accepted: 07/25/2022] [Indexed: 11/16/2022]
Abstract
This study was conducted to investigate the changes in the autonomic nervous system in middle-aged women induced by aerobic and resistance exercise. A randomized controlled design was adopted; 22 premenopausal middle-aged women were divided into the resistance training and aerobic exercise groups (n = 11 each). Each group followed a specific 60 min exercise program three times a week for 12 weeks. The participants’ heart rate variability (HRV) was measured to analyze the low(LF)- and high-frequency (HF) activity, and the LF/HF ratio was calculated to examine the autonomic nervous system’s activities. A repeated-measures analysis of variance was used to analyze the effects of resistance and aerobic exercise. LF activity significantly increased in both the resistance training (p < 0.001) and aerobic exercise (p < 0.5) groups, indicating a significant variation according to time effect. HF activity was significantly increased only in resistance training (p < 0.001) with a significant variation in time (p < 0.001) and an interaction effect (p < 0.01). The LF/HF ratio did not vary significantly in either group. The findings in this study suggest that both aerobic exercise and resistance training were effective for sympathetic nerve activities in middle-aged women and that the effects on the sympathetic and parasympathetic activities were greater for resistance training.
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Affiliation(s)
- Chae Kwan Lee
- Department of Physical Therapy, Catholic University of Pusan, 57 Oryundae-ro, Geumjeong-gu, Pusan 46252, Korea;
| | - Jae-Hoon Lee
- Department of Sports Science, University of Seoul, 163 Seoulsiripdae-ro, Dongdaemun-gu, Seoul 02504, Korea;
| | - Min-Seong Ha
- Department of Sports Culture, College of the Arts, Dongguk University-Seoul, 30 Pildong-ro 1-gil, Jung-gu, Seoul 04620, Korea
- Correspondence: ; Tel.: +82-2-2290-1926
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12
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Zhong XZ, Chen JJ. Resting-state functional magnetic resonance imaging signal variations in aging: The role of neural activity. Hum Brain Mapp 2022; 43:2880-2897. [PMID: 35293656 PMCID: PMC9120570 DOI: 10.1002/hbm.25823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 01/20/2022] [Accepted: 02/23/2022] [Indexed: 11/23/2022] Open
Abstract
Resting‐state functional magnetic resonance imaging (rs‐fMRI) has been extensively used to study brain aging, but the age effect on the frequency content of the rs‐fMRI signal has scarcely been examined. Moreover, the neuronal implications of such age effects and age–sex interaction remain unclear. In this study, we examined the effects of age and sex on the rs‐fMRI signal frequency using the Leipzig mind–brain–body data set. Over a frequency band of up to 0.3 Hz, we found that the rs‐fMRI fluctuation frequency is higher in the older adults, although the fluctuation amplitude is lower. The rs‐fMRI signal frequency is also higher in men than in women. Both age and sex effects on fMRI frequency vary with the frequency band examined but are not found in the frequency of physiological‐noise components. This higher rs‐fMRI frequency in older adults is not mediated by the electroencephalograph (EEG)‐frequency increase but a likely link between fMRI signal frequency and EEG entropy, which vary with age and sex. Additionally, in different rs‐fMRI frequency bands, the fMRI‐EEG amplitude ratio is higher in young adults. This is the first study to investigate the neuronal contribution to age and sex effects in the frequency dimension of the rs‐fMRI signal and may lead to the development of new, frequency‐based rs‐fMRI metrics. Our study demonstrates that Fourier analysis of the fMRI signal can reveal novel information about aging. Furthermore, fMRI and EEG signals reflect different aspects of age‐ and sex‐related brain differences, but the signal frequency and complexity, instead of amplitude, may hold their link.
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Affiliation(s)
- Xiaole Z Zhong
- Rotman Research Institute, Baycrest Health Sciences, Toronto, Ontario, Canada.,Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada
| | - J Jean Chen
- Rotman Research Institute, Baycrest Health Sciences, Toronto, Ontario, Canada.,Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada.,Institute of Biomedical Engineering, University of Toronto, Toronto, Ontario, Canada
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13
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Ugarte E, Johnson LE, Robins RW, Guyer AE, Hastings PD. The impact of social disadvantage on autonomic physiology of latinx adolescents: The role of environmental risks. New Dir Child Adolesc Dev 2022; 2022:91-124. [PMID: 35634899 PMCID: PMC9492630 DOI: 10.1002/cad.20462] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
The experience of poverty embodies complex, multidimensional stressors that may adversely affect physiological and psychological domains of functioning. Compounded by racial/ethnic discrimination, the financial aspect of family poverty typically coincides with additional social and physical environmental risks such as pollution exposure, housing burden, elevated neighborhood unemployment, and lower neighborhood education levels. In this study, we investigated the associations of multidimensional social disadvantage throughout adolescence with autonomic nervous system (ANS) functioning at 17 years. Two hundred and twenty nine low-income Mexican-American adolescents (48.6% female) and their parents were assessed annually between the ages of 10 and 16. Participants' census tracts were matched with corresponding annual administrative data of neighborhood housing burden, education, unemployment, drinking water quality, and fine particulate matter. We combined measures of adolescents' electrodermal response and respiratory sinuses arrhythmia at rest and during a social exclusion challenge (Cyberball) to use as ANS indices of sympathetic and parasympathetic activity, respectively. Controlling for family income-to-needs, youth exposed to greater cumulative water and air pollution from ages 10-16 displayed altered patterns of autonomic functioning at rest and during the social challenge. Conversely, youth living in areas with higher housing burden displayed healthy patterns of autonomic functioning. Altogether, results suggest that toxin exposure in youths' physical environments disrupts the ANS, representing a plausible mechanism by which pollutants and social disadvantage influence later physical and mental health.
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Affiliation(s)
- Elisa Ugarte
- Department of Human Ecology, University of California, Davis
- Center for Mind & Brain, University of California Davis
| | - Lisa E. Johnson
- Center for Mind & Brain, University of California Davis
- Department of Psychology, University of California, Davis
| | | | - Amanda E. Guyer
- Department of Human Ecology, University of California, Davis
- Center for Mind & Brain, University of California Davis
| | - Paul D. Hastings
- Center for Mind & Brain, University of California Davis
- Department of Psychology, University of California, Davis
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14
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Rossi A, Mikail N, Bengs S, Haider A, Treyer V, Buechel RR, Wegener S, Rauen K, Tawakol A, Bairey Merz CN, Regitz-Zagrosek V, Gebhard C. Heart-brain interactions in cardiac and brain diseases: why sex matters. Eur Heart J 2022; 43:3971-3980. [PMID: 35194633 PMCID: PMC9794190 DOI: 10.1093/eurheartj/ehac061] [Citation(s) in RCA: 33] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 01/24/2022] [Accepted: 01/30/2022] [Indexed: 12/31/2022] Open
Abstract
Cardiovascular disease and brain disorders, such as depression and cognitive dysfunction, are highly prevalent conditions and are among the leading causes limiting patient's quality of life. A growing body of evidence has shown an intimate crosstalk between the heart and the brain, resulting from a complex network of several physiological and neurohumoral circuits. From a pathophysiological perspective, both organs share common risk factors, such as hypertension, diabetes, smoking or dyslipidaemia, and are similarly affected by systemic inflammation, atherosclerosis, and dysfunction of the neuroendocrine system. In addition, there is an increasing awareness that physiological interactions between the two organs play important roles in potentiating disease and that sex- and gender-related differences modify those interactions between the heart and the brain over the entire lifespan. The present review summarizes contemporary evidence of the effect of sex on heart-brain interactions and how these influence pathogenesis, clinical manifestation, and treatment responses of specific heart and brain diseases.
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Affiliation(s)
- Alexia Rossi
- Department of Nuclear Medicine, University Hospital Zurich, Raemistrasse 100, 8091 Zurich, Switzerland,Center for Molecular Cardiology, University of Zurich, Schlieren, Switzerland
| | - Nidaa Mikail
- Department of Nuclear Medicine, University Hospital Zurich, Raemistrasse 100, 8091 Zurich, Switzerland,Center for Molecular Cardiology, University of Zurich, Schlieren, Switzerland
| | - Susan Bengs
- Department of Nuclear Medicine, University Hospital Zurich, Raemistrasse 100, 8091 Zurich, Switzerland,Center for Molecular Cardiology, University of Zurich, Schlieren, Switzerland
| | - Ahmed Haider
- Department of Nuclear Medicine, University Hospital Zurich, Raemistrasse 100, 8091 Zurich, Switzerland,Center for Molecular Cardiology, University of Zurich, Schlieren, Switzerland,Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Massachusetts General Hospital, and Harvard Medical School, Boston, MA, USA
| | - Valerie Treyer
- Department of Nuclear Medicine, University Hospital Zurich, Raemistrasse 100, 8091 Zurich, Switzerland
| | - Ronny Ralf Buechel
- Department of Nuclear Medicine, University Hospital Zurich, Raemistrasse 100, 8091 Zurich, Switzerland
| | - Susanne Wegener
- Department of Neurology, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Katrin Rauen
- Department of Geriatric Psychiatry, Psychiatric Hospital, Zurich, Switzerland,Institute for Stroke and Dementia Research, University Hospital, Ludwig Maximilian University of Munich, Munich, Germany
| | - Ahmed Tawakol
- Cardiovascular Imaging Research Center, Cardiology Division, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - C Noel Bairey Merz
- Barbra Streisand Women's Heart Center, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, United States
| | - Vera Regitz-Zagrosek
- Charité, Universitätsmedizin Berlin, Berlin, Germany,University of Zurich, Zurich, Switzerland
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15
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de Veld L, van der Lely N, Hermans BJM, van Hoof JJ, Wong L, Vink AS. QTc prolongation in adolescents with acute alcohol intoxication. Eur J Pediatr 2022; 181:2757-2770. [PMID: 35482092 PMCID: PMC9192465 DOI: 10.1007/s00431-022-04471-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 03/30/2022] [Accepted: 04/09/2022] [Indexed: 01/24/2023]
Abstract
In adults, alcohol intoxication is associated with prolongation of the QT interval corrected for heart rate (QTc). The QTc is influenced by age and sex. Although alcohol intoxication is increasingly common in adolescents, there are no data on the prevalence of QTc prolongation in adolescents with alcohol intoxication. This study aimed to determine the prevalence of QTc prolongation in adolescents with alcohol intoxication and identify at-risk adolescents. In this observational study including adolescents aged 10-18 years, heart rate and QT interval were automatically assessed from an electrocardiogram (ECG) at alcohol intoxication using a validated algorithm. The QTc was calculated using both the Bazett formula (QTcB) and Fridericia formula (QTcF). If present, an ECG recorded within 1 year of the date of admission to the emergency department was obtained as a reference ECG. A total of 317 adolescents were included; 13.3% had a QTcB and 7.9% a QTcF longer than the sex- and age-specific 95th-percentile. None of the adolescents had a QTcB or QTcF > 500 ms, but 11.8% of the adolescents with a reference ECG had a QTcB prolongation of > 60 ms, while no adolescents had a QTcF prolongation of > 60 ms. QTc prolongation was mainly attributable to an increase in heart rate rather than QT prolongation, which underlies the differences between QTcB and QTcF. Male sex and hypokalaemia increased the likelihood of QTc prolongation.Conclusion: QTc prolongation was seen in approximately 10% of the adolescents presenting with alcohol intoxication, and although no ventricular arrhythmias were observed in this cohort, QTc prolongation increases the potential for malignant QT-related arrhythmias. Clinicians must be aware of the possibility of QTc prolongation during alcohol intoxication and make an effort to obtain an ECG at presentation, measure the QT interval, and give an adequate assessment of the findings. We advocate admitting adolescents with alcohol intoxication and QTc prolongation. During hospital admission, we recommend limiting exposure to QTc-prolonging medication, increasing potassium levels to a high-normal range (4.5-5.0 mmol/L) and obtaining a reference ECG at discharge.
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Affiliation(s)
- Loes de Veld
- Erasmus School of Health Policy and Management, Erasmus University, Postbus 1738, 3000, Rotterdam, DR, Netherlands. .,Department of Pediatrics, Reinier de Graaf Hospital, Delft, Netherlands.
| | - Nico van der Lely
- Department of Pediatrics, Reinier de Graaf Hospital, Delft, Netherlands ,Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Ben J. M. Hermans
- Department of Physiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, Netherlands
| | - Joris J. van Hoof
- Department of Pediatrics, Reinier de Graaf Hospital, Delft, Netherlands
| | - Lichelle Wong
- Department of Pediatrics, Reinier de Graaf Hospital, Delft, Netherlands
| | - Arja Suzanne Vink
- Department of Cardiology, Heart Center, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands ,Department of Pediatric Cardiology, Emma Children’s Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
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16
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Minusa S, Mizuno K, Ojiro D, Tanaka T, Kuriyama H, Yamano E, Kuratsune H, Watanabe Y. Increase in rear-end collision risk by acute stress-induced fatigue in on-road truck driving. PLoS One 2021; 16:e0258892. [PMID: 34673839 PMCID: PMC8530353 DOI: 10.1371/journal.pone.0258892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 10/07/2021] [Indexed: 11/25/2022] Open
Abstract
Increasing road crashes related to occupational drivers’ deteriorating health has become a social problem. To prevent road crashes, warnings and predictions of increased crash risk based on drivers’ conditions are important. However, in on-road driving, the relationship between drivers’ physiological condition and crash risk remains unclear due to difficulties in the simultaneous measurement of both. This study aimed to elucidate the relationship between drivers’ physiological condition assessed by autonomic nerve function (ANF) and an indicator of rear-end collision risk in on-road driving. Data from 20 male truck drivers (mean ± SD, 49.0±8.2 years; range, 35–63 years) were analyzed. Over a period of approximately three months, drivers’ working behavior data, such as automotive sensor data, and their ANF data were collected during their working shift. Using the gradient boosting decision tree method, a rear-end collision risk index was developed based on the working behavior data, which enabled continuous risk quantification. Using the developed risk index and drivers’ ANF data, effects of their physiological condition on risk were analyzed employing a logistic quantile regression method, which provides wider information on the effects of the explanatory variables, after hierarchical model selection. Our results revealed that in on-road driving, activation of sympathetic nerve activity and inhibition of parasympathetic nerve activity increased each quantile of the rear-end collision risk index. The findings suggest that acute stress-induced drivers’ fatigue increases rear-end collision risk. Hence, in on-road driving, drivers’ physiological condition monitoring and ANF-based stress warning and relief system can contribute to promoting the prevention of rear-end truck collisions.
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Affiliation(s)
- Shunsuke Minusa
- Research & Development Group, Hitachi, Ltd., Tokyo, Japan
- * E-mail:
| | - Kei Mizuno
- Laboratory for Pathophysiological and Health Science, RIKEN Center for Biosystems Dynamics Research, Kobe, Hyogo, Japan
- RIKEN Compass to Healthy Life Research Complex Program, Kobe, Hyogo, Japan
- Osaka City University Center for Health Science Innovation, Osaka, Japan
- Department of Medical Science on Fatigue, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Daichi Ojiro
- Research & Development Group, Hitachi, Ltd., Tokyo, Japan
| | - Takeshi Tanaka
- Research & Development Group, Hitachi, Ltd., Tokyo, Japan
| | | | - Emi Yamano
- Laboratory for Pathophysiological and Health Science, RIKEN Center for Biosystems Dynamics Research, Kobe, Hyogo, Japan
- RIKEN Compass to Healthy Life Research Complex Program, Kobe, Hyogo, Japan
- Osaka City University Center for Health Science Innovation, Osaka, Japan
| | - Hirohiko Kuratsune
- Laboratory for Pathophysiological and Health Science, RIKEN Center for Biosystems Dynamics Research, Kobe, Hyogo, Japan
- Department of Metabolism, Endocrinology, and Molecular Medicine, Osaka City University Graduate School of Medicine, Osaka, Japan
- FMCC Co. Ltd., Osaka, Japan
- Division of Health Science, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Yasuyoshi Watanabe
- Laboratory for Pathophysiological and Health Science, RIKEN Center for Biosystems Dynamics Research, Kobe, Hyogo, Japan
- RIKEN Compass to Healthy Life Research Complex Program, Kobe, Hyogo, Japan
- Osaka City University Center for Health Science Innovation, Osaka, Japan
- Department of Metabolism, Endocrinology, and Molecular Medicine, Osaka City University Graduate School of Medicine, Osaka, Japan
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17
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Grässler B, Thielmann B, Böckelmann I, Hökelmann A. Effects of Different Exercise Interventions on Cardiac Autonomic Control and Secondary Health Factors in Middle-Aged Adults: A Systematic Review. J Cardiovasc Dev Dis 2021; 8:jcdd8080094. [PMID: 34436236 PMCID: PMC8396995 DOI: 10.3390/jcdd8080094] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 08/02/2021] [Accepted: 08/03/2021] [Indexed: 01/09/2023] Open
Abstract
This systematic review was conducted in accordance with the PRISMA guidelines to summarize the existing literature on the effects of different exercise interventions on cardiac autonomic control and secondary health factors. Resting heart rate variability (HRV) was used as indicator of cardiac autonomic control. Secondary factors were related to factors that contribute to cardiovascular health. Studies examining the effects of endurance, resistance, multimodal, or coordinative training interventions in healthy participants aged between 45 and 60 years old on average were considered. The methodological quality of the studies was examined using two assessment scales (TESTEX and STARDHRV). PROSPERO registration number: CRD42020206606. The literature review retrieved eight studies fulfilling all inclusion criteria. Cardiac autonomic control and cardiovascular health improved after endurance and multimodal interventions. Resistance training had no significant impact on HRV or any secondary health factor. Coordinative exercise interventions showed inconclusive results regarding HRV but showed significant improvements in secondary health factors. The quality assessment tools revealed some methodological and reporting deficits. Despite the small number of studies, we suggest endurance and multimodal interventions including aerobic exercises for the enhancement of cardiac autonomic control and the reduction of cardiovascular risk in middle-aged adults. Further studies need to be conducted to examine the long-term effects of exercise in the midlife period.
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Affiliation(s)
- Bernhard Grässler
- Department of Sport Science, Faculty of Humanities, Otto von Guericke University, 39106 Magdeburg, Germany;
- Correspondence: ; Tel.: +49-391-6756682
| | - Beatrice Thielmann
- Department of Occupational Medicine, Medical Faculty, Otto von Guericke University, 39120 Magdeburg, Germany; (B.T.); (I.B.)
| | - Irina Böckelmann
- Department of Occupational Medicine, Medical Faculty, Otto von Guericke University, 39120 Magdeburg, Germany; (B.T.); (I.B.)
| | - Anita Hökelmann
- Department of Sport Science, Faculty of Humanities, Otto von Guericke University, 39106 Magdeburg, Germany;
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18
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Jakovljević T, Janković MM, Savić AM, Soldatović I, Mačužić I, Jakulin TJ, Papa G, Ković V. The effect of colour on reading performance in children, measured by a sensor hub: From the perspective of gender. PLoS One 2021; 16:e0252622. [PMID: 34125863 PMCID: PMC8202909 DOI: 10.1371/journal.pone.0252622] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Accepted: 05/19/2021] [Indexed: 11/18/2022] Open
Abstract
In recent decades reported findings regarding gender differences in reading achievement, cognitive abilities and maturation process in boys and girls are conflicting. As reading is one of the most important processes in the maturation of an individual, the aim of the study was to better understand gender differences between primary school students. The study evaluates differences in Heart Rate Variability (HRV), Electroencephalography (EEG), Electrodermal Activities (EDA) and eye movement of participants during the reading task. Taking into account that colour may affect reading skills, in that it affects the emotional and physiological state of the body, the research attempts to provide a better understanding of gender differences in reading through examining the effect of colour, as applied to reading content. The physiological responses of 50 children (25 boys and 25 girls) to 12 different background and overlay colours of reading content were measured and summarised during the reading process. Our findings show that boys have shorter reading duration scores and a longer Saccade Count, Saccade Duration Total, and Saccade Duration Average when reading on a coloured background, especially purple, which could be caused by their motivation and by the type of reading task. Also, the boys had higher values for the Delta band and the Whole Range of EEG measurements in comparison to the girls when reading on coloured backgrounds, which could reflect the faster maturation of the girls. Regarding EDA measurements we did not find systematic differences between groups either on white or on coloured/overlay background. We found the most significant differences arose in the HRV parameters, namely (SDNN (ms), STD HR (beats/min), RMSSD (ms), NN50 (beats), pNN50 (%), CVRR) when children read the text on coloured/overlay backgrounds, where the girls showed systematically higher values on HRV measurements in comparison to the boys, mostly with yellow, red, and orange overlay colours.
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Affiliation(s)
- Tamara Jakovljević
- Sensor Technologies, Jožef Stefan International Postgraduate School, Ljubljana, Slovenia
| | - Milica M. Janković
- School of Electrical Engineering, University of Belgrade, Belgrade, Serbia
| | - Andrej M. Savić
- School of Electrical Engineering, University of Belgrade, Belgrade, Serbia
| | - Ivan Soldatović
- Institute of Medical Statistics and Informatics, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Ivan Mačužić
- Faculty of Engineering, University of Kragujevac, Kragujevac, Serbia
| | | | | | - Vanja Ković
- Laboratory for Neurocognition and Applied Cognition, Faculty of Philosophy, University of Belgrade, Belgrade, Serbia
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Yang PL, Heitkemper MM, Kamp KJ. Irritable bowel syndrome in midlife women: a narrative review. Womens Midlife Health 2021; 7:4. [PMID: 34059117 PMCID: PMC8166071 DOI: 10.1186/s40695-021-00064-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Accepted: 05/11/2021] [Indexed: 12/03/2022] Open
Abstract
Midlife women between the ages of 40 and 65 years have reported multiple challenges due to menopausal, developmental, and situational transitions from younger to older adulthood. During the midlife period, many women seek health care for gastrointestinal symptoms and irritable bowel syndrome (IBS). Multiple factors including stress, poor sleep, diet, and physical inactivity may contribute to IBS or gastrointestinal symptoms in midlife women. As such, a comprehensive assessment and treatment approach is needed for midlife women suffering gastrointestinal symptoms. This article reviews the main aspects of the menopausal transition, sex hormonal changes, abdominal and pelvic surgery, psychosocial distress, behavioral factors, and gut microbiome, as well as their relevance on IBS and gastrointestinal symptoms in midlife women. Also, management strategies for IBS in midlife women are discussed. To date, gastrointestinal symptoms during midlife years remain a critical area of women’s health. Additional research is needed to better understand the contributors to gastrointestinal symptoms in this group. Such efforts may provide a new window to refine or develop treatments of gastrointestinal symptoms for midlife women.
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Affiliation(s)
- Pei-Lin Yang
- School of Nursing, National Defense Medical Center, No. 161, Section 6, Minquan E Rd, Neihu District, Taipei, 114, Taiwan.
| | - Margaret M Heitkemper
- Department of Biobehavioral Nursing and Health Informatics, School of Nursing, University of Washington, Seattle, WA, 98195, USA
| | - Kendra J Kamp
- Division of Gastroenterology, School of Medicine, University of Washington, Seattle, WA, 98195, USA
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Farmer AD, Strzelczyk A, Finisguerra A, Gourine AV, Gharabaghi A, Hasan A, Burger AM, Jaramillo AM, Mertens A, Majid A, Verkuil B, Badran BW, Ventura-Bort C, Gaul C, Beste C, Warren CM, Quintana DS, Hämmerer D, Freri E, Frangos E, Tobaldini E, Kaniusas E, Rosenow F, Capone F, Panetsos F, Ackland GL, Kaithwas G, O'Leary GH, Genheimer H, Jacobs HIL, Van Diest I, Schoenen J, Redgrave J, Fang J, Deuchars J, Széles JC, Thayer JF, More K, Vonck K, Steenbergen L, Vianna LC, McTeague LM, Ludwig M, Veldhuizen MG, De Couck M, Casazza M, Keute M, Bikson M, Andreatta M, D'Agostini M, Weymar M, Betts M, Prigge M, Kaess M, Roden M, Thai M, Schuster NM, Montano N, Hansen N, Kroemer NB, Rong P, Fischer R, Howland RH, Sclocco R, Sellaro R, Garcia RG, Bauer S, Gancheva S, Stavrakis S, Kampusch S, Deuchars SA, Wehner S, Laborde S, Usichenko T, Polak T, Zaehle T, Borges U, Teckentrup V, Jandackova VK, Napadow V, Koenig J. International Consensus Based Review and Recommendations for Minimum Reporting Standards in Research on Transcutaneous Vagus Nerve Stimulation (Version 2020). Front Hum Neurosci 2021; 14:568051. [PMID: 33854421 PMCID: PMC8040977 DOI: 10.3389/fnhum.2020.568051] [Citation(s) in RCA: 131] [Impact Index Per Article: 43.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Accepted: 09/01/2020] [Indexed: 12/18/2022] Open
Abstract
Given its non-invasive nature, there is increasing interest in the use of transcutaneous vagus nerve stimulation (tVNS) across basic, translational and clinical research. Contemporaneously, tVNS can be achieved by stimulating either the auricular branch or the cervical bundle of the vagus nerve, referred to as transcutaneous auricular vagus nerve stimulation(VNS) and transcutaneous cervical VNS, respectively. In order to advance the field in a systematic manner, studies using these technologies need to adequately report sufficient methodological detail to enable comparison of results between studies, replication of studies, as well as enhancing study participant safety. We systematically reviewed the existing tVNS literature to evaluate current reporting practices. Based on this review, and consensus among participating authors, we propose a set of minimal reporting items to guide future tVNS studies. The suggested items address specific technical aspects of the device and stimulation parameters. We also cover general recommendations including inclusion and exclusion criteria for participants, outcome parameters and the detailed reporting of side effects. Furthermore, we review strategies used to identify the optimal stimulation parameters for a given research setting and summarize ongoing developments in animal research with potential implications for the application of tVNS in humans. Finally, we discuss the potential of tVNS in future research as well as the associated challenges across several disciplines in research and clinical practice.
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Affiliation(s)
- Adam D. Farmer
- Department of Gastroenterology, University Hospitals of North Midlands NHS Trust, Stoke on Trent, United Kingdom
| | - Adam Strzelczyk
- Department of Neurology, Epilepsy Center Frankfurt Rhine-Main, Goethe-University Frankfurt, Frankfurt am Main, Germany
| | | | - Alexander V. Gourine
- Department of Neuroscience, Physiology and Pharmacology, Centre for Cardiovascular and Metabolic Neuroscience, University College London, London, United Kingdom
| | - Alireza Gharabaghi
- Institute for Neuromodulation and Neurotechnology, University Hospital and University of Tuebingen, Tuebingen, Germany
| | - Alkomiet Hasan
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, University of Augsburg, Augsburg, Germany
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Andreas M. Burger
- Laboratory for Biological Psychology, Faculty of Psychology and Educational Sciences, University of Leuven, Leuven, Belgium
| | | | - Ann Mertens
- Department of Neurology, Institute for Neuroscience, 4Brain, Ghent University Hospital, Gent, Belgium
| | - Arshad Majid
- Sheffield Institute for Translational Neuroscience (SITraN), University of Sheffield, Sheffield, United Kingdom
| | - Bart Verkuil
- Clinical Psychology and the Leiden Institute of Brain and Cognition, Leiden University, Leiden, Netherlands
| | - Bashar W. Badran
- Department of Psychiatry, Medical University of South Carolina, Charleston, SC, United States
| | - Carlos Ventura-Bort
- Department of Biological Psychology and Affective Science, Faculty of Human Sciences, University of Potsdam, Potsdam, Germany
| | - Charly Gaul
- Migraine and Headache Clinic Koenigstein, Königstein im Taunus, Germany
| | - Christian Beste
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Dresden, Germany
| | | | - Daniel S. Quintana
- NORMENT, Division of Mental Health and Addiction, University of Oslo and Oslo University Hospital, Oslo, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
- KG Jebsen Centre for Neurodevelopmental Disorders, University of Oslo, Oslo, Norway
| | - Dorothea Hämmerer
- Medical Faculty, Institute of Cognitive Neurology and Dementia Research, Otto-von-Guericke University, Magdeburg, Germany
- Institute of Cognitive Neuroscience, University College London, London, United Kingdom
- Center for Behavioral Brain Sciences Magdeburg (CBBS), Otto-von-Guericke University, Magdeburg, Germany
| | - Elena Freri
- Department of Pediatric Neuroscience, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Eleni Frangos
- Pain and Integrative Neuroscience Branch, National Center for Complementary and Integrative Health, NIH, Bethesda, MD, United States
| | - Eleonora Tobaldini
- Department of Internal Medicine, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Eugenijus Kaniusas
- Institute of Electrodynamics, Microwave and Circuit Engineering, TU Wien, Vienna, Austria
- SzeleSTIM GmbH, Vienna, Austria
| | - Felix Rosenow
- Department of Neurology, Epilepsy Center Frankfurt Rhine-Main, Goethe-University Frankfurt, Frankfurt am Main, Germany
| | - Fioravante Capone
- Unit of Neurology, Neurophysiology, Neurobiology, Department of Medicine, Università Campus Bio-Medico di Roma, Rome, Italy
| | - Fivos Panetsos
- Faculty of Biology and Faculty of Optics, Complutense University of Madrid and Institute for Health Research, San Carlos Clinical Hospital (IdISSC), Madrid, Spain
| | - Gareth L. Ackland
- Translational Medicine and Therapeutics, Barts and The London School of Medicine and Dentistry, William Harvey Research Institute, Queen Mary University of London, London, United Kingdom
| | - Gaurav Kaithwas
- Department of Pharmaceutical Sciences, School of Biosciences and Biotechnology, Babasaheb Bhimrao Ambedkar University (A Central University), Lucknow, India
| | - Georgia H. O'Leary
- Department of Psychiatry, Medical University of South Carolina, Charleston, SC, United States
| | - Hannah Genheimer
- Department of Biological Psychology, Clinical Psychology and Psychotherapy, University of Würzburg, Würzburg, Germany
| | - Heidi I. L. Jacobs
- Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States
- Faculty of Health, Medicine and Life Sciences, School for Mental Health and Neuroscience, Alzheimer Centre Limburg, Maastricht University, Maastricht, Netherlands
| | - Ilse Van Diest
- Research Group Health Psychology, Faculty of Psychology and Educational Sciences, University of Leuven, Leuven, Belgium
| | - Jean Schoenen
- Headache Research Unit, Department of Neurology-Citadelle Hospital, University of Liège, Liège, Belgium
| | - Jessica Redgrave
- Sheffield Institute for Translational Neuroscience (SITraN), University of Sheffield, Sheffield, United Kingdom
| | - Jiliang Fang
- Functional Imaging Lab, Department of Radiology, Guang An Men Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Jim Deuchars
- School of Biomedical Science, Faculty of Biological Science, University of Leeds, Leeds, United Kingdom
| | - Jozsef C. Széles
- Division for Vascular Surgery, Department of Surgery, Medical University of Vienna, Vienna, Austria
| | - Julian F. Thayer
- Department of Psychological Science, University of California, Irvine, Irvine, CA, United States
| | - Kaushik More
- Institute for Cognitive Neurology and Dementia Research, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany
- Neuromodulatory Networks, Leibniz Institute for Neurobiology, Magdeburg, Germany
| | - Kristl Vonck
- Department of Neurology, Institute for Neuroscience, 4Brain, Ghent University Hospital, Gent, Belgium
| | - Laura Steenbergen
- Clinical and Cognitive Psychology and the Leiden Institute of Brain and Cognition, Leiden University, Leiden, Netherlands
| | - Lauro C. Vianna
- NeuroV̇ASQ̇ - Integrative Physiology Laboratory, Faculty of Physical Education, University of Brasilia, Brasilia, Brazil
| | - Lisa M. McTeague
- Department of Psychiatry, Medical University of South Carolina, Charleston, SC, United States
| | - Mareike Ludwig
- Department of Anatomy, Faculty of Medicine, Mersin University, Mersin, Turkey
| | - Maria G. Veldhuizen
- Mental Health and Wellbeing Research Group, Vrije Universiteit Brussel, Brussels, Belgium
| | - Marijke De Couck
- Faculty of Health Care, University College Odisee, Aalst, Belgium
- Division of Epileptology, Fondazione IRCCS Istituto Neurologico C. Besta, Milan, Italy
| | - Marina Casazza
- Department of Neurosurgery, University of Tübingen, Tübingen, Germany
| | - Marius Keute
- Institute for Neuromodulation and Neurotechnology, University Hospital and University of Tuebingen, Tuebingen, Germany
| | - Marom Bikson
- Department of Biomedical Engineering, City College of New York, New York, NY, United States
| | - Marta Andreatta
- Department of Biological Psychology, Clinical Psychology and Psychotherapy, University of Würzburg, Würzburg, Germany
- Department of Psychology, Education and Child Studies, Erasmus University Rotterdam, Rotterdam, Netherlands
| | - Martina D'Agostini
- Research Group Health Psychology, Faculty of Psychology and Educational Sciences, University of Leuven, Leuven, Belgium
| | - Mathias Weymar
- Department of Biological Psychology and Affective Science, Faculty of Human Sciences, University of Potsdam, Potsdam, Germany
- Faculty of Health Sciences Brandenburg, University of Potsdam, Potsdam, Germany
| | - Matthew Betts
- Department of Anatomy, Faculty of Medicine, Mersin University, Mersin, Turkey
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Magdeburg, Germany
- Center for Behavioral Brain Sciences, Otto-von-Guericke University, Magdeburg, Germany
| | - Matthias Prigge
- Neuromodulatory Networks, Leibniz Institute for Neurobiology, Magdeburg, Germany
| | - Michael Kaess
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
- Section for Translational Psychobiology in Child and Adolescent Psychiatry, Department of Child and Adolescent Psychiatry, Centre for Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany
| | - Michael Roden
- Division of Endocrinology and Diabetology, Medical Faculty, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University, Düsseldorf, Germany
- German Center for Diabetes Research, Munich, Germany
| | - Michelle Thai
- Department of Psychology, College of Liberal Arts, University of Minnesota, Minneapolis, MN, United States
| | - Nathaniel M. Schuster
- Department of Anesthesiology, Center for Pain Medicine, University of California, San Diego Health System, La Jolla, CA, United States
| | - Nicola Montano
- Department of Internal Medicine, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Niels Hansen
- Department of Psychiatry and Psychotherapy, University of Göttingen, Göttingen, Germany
- Laboratory of Systems Neuroscience and Imaging in Psychiatry (SNIPLab), University of Göttingen, Göttingen, Germany
| | - Nils B. Kroemer
- Department of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany
| | - Peijing Rong
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, China
| | - Rico Fischer
- Department of Psychology, University of Greifswald, Greifswald, Germany
| | - Robert H. Howland
- Department of Psychiatry, University of Pittsburgh School of Medicine, UPMC Western Psychiatric Hospital, Pittsburgh, PA, United States
| | - Roberta Sclocco
- Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, United States
- Department of Radiology, Logan University, Chesterfield, MO, United States
| | - Roberta Sellaro
- Cognitive Psychology Unit, Institute of Psychology, Leiden University, Leiden, Netherlands
- Leiden Institute for Brain and Cognition, Leiden, Netherlands
- Department of Developmental Psychology and Socialisation, University of Padova, Padova, Italy
| | - Ronald G. Garcia
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, United States
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | - Sebastian Bauer
- Department of Neurology, Epilepsy Center Frankfurt Rhine-Main, Goethe-University Frankfurt, Frankfurt am Main, Germany
| | - Sofiya Gancheva
- Division of Endocrinology and Diabetology, Medical Faculty, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University, Düsseldorf, Germany
- Heart Rhythm Institute, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Stavros Stavrakis
- Faculty of Biological Science, School of Biomedical Science, University of Leeds, Leeds, United Kingdom
| | - Stefan Kampusch
- Institute of Electrodynamics, Microwave and Circuit Engineering, TU Wien, Vienna, Austria
- SzeleSTIM GmbH, Vienna, Austria
| | - Susan A. Deuchars
- School of Biomedical Science, Faculty of Biological Science, University of Leeds, Leeds, United Kingdom
| | - Sven Wehner
- Department of Surgery, University Hospital Bonn, Bonn, Germany
| | - Sylvain Laborde
- Department of Performance Psychology, Institute of Psychology, Deutsche Sporthochschule, Köln, Germany
| | - Taras Usichenko
- Department of Anesthesiology, University Medicine Greifswald, Greifswald, Germany
- Department of Anesthesia, McMaster University, Hamilton, ON, Canada
| | - Thomas Polak
- Laboratory of Functional Neurovascular Diagnostics, AG Early Diagnosis of Dementia, Department of Psychiatry, Psychosomatics and Psychotherapy, University Clinic Würzburg, Würzburg, Germany
| | - Tino Zaehle
- Department of Neurology, Otto-von-Guericke University, Magdeburg, Germany
| | - Uirassu Borges
- Department of Performance Psychology, Institute of Psychology, Deutsche Sporthochschule, Köln, Germany
- Department of Social and Health Psychology, Institute of Psychology, Deutsche Sporthochschule, Köln, Germany
| | - Vanessa Teckentrup
- Department of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany
| | - Vera K. Jandackova
- Department of Epidemiology and Public Health, Faculty of Medicine, University of Ostrava, Ostrava, Czechia
- Department of Human Movement Studies, Faculty of Education, University of Ostrava, Ostrava, Czechia
| | - Vitaly Napadow
- Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, United States
- Department of Radiology, Logan University, Chesterfield, MO, United States
| | - Julian Koenig
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
- Section for Experimental Child and Adolescent Psychiatry, Department of Child and Adolescent Psychiatry, Centre for Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany
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21
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Hu E, Liu X, Chen Q, Wang C. Investigation on the Incidence of Syncope in Children and Adolescents Aged 2-18 Years in Changsha. Front Pediatr 2021; 9:638394. [PMID: 33829003 PMCID: PMC8019745 DOI: 10.3389/fped.2021.638394] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Accepted: 02/03/2021] [Indexed: 12/03/2022] Open
Abstract
Objectives: Syncope is a common clinical symptom, while there are less relevant literature and targeted research on childhood morbidity. This article makes a cross-section survey on the incidence of syncope in children and adolescents aged 2-18 years in Changsha. Materials and Methods: There were 4,352 children and adolescents aged 2-18 years randomly selected from six primary and secondary schools and three kindergartens in Changsha from March 2018 to November 2018. There were 4,916 standardized questionnaires issued, and 4,352 (88.53%) valid questionnaires were recovered. Results: (1) Incidence: 17.37% of children and adolescents aged 2-18 years who had at least more than one syncope; the incidence in the adolescence (28.85%) was higher than that in the school age (8.32%) and in the preschool age (2.71%) (P < 0.01). (2) Age at onset: 13.9 ± 3.1 years old, with a peak age of 16 years. (3) Gender difference: The incidence in adolescent females was higher than that in males (31.72 vs. 26.25%, P < 0.05). In inducements, females had higher rates than males in sweltering environment (P < 0.01), whereas males had higher rates than females in urination (P < 0.05). Dizziness, nausea, sweating, and facial pallor were higher in females than in males in presyncope (P < 0.05). Conclusions: The incidence of syncope in children and adolescents aged 2-18 years in Changsha is 17.37%. The incidence of syncope is different between males and females in different age groups; there are gender differences in syncope inducements and presyncope.
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Affiliation(s)
- Erlin Hu
- Department of Pediatric, Changsha Maternal and Child Health Hospital, Hunan Normal University, Changsha, China
- Department of Pediatric Cardiovasology, Children's Medical Center, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Xiaoyan Liu
- Department of Pediatric Cardiovasology, Children's Medical Center, The Second Xiangya Hospital, Central South University, Changsha, China
- Department of Pediatric, Changsha Central Hospital, University of South China, Changsha, China
| | - Qianqian Chen
- Department of Pediatric, Changsha Maternal and Child Health Hospital, Hunan Normal University, Changsha, China
| | - Cheng Wang
- Department of Pediatric Cardiovasology, Children's Medical Center, The Second Xiangya Hospital, Central South University, Changsha, China
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22
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Sitovskyi AM, Radchenko OV, Dmytruk VS, Andriichuk OY, Roda OB, Savchuk IV. Heart Rate Variability in 12- to 13-Year-Old Adolescents. NEUROPHYSIOLOGY+ 2021. [DOI: 10.1007/s11062-021-09883-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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23
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Magalhães BC, Soares Júnior NDJS, Dias Filho CAA, Andrade RM, Dias CJM, de Oliveira SDFA, Santana LSOS, Sena CDS, Monzani-Brito JDO, Ferreira AC, Mostarda CT. Effect of obesity on sleep quality, anthropometric and autonomic parameters in adolescent. SLEEP SCIENCE (SAO PAULO, BRAZIL) 2021; 13:298-303. [PMID: 33564377 PMCID: PMC7856663 DOI: 10.5935/1984-0063.20200037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Objective To compare the effects of obesity on sleep quality, the anthropometric and autonomic parameters of adolescents. Material and Methods A cross-sectional study was carried out with adolescents aged 11 to 18, analyzing parameters such as BMI, sleep quality records, waist circumference, fat percentage, blood pressure and sexual maturation, in addition to autonomic cardiac function through the analysis of heart rate variability. Results The anthropometric parameters of waist circumference, percentage fat mass, were significantly higher in the group of obese adolescents. Sympathetic modulation in LF% was significantly higher in obesity. Parasympathetic modulation in HF% was significantly lower in obese than in eutrophic. Conclusion Obese adolescents do not have poor sleep quality; there is no distinction between boys and girls regarding the analyzed variables; however, obesity alone was responsible for negatively influencing anthropometric parameters, as well as impairing the autonomic cardiac modulation.
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Affiliation(s)
- Bruna Cruz Magalhães
- Federal University of Maranhão, Department of Nutrition - São Luís - Maranhão - Brazil
| | | | - Carlos Alberto Alves Dias Filho
- Federal University of Maranhão, Laboratory of Cardiovascular Adaptations to Exercise (LACORE) - São Luís - Maranhão - Brazil
| | - Rafael Martins Andrade
- Federal University of Maranhão, Laboratory of Cardiovascular Adaptations to Exercise (LACORE) - São Luís - Maranhão - Brazil
| | - Carlos José Moraes Dias
- Federal University of Maranhão, Physical Education Department - São Luís - Maranhão - Brazil
| | | | | | - Carlan da Silva Sena
- Federal University of Maranhão, Laboratory of Cardiovascular Adaptations to Exercise (LACORE) - São Luís - Maranhão - Brazil
| | | | - Andressa Coelho Ferreira
- Federal University of Maranhão, Laboratory of Cardiovascular Adaptations to Exercise (LACORE) - São Luís - Maranhão - Brazil
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24
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Kunikullaya U K, Kunnavil R, Vijayadas, Goturu J, Prakash VS, Murthy NS. Normative data and gender differences in heart rate variability in the healthy young individuals aged 18-30 years, a South Indian cross-sectional study. Indian Pacing Electrophysiol J 2021; 21:112-119. [PMID: 33482336 PMCID: PMC7952895 DOI: 10.1016/j.ipej.2021.01.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 12/12/2020] [Accepted: 01/09/2021] [Indexed: 12/29/2022] Open
Affiliation(s)
- Kirthana Kunikullaya U
- Department of Physiology, M S Ramaiah Medical College, MSR Nagar, MSRIT Post, Bangalore, Karnataka, 560054, India.
| | - Radhika Kunnavil
- Department of Community Medicine, ESI Post Graduate Institute of Medical Science and Research, 41st Cross Rd, Rajajinagar, Bangalore, Karnataka, 560010, India.
| | - Vijayadas
- Department of Physiology, M S Ramaiah Medical College, MSR Nagar, MSRIT Post, Bangalore, Karnataka, 560054, India.
| | - Jaisri Goturu
- Department of Physiology, International Medical School, MSR Nagar, MSRIT Post, Bangalore, Karnataka, 560054, India.
| | - Vadagenahalli S Prakash
- Department of Cardiology, M S Ramaiah Memorial Hospitals, MSR Nagar, MSRIT Post, Bangalore, Karnataka, 560054, India.
| | - Nandagudi Srinivasa Murthy
- Department of Research and Patents, Gokula Education Foundation, MSR Nagar, MSRIT Post, Bangalore, Karnataka, 560054, India.
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25
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Memmini AK, Fountaine MFL, Broglio SP, Moore RD. Long-Term Influence of Concussion on Cardio-Autonomic Function in Adolescent Hockey Players. J Athl Train 2021; 56:141-147. [PMID: 33400783 DOI: 10.4085/1062-6050-0578.19] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT Concussion may negatively influence cardiovascular function and the autonomic nervous system, defined by alteration in heart rate variability (HRV). Differences in HRV most commonly emerge during a physical challenge, such as the final steps of the return-to-sport progression. OBJECTIVE To assess the effect of concussion history on aspects of cardio-autonomic function during recovery from a bout of submaximal exercise in adolescent male hockey athletes. DESIGN Case-control study. SETTING Research laboratory. PATIENTS OR OTHER PARTICIPANTS Thirty-three male athletes participating in Midget-AAA hockey were divided into those with (n = 15; age = 16 ± 1 years, height = 1.78 ± 0.06 m, mass = 73.9 ± 7.4 kg, 10.5 ± 1.6 years of sport experience, 25.2 ± 18.3 months since last injury) or without (n = 18; age = 16 ± 1 years, height = 1.78 ± 0.05 m, mass = 74.8 ± 7.6 kg, 10.6 ± 1.9 years of sport experience) a concussion history. Those with a concussion history were binned on total count: concussion) or 2 or more concussions. INTERVENTION(S) All athletes underwent 5 minutes of resting HRV assessment, followed by 20 minutes of aerobic exercise at 60% to 70% of their maximal target heart rate and a 9-minute, postexercise HRV assessment. MAIN OUTCOME MEASURE(S) Heart rate variability measures of mean NN interval, root mean square of successive differences, and standard deviation of NN interval (SDNN). RESULTS Group demographic characteristics were not different. When the control and concussed groups were compared, group and time main effects for heart rate recovery, root mean square of successive differences, and SDNN (P values < .01), and an interaction effect for SDNN (P < .05) were demonstrated. Recovery trends for each group indicated that a history of 2 or more concussions may negatively affect cardio-autonomic recovery postexercise. CONCLUSIONS Our findings suggest that those with more than 1 previous concussion may be associated with a greater risk for long-term dysautonomia. Future use of HRV may provide clinicians with objective guidelines for concussion-management and safe return-to-participation protocols.
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Affiliation(s)
| | - Michael F La Fountaine
- Department of Physical Therapy, School of Health and Medical Sciences; Institute for Advanced Study of Rehabilitation and Sports Science; Department of Medical Sciences and Neurology, Hackensack Meridian School of Medicine, Seton Hall University, Nutley, NJ
| | | | - Robert D Moore
- Arnold School of Public Health; Institute for Mind and Brain, University of South Carolina, Columbia
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26
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Guo ZP, Sörös P, Zhang ZQ, Yang MH, Liao D, Liu CH. Use of Transcutaneous Auricular Vagus Nerve Stimulation as an Adjuvant Therapy for the Depressive Symptoms of COVID-19: A Literature Review. Front Psychiatry 2021; 12:765106. [PMID: 34975571 PMCID: PMC8714783 DOI: 10.3389/fpsyt.2021.765106] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 11/12/2021] [Indexed: 12/17/2022] Open
Abstract
The coronavirus disease 2019 (COVID-19) comprises more than just severe acute respiratory syndrome. It also interacts with the cardiovascular, nervous, renal, and immune systems at multiple levels, increasing morbidity in patients with underlying cardiometabolic conditions and inducing myocardial injury or dysfunction. Transcutaneous auricular vagus nerve stimulation (taVNS), which is derived from auricular acupuncture, has become a popular therapy that is increasingly accessible to the general public in modern China. Here, we begin by outlining the historical background of taVNS, and then describe important links between dysfunction in proinflammatory cytokine release and related multiorgan damage in COVID-19. Furthermore, we emphasize the important relationships between proinflammatory cytokines and depressive symptoms. Finally, we discuss how taVNS improves immune function via the cholinergic anti-inflammatory pathway and modulates brain circuits via the hypothalamic-pituitary-adrenal axis, making taVNS an important treatment for depressive symptoms on post-COVID-19 sequelae. Our review suggests that the link between anti-inflammatory processes and brain circuits could be a potential target for treating COVID-19-related multiorgan damage, as well as depressive symptoms using taVNS.
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Affiliation(s)
- Zhi-Peng Guo
- Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, China
| | - Peter Sörös
- Research Center Neurosensory Science, Carl von Ossietzky University of Oldenburg, Oldenburg, Germany
| | - Zhu-Qing Zhang
- Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, China
| | - Ming-Hao Yang
- Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, China
| | - Dan Liao
- Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, China
| | - Chun-Hong Liu
- Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, China.,Beijing Key Laboratory of Acupuncture Neuromodulation, Beijing Institute of Traditional Chinese Medicine, Beijing, China
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Zeng C, Wang W, Chen C, Zhang C, Cheng B. Sex Differences in Time-Domain and Frequency-Domain Heart Rate Variability Measures of Fatigued Drivers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E8499. [PMID: 33212769 PMCID: PMC7696627 DOI: 10.3390/ijerph17228499] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 11/03/2020] [Accepted: 11/12/2020] [Indexed: 01/15/2023]
Abstract
The effects of fatigue on a driver's autonomic nervous system (ANS) were investigated through heart rate variability (HRV) measures considering the difference of sex. Electrocardiogram (ECG) data from 18 drivers were recorded during a simulator-based driving experiment. Thirteen short-term HRV measures were extracted through time-domain and frequency-domain methods. First, differences in HRV measures related to mental state (alert or fatigued) were analyzed in all subjects. Then, sex-specific changes between alert and fatigued states were investigated. Finally, sex differences between alert and fatigued states were compared. For all subjects, ten measures showed significant differences (Mann-Whitney U test, p < 0.01) between different mental states. In male and female drivers, eight and four measures, respectively, showed significant differences between different mental states. Six measures showed significant differences between males and females in an alert state, while ten measures showed significant sex differences in a fatigued state. In conclusion, fatigue impacts drivers' ANS activity, and this impact differs by sex; more differences exist between male and female drivers' ANS activity in a fatigued state than in an alert state.
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Affiliation(s)
- Chao Zeng
- College of Information Science and Engineering, Henan University of Technology, Zhengzhou 450001, China;
| | - Wenjun Wang
- State Key Laboratory of Automotive Safety and Energy, Tsinghua University, Beijing 100084, China; (C.Z.); (B.C.)
- School of Vehicle and Mobility, Tsinghua University, Beijing 100084, China
| | - Chaoyang Chen
- Department of Biomedical Engineering, Wayne State University, Detroit, MI 48201, USA;
| | - Chaofei Zhang
- State Key Laboratory of Automotive Safety and Energy, Tsinghua University, Beijing 100084, China; (C.Z.); (B.C.)
- School of Vehicle and Mobility, Tsinghua University, Beijing 100084, China
| | - Bo Cheng
- State Key Laboratory of Automotive Safety and Energy, Tsinghua University, Beijing 100084, China; (C.Z.); (B.C.)
- School of Vehicle and Mobility, Tsinghua University, Beijing 100084, China
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S S, Rao MY, Aslam SM. Assessment of Functions of the Autonomic Nervous System in the Elderly with Different Comorbid Factors. J Neurosci Rural Pract 2020; 12:80-87. [PMID: 33531764 PMCID: PMC7846347 DOI: 10.1055/s-0040-1718854] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Background Studies in healthy elderly patients have shown the prevalence of autonomic dysfunction (AD) in the range of 20 to 30%. However, there is paucity in data pertaining to AD in the elderly in the Indian context. Objective To assess the prevalence of AD in the elderly irrespective of their comorbidity status. Methods A total of 141 elderly patients with or without comorbidities/symptoms of AD were included. Demographic and clinical details of the patients were recorded. Autonomic function tests (AFTs) such as deep breathing test, Valsalva ratio, orthostatic heart rate (OHR), isometric handgrip test, and orthostatic blood pressure were performed based on Ewing's battery of tests. The sensitivity, specificity, positive predictive value, negative predictive value, and the accuracy of AFTs were evaluated. Results Most patients ( n = 85) were aged between 60 and 69 years, with a male predominance (58.87%). Hypertension and diabetes mellitus were the most common comorbidities. Postural hypotension was the most common symptom of AD. With advancing age, symptoms of AD manifested significantly more. Overall, 73.8% of patients had AD, of whom 45.4% had early AD. Number of AD symptoms, glycated hemoglobin (HbA1c) level, and comorbid factors (diabetes and hypertension) were significantly associated with the results of AFTs ( p < 0.05). AFTs were highly significant with respect to the results obtained ( p < 0.001). Deep breathing test, abnormal in majority of study patients, has a sensitivity of 93.3% and OHR has a specificity of 81.1% to determine AD. Conclusion The study concludes that age itself is an independent predictor of AD, which increases in severity if associated with comorbidities.
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Affiliation(s)
- Sushma S
- Department of General Medicine, M.S. Ramaiah Medical College and Hospitals, Bengaluru, Karnataka, India
| | - Medha Y Rao
- Department of General Medicine, M.S. Ramaiah Medical College and Hospitals, Bengaluru, Karnataka, India
| | - Shaikh Mohammed Aslam
- Department of General Medicine, M.S. Ramaiah Medical College and Hospitals, Bengaluru, Karnataka, India
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Relationship between truck driver fatigue and rear-end collision risk. PLoS One 2020; 15:e0238738. [PMID: 32915847 PMCID: PMC7485791 DOI: 10.1371/journal.pone.0238738] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Accepted: 08/21/2020] [Indexed: 12/28/2022] Open
Abstract
The fatigue of truck, bus, and taxi drivers has been a causal trigger for road accidents. However, the relationship between collision risk and the extent of objective fatigue has yet to be confirmed. In this study, we aimed to identify the relationship between autonomic nerve function as an objective parameter of fatigue and the extent of rear-end collision risk, which includes not only objectively risky events but also situations in which truck drivers require safety guidance from safety transport managers. Data of 33 truck driver participants (2 females, 31 males, 46.0 ± 9.1 years old, min–max: 24–65 years old) were analyzed. Drive recorder and automotive sensor data were collected over an eight-month period, and the autonomic nerve function during resting state in drivers was evaluated daily, pre- and post-shift, using pulse waves and electrocardiographic waveform measurement. The rear-end collision risk Index was developed using decision tree analysis of the audiovisual drive recorder data and distance data from the front automotive sensors. The rear-end collision risk index of shift-day was positively correlated with the sympathetic nerve activity index of post-shift condition on the previous day. This suggests that fatigue-related sympathetic nerve overactivity of post-shift condition increases the rear-end collision risk in the following day. Measures, such as actively seeking rest and undertaking fatigue recovery according to the degree of sympathetic nerve activity of post-shift condition, are necessary in order to prevent truck drivers’ rear-end collisions.
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Garbarino S, Lanteri P, Prada V, Falkenstein M, Sannita WG. Circadian Rhythms, Sleep, and Aging. J PSYCHOPHYSIOL 2020. [DOI: 10.1027/0269-8803/a000267] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Abstract. Circadian mechanisms and the sleep-wakefulness rhythms guarantee survival, adaptation, efficient action in everyday life or in emergencies and well-being. Disordered circadian processes at central and/or cellular levels, sleep disorders, and unhealthy wakefulness/sleep rhythms can impair the physiological circadian organization and result in subjective, professional, or behavioral changes ranging from functional inadequacy to higher risks at work or on the road to medical relevance. Circadian rhythms and the sleep organization change ontogenetically; major changes result from normal aging and from the multiple diseases that are often associated. There are circular functional interactions involving sleep/sleep disorders, the autonomic and immune systems, and the functional changes in the circadian system due to aging that deserve attention but have been overlooked thus far.
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Affiliation(s)
- Sergio Garbarino
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal/Child Sciences, University of Genova, Polyclinic Hospital San Martino IRCCS, Genova, Italy
| | - Paola Lanteri
- Department of Diagnostics and Applied Technology, Neurophysiopathology Center, Fondazione IRCCS, Istituto Neurologico C. Besta, Milano, Italy
| | - Valeria Prada
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal/Child Sciences, University of Genova, Polyclinic Hospital San Martino IRCCS, Genova, Italy
| | | | - Walter G. Sannita
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal/Child Sciences, University of Genova, Polyclinic Hospital San Martino IRCCS, Genova, Italy
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George K, S IJ, Thomas NS, R B, K B. Gender-Based Vegetarian and Nonvegetarian Dietary Impact on Cardiac Autonomic Function of Heart Rate Variability. J Am Coll Nutr 2020; 40:237-241. [PMID: 32314942 DOI: 10.1080/07315724.2020.1753130] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Objective: Cardiovascular disease is one among the major mortality threats throughout the world. Autonomic activity of the nervous system can be examined by heart rate variability (HRV) analysis. Association of sympathetic and parasympathetic activities is directly related to HRV modulation. The aim of the study is to determine variations in HRV parameters among adult/adolescent male and female subjects due to vegetarian and nonvegetarian diet.Method: Ninety undergraduate students in each male and female group (N = 180) volunteered for the study. Based upon food habits, male and female subjects were categorized into four groups. Short-term (5-minute) heart rate recordings were measured from the subjects in a seated position before breakfast with minimum of 12 hours' fasting. Two-way analysis of variance was performed among the time and frequency domain variables.Results: Time domain variables are observed as significant (p < 0.05) between vegetarian males and females and also (p < 0.05) between male vegetarian and female nonvegetarians for standard deviation of NN intervals. Frequency domain HRV indices such as low frequency (LF; p = 0.01), high frequency (HF; p = 0.0001), and LF/HF (p < 0.001) resulted between male and female vegetarians. Significance of LF (p = 0.02), HF (p < 0.0001), and LF/HF (p < 0.01) was measured between male vegetarians and female nonvegetarians. LF (p = 0.02), HF (p = 0.04), and LF/HF (p = 0.002) resulted between nonvegetarian males and females. HF (p = 0.05) was enumerated between male vegetarians and nonvegetarians.Conclusions: Significant predominance of sympathetic cardiac activity was observed among male nonvegetarian consumers more than female vegetarians. Analysis demonstrates that the gender-based influence of vegetarian and nonvegetarian diet has significant correlation under HRV measurements.
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Affiliation(s)
- Kiran George
- Department of Biomedical Engineering, Chennai Institute of Technology, Chennai, India
| | - Immaculate Joy S
- Department of Electronics and Communication Engineering, Veltech Multitech Dr Rangarajan Dr Sakunthala Engineering College, Chennai, India
| | - Nisha Susan Thomas
- Department of Biochemistry and Biotechnology, Annamalai University, India
| | - Balamurali R
- Department of Electronics and Communication Engineering, Chennai Institute of Technology, Chennai, India
| | - Baskaran K
- Bio Medical Engineer and Regional Manager, BIOPAC Systems Inc., GenTech Pvt. Ltd., New Delhi, India
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Liu I, Ni S, Peng K. Happiness at Your Fingertips: Assessing Mental Health with Smartphone Photoplethysmogram-Based Heart Rate Variability Analysis. Telemed J E Health 2020; 26:1483-1491. [PMID: 32101084 DOI: 10.1089/tmj.2019.0283] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Background: Heart rate variability (HRV) provides essential mental health information for clinical diagnosis, telemedicine, preventive medicine, and public health; however, the lack of a convenient detection method limits its potential. Objective: This study aims to investigate the feasibility and credibility of smartphone photoplethysmogram (PPG)-based HRV analysis for mental well-being and health assessment. Methods: Data were collected from 93 students and university employees in Shenzhen, China. Forty-six percent were male, and the average age was 23.71 years (σ = 4.33). An app recorded a 4-min video of their fingertips and converted the frames into five HRV measures, including the root mean square of successive differences (rMSSD), standard deviation of the normal-to-normal (NN) intervals (SDNN), percentage of successive NN intervals differing by ≥50 ms (pNN50), log high-frequency (HF) HRV, and log low-frequency (LF) HRV. Results: The data verify the positive relationship between mental well-being and HRV measures. Participants with higher Satisfaction With Life Scale (SWLS) scores have a higher rMSSD (p = 0.047), SDNN (p = 0.009), log HF (p = 0.02), and log LF (p = 0.003). Participants who suffer from depression have lower log HF (p = 0.048) and log LF (p = 0.02). Participants in the high-anxiety group have lower pNN50 (p = 0.04) and log HF (p = 0.03). Conclusions: The results of this study validate the feasibility of using the smartphone PPG by demonstrating similar results to previous findings. Our data also support the theorized positive link between mental health and HRV.
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Affiliation(s)
- Ivan Liu
- Data Science and Information Technology Research Center, Tsinghua-Berkeley Shenzhen Institute, Tsinghua University, Shenzhen, China
| | - Shiguang Ni
- Graduate School at Shenzhen, Tsinghua University, Shenzhen, China
| | - Kaiping Peng
- Data Science and Information Technology Research Center, Tsinghua-Berkeley Shenzhen Institute, Tsinghua University, Shenzhen, China.,Department of Psychology, Tsinghua University, Beijing, China
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Sorinas J, Ferrández JM, Fernandez E. Brain and Body Emotional Responses: Multimodal Approximation for Valence Classification. SENSORS 2020; 20:s20010313. [PMID: 31935909 PMCID: PMC6982758 DOI: 10.3390/s20010313] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Revised: 01/02/2020] [Accepted: 01/03/2020] [Indexed: 11/16/2022]
Abstract
In order to develop more precise and functional affective applications, it is necessary to achieve a balance between the psychology and the engineering applied to emotions. Signals from the central and peripheral nervous systems have been used for emotion recognition purposes, however, their operation and the relationship between them remains unknown. In this context, in the present work, we have tried to approach the study of the psychobiology of both systems in order to generate a computational model for the recognition of emotions in the dimension of valence. To this end, the electroencephalography (EEG) signal, electrocardiography (ECG) signal and skin temperature of 24 subjects have been studied. Each methodology has been evaluated individually, finding characteristic patterns of positive and negative emotions in each of them. After feature selection of each methodology, the results of the classification showed that, although the classification of emotions is possible at both central and peripheral levels, the multimodal approach did not improve the results obtained through the EEG alone. In addition, differences have been observed between cerebral and peripheral responses in the processing of emotions by separating the sample by sex; though, the differences between men and women were only notable at the peripheral nervous system level.
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Affiliation(s)
- Jennifer Sorinas
- The Institute of Bioengineering, University Miguel Hernandez, 03202 Elche, Spain
- Department of Electronics and Computer Technology, University of Cartagena, 30202 Cartagena, Spain;
- Correspondence: (J.S.); (E.F.)
| | - Jose Manuel Ferrández
- Department of Electronics and Computer Technology, University of Cartagena, 30202 Cartagena, Spain;
| | - Eduardo Fernandez
- The Institute of Bioengineering, University Miguel Hernandez, 03202 Elche, Spain
- Correspondence: (J.S.); (E.F.)
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Pasupula DK, Patthipati VS, Javed A, Siddappa Malleshappa SK. Takotsubo Cardiomyopathy: Understanding the Pathophysiology of Selective Left Ventricular Involvement. Cureus 2019; 11:e5972. [PMID: 31803554 PMCID: PMC6874293 DOI: 10.7759/cureus.5972] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
Takotsubo cardiomyopathy (TCM) has gained global recognition as a unique cardiovascular disease that mimics acute myocardial infarction. Since its initial description, more than three decades ago, we have significantly advanced our understanding of diagnosing, treating, and prognosticating this reversible cardiovascular phenomenon. However, the pathophysiological explanation behind its selective involvement of the left ventricle (LV), predominantly the LV apex in poorly understood. In this brief review on differential distribution of the adrenergic nerve (AN) and cholinergic nerve (CN) in the normal human heart, we try to extrapolate an idea of poor CN distribution in the LV apex as an associated factor augmenting microcirculatory dysfunction due to an unopposed AN activity from the catecholamine surge, as a plausible explanation for this characteristic phenomenon.
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Affiliation(s)
| | | | - Awais Javed
- Internal Medicine, University of Pittsburgh Medical Center, Pittsburgh, USA
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35
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Vila XA, Lado MJ, Cuesta-Morales P. Evidence Based Recommendations for Designing Heart Rate Variability Studies. J Med Syst 2019; 43:311. [PMID: 31451951 DOI: 10.1007/s10916-019-1437-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Accepted: 08/20/2019] [Indexed: 12/22/2022]
Abstract
Heart rate variability (HRV) analysis is a powerful instrument that provides information about the heart conditions. However, there exist some limitations in the use of HRV in the clinical practice. Examples are the lack of reference values for healthy populations, different HR (Heart Rate) acquisition systems, and varying software packages. Other factors that affect HRV values are the influence of lifestyle, drugs and alcohol consumption, and pollution. In this work, recommendations to perform HRV-based experiments were established. These suggestions refer to best moment of the day to record data, the optimal body position, and the quality and duration of the recorded signals. In this way, HR data from 6 healthy subjects (2 women, 4 men), with median age of 50 years old, were recorded during 15 days, 3 times a day. Recordings were performed in the following situations: both supine and sitting body positions, in the morning, in the afternoon and at night. Data were processed and HRV analysis was performed. Distorting factors affecting HRV have been determined. The most stable HRV indexes (less variation over the days) have also been established. For this task, a variation coefficient was calculated for each parameter, as the ratio between the standard deviation and the mean value. Results indicated that HR data should be recorded in the morning, the sitting position. Related to signals duration, when comparing HR signals, they should be of equal length (same recording time). In addition, HRVi (HRV triangular index) and MADRR (median of the absolute differences between adjacent RR intervals) resulted in the most robust indexes in both low and high frequency domains. For global indexes, the ApEn (approximate entropy) measure emerged as the most stable one. As a conclusion, researchers must be extremely cautious in studies involving HRV analysis; the moment of the day to record data, the body position, or the quality of recorded data will produce different HR signals, and thus, the values of the HRV parameters will be different in each case. This may clearly bias the conclusions of the study.
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Affiliation(s)
- Xosé A Vila
- Department of Computer Science, ESEI, University of Vigo, Campus As Lagoas, 32004, Ourense, Spain
| | - María J Lado
- Department of Computer Science, ESEI, University of Vigo, Campus As Lagoas, 32004, Ourense, Spain.
| | - P Cuesta-Morales
- Department of Computer Science, ESEI, University of Vigo, Campus As Lagoas, 32004, Ourense, Spain
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Lozupone M, La Montagna M, D'Urso F, Daniele A, Greco A, Seripa D, Logroscino G, Bellomo A, Panza F. The Role of Biomarkers in Psychiatry. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2019; 1118:135-162. [PMID: 30747421 DOI: 10.1007/978-3-030-05542-4_7] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Psychiatric illnesses are cognitive and behavioral disorders of the brain. At present, psychiatric diagnosis is based on DSM-5 criteria. Even if endophenotype specificity for psychiatric disorders is discussed, it is difficult to study and identify psychiatric biomarkers to support diagnosis, prognosis, or clinical response to treatment. This chapter investigates the innovative biomarkers of psychiatric diseases for diagnosis and personalized treatment, in particular post-genomic data and proteomic analyses.
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Affiliation(s)
- Madia Lozupone
- Neurodegenerative Disease Unit, Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari Aldo Moro, Bari, Italy
| | - Maddalena La Montagna
- Psychiatric Unit, Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Francesca D'Urso
- Psychiatric Unit, Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Antonio Daniele
- Institute of Neurology, Catholic University of Sacred Heart, Rome, Italy.,Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Antonio Greco
- Geriatric Unit, Fondazione IRCCS Casa Sollievo della Sofferenza, Foggia, Italy
| | - Davide Seripa
- Geriatric Unit, Fondazione IRCCS Casa Sollievo della Sofferenza, Foggia, Italy
| | - Giancarlo Logroscino
- Neurodegenerative Disease Unit, Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari Aldo Moro, Bari, Italy.,Department of Clinical Research in Neurology, University of Bari Aldo Moro, Lecce, Italy
| | - Antonello Bellomo
- Psychiatric Unit, Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Francesco Panza
- Neurodegenerative Disease Unit, Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari Aldo Moro, Bari, Italy. .,Geriatric Unit, Fondazione IRCCS Casa Sollievo della Sofferenza, Foggia, Italy. .,Department of Clinical Research in Neurology, University of Bari Aldo Moro, Lecce, Italy.
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Yiiong SP, Ting HY, Tan DYW, Chia R. Investigation of Relation between Sport’s Motion and Heart Rate Variability (HRV) Based on Biometric Parameters. ACTA ACUST UNITED AC 2019. [DOI: 10.1088/1757-899x/495/1/012015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Kamimura K, Sakamaki A, Kamimura H, Setsu T, Yokoo T, Takamura M, Terai S. Considerations of elderly factors to manage the complication of liver cirrhosis in elderly patients. World J Gastroenterol 2019; 25:1817-1827. [PMID: 31057296 PMCID: PMC6478616 DOI: 10.3748/wjg.v25.i15.1817] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2019] [Revised: 03/12/2019] [Accepted: 03/16/2019] [Indexed: 02/06/2023] Open
Abstract
The aging of the organ function causes sensitivity to the disease progression and need careful consideration for the medical treatment. With the increase of aging population, the opportunity to provide medical treatment for people in very old age is rapidly increasing therefore, the understanding of the various physiological changes of cellular function, size and function of organs are essential for the decision of therapeutic options. Among the various chronic conditions seen in elderly people, we have focused on liver cirrhosis, since despite specific therapeutic options for many of liver diseases including direct acting antivirals for hepatitis C virus, nucleoside analogs for hepatitis B, and corticosteroids for autoimmune hepatitis, there is currently no standard therapy to treat liver cirrhosis, which is the final stage of these liver diseases. Therefore, management of the various symptoms of liver cirrhosis is essential, and aging-related parameters must be considered in the decision making for therapeutic strategies and dosage of the available medicine. In this mini-review, we have summarized the therapeutic options to manage various symptoms of liver cirrhosis, carefully considering the physiological changes of various organs associated with aging.
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Affiliation(s)
- Kenya Kamimura
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata 951-8510, Japan
| | - Akira Sakamaki
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata 951-8510, Japan
| | - Hiroteru Kamimura
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata 951-8510, Japan
| | - Toru Setsu
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata 951-8510, Japan
| | - Takeshi Yokoo
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata 951-8510, Japan
| | - Masaaki Takamura
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata 951-8510, Japan
| | - Shuji Terai
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata 951-8510, Japan
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Clinical factors associated with the recovery of cardiovascular autonomic neuropathy in patients with type 2 diabetes mellitus. Cardiovasc Diabetol 2019; 18:29. [PMID: 30857534 PMCID: PMC6410519 DOI: 10.1186/s12933-019-0830-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Accepted: 02/19/2019] [Indexed: 02/07/2023] Open
Abstract
Background Cardiovascular autonomic neuropathy (CAN) is a major cause of morbidity and mortality in diabetes patients. Although several risk factors for CAN progression have been established, whether CAN is reversible remains unclear and the clinical factors associated with CAN recovery have not been identified. This study aimed to determine clinical factors related to CAN recovery. Methods Type 2 diabetes patients with CAN but free of cardiovascular disease at baseline were enrolled and followed for 2–3 years in this retrospective longitudinal study. CAN was classified as early (one abnormal parasympathetic test), definite (two or more abnormal parasympathetic tests), severe (definite plus orthostatic hypotension), or atypical (early plus orthostatic hypotension or orthostatic hypotension alone) based on Ewing’s method. CAN recovery was classified as partial or complete: Partial recovery was defined as one-step improvement in CAN stage (early to normal, definite to early, or severe to definite), including the disappearance of only one abnormal result in any stage. Complete recovery was defined as normalization from definite or severe CAN. Results Among 759 subjects with CAN, 29.9% (n = 227) experienced CAN recovery, and 1.2% (n = 9) recovered completely. In a multivariate model, younger age (odds ratio [OR] per 5-year decrease 1.49; 95% confidence interval [CI] 1.25–1.78, P < 0.001), shorter duration of diabetes (OR per 5-year decrease 1.33; 95% CI 1.05–1.67, P = 0.016), presence of micro/macroalbuminuria (OR 0.34; 95% CI 0.15–0.78, P = 0.011), body weight reduction (OR per 1-kg decrease 1.11; 95% CI 1.02–1.21, P = 0.016), and HbA1c reduction (OR per 1% decrease 1.32; 95% CI 1.05–1.67, P = 0.019) were significantly associated with composite events of partial and complete CAN recovery. Age had the highest relative significance among the associated clinical factors. In addition, younger age was the only significant factor in complete CAN recovery. Conclusions Younger age was the most important factor in CAN recovery in subjects with type 2 diabetes, including recovery from the definite or severe stage. HbA1c reduction, body weight reduction, no concurrent micro/macroalbuminuria, and shorter duration of diabetes were also significantly associated with CAN recovery. Electronic supplementary material The online version of this article (10.1186/s12933-019-0830-4) contains supplementary material, which is available to authorized users.
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Hammoud S, Karam R, Mourad R, Saad I, Kurdi M. Stress and Heart Rate Variability during University Final Examination among Lebanese Students. Behav Sci (Basel) 2018; 9:bs9010003. [PMID: 30591634 PMCID: PMC6358958 DOI: 10.3390/bs9010003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2018] [Revised: 12/18/2018] [Accepted: 12/18/2018] [Indexed: 11/16/2022] Open
Abstract
Real-life stressors, such as university examination, cause an increase in sympathetic activity of the nervous system innervating the heart, and thus an increase in heart rate (HR). Our study aimed to detect changes in heart rate variability (HRV) during different stages of an exam in a group of 90 healthy university students (30 males and 60 females), over 4 h of monitoring divided into 1 h before, 2 h during, and 1 h after the examination. HRV was significantly highest after the exam, indicating release from stress, as compared to before and during the examination when stress was observable. Undergraduate students in different academic years did not differ in terms of stress, indicating the absence of adaptation to exam procedures. However, HR and R-R interval after the exam showed significant difference between first year undergraduate studies and first year of a graduate program, indicating a higher degree of confidence in graduate students. Results also suggest that HRV in females is significantly lower than that in males before and after examination, despite men having greater sympathetic input. In conclusion, the results of our novel study assessing stress in real-time examination show important gender differences, and lack of adaptation with academic study year.
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Affiliation(s)
- Sabah Hammoud
- Laboratory of Experimental and Clinical Pharmacology, Department of Chemistry and Biochemistry, Faculty of Sciences, Section 1, Lebanese University, Rafic Hariri Educational Campus, P.O. Box 6573/14 Hadath, Lebanon.
| | - Rita Karam
- Laboratory of Experimental and Clinical Pharmacology, Department of Chemistry and Biochemistry, Faculty of Sciences, Section 1, Lebanese University, Rafic Hariri Educational Campus, P.O. Box 6573/14 Hadath, Lebanon.
| | - Rabih Mourad
- Laboratory of Experimental and Clinical Pharmacology, Department of Chemistry and Biochemistry, Faculty of Sciences, Section 1, Lebanese University, Rafic Hariri Educational Campus, P.O. Box 6573/14 Hadath, Lebanon.
| | - Iman Saad
- Laboratory of Experimental and Clinical Pharmacology, Department of Chemistry and Biochemistry, Faculty of Sciences, Section 1, Lebanese University, Rafic Hariri Educational Campus, P.O. Box 6573/14 Hadath, Lebanon.
| | - Mazen Kurdi
- Laboratory of Experimental and Clinical Pharmacology, Department of Chemistry and Biochemistry, Faculty of Sciences, Section 1, Lebanese University, Rafic Hariri Educational Campus, P.O. Box 6573/14 Hadath, Lebanon.
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Carvalho LP, Di Thommazo-Luporini L, Mendes RG, Cabiddu R, Ricci PA, Basso-Vanelli RP, Oliveira-Junior MC, Vieira RP, Bonjorno-Junior JC, Oliveira CR, Luporini RL, Borghi-Silva A. Response to the letter to the editor: "Is metabolic syndrome related to exercise autonomic modulation in obese adults? (Lopes et al., 2018)". Auton Neurosci 2018; 216:88-90. [PMID: 30501953 DOI: 10.1016/j.autneu.2018.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Accepted: 11/13/2018] [Indexed: 11/24/2022]
Affiliation(s)
- Lívia P Carvalho
- Department of Physical Therapy, Federal University of Sao Carlos, Sao Carlos, Sao Paulo, Brazil
| | | | - Renata G Mendes
- Department of Physical Therapy, Federal University of Sao Carlos, Sao Carlos, Sao Paulo, Brazil
| | - Ramona Cabiddu
- Department of Physical Therapy, Federal University of Sao Carlos, Sao Carlos, Sao Paulo, Brazil
| | - Paula A Ricci
- Department of Physical Therapy, Federal University of Sao Carlos, Sao Carlos, Sao Paulo, Brazil
| | - Renata P Basso-Vanelli
- Department of Physical Therapy, Federal University of Sao Carlos, Sao Carlos, Sao Paulo, Brazil
| | - Manoel C Oliveira-Junior
- Laboratory of Pulmonary and Exercise Immunology (LABPEI)/Brazilian Institute of Teaching and Research in Pulmonary and Exercise Immunology (IBEPIPE), Nove de Julho University, Sao Paulo, Sao Paulo, Brazil
| | - Rodolfo P Vieira
- Brazilian Institute of Teaching and Research in Pulmonary and Exercise Immunology (IBEPIPE), School of Medical Sciences of Sao Jose dos Campos Humanitas and Universidade Brasil, Sao Jose dos Campos, Sao Paulo, Brazil
| | | | - Cláudio R Oliveira
- Department of Medicine, Federal University of Sao Carlos, Sao Carlos, Sao Paulo, Brazil
| | - Rafael L Luporini
- Department of Medicine, Federal University of Sao Carlos, Sao Carlos, Sao Paulo, Brazil
| | - Audrey Borghi-Silva
- Department of Physical Therapy, Federal University of Sao Carlos, Sao Carlos, Sao Paulo, Brazil.
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Chadda KR, Ajijola OA, Vaseghi M, Shivkumar K, Huang CLH, Jeevaratnam K. Ageing, the autonomic nervous system and arrhythmia: From brain to heart. Ageing Res Rev 2018; 48:40-50. [PMID: 30300712 DOI: 10.1016/j.arr.2018.09.005] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2018] [Revised: 08/21/2018] [Accepted: 09/30/2018] [Indexed: 02/08/2023]
Abstract
An ageing myocardium possesses significant electrophysiological alterations that predisposes the elderly patient to arrhythmic risk. Whilst these alterations are intrinsic to the cardiac myocytes, they are modulated by the cardiac autonomic nervous system (ANS) and consequently, ageing of the cardiac ANS is fundamental to the development of arrhythmias. A systems-based approach that incorporates the influence of the cardiac ANS could lead to better mechanistic understanding of how arrhythmogenic triggers and substrates interact spatially and temporally to produce sustained arrhythmia and why its incidence increases with age. Despite the existence of physiological oscillations of ANS activity on the heart, pathological oscillations can lead to defective activation and recovery properties of the myocardium. Such changes can be attributable to the decrease in functionality and structural alterations to ANS specific receptors in the myocardium with age. These altered ANS adaptive responses can occur either as a normal ageing process or accelerated in the presence of specific cardiac pathologies, such as genetic mutations or neurodegenerative conditions. Targeted intervention that seek to manipulate the ageing ANS influence on the myocardium may prove to be an efficacious approach for the management of arrhythmia in the ageing population.
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Affiliation(s)
- Karan R Chadda
- Faculty of Health and Medical Sciences, University of Surrey, Guildford, GU2 7AL, United Kingdom; Physiological Laboratory, University of Cambridge, Downing Street, Cambridge, CB2 3EG, United Kingdom
| | - Olujimi A Ajijola
- UCLA Cardiac Arrhythmia Center, UCLA Health System/David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Marmar Vaseghi
- UCLA Cardiac Arrhythmia Center, UCLA Health System/David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Kalyanam Shivkumar
- UCLA Cardiac Arrhythmia Center, UCLA Health System/David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Christopher L-H Huang
- Physiological Laboratory, University of Cambridge, Downing Street, Cambridge, CB2 3EG, United Kingdom; Department of Biochemistry, Hopkins Building, University of Cambridge, Cambridge, CB2 1QW, United Kingdom
| | - Kamalan Jeevaratnam
- Faculty of Health and Medical Sciences, University of Surrey, Guildford, GU2 7AL, United Kingdom; Physiological Laboratory, University of Cambridge, Downing Street, Cambridge, CB2 3EG, United Kingdom.
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Damerla VR, Goldstein B, Wolf D, Madhavan K, Patterson N. Novice Meditators of an Easily Learnable Audible Mantram Sound Self-Induce an Increase in Vagal Tone During Short-term Practice: A Preliminary Study. Integr Med (Encinitas) 2018; 17:20-28. [PMID: 31043916 PMCID: PMC6469452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
INTRODUCTION The autonomic nervous system (ANS) plays a vital role in regulation of the physiological processes during normal and pathological conditions. Heart rate variability (HRV) is regarded as a major indicator of the self-regulatory strength and balance of parasympathetic nervous system (PNS) and sympathetic nerve system (SNS) impulses, as interpreted by the intrinsic nervous system of the heart. The present study focuses on the evaluation of the effects of audible and mindful practice of chanting meditation on HRV and on the cognitive disposition. METHODOLOGY The subjects were randomly assigned to 2 different sounds based on monotone repetition. One was the Hare Krishna Mantram (HKM-Sanskrit experimental sound) and the other was a concocted sound (Sanskrit placebo). Changes in vagal tone were measured with respect to both time domain and frequency domains. Five-min baseline and postmeditation measurements were obtained on different days over the next 6 wk. The subjects who chanted the placebo/sham sound switched to the experimental sound at the 4-wk mark for the next 2 wk. All subjects completed an experience survey. RESULTS Paired t test results for all HRV parameters achieved statistical significance in the test group. Statistical significance in all the aforementioned measures of HRV was also observed on switching the control group placebo sound chanting to the experimental sound. HRV wave forms showed relaxation, a pattern and experience survey suggests an increase in attributes associated with higher self-regulation. CONCLUSION This study suggests statistically significant efficacy data and that a larger randomized study is feasible to test the potential of the audible repetition of the HKM in clinical settings. It may therefore enable beneficial lifestyle for health creation and thus play a role in the prevention of chronic diseases. Further, large scale studies are required for a better perspective on the effect of mantram repetition on the HRV.
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Lindberg CM, Srinivasan K, Gilligan B, Razjouyan J, Lee H, Najafi B, Canada KJ, Mehl MR, Currim F, Ram S, Lunden MM, Heerwagen JH, Kampschroer K, Sternberg EM. Effects of office workstation type on physical activity and stress. Occup Environ Med 2018; 75:689-695. [PMID: 30126872 PMCID: PMC6166591 DOI: 10.1136/oemed-2018-105077] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Revised: 06/21/2018] [Accepted: 07/08/2018] [Indexed: 12/20/2022]
Abstract
OBJECTIVE Office environments have been causally linked to workplace-related illnesses and stress, yet little is known about how office workstation type is linked to objective metrics of physical activity and stress. We aimed to explore these associations among office workers in US federal office buildings. METHODS We conducted a wearable, sensor-based, observational study of 231 workers in four office buildings. Outcome variables included workers' physiological stress response, physical activity and perceived stress. Relationships between office workstation type and these variables were assessed using structural equation modelling. RESULTS Workers in open bench seating were more active at the office than those in private offices and cubicles (open bench seating vs private office=225.52 mG (31.83% higher on average) (95% CI 136.57 to 314.46); open bench seating vs cubicle=185.13 mG (20.16% higher on average) (95% CI 66.53 to 303.72)). Furthermore, workers in open bench seating experienced lower perceived stress at the office than those in cubicles (-0.27 (9.10% lower on average) (95% CI -0.54 to -0.02)). Finally, higher physical activity at the office was related to lower physiological stress (higher heart rate variability in the time domain) outside the office (-26.12 ms/mG (14.18% higher on average) (95% CI -40.48 to -4.16)). CONCLUSIONS Office workstation type was related to enhanced physical activity and reduced physiological and perceived stress. This research highlights how office design, driven by office workstation type, could be a health-promoting factor.
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Affiliation(s)
- Casey M Lindberg
- College of Medicine, Institute on Place, Wellbeing & Performance, University of Arizona, Tucson, Arizona, USA
| | - Karthik Srinivasan
- INSITE Center for Business Intelligence and Analytics, Department of MIS, Eller College of Management, University of Arizona, Tucson, Arizona, USA
| | - Brian Gilligan
- Office of Federal High-Performance Buildings, US General Services Administration, Washington, District of Columbia, USA
| | - Javad Razjouyan
- Michael E DeBakey Department of Surgery, Baylor College of Medicine, Interdisciplinary Consortium on Advanced Motion Performance (iCAMP), Houston, Texas, USA.,Center for Innovations in Quality, Effectiveness and Safety, Houston, Texas, USA
| | - Hyoki Lee
- Michael E DeBakey Department of Surgery, Baylor College of Medicine, Interdisciplinary Consortium on Advanced Motion Performance (iCAMP), Houston, Texas, USA
| | - Bijan Najafi
- Michael E DeBakey Department of Surgery, Baylor College of Medicine, Interdisciplinary Consortium on Advanced Motion Performance (iCAMP), Houston, Texas, USA
| | | | - Matthias R Mehl
- Department of Psychology, University of Arizona, Tucson, Arizona, USA
| | - Faiz Currim
- INSITE Center for Business Intelligence and Analytics, Department of MIS, Eller College of Management, University of Arizona, Tucson, Arizona, USA
| | - Sudha Ram
- INSITE Center for Business Intelligence and Analytics, Department of MIS, Eller College of Management, University of Arizona, Tucson, Arizona, USA
| | | | - Judith H Heerwagen
- Office of Federal High-Performance Buildings, US General Services Administration, Washington, District of Columbia, USA
| | - Kevin Kampschroer
- Office of Federal High-Performance Buildings, US General Services Administration, Washington, District of Columbia, USA
| | - Esther M Sternberg
- College of Medicine, Institute on Place, Wellbeing & Performance, University of Arizona, Tucson, Arizona, USA
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Kingsley JD, Tai YL, Marshall EM, Glasgow A, Oliveira R, Parks JC, Mayo X. Autonomic modulation and baroreflex sensitivity after acute resistance exercise: responses between sexes. J Sports Med Phys Fitness 2018; 59:1036-1044. [PMID: 30035471 DOI: 10.23736/s0022-4707.18.08864-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND The aim of this study was to evaluate autonomic modulation, blood pressure variability and baroreflex sensitivity (BRS) responses to an acute bout of free-weight resistance exercise in resistance-trained men (N.=14) and women (N.=13). METHODS Participants underwent both an acute bout of resistance exercise (RE) consisting of 3 sets of 10 repetitions at 75% 1-repetition maximum on the squat, bench press, and deadlift, and a quiet control. Autonomic modulation, blood pressure variability (LFSAP), and cardiovagal BRS were assessed at rest, 15-20 minutes (Rec1) and 25-30 minutes (Rec2) postexercise. Log transformed measures of autonomic modulation included root square of the mean ssquared differences of successive RR intervals (LnRMSSD), high-frequency power (LnHFRR) and low-frequency power (LnLFRR) and sympathovagal balance (LnLFRR/HFRR). LFSAP was used as a measurement of vasomotor tone. Cardiovagal BRS was assessed using the sequence method. RESULTS There were no significant sex differences at rest and no significant sex by time by condition interactions for any variable. Compared with rest there were augmentations in LnLFRR/HFRR (P=0.002) and LFSAP (P=0.001) at Rec1 and Rec2. RMSSD and cardiovagal BRS were significantly (P=0.0001) decreased at Rec1 and Rec2 compared to rest after the acute RE. CONCLUSIONS Both sexes demonstrated that acute resistance exercise using free weights has a profound impact on autonomic modulation, blood pressure variability and cardiovagal BRS.
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Affiliation(s)
- J Derek Kingsley
- Cardiovascular Dynamics Laboratory, Exercise Physiology, Kent State University, Kent, OH, USA
| | - Yu-Lun Tai
- Cardiovascular Dynamics Laboratory, Exercise Physiology, Kent State University, Kent, OH, USA -
| | - Erica M Marshall
- Cardiovascular Dynamics Laboratory, Exercise Physiology, Kent State University, Kent, OH, USA
| | - Alaina Glasgow
- Cardiovascular Dynamics Laboratory, Exercise Physiology, Kent State University, Kent, OH, USA
| | | | - Jason C Parks
- Cardiovascular Dynamics Laboratory, Exercise Physiology, Kent State University, Kent, OH, USA
| | - Xian Mayo
- Observatory of Healthy & Active Living of Spain Active Foundation, Center for Sport Studies, King Juan Carlos University, Madrid, Spain
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Fiol-Veny A, De La Torre-Luque A, Balle M, Bornas X. Altered Heart Rate Regulation in Adolescent Girls and the Vulnerability for Internalizing Disorders. Front Physiol 2018; 9:852. [PMID: 30038579 PMCID: PMC6046384 DOI: 10.3389/fphys.2018.00852] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Accepted: 06/15/2018] [Indexed: 12/19/2022] Open
Abstract
Background: The association between decreased heart rate variability (HRV) and increased internalizing symptoms is well documented. Adolescence is a critical period for the development of mental health problems, in particular internalizing symptoms. Previous research has illustrated sex differences in adolescent HRV, such that females have reduced short-term resting state HRV compared to males. Studies on long-term ecological recordings of HRV in adolescents are scarce. The aims of the present study were, (a) to test if adolescent females show decreased long-term HRV and cardiac complexity (CC) compared to males, and (b) to explore whether sex and HRV and CC measures, as well as their interaction, would predict internalizing symptoms. Materials and Methods: HRV was recorded in n = 166 adolescents (86 girls), on a normal school day. HRV and CC measures were calculated on the interbeat interval time series. Results: Females showed lower HRV and CC in most of the assessed indices. Internalizing symptoms were mainly predicted by HRV whereas sex only predicted symptoms of social anxiety. The interaction between sex and HRV did not predict internalizing symptoms. Conclusions: Results suggest that reduced HRV should be considered as a potential contributor to exacerbating internalizing symptoms in adolescence. Girls with reduced HRV and CC might be prone to the development of internalizing disorders. HRV is a promising tool for the early identification of vulnerability.
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Affiliation(s)
- Aina Fiol-Veny
- Department of Psychology, University Research Institute on Health Sciences (IUNICS), University of the Balearic Islands, Palma, Spain
| | - Alejandro De La Torre-Luque
- Department of Psychiatry, Mental Health Networking Biomedical Research Centre, Autonomous University of Madrid, Madrid, Spain
| | - Maria Balle
- Department of Psychology, University Research Institute on Health Sciences (IUNICS), University of the Balearic Islands, Palma, Spain
| | - Xavier Bornas
- Department of Psychology, University Research Institute on Health Sciences (IUNICS), University of the Balearic Islands, Palma, Spain
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Goldberg E, Grau JB, Fortier JH, Salvati E, Levy RJ, Ferrari G. Serotonin and catecholamines in the development and progression of heart valve diseases. Cardiovasc Res 2018; 113:849-857. [PMID: 28863437 DOI: 10.1093/cvr/cvx092] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Accepted: 06/01/2017] [Indexed: 01/11/2023] Open
Abstract
Heart valve diseases (HVDs) arise from a number of different processes that affect both the structure and function of the valve apparatus. Despite diverse aetiologies, treatments for HVDs are limited to percutaneous or surgical interventions. The search for medical therapies to prevent or slow the progression of HVDs has been hampered by our poor understanding of the progression from subclinical to symptomatic phases, and our limited knowledge of the molecular signals that control the susceptibility of valve interstitial cells to pathological remodeling. Clinical evidence has suggested a link between certain neurotransmitters and valvular diseases of the heart. The fenfluramine-phentermine appetite suppressants popular in the 1980s were linked to mitral valve dysfunction, and ergot-derived dopamine agonists for Parkinson's disease have been associated with an increased risk of mitral and aortic valve regurgitation. The effect does not appear to be limited to medications, as valvular pathologies have also been observed in patients with carcinoid tumours of serotonin-producing enterochromaffin cells. The role of neurotransmitter molecules in valve pathology has not been adequately characterized and may represent a target for future medical therapies. Here we present current evidence from both clinical and basic science suggesting a link between neurotransmitters and HVDs, opening the door to future research in this area.
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Affiliation(s)
- Elliott Goldberg
- Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Juan B Grau
- The Valley Hospital, Ridgewood, NJ, USA.,University of Ottawa Heart Institute, Ottawa, Canada
| | | | - Elisa Salvati
- The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Robert J Levy
- The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Giovanni Ferrari
- Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
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Fiol-Veny A, De la Torre-Luque A, Balle M, Bornas X. Diminished heart rate complexity in adolescent girls: a sign of vulnerability to anxiety disorders? ANXIETY STRESS AND COPING 2018; 31:375-386. [PMID: 29768021 DOI: 10.1080/10615806.2018.1475004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
BACKGROUND AND OBJECTIVES Diminished heart rate variability has been found to be associated with high anxiety symptomatology. Since adolescence is the period of onset for many anxiety disorders, this study aimed to determine sex- and anxiety-related differences in heart rate variability and complexity in adolescents. METHODS We created four groups according to sex and anxiety symptomatology: high-anxiety girls (n = 24) and boys (n = 25), and low-anxiety girls (n = 22) and boys (n = 24) and recorded their cardiac function while they performed regular school activities. A series of two-way (sex and anxiety) MANOVAs were performed on time domain variability, frequency domain variability, and non-linear complexity. RESULTS We obtained no multivariate interaction effects between sex and anxiety, but highly anxious participants had lower heart rate variability than the low-anxiety group. Regarding sex, girls showed lower heart rate variability and complexity than boys. CONCLUSIONS The results suggest that adolescent girls have a less flexible cardiac system that could be a marker of the girls' vulnerability to developing anxiety disorders.
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Affiliation(s)
- Aina Fiol-Veny
- a University Research Institute on Health Sciences (IUNICS) , University of the Balearic Islands , Palma , Spain
| | - Alejandro De la Torre-Luque
- a University Research Institute on Health Sciences (IUNICS) , University of the Balearic Islands , Palma , Spain
| | - Maria Balle
- a University Research Institute on Health Sciences (IUNICS) , University of the Balearic Islands , Palma , Spain
| | - Xavier Bornas
- a University Research Institute on Health Sciences (IUNICS) , University of the Balearic Islands , Palma , Spain
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Shivaprasad C, Amit G, Anish K, Rakesh B, Anupam B, Aiswarya Y. Clinical correlates of sudomotor dysfunction in patients with type 2 diabetes and peripheral neuropathy. Diabetes Res Clin Pract 2018. [PMID: 29524484 DOI: 10.1016/j.diabres.2018.03.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
AIMS To investigate the factors associated with abnormal electrochemical skin conductance (ESC) in patients with type 2 diabetes mellitus (T2D) and early diabetic peripheral neuropathy (DPN). METHODS We recruited 523 consecutive patients with T2D (median age: 50 [interquartile range: 16] years; median T2D duration: 4 [5] years). Sudomotor dysfunction was defined as an ESC <60 µS, and DPN as a neuropathy disability score (NDS) ≥6. Logistic regression was performed to determine the predictors of sudomotor dysfunction in patients with DPN. RESULTS The prevalence of sudomotor dysfunction was 29% for all patients and 84.5% for patients with DPN. A significant negative correlation was observed between the NDS and ESC measurements (r = -0.52, p < 0.0001). In the univariate analysis, abnormal ESC measures were associated with age, diabetes duration, glycated hemoglobin, diabetic retinopathy, insulin therapy, and foot abnormalities. In the multivariate analysis, ESC abnormalities were associated with age, diabetes duration, glycated hemoglobin levels, insulin therapy, and foot deformities. There was a robust association between foot deformities and abnormal ESC (p = 0.049; odds ratio = 16.02) in patients with DPN. CONCLUSION Sudomotor dysfunction is highly prevalent in patients with T2D, especially in those with DPN. Various diabetes-related factors were linked to lower ESC values, indicating an association between chronic hyperglycemia and sudomotor function. We also observed a strong relationship between foot deformities and ESC abnormalities. We conclude that the factors associated with DPN are also relevant to sudomotor dysfunction.
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Affiliation(s)
- Channabasappa Shivaprasad
- Department of Endocrinology, Vydehi Institute of Medical Sciences and Research Centre, Bangalore, India.
| | - Goel Amit
- Department of Endocrinology, Vydehi Institute of Medical Sciences and Research Centre, Bangalore, India
| | - Kolly Anish
- Department of Endocrinology, Vydehi Institute of Medical Sciences and Research Centre, Bangalore, India
| | - Boppana Rakesh
- Department of Endocrinology, Vydehi Institute of Medical Sciences and Research Centre, Bangalore, India
| | - Biswas Anupam
- Department of Endocrinology, Vydehi Institute of Medical Sciences and Research Centre, Bangalore, India
| | - Yalamanchi Aiswarya
- Department of Endocrinology, Vydehi Institute of Medical Sciences and Research Centre, Bangalore, India
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Estévez-Báez M, Carricarte-Naranjo C, Jas-García JD, Rodríguez-Ríos E, Machado C, Montes-Brown J, Leisman G, Schiavi A, Machado-García A, Luaces CS, Pié EA. Influence of Heart Rate, Age, and Gender on Heart Rate Variability in Adolescents and Young Adults. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2018; 1133:19-33. [PMID: 30414070 DOI: 10.1007/5584_2018_292] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Key autonomic functions are in continuous development during adolescence which can be assessed using the heart rate variability (HRV). However, the influence of different demographic and physiological factors on HRV indices has not been fully explored in adolescents. In this study we aimed to assess the effect of age, gender, and heart rate on HRV indices in two age groups of healthy adolescents (age ranges, 13-16 and 17-20 years) and two groups of healthy young adults (21-24 and 25-30 years). We addressed the issue using 5-min ECG recordings performed in the sitting position in 255 male and female participants. Time, frequency, and informational domains of HRV were calculated. Changes in HRV indices were assessed using a multiple linear regression model to adjust for the effects of heart rate, age, and gender. We found that heart rate produced more significant effects on HRV indices than age or gender. There was a progressive reduction in HRV with increasing age. Sympathetic influence increased with age and parasympathetic influence progressively decreased with age. The influence of gender was manifest only in younger adolescents and young adults. In conclusion, age, gender, and particularly heart rate have a substantial influence on HRV indices, which ought to be considered to avoid biases in the study of the autonomic nervous system development. The lack of the gender-related effects on HRV indices in late adolescence could be related to non-completely achieved maturity of the autonomic mechanisms, which deserves further exploration.
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Affiliation(s)
- Mario Estévez-Báez
- Institute of Neurology and Neurosurgery, Ministry of Health, Havana, Cuba
| | | | | | | | - Calixto Machado
- Institute of Neurology and Neurosurgery, Ministry of Health, Havana, Cuba
| | - Julio Montes-Brown
- Department of Medicine & Health Science, University of Sonora, Hermosillo, Mexico
| | - Gerry Leisman
- Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel. .,National Institute for Brain and Rehabilitation Sciences, Nazareth, Israel. .,Faculty 'Manuel Fajardo', University of the Medical Sciences, Havana, Cuba.
| | - Adam Schiavi
- Anesthesiology and Critical Care Medicine, Neurosciences Critical Care Division, Johns Hopkins Hospital, Baltimore, MD, USA
| | | | | | - Eduardo Arrufat Pié
- Institute of Basic and Preclinical Sciences "Victoria de Girón", Havana, Cuba
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