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Girishan Prabhu V, Stanley L, Morgan R, Shirley B. Designing and developing a nature-based virtual reality with heart rate variability biofeedback for surgical anxiety and pain management: evidence from total knee arthroplasty patients. Aging Ment Health 2024; 28:738-753. [PMID: 37850735 DOI: 10.1080/13607863.2023.2270442] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 10/06/2023] [Indexed: 10/19/2023]
Abstract
OBJECTIVES Total knee arthroplasty (TKA) is one of the most common joint surgeries, with over a million procedures performed annually in the US. Over 70% of patients report moderate to high pain and anxiety surrounding TKA surgery, and 96% are discharged with an opioid prescription. This population requires special attention as approximately 90% of TKA patients are older adults and one of the riskiest groups prone to misusing opioids. This study aimed to develop and compare the efficacy of nature-based virtual reality (VR) with heart rate variability biofeedback (HRVBF) to mitigate surgical pain and anxiety. METHODS This randomized control trial recruited 30 patients (mean age = 66.3 ± 8.2 years, 23 F, 7 M) undergoing TKA surgery and randomly assigned to a control, 2D video with HRVBF, or VR with HRVBF group. A visual analog scale (VAS) was used to measure pain levels before and after the intervention. In addition, a second VAS and the State-Trait Anxiety Inventory (STAI) were used to measure anxiety before and after the intervention. Electrocardiogram (ECG) was used to continuously measure HRV and respiration rate in preoperative and postoperative settings. RESULTS VR and 2D-video with HRVBF decreased pain and anxiety post-intervention compared with the control group, p's <.01. On analyzing physiological signals, both treatment groups showed greater parasympathetic activity levels, and VR with HRVBF reduced pain more than the 2D video, p < .01. CONCLUSIONS Nature-based VR and 2D video with HRVBF can mitigate surgical pain and anxiety. However, VR may be more efficacious than 2D video in reducing pain.
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Affiliation(s)
| | - Laura Stanley
- Gianforte School of Computing, Montana State University, Bozeman, MT, USA
| | - Robert Morgan
- Department of Anesthesiology, Prisma Health, Greenville, SC, USA
| | - Brayton Shirley
- Department of Orthopaedics, Prisma Health, Greenville, SC, USA
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You M, Laborde S, Ackermann S, Borges U, Dosseville F, Mosley E. Influence of Respiratory Frequency of Slow-Paced Breathing on Vagally-Mediated Heart Rate Variability. Appl Psychophysiol Biofeedback 2024; 49:133-143. [PMID: 38063977 DOI: 10.1007/s10484-023-09605-2] [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] [Accepted: 09/23/2023] [Indexed: 02/16/2024]
Abstract
Breathing techniques, particularly slow-paced breathing (SPB), have gained popularity among athletes due to their potential to enhance performance by increasing cardiac vagal activity (CVA), which in turn can help manage stress and regulate emotions. However, it is still unclear whether the frequency of SPB affects its effectiveness in increasing CVA. Therefore, this study aimed to investigate the effects of a brief SPB intervention (i.e., 5 min) on CVA using heart rate variability (HRV) measurement as an index. A total of 75 athletes (22 female; Mage = 22.32; age range = 19-31) participated in the study, attending one lab session where they performed six breathing exercises, including SPB at different frequencies (5 cycles per minute (cpm), 5.5 cpm, 6 cpm, 6.5 cpm, 7 cpm), and a control condition of spontaneous breathing. The study found that CVA was significantly higher in all SPB conditions compared to the control condition, as indexed by both root mean square of the successive differences (RMSSD) and low-frequency HRV (LF-HRVms2). Interestingly, LF-HRVms2 was more sensitive in differentiating the respiratory frequencies than RMSSD. These results suggest that SPB at a range of 5 cpm to 7 cpm can be an effective method to increase CVA and potentially improve stress management and emotion regulation in athletes. This short SPB exercise can be a simple yet useful tool for athletes to use during competitive scenarios and short breaks in competitions. Overall, these findings highlight the potential benefits of incorporating SPB into athletes' training and competition routines.
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Affiliation(s)
- Min You
- School of Teacher Education, University of Weifang, Weifang, China.
- UFR Psychologie, UR 3918 CERREV, Université de Caen Normandie, Caen, 14032, France.
| | - Sylvain Laborde
- Department of Performance Psychology, Institute of Psychology, German Sport University, Cologne, Germany
- UFR STAPS, UR 7480 VERTEX, Université de Caen Normandie, Caen, 14032, France
| | - Stefan Ackermann
- Department of Performance Psychology, Institute of Psychology, German Sport University, Cologne, Germany
| | - Uirassu Borges
- Department of Health & Social Psychology, Institute of Psychology, German Sport University, Cologne, Germany
| | - Fabrice Dosseville
- UFR STAPS, UR 7480 VERTEX, Université de Caen Normandie, Caen, 14032, France
- CNDAPS, Colombelles, F-14460, France
| | - Emma Mosley
- Department of Rehabilitation and Sport Sciences, School of Sport, Bournemouth University, Fern Barrow, Poole, Dorset, BH12 5BB, UK
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3
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Liang WM, Ji YX, Xiao J, Truskauskaitė I, Hendrixson A, Bai ZM, Ruksenas O. Respiratory patterns and physical fitness in healthy adults: a cross-sectional study. BMC Public Health 2024; 24:228. [PMID: 38243241 PMCID: PMC10797802 DOI: 10.1186/s12889-024-17687-8] [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: 07/13/2023] [Accepted: 01/05/2024] [Indexed: 01/21/2024] Open
Abstract
BACKGROUND The altered respiratory patterns have a significant impact on our health. However, the links between respiration patterns during spontaneous breathing and physical fitness remain unknown. Therefore, we sought to examine how the respiratory pattern during spontaneous breathing interacts with physical fitness. METHODS A total of 610 participants (aged 20-59 years) were enrolled; 163 men (age = 41 ± 11) and 401 women (age = 42 ± 9) were included for analysis. The parameters of the respiration pattern were respiration rate (RR) and inhalation/exhalation (I/E) ratio. The physical fitness components were body size, visuomotor reaction time, balance, flexibility, hand grip strength, back extension strength, vertical jump height, number of push-ups, number of sit-ups, and the maximum rate of oxygen consumption. The data were analyzed separately for two gender groups. Participants within each gender group were further divided into two age categories (young: 20-39 years, middle-aged: 40-59 years) for the analysis, and both correlational and comparative tests were used to solidify the results. RESULTS Neither RRs nor the I/E ratios were substantially correlated with physical fitness in women. In addition, the I/E ratios showed no significant correlation with physical fitness in young men, while the results from correlational and comparative tests were inconsistent in middle-aged men. Consistently, men with lower RRs exhibited significantly shorter visuomotor reaction times in two age groups, and demonstrated significantly higher vertical jump heights in the middle-aged group. CONCLUSIONS In women, respiratory patterns were not correlated with physical fitness. The relationship between middle-aged men's I/E ratios and their physical fitness warrants further investigation. Men with lower RRs may have better visual-motor coordination and/or sustained attention, while middle-aged men with lower RRs may also have greater leg explosive power and neuromuscular coordination, which should be considered for physical assessment and health improvement.
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Affiliation(s)
- Wen-Ming Liang
- Department of Physiotherapy and Rehabilitation, Xiyuan Hospital, Chinese Academy of Chinese Medical Sciences, Beijing, China
- Life Sciences Center, Vilnius University, Vilnius, Lithuania
| | - Yu-Xuan Ji
- Department of Physiotherapy and Rehabilitation, Xiyuan Hospital, Chinese Academy of Chinese Medical Sciences, Beijing, China
| | - Jing Xiao
- Department of Physiotherapy and Rehabilitation, Xiyuan Hospital, Chinese Academy of Chinese Medical Sciences, Beijing, China.
| | | | | | - Zhen-Min Bai
- Department of Sports Rehabilitation, School of Sports Medicine and Rehabilitation, Beijing Sport University, Beijing, China
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Ok J, Park S, Jung YH, Kim TI. Wearable and Implantable Cortisol-Sensing Electronics for Stress Monitoring. ADVANCED MATERIALS (DEERFIELD BEACH, FLA.) 2024; 36:e2211595. [PMID: 36917076 DOI: 10.1002/adma.202211595] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 02/27/2023] [Indexed: 06/18/2023]
Abstract
Cortisol is a steroid hormone that is released from the body in response to stress. Although a moderate level of cortisol secretion can help the body maintain homeostasis, excessive secretion can cause various diseases, such as depression and anxiety. Conventional methods for cortisol measurement undergo procedures that limit continuous monitoring, typically collecting samples of bodily fluids, followed by separate analysis in a laboratory setting that takes several hours. Thus, recent studies demonstrate wearable, miniaturized sensors integrated with electronic modules that enable wireless real-time analysis. Here, the primary focus is on wearable and implantable electronic devices that continuously measure cortisol concentration. Diverse types of cortisol-sensing techniques, such as antibody-, DNA-aptamer-, and molecularly imprinted polymer-based sensors, as well as wearable and implantable devices that aim to continuously monitor cortisol in a minimally invasive fashion are discussed. In addition to the cortisol monitors that directly measure stress levels, other schemes that indirectly measure stress, such as electrophysiological signals and sweat are also summarized. Finally, the challenges and future directions in stress monitoring and management electronics are reviewed.
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Affiliation(s)
- Jehyung Ok
- School of Chemical Engineering, Sungkyunkwan University (SKKU), Suwon, 16419, Republic of Korea
| | - Sumin Park
- Department of Electronic Engineering, Hanyang University, Seoul, 04763, Republic of Korea
| | - Yei Hwan Jung
- Department of Electronic Engineering, Hanyang University, Seoul, 04763, Republic of Korea
| | - Tae-Il Kim
- School of Chemical Engineering, Sungkyunkwan University (SKKU), Suwon, 16419, Republic of Korea
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Zawadka-Kunikowska M, Rzepiński Ł, Cieślicka M, Fanslau J, Klawe JJ, Tafil-Klawe M. Correlation between Cardiovascular Autonomic and Pulmonary Ventilation Functions in Myasthenia Gravis Patients. Adv Respir Med 2023; 91:546-559. [PMID: 38131875 PMCID: PMC10740449 DOI: 10.3390/arm91060040] [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: 10/16/2023] [Revised: 11/25/2023] [Accepted: 11/28/2023] [Indexed: 12/23/2023]
Abstract
This study aimed to investigate the relationship between pulmonary function and cardiac autonomic function parameters in clinically stable myasthenia gravis (MG) patients. A total of 22 MG patients and 22 healthy controls (HCs) were evaluated. Pulmonary function test parameters, heart rate variability (HRV), baroreflex sensitivity (BRS), and cardiovascular autonomic function test parameters (the Valsalva ratio, expiration/inspiration (E/I) ratio) were assessed. Compared with the HCs, the patients demonstrated a similar diffusion capacity for carbon monoxide (DLCO); a lower forced vital capacity (FVC%pred); a lower forced expiratory volume in 1 s (FEV1%pred); lower BRS and HRV, including high-frequency and total power spectral density; and a higher percentage of abnormal cardiovagal function test results (p < 0.05). A lower BRS in the patient group was associated with worse clinical disease outcomes and reduced pulmonary function (DLCO%pred, R = 0.59; TLC%pred, R = 0.48). Age, forced vital capacity, and total lung capacity predicted the E/I ratio (R2 values ranging from 0.48 to 0.49). Our study demonstrated a significant relationship between a reduced pulmonary ventilation function and respiratory mechanics with cardiovascular autonomic parameters, including the E/I ratio, BRS, and HRV measures at rest, as shown in the MG group. Future studies should focus on the interplay between respiratory and autonomic function testing, as well as pulmonary rehabilitation, to mitigate cardiovascular risk in these patients.
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Affiliation(s)
- Monika Zawadka-Kunikowska
- Department of Human Physiology, Nicolaus Copernicus University in Torun, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Karłowicza 24, 85-092 Bydgoszcz, Poland; (M.C.); (J.F.); (M.T.-K.)
| | - Łukasz Rzepiński
- Sanitas—Neurology Outpatient Clinic, Dworcowa 110, 85-010 Bydgoszcz, Poland;
- Department of Neurology, 10th Military Research Hospital and Polyclinic, 85-681 Bydgoszcz, Poland
| | - Mirosława Cieślicka
- Department of Human Physiology, Nicolaus Copernicus University in Torun, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Karłowicza 24, 85-092 Bydgoszcz, Poland; (M.C.); (J.F.); (M.T.-K.)
| | - Joanna Fanslau
- Department of Human Physiology, Nicolaus Copernicus University in Torun, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Karłowicza 24, 85-092 Bydgoszcz, Poland; (M.C.); (J.F.); (M.T.-K.)
| | - Jacek J. Klawe
- Department of Hygiene, Epidemiology, Ergonomy and Postgraduate Education, Nicolaus Copernicus University in Torun, Ludwik Rydygier Collegium Medicum in Bydgoszcz, M. Sklodowskiej-Curie 9, 85-094 Bydgoszcz, Poland;
| | - Małgorzata Tafil-Klawe
- Department of Human Physiology, Nicolaus Copernicus University in Torun, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Karłowicza 24, 85-092 Bydgoszcz, Poland; (M.C.); (J.F.); (M.T.-K.)
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Tymko MM, Young D, Vergel D, Matenchuk BA, Maier LE, Sivak A, Davenport MH, Steinback CD. The effect of hypoxemia on muscle sympathetic nerve activity and cardiovascular function: a systematic review and meta-analysis. Am J Physiol Regul Integr Comp Physiol 2023; 325:R474-R489. [PMID: 37642283 DOI: 10.1152/ajpregu.00021.2023] [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: 01/23/2023] [Revised: 08/01/2023] [Accepted: 08/08/2023] [Indexed: 08/31/2023]
Abstract
We conducted a systematic review and meta-analysis to determine the effect of acute poikilocapnic, high-altitude, and acute isocapnia hypoxemia on muscle sympathetic nerve activity (MSNA) and cardiovascular function. A comprehensive search across electronic databases was performed until June 2021. All observational designs were included: population (healthy individuals); exposures (MSNA during hypoxemia); comparators (hypoxemia severity and duration); outcomes (MSNA; heart rate, HR; and mean arterial pressure, MAP). Sixty-one studies were included in the meta-analysis. MSNA burst frequency increased by a greater extent during high-altitude hypoxemia [P < 0.001; mean difference (MD), +22.5 bursts/min; confidence interval (CI) = -19.20 to 25.84] compared with acute poikilocapnic hypoxemia (P < 0.001; MD, +5.63 bursts/min; CI = -4.09 to 7.17) and isocapnic hypoxemia (P < 0.001; MD, +4.72 bursts/min; CI = -3.37 to 6.07). MSNA burst amplitude was only elevated during acute isocapnic hypoxemia (P = 0.03; standard MD, +0.46 au; CI = -0.03 to 0.90), and MSNA burst incidence was only elevated during high-altitude hypoxemia [P < 0.001; MD, 33.05 bursts/100 heartbeats; CI = -28.59 to 37.51]. Meta-regression analysis indicated a strong relationship between MSNA burst frequency and hypoxemia severity for acute isocapnic studies (P < 0.001) but not acute poikilocapnia (P = 0.098). HR increased by the same extent across each type of hypoxemia [P < 0.001; MD +13.81 heartbeats/min; 95% CI = 12.59-15.03]. MAP increased during high-altitude hypoxemia (P < 0.001; MD, +5.06 mmHg; CI = 3.14-6.99), and acute isocapnic hypoxemia (P < 0.001; MD, +1.91 mmHg; CI = 0.84-2.97), but not during acute poikilocapnic hypoxemia (P = 0.95). Both hypoxemia type and severity influenced sympathetic nerve and cardiovascular function. These data are important for the better understanding of healthy human adaptation to hypoxemia.
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Affiliation(s)
- Michael M Tymko
- Integrative Cerebrovascular and Environmental Physiology SB Laboratory, Department of Human Health and Nutritional Sciences, College of Biological Science, University of Guelph, Guelph, Ontario, Canada
- Department of Medicine, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
- Neurovascular Health Lab, Faculty of Kinesiology, Sport, & Recreation, University of Alberta, Edmonton, Alberta, Canada
| | - Desmond Young
- Neurovascular Health Lab, Faculty of Kinesiology, Sport, & Recreation, University of Alberta, Edmonton, Alberta, Canada
| | - Daniel Vergel
- Neurovascular Health Lab, Faculty of Kinesiology, Sport, & Recreation, University of Alberta, Edmonton, Alberta, Canada
| | - Brittany A Matenchuk
- Neurovascular Health Lab, Faculty of Kinesiology, Sport, & Recreation, University of Alberta, Edmonton, Alberta, Canada
- Program for Pregnancy and Postpartum Health, Faculty of Kinesiology, Sports and Recreation, Women and Children's Health Research Institute, Alberta Diabetes Institute, University of Alberta, Edmonton, Alberta, Canada
| | - Lauren E Maier
- Neurovascular Health Lab, Faculty of Kinesiology, Sport, & Recreation, University of Alberta, Edmonton, Alberta, Canada
| | - Allison Sivak
- H.T. Coutts Education and Physical Education Library, University of Alberta, Edmonton, Alberta, Canada
| | - Margie H Davenport
- Neurovascular Health Lab, Faculty of Kinesiology, Sport, & Recreation, University of Alberta, Edmonton, Alberta, Canada
- Program for Pregnancy and Postpartum Health, Faculty of Kinesiology, Sports and Recreation, Women and Children's Health Research Institute, Alberta Diabetes Institute, University of Alberta, Edmonton, Alberta, Canada
| | - Craig D Steinback
- Neurovascular Health Lab, Faculty of Kinesiology, Sport, & Recreation, University of Alberta, Edmonton, Alberta, Canada
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Migliaccio GM, Russo L, Maric M, Padulo J. Sports Performance and Breathing Rate: What Is the Connection? A Narrative Review on Breathing Strategies. Sports (Basel) 2023; 11:sports11050103. [PMID: 37234059 DOI: 10.3390/sports11050103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 05/08/2023] [Accepted: 05/09/2023] [Indexed: 05/27/2023] Open
Abstract
Breathing is a natural and necessary process for humans. At the same time, the respiratory pace and frequency can vary so much, depending on the status of the subject. Specifically, in sports, breathing can have the effect of limiting performance from a physiological point of view, or, on the other hand, breathing can regulate the psychological status of the athletes. Therefore, the aim of this narrative review is to focus on the literature about the physiological and psychological aspects of breathing pace in sports performance, merging these two aspects because they are usually considered split, in order to create a new integrated vision of breathing and sports performance. Voluntary breathing can be divided into a slow or fast pace (VSB and VFB, respectively), and their effects on both the physiological and psychological parameters are very different. VSB can benefit athletes in a variety of ways, not just physically but mentally as well. It can help improve cardiovascular fitness, reduce stress and anxiety, and improve overall health and well-being, allowing athletes to maintain focus and concentration during training and competition. VFB is normal during physical training and competition, but away from training, if it is not voluntary, it can cause feelings of anxiety, panic, dizziness, and lightheadedness and trigger a stress response in the body, affecting the athlete's quality of life. In summary, the role of breathing in the performance of athletes should be considered, although no definitive data are available. The connection between breathing and sports performance is still unclear, but athletes can obtain benefits in focus and concentration using slow breathing strategies.
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Affiliation(s)
| | - Luca Russo
- Department of Human Sciences, Università Telematica degli Studi IUL, 50122 Florence, Italy
| | - Mike Maric
- Department of Performance, Sport Science Lab, 09131 Cagliari, Italy
| | - Johnny Padulo
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, 20133 Milan, Italy
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Yawata Y, Shikano Y, Ogasawara J, Makino K, Kashima T, Ihara K, Yoshimoto A, Morikawa S, Yagishita S, Tanaka KF, Ikegaya Y. Mesolimbic dopamine release precedes actively sought aversive stimuli in mice. Nat Commun 2023; 14:2433. [PMID: 37106002 PMCID: PMC10140067 DOI: 10.1038/s41467-023-38130-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 04/17/2023] [Indexed: 04/29/2023] Open
Abstract
In some models, animals approach aversive stimuli more than those housed in an enriched environment. Here, we found that male mice in an impoverished and unstimulating (i.e., boring) chamber without toys sought aversive air puffs more often than those in an enriched chamber. Using this animal model, we identified the insular cortex as a regulator of aversion-seeking behavior. Activation and inhibition of the insular cortex increased and decreased the frequencies of air-puff self-stimulation, respectively, and the firing patterns of insular neuron ensembles predicted the self-stimulation timing. Dopamine levels in the ventrolateral striatum decreased with passive air puffs but increased with actively sought puffs. Around 20% of mice developed intense self-stimulation despite being offered toys, which was prevented by administering opioid receptor antagonists. This study establishes a basis for comprehending the neural underpinnings of usually avoided stimulus-seeking behaviors.
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Affiliation(s)
- Yosuke Yawata
- Graduate School of Pharmaceutical Sciences, The University of Tokyo, Tokyo, 113-0033, Japan
| | - Yu Shikano
- Division of Brain Science, Keio University School of Medicine, Tokyo, 160-8582, Japan
| | - Jun Ogasawara
- Graduate School of Pharmaceutical Sciences, The University of Tokyo, Tokyo, 113-0033, Japan
| | - Kenichi Makino
- Graduate School of Pharmaceutical Sciences, The University of Tokyo, Tokyo, 113-0033, Japan
| | - Tetsuhiko Kashima
- Graduate School of Pharmaceutical Sciences, The University of Tokyo, Tokyo, 113-0033, Japan
| | - Keiko Ihara
- Division of Brain Science, Keio University School of Medicine, Tokyo, 160-8582, Japan
| | - Airi Yoshimoto
- Graduate School of Pharmaceutical Sciences, The University of Tokyo, Tokyo, 113-0033, Japan
| | - Shota Morikawa
- Graduate School of Pharmaceutical Sciences, The University of Tokyo, Tokyo, 113-0033, Japan
- Institute for AI and Beyond, The University of Tokyo, Tokyo, 113-0033, Japan
| | - Sho Yagishita
- Center for Disease Biology and Integrative Medicine, Faculty of Medicine, The University of Tokyo, Tokyo, 113-0033, Japan
| | - Kenji F Tanaka
- Division of Brain Science, Keio University School of Medicine, Tokyo, 160-8582, Japan
| | - Yuji Ikegaya
- Graduate School of Pharmaceutical Sciences, The University of Tokyo, Tokyo, 113-0033, Japan.
- Institute for AI and Beyond, The University of Tokyo, Tokyo, 113-0033, Japan.
- Center for Information and Neural Networks, National Institute of Information and Communications Technology, Osaka, 565-0871, Japan.
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9
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Burtscher J, Niedermeier M, Hüfner K, van den Burg E, Kopp M, Stoop R, Burtscher M, Gatterer H, Millet GP. The interplay of hypoxic and mental stress: Implications for anxiety and depressive disorders. Neurosci Biobehav Rev 2022; 138:104718. [PMID: 35661753 DOI: 10.1016/j.neubiorev.2022.104718] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 05/26/2022] [Accepted: 05/27/2022] [Indexed: 12/14/2022]
Abstract
Adequate oxygen supply is essential for the human brain to meet its high energy demands. Therefore, elaborate molecular and systemic mechanism are in place to enable adaptation to low oxygen availability. Anxiety and depressive disorders are characterized by alterations in brain oxygen metabolism and of its components, such as mitochondria or hypoxia inducible factor (HIF)-pathways. Conversely, sensitivity and tolerance to hypoxia may depend on parameters of mental stress and the severity of anxiety and depressive disorders. Here we discuss relevant mechanisms of adaptations to hypoxia, as well as their involvement in mental stress and the etiopathogenesis of anxiety and depressive disorders. We suggest that mechanisms of adaptations to hypoxia (including metabolic responses, inflammation, and the activation of chemosensitive brain regions) modulate and are modulated by stress-related pathways and associated psychiatric diseases. While severe chronic hypoxia or dysfunctional hypoxia adaptations can contribute to the pathogenesis of anxiety and depressive disorders, harnessing controlled responses to hypoxia to increase cellular and psychological resilience emerges as a novel treatment strategy for these diseases.
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Affiliation(s)
- Johannes Burtscher
- Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland; Department of Biomedical Sciences, University of Lausanne, Lausanne, Switzerland.
| | - Martin Niedermeier
- Department of Sport Science, University of Innsbruck, Innsbruck, Austria
| | - Katharina Hüfner
- Department of Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology, University Clinic for Psychiatry II, Innsbruck Medical University, Innsbruck, Austria
| | - Erwin van den Burg
- Department of Psychiatry, Center of Psychiatric Neuroscience (CNP), University Hospital of Lausanne (CHUV), Prilly, Lausanne, Switzerland
| | - Martin Kopp
- Department of Sport Science, University of Innsbruck, Innsbruck, Austria
| | - Ron Stoop
- Department of Psychiatry, Center of Psychiatric Neuroscience (CNP), University Hospital of Lausanne (CHUV), Prilly, Lausanne, Switzerland
| | - Martin Burtscher
- Department of Sport Science, University of Innsbruck, Innsbruck, Austria
| | - Hannes Gatterer
- Institute of Mountain Emergency Medicine, Eurac Research, Bolzano, Italy
| | - Grégoire P Millet
- Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland; Department of Biomedical Sciences, University of Lausanne, Lausanne, Switzerland
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10
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Heart rate variability comparison between young males after 4-6 weeks from the end of SARS-CoV-2 infection and controls. Sci Rep 2022; 12:8832. [PMID: 35614330 PMCID: PMC9130989 DOI: 10.1038/s41598-022-12844-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 05/11/2022] [Indexed: 11/11/2022] Open
Abstract
Due to the prolonged inflammatory process induced by infection of the novel severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), indices of autonomic nervous system dysfunction may persist long after viral shedding. Previous studies showed significant changes in HRV parameters in severe (including fatal) infection of SARS-CoV-2. However, few studies have comprehensively examined HRV in individuals who previously presented as asymptomatic or mildly symptomatic cases of COVID-19. In this study, we examined HRV in asymptomatic or mildly symptomatic individuals 5–7 weeks following positive confirmation of SARS-CoV-2 infection. Sixty-five ECG Holter recordings from young (mean age 22.6 ± 3.4 years), physically fit male subjects 4–6 weeks after the second negative test (considered to be the start of recovery) and twenty-six control male subjects (mean age 23.2 ± 2.9 years) were considered in the study. Night-time RR time series were extracted from ECG signals. Selected linear as well as nonlinear HRV parameters were calculated. We found significant differences in Porta’s symbolic analysis parameters V0 and V2 (p < 0.001), α2 (p < 0.001), very low-frequency component (VLF; p = 0.022) and respiratory peak (from the PRSA method; p = 0.012). These differences may be caused by the changes of activity of the parasympathetic autonomic nervous system as well as by the coupling of respiratory rhythm with heart rate due to an increase in pulmonary arterial vascular resistance. The results suggest that the differences with the control group in the HRV parameters, that reflect the functional state of the autonomic nervous system, are measurable after a few weeks from the beginning of the recovery even in the post-COVID group—a young and physically active population. We indicate HRV sensitive markers which may be used in long-term monitoring of patients after recovery.
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11
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Khoshnoud S, Alvarez Igarzábal F, Wittmann M. Brain–Heart Interaction and the Experience of Flow While Playing a Video Game. Front Hum Neurosci 2022; 16:819834. [PMID: 35572002 PMCID: PMC9096496 DOI: 10.3389/fnhum.2022.819834] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 04/06/2022] [Indexed: 11/13/2022] Open
Abstract
The flow state – an experience of complete absorption in an activity – is linked with less self-referential processing and increased arousal. We used the heart-evoked potential (HEP), an index representing brain–heart interaction, as well as indices of peripheral physiology to assess the state of flow in individuals playing a video game. 22 gamers and 21 non-gamers played the video game Thumper for 25 min while their brain and cardiorespiratory signals were simultaneously recorded. The more participants were absorbed in the game, the less they thought about time and the faster time passed subjectively. On the cortical level, the fronto-central HEP amplitude was significantly lower while playing the game compared to resting states before and after the game, reflecting less self-referential processing while playing. This HEP effect corresponded with lower activity during gameplay in brain regions contributing to interoceptive processing. The HEP amplitude predicted the level of absorption in the game. While the HEP amplitude was overall lower during the gaming session than during the resting states, within the gaming session the amplitude of HEP was positively associated with absorption. Since higher absorption was related to higher performance in the game, the higher HEP in more absorbed individuals reflects more efficient brain–heart interaction, which is necessary for efficient game play. On the physiological level, a higher level of flow was associated with increased overall sympathetic activity and less inhibited parasympathetic activity toward the end of the game. These results are building blocks for future neurophysiological assessments of flow.
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Affiliation(s)
- Shiva Khoshnoud
- Institute for Frontier Areas of Psychology and Mental Health, Freiburg, Germany
- Department of Neurosurgery and Neurotechnology, Institute for Neuromodulation and Neurotechnology, University of Tübingen, Tübingen, Germany
- *Correspondence: Shiva Khoshnoud,
| | | | - Marc Wittmann
- Institute for Frontier Areas of Psychology and Mental Health, Freiburg, Germany
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Gąsior JS, Rosoł M, Młyńczak M, Flatt AA, Hoffmann B, Baranowski R, Werner B. Reliability of Symbolic Analysis of Heart Rate Variability and Its Changes During Sympathetic Stimulation in Elite Modern Pentathlon Athletes: A Pilot Study. Front Physiol 2022; 13:829887. [PMID: 35295583 PMCID: PMC8918944 DOI: 10.3389/fphys.2022.829887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 01/21/2022] [Indexed: 11/24/2022] Open
Abstract
Background and Purpose Most studies on heart rate variability (HRV) in professional athletes concerned linear, time-, and frequency-domain indices, and there is lack of studies on non-linear parameters in this group. The study aimed to determine the inter-day reliability, and group-related and individual changes of short-term symbolic dynamics (SymDyn) measures during sympathetic nervous system activity (SNSa) stimulation among elite modern pentathletes. Methods Short-term electrocardiographic recordings were performed in stable measurement conditions with a 7-day interval between tests. SNSa stimulation via isometric handgrip strength test was conducted on the second day of study. The occurrence rate of patterns without variations (0V), with one variation (1V), two like (2LV), and two unlike variations (2UV) obtained using three approaches (the Max–min, the σ, and the Equal-probability methods) were analyzed. Relative and absolute reliability were evaluated. Results All SymDyn indices obtained using the Max–min method, 0V, and 2UV obtained using the σ method, 2UV obtained using the Equal-probability method presented acceptable inter-day reliability (the intraclass correlation coefficient between .91 and .99, Cohen’s d between −.08 and .10, the within-subject coefficient of variation between 4% and 22%). 2LV, 2UV, and 0V obtained using the Max–min and σ methods significantly decreased and increased, respectively, during SNSa stimulation—such changes were noted for all athletes. There was no significant association between differences in SymDyn parameters and respiratory rate in stable conditions and while comparing stable conditions and SNSa stimulation. Conclusion SymDyn indices may be used as reliable non-respiratory-associated parameters in laboratory settings to detect autonomic nervous system (ANS) activity modulations in elite endurance athletes. These findings provide a potential solution for addressing the confounding influence of respiration frequency on HRV-derived inferences of cardiac autonomic function. For this reason, SymDyn may prove to be preferable for field-based monitoring where measurements are unsupervised.
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Affiliation(s)
- Jakub S. Gąsior
- Department of Pediatric Cardiology and General Pediatrics, Medical University of Warsaw, Warsaw, Poland
- *Correspondence: Jakub S. Gąsior,
| | - Maciej Rosoł
- Faculty of Mechatronics, Institute of Metrology and Biomedical Engineering, Warsaw University of Technology, Warsaw, Poland
| | - Marcel Młyńczak
- Faculty of Mechatronics, Institute of Metrology and Biomedical Engineering, Warsaw University of Technology, Warsaw, Poland
| | - Andrew A. Flatt
- Biodynamics and Human Performance Center, Department of Health Sciences and Kinesiology, Georgia Southern University (Armstrong Campus), Savannah, GA, United States
| | - Bartosz Hoffmann
- Physiotherapy Division, Faculty of Medical Sciences, Medical University of Warsaw, Warsaw, Poland
| | - Rafał Baranowski
- Department of Heart Rhythm Disorders, National Institute of Cardiology, Warsaw, Poland
| | - Bożena Werner
- Department of Pediatric Cardiology and General Pediatrics, Medical University of Warsaw, Warsaw, Poland
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Deckmyn B, Domenger D, Blondel C, Ducastel S, Nicolas E, Dorchies E, Caron E, Charton J, Vallez E, Deprez B, Annicotte JS, Lestavel S, Tailleux A, Magnan C, Staels B, Bantubungi K. Farnesoid X Receptor Activation in Brain Alters Brown Adipose Tissue Function via the Sympathetic System. Front Mol Neurosci 2022; 14:808603. [PMID: 35058750 PMCID: PMC8764415 DOI: 10.3389/fnmol.2021.808603] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Accepted: 12/07/2021] [Indexed: 12/14/2022] Open
Abstract
The nuclear bile acid (BA) receptor farnesoid X receptor (FXR) is a major regulator of metabolic/energy homeostasis in peripheral organs. Indeed, enterohepatic-expressed FXR controls metabolic processes (BA, glucose and lipid metabolism, fat mass, body weight). The central nervous system (CNS) regulates energy homeostasis in close interaction with peripheral organs. While FXR has been reported to be expressed in the brain, its function has not been studied so far. We studied the role of FXR in brain control of energy homeostasis by treating wild-type and FXR-deficient mice by intracerebroventricular (ICV) injection with the reference FXR agonist GW4064. Here we show that pharmacological activation of brain FXR modifies energy homeostasis by affecting brown adipose tissue (BAT) function. Brain FXR activation decreases the rate-limiting enzyme in catecholamine synthesis, tyrosine hydroxylase (TH), and consequently the sympathetic tone. FXR activation acts by inhibiting hypothalamic PKA-CREB induction of TH expression. These findings identify a function of brain FXR in the control of energy homeostasis and shed new light on the complex control of energy homeostasis by BA through FXR.
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Affiliation(s)
- Benjamin Deckmyn
- EGID, U1011, University of Lille, Lille, France
- Inserm, U1011, Lille, France
- CHU Lille, Lille, France
- Institut Pasteur de Lille, Lille, France
- Laboratory of Lille Catholic Hospitals, Medical Biology Department, Lille Catholic University, Lille, France
| | - Dorothée Domenger
- EGID, U1011, University of Lille, Lille, France
- Inserm, U1011, Lille, France
- CHU Lille, Lille, France
- Institut Pasteur de Lille, Lille, France
| | - Chloé Blondel
- EGID, U1011, University of Lille, Lille, France
- Inserm, U1011, Lille, France
- CHU Lille, Lille, France
- Institut Pasteur de Lille, Lille, France
| | - Sarah Ducastel
- EGID, U1011, University of Lille, Lille, France
- Inserm, U1011, Lille, France
- CHU Lille, Lille, France
- Institut Pasteur de Lille, Lille, France
| | - Emilie Nicolas
- EGID, U1011, University of Lille, Lille, France
- Inserm, U1011, Lille, France
- CHU Lille, Lille, France
- Institut Pasteur de Lille, Lille, France
| | - Emilie Dorchies
- EGID, U1011, University of Lille, Lille, France
- Inserm, U1011, Lille, France
- CHU Lille, Lille, France
- Institut Pasteur de Lille, Lille, France
| | | | - Julie Charton
- Institut Pasteur de Lille, Lille, France
- Inserm U1177, Lille, France
- Drugs and Molecules for Living Systems, U1177, University of Lille, Lille, France
| | - Emmanuelle Vallez
- EGID, U1011, University of Lille, Lille, France
- Inserm, U1011, Lille, France
- CHU Lille, Lille, France
- Institut Pasteur de Lille, Lille, France
| | - Benoit Deprez
- Institut Pasteur de Lille, Lille, France
- Inserm U1177, Lille, France
- Drugs and Molecules for Living Systems, U1177, University of Lille, Lille, France
| | | | - Sophie Lestavel
- EGID, U1011, University of Lille, Lille, France
- Inserm, U1011, Lille, France
- CHU Lille, Lille, France
- Institut Pasteur de Lille, Lille, France
| | - Anne Tailleux
- EGID, U1011, University of Lille, Lille, France
- Inserm, U1011, Lille, France
- CHU Lille, Lille, France
- Institut Pasteur de Lille, Lille, France
| | | | - Bart Staels
- EGID, U1011, University of Lille, Lille, France
- Inserm, U1011, Lille, France
- CHU Lille, Lille, France
- Institut Pasteur de Lille, Lille, France
- *Correspondence: Bart Staels,
| | - Kadiombo Bantubungi
- EGID, U1011, University of Lille, Lille, France
- Inserm, U1011, Lille, France
- CHU Lille, Lille, France
- Institut Pasteur de Lille, Lille, France
- Kadiombo Bantubungi,
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Thurner C, Horing B, Zipfel S, Stengel A, Mazurak N. Autonomic changes as reaction to experimental social stress in an inpatient psychosomatic cohort. Front Psychiatry 2022; 13:817778. [PMID: 35990055 PMCID: PMC9385984 DOI: 10.3389/fpsyt.2022.817778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 07/18/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES Patients with psychosomatic disorders suffer from social isolation that might further lead to destabilization and exacerbation of bodily symptoms via autonomic pathways. We aimed to investigate the influence of controlled social stress (model of social ostracism) on the autonomic nerve system (ANS) in an inpatient cohort with psychosomatic disorders. METHODS We examined heart rate variability (HRV), skin conductance (SC) and skin temperature (ST) as well as ECG-derived respiration rate (EDR) and subjective reports on stress during exposure to experimental social stress (cyberball game). Data were collected from 123 participants (f:m = 88:35, 42.01 ± 13.54 years) on admission and upon discharge from the university psychosomatic clinic. All data were recorded during baseline, inclusion and exclusion phases of the cyberball game as well as during the recovery phase. RESULTS We found significant changes between admission and discharge with a decline in parasympathetic-related HRV parameters (SDRR -3.20 ± 1.30 ms, p = 0.026; RMSSD: -3.77 ± 1.28 ms, p = 0.007) as well as a decrease in SC (-0.04 ± 0.17 μS, p = 0.019) and EDR (-0.01 ± 0.01 Hz, p = 0.007), suggesting a drop in sympathetic tonus, with no changes in ST (p = 0.089) and subjective stress levels (p = 0.322). HRV parameters decreased during the cyberball game (SDRR p = 0.026; RMSSD p = 0.002; lnHF p < 0.001). In contrast, both SC (p < 0.001) and EDR (p < 0.001) increased during the game with SC being slightly lower during the exclusion phase. This can point toward a stimulation of sympathetic nervous system during game participation, which was concordant with the rise in subjective stress values (p < 0.001). ST showed a continuous, unspecific rise over time (p < 0.001). CONCLUSION Our data demonstrate the decrease of ANS parameters during experimental social stress when data upon discharge were compared to those upon admission. These results are partially contradictory to previous studies that showed a rise in HRV in a psychiatric cohort over the course of (outpatient) treatment. Further research is required to help attributing these differences to effects of treatment or acute states relating to admission to or discharge from a psychosomatic department.
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Affiliation(s)
- Carolin Thurner
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital, Tübingen, Germany
| | - Bjoern Horing
- Department of Systems Neuroscience, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Stephan Zipfel
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital, Tübingen, Germany
| | - Andreas Stengel
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital, Tübingen, Germany.,Clinic for Psychosomatic Medicine, Charité Center for Internal Medicine and Dermatology, Humboldt-Universität zu Berlin and Berlin Institute of Health, Charite - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Berlin, Germany
| | - Nazar Mazurak
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital, Tübingen, Germany
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15
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Single Slow-Paced Breathing Session at Six Cycles per Minute: Investigation of Dose-Response Relationship on Cardiac Vagal Activity. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182312478. [PMID: 34886206 PMCID: PMC8656666 DOI: 10.3390/ijerph182312478] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Revised: 11/23/2021] [Accepted: 11/24/2021] [Indexed: 12/12/2022]
Abstract
The practice of slow-paced breathing (SPB) has been linked to a range of positive outcomes, such as decreasing symptoms of depression, anxiety, and stress, as well as increasing well-being. Among the suggested mechanisms of action, SPB has been shown to increase cardiac vagal activity (CVA). The present study aimed to investigate whether there is a dose-response relationship modulating the effects of SPB on CVA. A total of 59 participants were involved in this study. In a within-subject design, participants attended the lab five times, and realized SPB at six cycles per minute with different durations (5, 10, 15, and 20 min), as well as a control condition without SPB. CVA was indexed via the root mean square of successive differences (RMSSD). During SPB, findings showed an increase in RMSSD in all conditions compared to the control condition. However, no differences were found in RMSSD among the different session durations, during SPB or during the resting measurement completed immediately after SPB. Noteworthily, session duration showed an influence on the spontaneous respiratory frequency in the resting measurement occurring immediately after SPB. Specifically, respiratory frequency appears to decrease with session duration, thus potentially contributing to additional relaxing effects.
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16
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Burtscher J, Millet GP, Burtscher M. Sex-dependent blood pressure regulation in acute hypoxia. Hypertens Res 2021; 44:1689. [PMID: 34580425 DOI: 10.1038/s41440-021-00728-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Accepted: 08/01/2021] [Indexed: 11/09/2022]
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17
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Shin SY, Kim MJ, Joo J. Oculocardiac reflex and oculorespiratory reflex during strabismus surgery under general anesthesia using the laryngeal mask airway with maintenance of spontaneous respiration: A retrospective study. J Int Med Res 2021; 48:300060520945158. [PMID: 32787487 PMCID: PMC7427032 DOI: 10.1177/0300060520945158] [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] [Indexed: 11/17/2022] Open
Abstract
Objective To determine (1) how the specific muscle undergoing surgical treatment affects the occurrence of the oculocardiac reflex (OCR) and oculorespiratory reflex (ORR) and (2) whether the depth of anesthesia influences the occurrence of the OCR and ORR in patients undergoing strabismus surgery with a laryngeal mask airway with maintenance of spontaneous respiration. Methods The medical records of patients who underwent strabismus surgery on the lateral rectus (LR) and medial rectus (MR) muscles from January 2017 to December 2017 were retrospectively reviewed. Results The incidence of the OCR was not significantly different between LR and MR operations in either pediatric or adult patients. The incidence of the ORR as indexed by the tidal volume (TV) was significantly higher during MR than LR surgery in pediatric patients (29.3% vs. 10.1%, respectively). The change in TV during muscle traction and the bispectral index were significantly correlated in both pediatric and adult patients (r2 = 0.034 and 0.058, respectively). Conclusions The OCR was not influenced by the specific muscle undergoing surgery or the depth of anesthesia. The incidence of the ORR as indexed by the TV was higher during MR surgery in pediatric patients and was positively correlated with the depth of anesthesia.
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Affiliation(s)
- Sun Young Shin
- Department of Ophthalmology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Min Ju Kim
- Department of Anesthesiology and Pain Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jin Joo
- Department of Anesthesiology and Pain Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
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McKeown P, O’Connor-Reina C, Plaza G. Breathing Re-Education and Phenotypes of Sleep Apnea: A Review. J Clin Med 2021; 10:jcm10030471. [PMID: 33530621 PMCID: PMC7865730 DOI: 10.3390/jcm10030471] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Revised: 01/18/2021] [Accepted: 01/20/2021] [Indexed: 12/13/2022] Open
Abstract
Four phenotypes of obstructive sleep apnea hypopnea syndrome (OSAHS) have been identified. Only one of these is anatomical. As such, anatomically based treatments for OSAHS may not fully resolve the condition. Equally, compliance and uptake of gold-standard treatments is inadequate. This has led to interest in novel therapies that provide the basis for personalized treatment protocols. This review examines each of the four phenotypes of OSAHS and explores how these could be targeted using breathing re-education from three dimensions of functional breathing: biochemical, biomechanical and resonant frequency. Breathing re-education and myofunctional therapy may be helpful for patients across all four phenotypes of OSAHS. More research is urgently needed to investigate the therapeutic benefits of restoring nasal breathing and functional breathing patterns across all three dimensions in order to provide a treatment approach that is tailored to the individual patient.
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Affiliation(s)
- Patrick McKeown
- Buteyko Clinic International, Loughwell, Moycullen, Co., H91 H4C1 Galway, Ireland;
| | - Carlos O’Connor-Reina
- Otorhinolaryngology Department, Hospital Quironsalud Marbella, 29603 Marbella, Spain;
- Otorhinolaryngology Department, Hospital Quironsalud Campo de Gibraltar, 11379 Palmones, Spain
| | - Guillermo Plaza
- Otorhinolaryngology Department, Hospital Universitario de Fuenlabrada, Universidad Rey Juan Carlos, 28042 Madrid, Spain
- Otorhinolaryngology Department, Hospital Sanitas la Zarzuela, 28023 Madrid, Spain
- Correspondence:
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Bellissimo G, Leslie E, Maestas V, Zuhl M. The Effects of Fast and Slow Yoga Breathing on Cerebral and Central Hemodynamics. Int J Yoga 2020; 13:207-212. [PMID: 33343150 PMCID: PMC7735505 DOI: 10.4103/ijoy.ijoy_98_19] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 02/26/2020] [Accepted: 04/08/2020] [Indexed: 12/17/2022] Open
Abstract
Background: Yoga breathing has shown to impose significant cardiovascular and psychological health benefits. Objective: The mechanism (s) responsible for these health benefits remain unclear. The aim of the present study was to assess the differences in cerebral and central hemodynamic responses following fast breathing (FB) and slow breathing (SB) protocols compared to breathing awareness (BA) as a control. Methods: Twenty healthy participants (10 males and 10 females) volunteered to take part in the study. Participants were between ages 18–55 years (group mean: 24 ± 5 years), with a height of 168.7 ± 9.8 cm and a weight of 70.16 ± 10.9 kg. A familiarization trial including FB and SB protocols were performed by each participant at least 24 h before the testing day. The breathing protocols were designed to achieve 6 breath/min for SB and ~ 120 breaths/min for FB. Results: FB resulted in an increase in both right prefrontal cortex (RPFC) and left prefrontal cortex (LPFC) hemoglobin difference (Hbdiff) (brain oxygenation) compared to BA (P < 0.05). FB resulted in an increased Hbdiff in LPFC compared to RPFC SB (P < 0.05). FB resulted in an increased Hbdiff in LPFC compared to SB (P < 0.05). Conclusion: FB may be an effective yoga breathing technique for eliciting cerebral brain oxygenation indicated by increased Hbdiff. These results may be applicable to both healthy and clinical populations.
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Affiliation(s)
- Gabriella Bellissimo
- Department of Health, Exercise, and Sports Sciences, University of New Mexico, Albuquerque, NM, USA
| | - Eric Leslie
- Department of Health, Exercise, and Sports Sciences, University of New Mexico, Albuquerque, NM, USA
| | - Valarie Maestas
- Department of Health, Exercise, and Sports Sciences, University of New Mexico, Albuquerque, NM, USA
| | - Micah Zuhl
- Department of Health, Exercise, and Sports Sciences, University of New Mexico, Albuquerque, NM, USA.,School of Health Sciences, Central Michigan University, Mt. Pleasant, MI, USA
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Zamoscik V, Schmidt SN, Timm C, Kuehner C, Kirsch P. Modulation of respiration pattern variability and its relation to anxiety symptoms in remitted recurrent depression. Heliyon 2020; 6:e04261. [PMID: 32685708 PMCID: PMC7358718 DOI: 10.1016/j.heliyon.2020.e04261] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Revised: 03/27/2020] [Accepted: 06/17/2020] [Indexed: 12/04/2022] Open
Abstract
Background Depression is related to default mode network (DMN) connectivity and higher respiration pattern variability (RPV). In addition, DMN connectivity and RPV are interrelated and predict a poorer clinical course of depression. The association of RPV and depression might further be boosted by anxiety levels. Aim of the present study was to investigate whether a mindfulness-based training in emotionally challenged remitted depressed participants (rMDD) leads to reduced DMN connectivity and lower RPV, and if RPV interacts with anxiety levels. Methods To challenge participants, sad mood was induced with keywords of personal negative life events in 49 rMDD during fMRI before and after a 4-week mindfulness-based attention training (MBAT) or progressive muscle relaxation. Respiration was measured by means of a built-in respiration belt. Results After both trainings, rMDD showed no significant changes in DMN connectivity. However, MBAT was effective in reducing the RPV which was related to lower anxiety levels especially in high anxious individuals. Conclusions RPV can be influenced by training which may hint to an underlying biological pathway of training effects. Importantly, these effects seem to be associated with anxiety levels. Therefore, respiration focused training might be an important tool assisting the treatment of depression and anxiety.
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Affiliation(s)
- Vera Zamoscik
- Department Clinical Psychology, Central Institute of Mental Health, Mannheim, Medical Faculty Mannheim, Heidelberg University, Germany
- Department of Psychology, University of Bonn, Germany
- Corresponding author.
| | - Stephanie N.L. Schmidt
- Department Clinical Psychology, Central Institute of Mental Health, Mannheim, Medical Faculty Mannheim, Heidelberg University, Germany
- Research Group of Clinical Psychology, Department of Psychology, University of Konstanz, Germany
| | - Christina Timm
- Research Group Longitudinal and Intervention Research, Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Mannheim, Medical Faculty Mannheim, Heidelberg University, Germany
| | - Christine Kuehner
- Research Group Longitudinal and Intervention Research, Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Mannheim, Medical Faculty Mannheim, Heidelberg University, Germany
| | - Peter Kirsch
- Department Clinical Psychology, Central Institute of Mental Health, Mannheim, Medical Faculty Mannheim, Heidelberg University, Germany
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21
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Bartling B, Schwarzmann L, Pliquett RU, Simm A, Hofmann B. Simultaneous influence of sex and age on blood pressure difference between supine and sitting body positions. Z Gerontol Geriatr 2020; 54:597-604. [PMID: 32647989 DOI: 10.1007/s00391-020-01756-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 06/22/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Doctors' offices and outpatient departments typically measure blood pressure (BP) with the patient in a sitting position, whereas inpatient departments also use the supine position. As sex and age influence the autonomic function associated with BP regulation our study compared BP measurements in supine and sitting positions for men and women of different ages. METHODS We included 91 men and 118 women (≥18 years) without severe diseases. Hypertension was not an exclusion criterion because it is common in older persons. Mean left brachial BP and heart rate were determined by a digital sphygmomanometer in supine position as well as in sitting position before and after hand force measurement. RESULTS In a supine position women had slightly lower diastolic BP values than men. After sitting up, the diastolic BP increased in nearly all subjects. This increase was greater in women older than 50 years than for aged-matched men. In contrast to diastolic BP the systolic BP increased after sitting up in only two thirds of the subjects. Especially in women younger than 50 years the systolic BP often did not increase but decreased in response to postural change. The pulse pressure was mostly reduced after sitting up. This reduction was more pronounced in women than men independent of age and physical effort (i.e. hand force measurement). The sitting position also caused an increased heart rate, which was independent of sex and age. CONCLUSION Postural changes in the systolic and diastolic BP simultaneously depend on sex and age that needs to be considered for BP measurements in supine and sitting body positions.
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Affiliation(s)
- Babett Bartling
- Department of Cardiac Surgery, Mid-German Heart Centre, University Hospital Halle (Saale), Ernst-Grube-Str. 40, 06120, Halle (Saale), Germany.
| | - Luisa Schwarzmann
- Department of Cardiac Surgery, Mid-German Heart Centre, University Hospital Halle (Saale), Ernst-Grube-Str. 40, 06120, Halle (Saale), Germany
| | - Rainer Ullrich Pliquett
- Department for Internal Medicine II, Medical Faculty, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
- Department for Nephrology and Diabetology, Carl Thiem Hospital, Cottbus, Germany
| | - Andreas Simm
- Department of Cardiac Surgery, Mid-German Heart Centre, University Hospital Halle (Saale), Ernst-Grube-Str. 40, 06120, Halle (Saale), Germany
| | - Britt Hofmann
- Department of Cardiac Surgery, Mid-German Heart Centre, University Hospital Halle (Saale), Ernst-Grube-Str. 40, 06120, Halle (Saale), Germany
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Wybranski C, Siedek F, Damm R, Gazis A, Wenzel O, Haneder S, Persigehl T, Steinhauser S, Pech M, Fischbach F, Fischbach K. Respiratory motion artefacts in Gd-EOB-DTPA (Primovist/Eovist) and Gd-DOTA (Dotarem)-enhanced dynamic phase liver MRI after intensified and standard pre-scan patient preparation: A bi-institutional analysis. PLoS One 2020; 15:e0230024. [PMID: 32196535 PMCID: PMC7083299 DOI: 10.1371/journal.pone.0230024] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Accepted: 02/18/2020] [Indexed: 12/15/2022] Open
Abstract
Objective The objective of this study is to evaluate if intensified pre-scan patient preparation (IPPP) that comprises custom-made educational material on dynamic phase imaging and supervised pre-imaging breath-hold training in addition to standard informative conversation with verbal explanation of breath-hold commands (standard pre-scan patient preparation–SPPP) might reduce the incidence of gadoxetate disodium (Gd-EOB-DTPA)-related transient severe respiratory motion (TSM) and severity of respiratory motion (RM) during dynamic phase liver MRI. Material and methods In this bi-institutional study 100 and 110 patients who received Gd-EOB-DTPA for dynamic phase liver MRI were allocated to either IPPP or SPPP at site A and B. The control group comprised 202 patients who received gadoterate meglumine (Gd-DOTA) of which each 101 patients were allocated to IPPP or SPPP at site B. RM artefacts were scored retrospectively in dynamic phase images (1: none– 5: extensive) by five and two blinded readers at site A and B, respectively, and in the hepatobiliary phase of the Gd-EOB-DTPA-enhanced scans by two blinded readers at either site. Results The incidence of TSM was 15% at site A and 22.7% at site B (p = 0.157). IPPP did not reduce the incidence of TSM in comparison to SPPP: 16.7% vs. 21.6% (p = 0.366). This finding was consistent at site A: 12% vs. 18% (p = 0.401) and site B: 20.6% vs. 25% (p = 0.590). The TSM incidence in patients with IPPP and SPPP did not differ significantly between both sites (p = 0.227; p = 0.390). IPPP did not significantly mitigate RM in comparison to SPPP in any of the Gd-EOB-DTPA-enhanced dynamic phases and the hepatobiliary phase in patients without TSM (all p≥0.072). In the Gd-DOTA control group on the other hand, IPPP significantly mitigated RM in all dynamic phases in comparison to SPPP (all p≤0.031). Conclusions We conclude that Gd-EOB-DTPA-related TSM cannot be mitigated by education and training and that Gd-EOB-DTPA-related breath-hold difficulty does not only affect the subgroup of patients with TSM or exclusively the arterial phase as previously proposed.
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Affiliation(s)
- Christian Wybranski
- Institute of Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Cologne, Germany
| | - Florian Siedek
- Institute of Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Cologne, Germany
- * E-mail:
| | - Robert Damm
- Department of Radiology and Nuclear Medicine, University Hospital of Magdeburg, Magdeburg, Germany
| | - Angelos Gazis
- Department of Radiology and Nuclear Medicine, University Hospital of Magdeburg, Magdeburg, Germany
| | - Ortrud Wenzel
- Department of Radiology and Nuclear Medicine, University Hospital of Magdeburg, Magdeburg, Germany
| | - Stefan Haneder
- Institute of Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Cologne, Germany
| | - Thorsten Persigehl
- Institute of Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Cologne, Germany
| | - Susanne Steinhauser
- Institute of Medical Statistics and Computational Biology, University Hospital of Cologne, Cologne, Germany
| | - Maciej Pech
- Department of Radiology and Nuclear Medicine, University Hospital of Magdeburg, Magdeburg, Germany
| | - Frank Fischbach
- Department of Radiology and Nuclear Medicine, University Hospital of Magdeburg, Magdeburg, Germany
| | - Katharina Fischbach
- Department of Radiology and Nuclear Medicine, University Hospital of Magdeburg, Magdeburg, Germany
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Too Real to Be Virtual: Autonomic and EEG Responses to Extreme Stress Scenarios in Virtual Reality. Behav Neurol 2020; 2020:5758038. [PMID: 32256856 PMCID: PMC7091527 DOI: 10.1155/2020/5758038] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Revised: 12/28/2019] [Accepted: 01/20/2020] [Indexed: 02/04/2023] Open
Abstract
The evolution of virtual reality (VR) technologies requires setting boundaries of its use. In this study, 3 female participants were experiencing VR scenarios with stressful content and their activity of the autonomic nervous system and EEG were recorded. It has been discovered that virtual reality can evoke acute stress reactions accompanied by activation of the sympathetic nervous system and a decrease in the activity of the parasympathetic nervous system. The high-stress response is accompanied by a decrease in the power of the EEG, and, on the contrary, the activation of the avoidance reaction is accompanied by an increase in the power of the EEG alpha waves. Therefore, the use of stressful VR content can cause high emotional stress to a user and restrictions should be considered.
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Keir DA, Duffin J, Millar PJ, Floras JS. Simultaneous assessment of central and peripheral chemoreflex regulation of muscle sympathetic nerve activity and ventilation in healthy young men. J Physiol 2019; 597:3281-3296. [DOI: 10.1113/jp277691] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Accepted: 05/13/2019] [Indexed: 12/20/2022] Open
Affiliation(s)
- Daniel A. Keir
- University Health Network and Mount Sinai Hospital Division of CardiologyDepartment of Medicine, University of Toronto Toronto Ontario Canada
| | - James Duffin
- Departments of Anaesthesia and PhysiologyUniversity of Toronto Toronto Ontario Canada
- Thornhill Research Inc. Toronto Ontario Canada
| | - Philip J. Millar
- University Health Network and Mount Sinai Hospital Division of CardiologyDepartment of Medicine, University of Toronto Toronto Ontario Canada
- Human Health and Nutritional ScienceUniversity of Guelph Guelph Ontario Canada
| | - John S. Floras
- University Health Network and Mount Sinai Hospital Division of CardiologyDepartment of Medicine, University of Toronto Toronto Ontario Canada
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25
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De Souza LA, Ferreira JB, Schein ASDO, Dartora DR, Casali AG, Scassola CMC, Tobaldini E, Montano N, Guzzetti S, Porta A, Irigoyen MC, Casali KR. Optimization of Vagal Stimulation Protocol Based on Spontaneous Breathing Rate. Front Physiol 2018; 9:1341. [PMID: 30319449 PMCID: PMC6168675 DOI: 10.3389/fphys.2018.01341] [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: 05/14/2018] [Accepted: 09/05/2018] [Indexed: 11/13/2022] Open
Abstract
Controlled breathing maneuver is being widely applied for cardiovascular autonomic control evaluation and cardiac vagal activation through reduction of breathing rate (BR). However, this maneuver presented contradictory results depending on the protocol and the chosen BR. These variations may be related to the individual intrinsic profile baseline sympathetic tonus, as described before by others. In this study, we evaluated the effect of controlled breathing maneuver on cardiovascular autonomic control in 26 healthy subjects allocated into two protocols: (1) controlled breathing in three different rates (10, 15, and 20 breaths/min) and (2) controlled breathing in rates normalized by the individual spontaneous breathing rate (SBR) at 100, 80, 70, and 50%. Our results showed autonomic responses favorable to vagal modulation with the lower BR maneuvers. Nevertheless, while this activation was variable using the standard protocol, all participants of the normalized protocol demonstrated an increase of vagal modulation at 80% BR (HFnu 80 = 67.5% vs. 48.2%, p < 0.0001). These results suggest that controlled breathing protocols to induce vagal activation should consider the SBR, being limited to values moderately lower than the baseline.
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Affiliation(s)
- Liliane Appratto De Souza
- Institute of Cardiology of Rio Grande do Sul, University Foundation of Cardiology, Porto Alegre, Brazil
| | | | | | - Daniela Ravizzoni Dartora
- Institute of Cardiology of Rio Grande do Sul, University Foundation of Cardiology, Porto Alegre, Brazil
| | - Adenauer Girardi Casali
- Department of Science and Technology, Institute of Science and Technology, Federal University of São Paulo, São José dos Campos, Brazil
| | - Catharina M Carvalho Scassola
- Department of Science and Technology, Institute of Science and Technology, Federal University of São Paulo, São José dos Campos, Brazil
| | - Eleonora Tobaldini
- Department of Clinical Science, Luigi Sacco Hospital, University of Milan, Milan, Italy
| | - Nicola Montano
- Department of Clinical Science, Luigi Sacco Hospital, University of Milan, Milan, Italy
| | - Stefano Guzzetti
- Department of Clinical Science, Luigi Sacco Hospital, University of Milan, Milan, Italy
| | - Alberto Porta
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy.,Department of Cardiothoracic, Vascular Anesthesia and Intensive Care, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy
| | - Maria Claudia Irigoyen
- Institute of Cardiology of Rio Grande do Sul, University Foundation of Cardiology, Porto Alegre, Brazil.,Hypertension Division, Medicine School, Heart Institute, São Paulo University, São Paulo, Brazil
| | - Karina Rabello Casali
- Institute of Cardiology of Rio Grande do Sul, University Foundation of Cardiology, Porto Alegre, Brazil.,Department of Science and Technology, Institute of Science and Technology, Federal University of São Paulo, São José dos Campos, Brazil
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26
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Toschi-Dias E, Trombetta IC, Silva VJD, Maki-Nunes C, Cepeda FX, Alves MJNN, Carvalho GL, Drager LF, Lorenzi-Filho G, Negrão CE, Rondon MUPB. Diet associated with exercise improves baroreflex control of sympathetic nerve activity in metabolic syndrome and sleep apnea patients. Sleep Breath 2018; 23:143-151. [PMID: 29948856 DOI: 10.1007/s11325-018-1675-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Revised: 05/23/2018] [Accepted: 05/29/2018] [Indexed: 12/28/2022]
Abstract
PURPOSE We tested the hypothesis that (i) diet associated with exercise would improve arterial baroreflex (ABR) control in metabolic syndrome (MetS) patients with and without obstructive sleep apnea (OSA) and (ii) the effects of this intervention would be more pronounced in patients with OSA. METHODS Forty-six MetS patients without (noOSA) and with OSA (apnea-hypopnea index, AHI > 15 events/h) were allocated to no treatment (control, C) or hypocaloric diet (- 500 kcal/day) associated with exercise (40 min, bicycle exercise, 3 times/week) for 4 months (treatment, T), resulting in four groups: noOSA-C (n = 10), OSA-C (n = 12), noOSA-T (n = 13), and OSA-T (n = 11). Muscle sympathetic nerve activity (MSNA), beat-to-beat BP, and spontaneous arterial baroreflex function of MSNA (ABRMSNA, gain and time delay) were assessed at study entry and end. RESULTS No significant changes occurred in C groups. In contrast, treatment in both patients with and without OSA led to a significant decrease in weight (P < 0.05) and the number of MetS factors (P = 0.03). AHI declined only in the OSA-T group (31 ± 5 to 17 ± 4 events/h, P < 0.05). Systolic BP decreased in both treatment groups, and diastolic BP decreased significantly only in the noOSA-T group. Treatment decreased MSNA in both groups. Compared with baseline, ABRMSNA gain increased in both OSA-T (13 ± 1 vs. 24 ± 2 a.u./mmHg, P = 0.01) and noOSA-T (27 ± 3 vs. 37 ± 3 a.u./mmHg, P = 0.03) groups. The time delay of ABRMSNA was reduced only in the OSA-T group (4.1 ± 0.2 s vs. 2.8 ± 0.3 s, P = 0.04). CONCLUSIONS Diet associated with exercise improves baroreflex control of sympathetic nerve activity and MetS components in patients with MetS regardless of OSA.
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Affiliation(s)
- Edgar Toschi-Dias
- Heart Institute (InCor), University of São Paulo Medical School, São Paulo, SP, Brazil.
| | | | - Valdo J D Silva
- Biological Sciences Institute, Triangulo Mineiro Federal University, Uberaba, MG, Brazil
| | - Cristiane Maki-Nunes
- Heart Institute (InCor), University of São Paulo Medical School, São Paulo, SP, Brazil
| | - Felipe X Cepeda
- Heart Institute (InCor), University of São Paulo Medical School, São Paulo, SP, Brazil
| | | | - Glauce L Carvalho
- Heart Institute (InCor), University of São Paulo Medical School, São Paulo, SP, Brazil
| | - Luciano F Drager
- Heart Institute (InCor), University of São Paulo Medical School, São Paulo, SP, Brazil
| | - Geraldo Lorenzi-Filho
- Heart Institute (InCor), University of São Paulo Medical School, São Paulo, SP, Brazil
| | - Carlos E Negrão
- Heart Institute (InCor), University of São Paulo Medical School, São Paulo, SP, Brazil.,School of Physical Education and Sport, University of São Paulo, São Paulo, SP, Brazil
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Macoun T, Botek M, Krejčí J, McKune AJ. Vagal activity and oxygen saturation response to hypoxia: Effects of aerobic fitness and rating of hypoxia tolerance. ACTA GYMNICA 2017. [DOI: 10.5507/ag.2017.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Lachowska K, Gruchała M, Narkiewicz K, Hering D. Sympathetic Activation in Chronic Heart Failure: Potential Benefits of Interventional Therapies. Curr Hypertens Rep 2017; 18:51. [PMID: 27193773 DOI: 10.1007/s11906-016-0660-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Heart failure (HF) is a major and growing public health problem. This condition is associated with poor prognosis, a high rate of mortality, frequent hospitalization and increasing costs to health care systems. Pharmacological approaches aimed at reducing morbidity and mortality in HF have primarily focused on inhibition of the renin-angiotensin-aldosterone system (RAAS) and the sympathetic nervous system (SNS), both of which have been associated with disease development, progression and adverse cardiovascular (CV) outcomes. The increasing number of hospitalizations for HF decompensation suggests the failure of available treatment options, indicating the necessity for alternative therapeutic approaches. Alongside pharmacological and cardiac resynchronization therapies in selected patients with arrhythmia, recent advancements in the management of HF have been directed at inhibiting relevant neurogenic pathways underlying disease development and progression. Initial evidence regarding the safety and effectiveness of interventional procedures suggests that HF patients may benefit from novel adjunctive therapies. Here we review the critical role of sympathetic activation in HF and the rationale for therapeutic interventions including device-based and interventional approaches aimed at restoring autonomic neural balance in this condition.
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Affiliation(s)
- Kamila Lachowska
- First Department of Cardiology, Medical University of Gdansk, Gdansk, Poland
| | - Marcin Gruchała
- First Department of Cardiology, Medical University of Gdansk, Gdansk, Poland
| | - Krzysztof Narkiewicz
- Department of Hypertension and Diabetology, Medical University of Gdansk, Gdansk, Poland
| | - Dagmara Hering
- Dobney Hypertension Centre, School of Medicine and Pharmacology-Royal Perth Hospital Unit, The University of Western Australia, Level 3 MRF Building, Rear 50 Murray Street, Perth, WA, 6000, MDBP: M570, Australia.
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29
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Tracy LM, Giummarra MJ. Sex differences in empathy for pain: What is the role of autonomic regulation? Psychophysiology 2017; 54:1549-1558. [DOI: 10.1111/psyp.12895] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2017] [Revised: 04/27/2017] [Accepted: 04/28/2017] [Indexed: 12/15/2022]
Affiliation(s)
- Lincoln M. Tracy
- School of Psychological Sciences and Monash Institute of Cognitive and Clinical Neurosciences; Monash University; Clayton Victoria Australia
- Pain Management and Research Centre, Caulfield Hospital; Caulfield Victoria Australia
| | - Melita J. Giummarra
- Pain Management and Research Centre, Caulfield Hospital; Caulfield Victoria Australia
- School of Public Health and Preventive Medicine; Monash University; Melbourne Victoria Australia
- Institute for Safety, Compensation and Recovery Research, Monash University; Melbourne Victoria Australia
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30
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McBryde FD, Hart EC, Ramchandra R, Paton JF. Evaluating the carotid bodies and renal nerves as therapeutic targets for hypertension. Auton Neurosci 2017; 204:126-130. [DOI: 10.1016/j.autneu.2016.08.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2016] [Revised: 07/28/2016] [Accepted: 08/01/2016] [Indexed: 11/30/2022]
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Reulecke S, Charleston-Villalobos S, Voss A, González-Camarena R, González-Hermosillo J, Gaitán-González M, Hernández-Pacheco G, Schroeder R, Aljama-Corrales T. Dynamics of the cardiovascular autonomic regulation during orthostatic challenge is more relaxed in women. ACTA ACUST UNITED AC 2017; 63:139-150. [DOI: 10.1515/bmt-2016-0150] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Accepted: 11/28/2016] [Indexed: 11/15/2022]
Abstract
Abstract
Linear dynamic analysis of cardiovascular and respiratory time series was performed in healthy subjects with respect to gender by shifted short-term segments throughout a head-up tilt (HUT) test. Beat-to-beat intervals (BBI), systolic (SYS) and diastolic (DIA) blood pressure and respiratory interval (RESP) time series were acquired in 14 men and 15 women. In time domain (TD), the descending slope of the auto-correlation function (ACF) (BBI_a31cor) was more pronounced in women than in men (p<0.05) during the HUT test and considerably steeper (p<0.01) at the end of orthostatic phase (OP). The index SYS_meanNN was slightly but significantly lower (p<0.05) in women during the complete test, while higher respiratory frequency and variability (RESP_sdNN) were found in women (p<0.05), during 10–20 min after tilt-up. In frequency domain (FD), during baseline (BL), BBI-normalized low frequency (BBI_LFN) and BBI_LF/HF were slightly but significantly lower (p<0.05), while normalized high frequency (BBI_HFN) was significantly higher in women. These differences were highly significant from the first 5 min after tilt-up (p<0.01) and highly significant (p<0.001) during 10–14 min of OP. Findings revealed that men showed instantaneously a pronounced and sustained increase in sympathetic activity to compensate orthostatism. In women, sympathetic activity was just increased slightly with delayed onset without considerably affecting sympatho-vagal balance.
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Affiliation(s)
- Sina Reulecke
- Universidad Autónoma Metropolitana , Electrical Engineering Department , 09340 Mexico City , Mexico
| | | | - Andreas Voss
- Institute of Innovative Health Technologies, Ernst-Abbe-Hochschule Jena , 07745 Jena , Germany
| | | | | | | | | | - Rico Schroeder
- Ernst-Abbe-Hochschule Jena , Department of Medical Engineering and Biotechnology , 07745 Jena , Germany
| | - Tomás Aljama-Corrales
- Universidad Autónoma Metropolitana , Electrical Engineering Department , 09340 Mexico City , Mexico
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Eckberg DL, Cooke WH, Diedrich A, Biaggioni I, Buckey JC, Pawelczyk JA, Ertl AC, Cox JF, Kuusela TA, Tahvanainen KUO, Mano T, Iwase S, Baisch FJ, Levine BD, Adams-Huet B, Robertson D, Blomqvist CG. Respiratory modulation of human autonomic function on Earth. J Physiol 2016; 594:5611-27. [PMID: 27028958 PMCID: PMC5043049 DOI: 10.1113/jp271654] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2015] [Accepted: 03/14/2016] [Indexed: 11/08/2022] Open
Abstract
KEY POINTS We studied healthy supine astronauts on Earth with electrocardiogram, non-invasive arterial pressure, respiratory carbon dioxide concentrations, breathing depth and sympathetic nerve recordings. The null hypotheses were that heart beat interval fluctuations at usual breathing frequencies are baroreflex mediated, that they persist during apnoea, and that autonomic responses to apnoea result from changes of chemoreceptor, baroreceptor or lung stretch receptor inputs. R-R interval fluctuations at usual breathing frequencies are unlikely to be baroreflex mediated, and disappear during apnoea. The subjects' responses to apnoea could not be attributed to changes of central chemoreceptor activity (hypocapnia prevailed); altered arterial baroreceptor input (vagal baroreflex gain declined and muscle sympathetic nerve burst areas, frequencies and probabilities increased, even as arterial pressure climbed to new levels); or altered pulmonary stretch receptor activity (major breathing frequency and tidal volume changes did not alter vagal tone or sympathetic activity). Apnoea responses of healthy subjects may result from changes of central respiratory motoneurone activity. ABSTRACT We studied eight healthy, supine astronauts on Earth, who followed a simple protocol: they breathed at fixed or random frequencies, hyperventilated and then stopped breathing, as a means to modulate and expose to view important, but obscure central neurophysiological mechanisms. Our recordings included the electrocardiogram, finger photoplethysmographic arterial pressure, tidal volume, respiratory carbon dioxide concentrations and peroneal nerve muscle sympathetic activity. Arterial pressure, vagal tone and muscle sympathetic outflow were comparable during spontaneous and controlled-frequency breathing. Compared with spontaneous, 0.1 and 0.05 Hz breathing, however, breathing at usual frequencies (∼0.25 Hz) lowered arterial baroreflex gain, and provoked smaller arterial pressure and R-R interval fluctuations, which were separated by intervals that were likely to be too short and variable to be attributed to baroreflex physiology. R-R interval fluctuations at usual breathing frequencies disappear during apnoea, and thus cannot provide evidence for the existence of a central respiratory oscillation. Apnoea sets in motion a continuous and ever changing reorganization of the relations among stimulatory and inhibitory inputs and autonomic outputs, which, in our study, could not be attributed to altered chemoreceptor, baroreceptor, or pulmonary stretch receptor activity. We suggest that responses of healthy subjects to apnoea are driven importantly, and possibly prepotently, by changes of central respiratory motoneurone activity. The companion article extends these observations and asks the question, Might terrestrial responses to our 20 min breathing protocol find expression as long-term neuroplasticity in serial measurements made over 20 days during and following space travel?
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Affiliation(s)
- Dwain L Eckberg
- Departments of Medicine and Physiology, Hunter Holmes McGuire Department of Veterans Affairs, Medical Center and Virginia Commonwealth University School of Medicine, Richmond, VA, USA.
| | - William H Cooke
- Department of Kinesiology, Health, and Nutrition, University of Texas at San Antonio, San Antonio, TX, USA
| | - André Diedrich
- Department of Medicine, Division of Clinical Pharmacology, Autonomic Dysfunction Center, Vanderbilt University School of Medicine, Vanderbilt University, Nashville, TN, USA
| | - Italo Biaggioni
- Department of Medicine, Division of Clinical Pharmacology, Autonomic Dysfunction Center, Vanderbilt University School of Medicine, Vanderbilt University, Nashville, TN, USA
| | - Jay C Buckey
- Dartmouth Hitchcock Medical Center, Lebanon, NH, USA
| | - James A Pawelczyk
- Department of Physiology, Pennsylvania State University, University Park and Hershey, PA, USA
| | - Andrew C Ertl
- Department of Medicine, Division of Clinical Pharmacology, Autonomic Dysfunction Center, Vanderbilt University School of Medicine, Vanderbilt University, Nashville, TN, USA
| | - James F Cox
- Departments of Medicine and Physiology, Hunter Holmes McGuire Department of Veterans Affairs, Medical Center and Virginia Commonwealth University School of Medicine, Richmond, VA, USA
| | - Tom A Kuusela
- Department of Physics, University of Turku, Turku, Finland
| | - Kari U O Tahvanainen
- Department of Clinical Physiology and Nuclear Medicine, South Karelia Central Hospital, Lappeenranta, Finland
| | - Tadaaki Mano
- Gifu University of Medical Science, 795-1 Nagamine Ichihiraga, Seki, Gifu, 501-3892, Japan
| | - Satoshi Iwase
- Department of Physiology, Aichi Medical University, Aichi, Japan
| | | | - Benjamin D Levine
- Department of Medicine, University of Texas Southwestern Medical Center at Dallas, Dallas, TX, USA
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital, Dallas, TX, USA
| | | | - David Robertson
- Department of Medicine, Division of Clinical Pharmacology, Autonomic Dysfunction Center, Vanderbilt University School of Medicine, Vanderbilt University, Nashville, TN, USA
| | - C Gunnar Blomqvist
- Department of Medicine, University of Texas Southwestern Medical Center at Dallas, Dallas, TX, USA
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Zimmerman E, Thompson K. A pilot study: the role of the autonomic nervous system in cardiorespiratory regulation in infant feeding. Acta Paediatr 2016; 105:286-91. [PMID: 26613548 DOI: 10.1111/apa.13289] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2015] [Revised: 10/19/2015] [Accepted: 11/23/2015] [Indexed: 11/29/2022]
Abstract
AIM The purpose of this pilot study was to examine the interplay between the parasympathetic (PNS) and sympathetic nervous systems' (SNS) contributions to prefeeding, feeding and satiation in young, healthy infants. METHOD This prospective study was completed on eleven full-term infants, less than 6 months old. Respiratory rate, heart rate, heart rate variability (HRV), electrodermal activity and low-frequency/high-frequency heart rate variability ratio were sampled from the infant during prefeeding, feeding and satiation periods. RESULTS A repeated-measures ANOVA revealed a significant difference in respiratory patterning during the three feeding phases (p = .049); however, none of the other physiological measures reached significance. An emerging trend across physiological measures suggests that the feeding phase was influenced by the SNS with increasing respiratory rate, heart rate, low-frequency HRV, electrodermal activity and decreasing high-frequency HRV compared to the prefeeding and satiation phases, which were influenced predominantly by the PNS. CONCLUSION Respiration rate increased significantly during the feeding phase compared to prefeeding and postfeeding phases. Emerging trends indicate a pattern of alternating relative tone in PNS versus SNS across feeding phases - with SNS predominating the feeding phase. More clinical research examining the SNS and PNS contributions to feeding should be completed across patient populations.
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Affiliation(s)
- Emily Zimmerman
- Department of Communication Sciences & Disorders Northeastern University Boston MA USA
| | - Kelsey Thompson
- Department of Communication Sciences & Disorders Northeastern University Boston MA USA
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34
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Pfoh JR, Tymko MM, Abrosimova M, Boulet LM, Foster GE, Bain AR, Ainslie PN, Steinback CD, Bruce CD, Day TA. Comparing and characterizing transient and steady-state tests of the peripheral chemoreflex in humans. Exp Physiol 2016; 101:432-47. [DOI: 10.1113/ep085498] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2015] [Accepted: 11/30/2015] [Indexed: 11/08/2022]
Affiliation(s)
- Jamie R. Pfoh
- Department of Biology, Faculty of Science and Technology; Mount Royal University; Calgary Alberta Canada
| | - Michael M. Tymko
- School of Health and Exercise Sciences, Faculty of Health and Social Development; University of British Columbia Okanagan; Kelowna British Columbia Canada
| | - Maria Abrosimova
- Department of Biology, Faculty of Science and Technology; Mount Royal University; Calgary Alberta Canada
| | - Lindsey M. Boulet
- Department of Biology, Faculty of Science and Technology; Mount Royal University; Calgary Alberta Canada
- School of Health and Exercise Sciences, Faculty of Health and Social Development; University of British Columbia Okanagan; Kelowna British Columbia Canada
| | - Glen E. Foster
- School of Health and Exercise Sciences, Faculty of Health and Social Development; University of British Columbia Okanagan; Kelowna British Columbia Canada
| | - Anthony R. Bain
- School of Health and Exercise Sciences, Faculty of Health and Social Development; University of British Columbia Okanagan; Kelowna British Columbia Canada
| | - Philip N. Ainslie
- School of Health and Exercise Sciences, Faculty of Health and Social Development; University of British Columbia Okanagan; Kelowna British Columbia Canada
| | - Craig D. Steinback
- Faculty of Physical Education and Recreation; University of Alberta; Edmonton Alberta Canada
| | - Christina D. Bruce
- Department of Biology, Faculty of Science and Technology; Mount Royal University; Calgary Alberta Canada
| | - Trevor A. Day
- Department of Biology, Faculty of Science and Technology; Mount Royal University; Calgary Alberta Canada
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Cash E, Salmon P, Weissbecker I, Rebholz WN, Bayley-Veloso R, Zimmaro LA, Floyd A, Dedert E, Sephton SE. Mindfulness meditation alleviates fibromyalgia symptoms in women: results of a randomized clinical trial. Ann Behav Med 2016; 49:319-30. [PMID: 25425224 DOI: 10.1007/s12160-014-9665-0] [Citation(s) in RCA: 82] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
BACKGROUND Several recent reviews have evaluated evidence on the efficacy of Mindfulness-Based Stress Reduction (MBSR) among fibromyalgia sufferers, and concluded that more research should test effects on both psychological and physiological functioning. PURPOSE We conducted a randomized prospective trial of MBSR among female fibromyalgia patients. METHODS Effects on perceived stress, pain, sleep quality, fatigue, symptom severity, and salivary cortisol were tested in treatment (n=51) versus wait-list control participants (n=40) using data at baseline, post-program, and 2-month follow-up. RESULTS Analyses revealed that MBSR significantly reduced perceived stress, sleep disturbance, and symptom severity, with gains maintained at follow-up. Greater home practice at follow-up was associated with reduced symptom severity. MBSR did not significantly alter pain, physical functioning, or cortisol profiles. CONCLUSION MBSR ameliorated some of the major symptoms of fibromyalgia and reduced subjective illness burden. Further exploration of MBSR effects on physiological stress responses is warranted. These results support use of MBSR as a complementary treatment for women with fibromyalgia ( ISRCTN 34628811).
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Affiliation(s)
- Elizabeth Cash
- Department of Surgery, Division of Otolaryngology, University of Louisville School of Medicine, Louisville, KY, USA
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Device-guided slow-paced respiration for menopausal hot flushes: a randomized controlled trial. Obstet Gynecol 2015; 125:1130-1138. [PMID: 25932840 DOI: 10.1097/aog.0000000000000821] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To evaluate the efficacy of device-guided slow-paced respiration for reducing the frequency and severity of menopausal hot flushes. METHODS Perimenopausal or postmenopausal women reporting four or more hot flushes per day were recruited into a parallel-group, randomized trial of slow-paced respiration using a portable guided-breathing device. Women were randomly assigned to use a standard device to practice slowing their resting breathing rate to less than 10 breaths per minute for at least 15 minutes everyday or use an identical-appearing control device programmed to play relaxing nonrhythmic music while monitoring spontaneous breathing. The primary outcome, change in hot flush frequency over 12 weeks, was assessed using data from validated 7-day diaries abstracted by blinded analysts. RESULTS Among the 123 participants, mean age was 53.4 (±3.4) years. Women reported an average of 8.5 (±3.5) hot flushes per day at baseline. After 12 weeks, women randomized to paced respiration (n=61) reported an average reduction of 1.8 (95% confidence interval [CI] 0.9-2.6) hot flushes per day (-21%) compared with 3.0 (95% CI 2.1-3.8) hot flushes per day (-35%) in the music-listening group (n=62) (P=.048). Paced respiration was associated with a 19% decrease in frequency of moderate-to-severe hot flushes compared with a 44% decrease with music listening (P=.02). CONCLUSION In this randomized trial, women assigned to device-guided slow-paced respiration reported modest improvements in the frequency and severity of their hot flushes, but the paced respiration intervention was significantly less effective than a music-listening intervention in decreasing the frequency and severity of these symptoms. LEVEL OF EVIDENCE I.
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Ratcliffe LEK, Pijacka W, McBryde FD, Abdala AP, Moraes DJ, Sobotka PA, Hart EC, Narkiewicz K, Nightingale AK, Paton JFR. CrossTalk opposing view: Which technique for controlling resistant hypertension? Carotid chemoreceptor denervation/modulation. J Physiol 2015; 592:3941-4. [PMID: 25225253 DOI: 10.1113/jphysiol.2013.268227] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Affiliation(s)
- L E K Ratcliffe
- CardioNomics Research Group, Clinical Research and Imaging Centre and School of Physiology and Pharmacology, University of Bristol, Bristol, BS8 1TD, UK
| | - W Pijacka
- CardioNomics Research Group, Clinical Research and Imaging Centre and School of Physiology and Pharmacology, University of Bristol, Bristol, BS8 1TD, UK
| | - F D McBryde
- Department of Physiology, University of Auckland, Auckland, New Zealand
| | - A P Abdala
- CardioNomics Research Group, Clinical Research and Imaging Centre and School of Physiology and Pharmacology, University of Bristol, Bristol, BS8 1TD, UK
| | - D J Moraes
- Department of Physiology, School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, 14049-900, SP, Brazil
| | - P A Sobotka
- The Ohio State University, 2015 Marywood Lane West, St Paul, MN, 55118, USA
| | - E C Hart
- CardioNomics Research Group, Clinical Research and Imaging Centre and School of Physiology and Pharmacology, University of Bristol, Bristol, BS8 1TD, UK
| | - K Narkiewicz
- Department of Hypertension and Diabetology, Medical University of Gdansk, Debinki 7c, 80-952, Gdansk, Poland
| | - A K Nightingale
- CardioNomics Research Group, Clinical Research and Imaging Centre and School of Physiology and Pharmacology, University of Bristol, Bristol, BS8 1TD, UK
| | - J F R Paton
- CardioNomics Research Group, Clinical Research and Imaging Centre and School of Physiology and Pharmacology, University of Bristol, Bristol, BS8 1TD, UK
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Vaschillo EG, Vaschillo B, Buckman JF, Nguyen-Louie T, Heiss S, Pandina RJ, Bates ME. The effects of sighing on the cardiovascular system. Biol Psychol 2015; 106:86-95. [PMID: 25720947 PMCID: PMC4386588 DOI: 10.1016/j.biopsycho.2015.02.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2014] [Revised: 02/11/2015] [Accepted: 02/14/2015] [Indexed: 11/23/2022]
Abstract
Elicitation of high-amplitude oscillations in the cardiovascular system may serve to dampen psychophysiological reactivity to emotional and cognitive loading. Prior work has used paced breathing to impose clinically valuable high-amplitude ∼ 0.1 Hz oscillations. In this study, we investigated whether rhythmical sighing could likewise produce high-amplitude cardiovascular oscillations in the very low frequency range (0.003-0.05 Hz). ECG, respiration, skin conductance, and beat-to-beat blood pressure were collected in 24 healthy participants during baseline, 0.1 Hz paced breathing, and 0.02 Hz paced sighing (1 sigh every 50s, with normal breathing interspersed). Results showed that each sigh elicited a strong, well-defined reaction in the cardiovascular system. This reaction did not habituate when participants repeatedly sighed for 8.5 min. The result was a high-amplitude 0.02 Hz oscillation in multiple cardiovascular parameters. Thus, paced sighing is a reliable method for imposing very low frequency oscillations in the cardiovascular system, which has research and clinical implications that warrant further study.
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Affiliation(s)
- Evgeny G Vaschillo
- Center of Alcohol Studies, Rutgers, The State University of New Jersey, Piscataway, NJ, USA.
| | - Bronya Vaschillo
- Center of Alcohol Studies, Rutgers, The State University of New Jersey, Piscataway, NJ, USA
| | - Jennifer F Buckman
- Center of Alcohol Studies, Rutgers, The State University of New Jersey, Piscataway, NJ, USA
| | - Tam Nguyen-Louie
- Center of Alcohol Studies, Rutgers, The State University of New Jersey, Piscataway, NJ, USA.
| | - Sydney Heiss
- Center of Alcohol Studies, Rutgers, The State University of New Jersey, Piscataway, NJ, USA
| | - Robert J Pandina
- Center of Alcohol Studies, Rutgers, The State University of New Jersey, Piscataway, NJ, USA
| | - Marsha E Bates
- Center of Alcohol Studies, Rutgers, The State University of New Jersey, Piscataway, NJ, USA
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Charkoudian N, Wallin BG. Sympathetic neural activity to the cardiovascular system: integrator of systemic physiology and interindividual characteristics. Compr Physiol 2014; 4:825-50. [PMID: 24715570 DOI: 10.1002/cphy.c130038] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
The sympathetic nervous system is a ubiquitous, integrating controller of myriad physiological functions. In the present article, we review the physiology of sympathetic neural control of cardiovascular function with a focus on integrative mechanisms in humans. Direct measurement of sympathetic neural activity (SNA) in humans can be accomplished using microneurography, most commonly performed in the peroneal (fibular) nerve. In humans, muscle SNA (MSNA) is composed of vasoconstrictor fibers; its best-recognized characteristic is its participation in transient, moment-to-moment control of arterial blood pressure via the arterial baroreflex. This property of MSNA contributes to its typical "bursting" pattern which is strongly linked to the cardiac cycle. Recent evidence suggests that sympathetic neural mechanisms and the baroreflex have important roles in the long term control of blood pressure as well. One of the striking characteristics of MSNA is its large interindividual variability. However, in young, normotensive humans, higher MSNA is not linked to higher blood pressure due to balancing influences of other cardiovascular variables. In men, an inverse relationship between MSNA and cardiac output is a major factor in this balance, whereas in women, beta-adrenergic vasodilation offsets the vasoconstrictor/pressor effects of higher MSNA. As people get older (and in people with hypertension) higher MSNA is more likely to be linked to higher blood pressure. Skin SNA (SSNA) can also be measured in humans, although interpretation of SSNA signals is complicated by multiple types of neurons involved (vasoconstrictor, vasodilator, sudomotor and pilomotor). In addition to blood pressure regulation, the sympathetic nervous system contributes to cardiovascular regulation during numerous other reflexes, including those involved in exercise, thermoregulation, chemoreflex regulation, and responses to mental stress.
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Affiliation(s)
- N Charkoudian
- U.S. Army Research Institute of Environmental Medicine, Natick, Massachusetts
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de Barros S, da Silva GV, de Gusmão JL, de Araujo TG, Mion D. Reduction of sympathetic nervous activity with device-guided breathing. J Clin Hypertens (Greenwich) 2014; 16:614-5. [PMID: 24953782 DOI: 10.1111/jch.12360] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Silvana de Barros
- Nephrology Department, Hypertension Unit, General Hospital - University of São Paulo School of Medicine, São Paulo, Brazil
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The effect of a single session of short duration biofeedback-induced deep breathing on measures of heart rate variability during laboratory-induced cognitive stress: a pilot study. Appl Psychophysiol Biofeedback 2013; 38:81-90. [PMID: 23435801 DOI: 10.1007/s10484-013-9210-0] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
This study examines the acute effect of heart rate variability (HRV) biofeedback on HRV measures during and immediately after biofeedback and during the following laboratory-induced stress. Eighteen healthy males exposed to work-related stress were randomised into an HRV biofeedback group (BIO) or a comparative group (COM). Subjects completed a modified Stroop task before (Stroop 1) and after (Stroop 2) the intervention. Both groups had similar physiological responses to stress in Stroop 1. In Stroop 2, the COM group responded similarly to the way they did to Stroop 1: respiratory frequency (RF) and heart rate (HR) increased, RMSSD and high frequency (HF) power decreased or had a tendency to decrease, while low frequency (LF) power showed no change. The BIO group responded differently in Stroop 2: while RF increased and LF power decreased, HR, RMSSD and HF power showed no change. In the BIO group, RMSSD was higher in Stroop 2 compared to Stroop 1. In conclusion, HRV biofeedback induced a short term carry-over effect during both the following rest period and laboratory-induced stress suggesting maintained HF vagal modulation in the BIO group after the intervention, and maintained LF vagal modulation in the COM group.
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Khan HM, Ahmed B, Choi J, Gutierrez-Osuna R. Using an ambulatory stress monitoring device to identify relaxation due to untrained deep breathing. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2013; 2013:1744-7. [PMID: 24110044 DOI: 10.1109/embc.2013.6609857] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
The objective of this paper is to assess the efficacy of deep breathing as a relaxation activity using a wearable stress monitor. For this purpose, we developed a protocol with different mentally stressful activities interleaved with regular sessions of deep breathing. We used three physiological sensors: a heart rate monitor, a respiration sensor, and an electrodermal activity sensor, to extract parameters that are consistent with the dominance of the sympathetic nervous system. Our results indicate that a large number of subjects were not able to perform the paced deep breathing exercise properly, which caused their stress levels to increase rather than to decrease. The study also showed that our wearable stress monitor can be used to monitor breathing technique and assess its effectiveness in relaxing individuals.
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Stankovski T, Cooke WH, Rudas L, Stefanovska A, Eckberg DL. Time-frequency methods and voluntary ramped-frequency breathing: a powerful combination for exploration of human neurophysiological mechanisms. J Appl Physiol (1985) 2013; 115:1806-21. [PMID: 24114700 DOI: 10.1152/japplphysiol.00802.2013] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
We experimentally altered the timing of respiratory motoneuron activity as a means to modulate and better understand otherwise hidden human central neural and hemodynamic oscillatory mechanisms. We recorded the electrocardiogram, finger photoplethysmographic arterial pressure, tidal carbon dioxide concentrations, and muscle sympathetic nerve activity in 13 healthy supine young men who gradually increased or decreased their breathing frequencies between 0.05 and 0.25 Hz over 9-min periods. We analyzed results with traditional time- and frequency-domain methods, and also with time-frequency methods (wavelet transform, wavelet phase coherence, and directional coupling). We determined statistical significance and identified frequency boundaries by comparing measurements with randomly generated surrogates. Our results support several major conclusions. First, respiration causally modulates both sympathetic (weakly) and vagal motoneuron (strongly) oscillations over a wide frequency range-one that extends well below the frequency of actual breaths. Second, breathing frequency broadly modulates vagal baroreflex gain, with peak gains registered in the low frequency range. Third, breathing frequency does not influence median levels of sympathetic or vagal activity over time. Fourth, phase relations between arterial pressure and sympathetic and vagal motoneurons are unaffected by breathing, and are therefore likely secondary to intrinsic responsiveness of these motoneurons to other synaptic inputs. Finally, breathing frequency does not affect phase coherence between diastolic pressure and muscle sympathetic oscillations, but it augments phase coherence between systolic pressure and R-R interval oscillations over a limited portion of the usual breathing frequency range. These results refine understanding of autonomic oscillatory processes and those physiological mechanisms known as the human respiratory gate.
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Effects of acute and long-term slow breathing exercise on muscle sympathetic nerve activity in untreated male patients with hypertension. J Hypertens 2013; 31:739-46. [PMID: 23385649 DOI: 10.1097/hjh.0b013e32835eb2cf] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECTIVE Acute slow breathing (SLOWB) affects sympathetic cardiovascular regulation, but its long-term effects are unknown. Using device-guided breathing we explored short-term and long-term SLOWB effects on blood pressure (BP), heart rate (HR) and muscle sympathetic nerve activity (MSNA) in essential hypertension. METHODS We measured BP, HR and MSNA in 10 hypertensive individuals at rest, during laboratory stressors, before and after acute SLOWB, and 8 weeks after SLOWB exercise. Twelve matched hypertensive controls underwent a similar protocol excluding SLOWB intervention. Office and 24-h BP were obtained at baseline and at follow-up. RESULTS Acute SLOWB had no influence on BP, HR, but decreased MSNA (P < 0.01). BP, HR, MSNA responses to handgrip were comparable before and after acute SLOWB. Acute SLOWB tended to reduce SBP (P = 0.09), HR (P = 0.08), but not MSNA (P = 0.20) responses to mental stress. Long-term SLOWB decreased office SBP (P < 0.001), DBP (P < 0.01), HR (P = 0.004), but not 24-h BP. Resting MSNA was unchanged after long-term SLOWB (P = 0.68). Long-term SLOWB did not influence BP, HR or MSNA responses to handgrip and cold pressor, but reduced SBP (P = 0.03), HR (P = 0.03) responses to mental stress without MSNA changes. In controls BP, HR, MSNA responses to laboratory stressors remained unchanged at baseline and at follow-up. CONCLUSION In essential hypertension, MSNA is reduced during acute SLOWB, but remains unaltered following long-term SLOWB. Long-term SLOWB reduces office, but not ambulatory BP and HR. SLOWB attenuates cardiovascular response to mental stress, but not physical stressors. These findings may be indicative of beneficial SLOWB effects on stress reduction in essential hypertension.
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Cardiovascular and respiratory effect of yogic slow breathing in the yoga beginner: what is the best approach? EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2013; 2013:743504. [PMID: 23710236 PMCID: PMC3655580 DOI: 10.1155/2013/743504] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/18/2012] [Accepted: 03/22/2013] [Indexed: 11/20/2022]
Abstract
Slow breathing increases cardiac-vagal baroreflex sensitivity (BRS), improves oxygen saturation, lowers blood pressure, and reduces anxiety. Within the yoga tradition slow breathing is often paired with a contraction of the glottis muscles. This resistance breath “ujjayi” is performed at various rates and ratios of inspiration/expiration. To test whether ujjayi had additional positive effects to slow breathing, we compared BRS and ventilatory control under different breathing patterns (equal/unequal inspiration/expiration at 6 breath/min, with/without ujjayi), in 17 yoga-naive young healthy participants. BRS increased with slow breathing techniques with or without expiratory ujjayi (P < 0.05 or higher) except with inspiratory + expiratory ujjayi. The maximal increase in BRS and decrease in blood pressure were found in slow breathing with equal inspiration and expiration. This corresponded with a significant improvement in oxygen saturation without increase in heart rate and ventilation. Ujjayi showed similar increase in oxygen saturation but slightly lesser improvement in baroreflex sensitivity with no change in blood pressure. The slow breathing with equal inspiration and expiration seems the best technique for improving baroreflex sensitivity in yoga-naive subjects. The effects of ujjayi seems dependent on increased intrathoracic pressure that requires greater effort than normal slow breathing.
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Chang ET, Silberstein D, Rambod M, Porszasz J, Casaburi R. Heart rate variability during constant work rate exercise at and above the critical power in patients with severe chronic obstructive pulmonary disease. Tzu Chi Med J 2011. [DOI: 10.1016/j.tcmj.2011.05.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Hart EC, Wallin BG, Curry TB, Joyner MJ, Karlsson T, Charkoudian N. Hysteresis in the sympathetic baroreflex: role of baseline nerve activity. J Physiol 2011; 589:3395-404. [PMID: 21540345 DOI: 10.1113/jphysiol.2011.208538] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Sympathetic baroreflex sensitivity (BRS) is greater during decreasing compared to increasing diastolic blood pressure (DBP) in young men and women. In older men and women there is no difference in sympathetic BRS to increasing and decreasing DBP. We investigated whether the sensitivity of the central nervous system to increasing and decreasing DBP is dependent upon baseline muscle sympathetic nerve activity (MSNA). We hypothesised that the difference in sympathetic BRS between falling and rising segments of DBP would be positively related to baseline MSNA in 30 young men, 21 young women, 14 older men and 14 postmenopausal women. MSNA was measured using peroneal microneurography and BRS was measured using the spontaneous baroreflex threshold technique. On average, sympathetic BRS was greater during decreasing compared to increasing DBP in young men (P <0.05) and women (P <0.05). In older men and women, mean sympathetic BRS was similar in response to increasing and decreasing DBP. The difference (delta) between the falling and rising BRS correlated with baseline MSNA in young (r =0.58, P <0.05) and older men (r =0.66, P <0.05) and postmenopausal women (r =0.74, P <0.05). Thus, all men, and older women, with higher BRS to falling DBP had lower baseline MSNA. This relationship was not observed in young women (r =0.14, P >0.05). In summary, baseline MSNA plays a role in determining sympathetic BRS to falling and rising DBP in young and older men and postmenopausal women, but not in young women. This relationship is consistent with a decreased potential for sympathoexcitation in people with higher resting MSNA. Furthermore, the lack of relationship in young women suggests important contributions of sex hormones to differential responses of MSNA to falling and rising pressures.
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Affiliation(s)
- Emma C Hart
- Department of Anesthesiology, Mayo Clinic, 200 First St SW, Rochester, MN 59906, USA.
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Wallin BG, Hart EC, Wehrwein EA, Charkoudian N, Joyner MJ. Relationship between breathing and cardiovascular function at rest: sex-related differences. Acta Physiol (Oxf) 2010; 200:193-200. [PMID: 20345407 DOI: 10.1111/j.1748-1716.2010.02126.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIM to compare relationships at rest between breathing rate, levels of muscle sympathetic nerve activity, total peripheral resistance and cardiac output among young men and women. METHODS recordings were made of respiratory movements, sympathetic nerve activity (peroneal microneurography), intra-arterial blood pressure, electrocardiogram, cardiac output (open-circuit acetylene uptake technique) in 19 healthy men (age 27 (+/-) 2years, mean (+/-) SEM) and 17 healthy women (age 25 (+/-) 1years). Total peripheral resistance and stroke volume were calculated. Four minutes epochs of data were analysed. RESULTS breathing rates and sympathetic activity were similar in men and women but compared to men, women had significantly lower blood pressures, cardiac output and stroke volume. In men breathing rate correlated positively with sympathetic activity (r = 0.58, P < 0.05) but not in women (r = 0.12, P > 0.05). Furthermore, in men, respiratory rate correlated positively with total peripheral resistance (r = 0.65, P < 0.05) and inversely with cardiac output (r =-0.84, P < 0.05) and heart rate (r = -0.60, P < 0.05) but there were no such relationships in women (P > 0.05 for all). CONCLUSIONS the positive relationship between breathing and sympathetic activity in men, and the inverse coupling of breathing to cardiac output and heart rate suggest that influences of respiration may be important not only for dynamic but also for 'tonic' cardiovascular function. The lack of relationships among these variables in women shows that there are fundamental differences in basic blood pressure regulation between the sexes.
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Affiliation(s)
- B G Wallin
- Department of ClinicalNeurophysiology, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden.
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Mourya M, Mahajan AS, Singh NP, Jain AK. Effect of slow- and fast-breathing exercises on autonomic functions in patients with essential hypertension. J Altern Complement Med 2009; 15:711-7. [PMID: 19534616 DOI: 10.1089/acm.2008.0609] [Citation(s) in RCA: 81] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVES Breathing exercises practiced in various forms of meditations such as yoga may influence autonomic functions. This may be the basis of therapeutic benefit to hypertensive patients. DESIGN The study design was a randomized, prospective, controlled clinical study using three groups. SUBJECTS The subjects comprised 60 male and female patients aged 20-60 years with stage 1 essential hypertension. INTERVENTION Patients were randomly and equally divided into the control and other two intervention groups, who were advised to do 3 months of slow-breathing and fast-breathing exercises, respectively. Baseline and postintervention recording of blood pressure (BP), autonomic function tests such as standing-to-lying ratio (S/L ratio), immediate heart rate response to standing (30:15 ratio), Valsalva ratio, heart rate variation with respiration (E/I ratio), hand-grip test, and cold pressor response were done in all subjects. RESULTS Slow breathing had a stronger effect than fast breathing. BP decreased longitudinally over a 3-month period with both interventions. S/L ratio, 30:15 ratio, E/I ratio, and BP response in the hand grip and cold pressor test showed significant change only in patients practicing the slow-breathing exercise. CONCLUSIONS Both types of breathing exercises benefit patients with hypertension. However, improvement in both the sympathetic and parasympathetic reactivity may be the mechanism that is associated in those practicing the slow-breathing exercise.
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Affiliation(s)
- Monika Mourya
- Department of Physiology, Maulana Azad Medical College, New Delhi, India
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Repeated assessment of cardiovascular and respiratory functions using combined telemetry and whole-body plethysmography in the rat. J Pharmacol Toxicol Methods 2009; 60:117-29. [DOI: 10.1016/j.vascn.2009.07.003] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2009] [Accepted: 07/06/2009] [Indexed: 11/19/2022]
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