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Grinevich AA, Chemeris NK. Age-Related Changes in Heart Rate Variability from the Neonatal Period to Adulthood. DOKL BIOCHEM BIOPHYS 2024:10.1134/S1607672924600829. [PMID: 39400765 DOI: 10.1134/s1607672924600829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2024] [Revised: 08/15/2024] [Accepted: 08/17/2024] [Indexed: 10/15/2024]
Abstract
The aim of the study was to reveal the patterns of the age-related dynamics of the frequency-dependent regulation of heart rate variability (HRV) based on the analysis of Holter ECG recordings from healthy subjects of four age groups: neonates, one-year-old infants, adolescents, and adults. A wide spectral composition of HRV is shown, consisting of nine Hilbert-Huang modes in the frequency range from 0.0001 to 2 Hz. A decrease in the central frequencies of all modes is shown in the postnatal period with a plateau in adolescence. A rapid progression of systemic humoral regulation of HRV, characterized by a consolidated increase in the amplitudes of the corresponding modes with a plateau in adolescence, is demonstrated. The dome-shaped character of age-related changes in amplitude of modes associated with autonomic control with a maximum in adolescence is shown. The results obtained quantitatively demonstrate age-related consolidated changes in HRV parameters from neonates to adulthood.
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Affiliation(s)
- A A Grinevich
- Institute of Cell Biophysics, Russian Academy of Sciences, Pushchino, Moscow oblast, Russia.
| | - N K Chemeris
- Institute of Cell Biophysics, Russian Academy of Sciences, Pushchino, Moscow oblast, Russia.
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2
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Debra G, Michels N, Giletta M. Cognitive control processes and emotion regulation in adolescence: Examining the impact of affective inhibition and heart-rate-variability on emotion regulation dynamics in daily life. Dev Cogn Neurosci 2024; 70:101454. [PMID: 39357147 PMCID: PMC11472638 DOI: 10.1016/j.dcn.2024.101454] [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: 03/15/2024] [Revised: 09/13/2024] [Accepted: 09/22/2024] [Indexed: 10/04/2024] Open
Abstract
Cognitive control processes likely influence the extent to which adolescents can successfully regulate their emotions. This study examined whether individual differences in affective inhibition and heart rate variability (HRV), as a peripheral index of cognitive control, moderated the association between momentary emotion regulation and negative affect (NA). Ecological Momentary Assessments (EMA) over 14 days were obtained in 235 adolescents (Mage = 13.48 years; 106 females). At each assessment, participants reported their current NA and the extent to which they used cognitive reappraisal and rumination. Moreover, at three time points (approximately 1 year, 6 months, and just before the EMA), affective inhibition was assessed using an affective go/no-go task and HRV was recorded at rest. Results indicate that adolescents with lower affective inhibition reported lower average levels of daily rumination. However, affective inhibition did not moderate the association between either daily cognitive reappraisal or rumination and momentary NA. Consistent with hypotheses, the association between momentary rumination and NA was weaker in adolescents showing higher levels of resting HRV. Overall, findings may underscore the importance of interventions targeting HRV as a malleable factor for enhancing adolescents' affective well-being.
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Affiliation(s)
- Gillian Debra
- Department of Developmental, Personality and Social Psychology, Ghent University, Belgium.
| | - Nathalie Michels
- Department of Developmental, Personality and Social Psychology, Ghent University, Belgium
| | - Matteo Giletta
- Department of Developmental, Personality and Social Psychology, Ghent University, Belgium
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Braet J, Giletta M, Desmedt O, Wante L, Rapp L, Pollatos O, Braet C. Should Adolescents Listen to Their Hearts? A Closer Look at the Associations Between Interoception, Emotional Awareness and Emotion Regulation in Adolescents. Psychol Rep 2024:332941241286435. [PMID: 39303215 DOI: 10.1177/00332941241286435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/22/2024]
Abstract
The aim of the current study was to replicate findings from prior work among adults showing that individuals with better interoceptive skills have more emotional awareness, and show better emotion regulation abilities, in a sample of adolescents and by relying on instructions that reduce the contamination of known confound variables. A total of 102 Belgian adolescents (Mage = 14.10 years, SDage = .63; 50 males) completed self-report questionnaires of emotional processes (FEEL-KJ and DERS) and the modified heartbeat counting task. From this task, interoceptive accuracy, interoceptive sensibility (confidence ratings), and interoceptive awareness scores (within-person correlations) were derived per participant. Results revealed no associations between the three dimensions of interoception and adolescents' levels of emotional awareness, adaptive, and maladaptive emotion regulation. The lack of associations which contrast some prior work with adults may be due to developmental differences. However, these might also support the low validity of the heartbeat counting task, or could be attributed to the measurement of the emotion measures (i.e., self-report). Future studies should, nevertheless, also test whether these non-significant results can be explained by the developmental differences in adolescents. Longitudinal research is needed to capture interoceptive changes during adolescence, as well as to replicate the current findings using rigorous multimethod approaches that increase the validity of interoception measurement.
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Affiliation(s)
- Jolien Braet
- Department of Developmental, Personality and Social Psychology, Ghent University, Ghent, Belgium
| | - Matteo Giletta
- Department of Developmental, Personality and Social Psychology, Ghent University, Ghent, Belgium
| | - Olivier Desmedt
- Institute of Psychology, University of Lausanne, Lausanne, Switzerland
| | - Laura Wante
- Department of Developmental, Personality and Social Psychology, Ghent University, Ghent, Belgium
| | - Lorenz Rapp
- Department of Clinical and Health Psychology, Universität Ulm, Ulm, Germany
| | - Olga Pollatos
- Department of Clinical and Health Psychology, Universität Ulm, Ulm, Germany
| | - Caroline Braet
- Department of Developmental, Personality and Social Psychology, Ghent University, Ghent, Belgium
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Almeida-Neto PFD, de Oliveira FCS, de Oliveira-Júnior JM, Alves JCM, Rocha MDL, da Silva IM, Rocha RFC, Dantas PMS, Cabral BGDAT. Influence of biological maturation on cardiac autonomic recovery in female volleyball players during & after repeated sprints training: An experimental trial. SPORTS MEDICINE AND HEALTH SCIENCE 2024; 6:279-286. [PMID: 39234484 PMCID: PMC11369838 DOI: 10.1016/j.smhs.2023.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 09/21/2023] [Accepted: 10/08/2023] [Indexed: 09/06/2024] Open
Abstract
Previously, it was suggested that biological maturation (BM) could be linked to cardiac autonomic recovery (CAR) in the pediatric population. However, this influence hasn't been confirmed yet. Our aim was to investigate the impact of BM on CAR in female volleyball players. Experimental study with a sample of 38 volleyball players, comprising 20 girls (age: [11.6 ± 2.1] years) and 18 women (age: [24.5 ± 5.5] years), we analyzed BM, comparing maturing subjects (girls) with mature subjects (women). Additionally, we assessed peak height velocity (PHV) in girls. We conducted a training session involving repeated sprints (3 rounds of 6 sprints interspersed by 5 min [min] of passive rest). Using short-range radio telemetry, we analyzed CAR during (at the end of the 1st and 2nd rounds) and after (following the 3rd round) the training session of repeated sprints by applying the 60-s to 300-s heart rate recovery index (HRR-Index). Girls exhibited superior CAR compared to women (round 2: 60-s, 120-s, 240-s, and 300-s, p < 0.005). Subgroup analyses of BM indicated that individuals in the Late-PHV stage demonstrated superior CAR compared to those in the Early-PHV and During-PHV groups. (60-s to 300-s, η 2 p > 0.4, p < 0.05). Subjects in the During-PHV stage were superior to those in the Early-PHV stage (240-s á 300-s, η 2 p > 0.4, p < 0.05). We have concluded that biological maturation has a significant impact on cardiac autonomic recovery.
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Affiliation(s)
- Paulo Francisco de Almeida-Neto
- Health Sciences Center, Federal University of Rio Grande do Norte, CCS-UFRN, Natal, 59012-570, RN, Brazil
- Department of Physical Education, Federal University of Rio Grande do Norte, DEF-UFRN, Natal, 59078-970, RN, Brazil
| | | | | | - Júlio César Medeiros Alves
- Department of Physical Education, Federal University of Rio Grande do Norte, DEF-UFRN, Natal, 59078-970, RN, Brazil
| | - Matheus de Lima Rocha
- Department of Physical Education, Federal University of Rio Grande do Norte, DEF-UFRN, Natal, 59078-970, RN, Brazil
| | - Iago Medeiros da Silva
- Department of Physical Education, Federal University of Rio Grande do Norte, DEF-UFRN, Natal, 59078-970, RN, Brazil
| | - Roberto Felipe Câmara Rocha
- Department of Physical Education, Federal University of Rio Grande do Norte, DEF-UFRN, Natal, 59078-970, RN, Brazil
| | - Paulo Moreira Silva Dantas
- Health Sciences Center, Federal University of Rio Grande do Norte, CCS-UFRN, Natal, 59012-570, RN, Brazil
- Department of Physical Education, Federal University of Rio Grande do Norte, DEF-UFRN, Natal, 59078-970, RN, Brazil
| | - Breno Guilherme de Araújo Tinôco Cabral
- Health Sciences Center, Federal University of Rio Grande do Norte, CCS-UFRN, Natal, 59012-570, RN, Brazil
- Department of Physical Education, Federal University of Rio Grande do Norte, DEF-UFRN, Natal, 59078-970, RN, Brazil
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Quigley KS, Gianaros PJ, Norman GJ, Jennings JR, Berntson GG, de Geus EJC. Publication guidelines for human heart rate and heart rate variability studies in psychophysiology-Part 1: Physiological underpinnings and foundations of measurement. Psychophysiology 2024; 61:e14604. [PMID: 38873876 DOI: 10.1111/psyp.14604] [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: 05/11/2022] [Revised: 12/22/2023] [Accepted: 04/04/2024] [Indexed: 06/15/2024]
Abstract
This Committee Report provides methodological, interpretive, and reporting guidance for researchers who use measures of heart rate (HR) and heart rate variability (HRV) in psychophysiological research. We provide brief summaries of best practices in measuring HR and HRV via electrocardiographic and photoplethysmographic signals in laboratory, field (ambulatory), and brain-imaging contexts to address research questions incorporating measures of HR and HRV. The Report emphasizes evidence for the strengths and weaknesses of different recording and derivation methods for measures of HR and HRV. Along with this guidance, the Report reviews what is known about the origin of the heartbeat and its neural control, including factors that produce and influence HRV metrics. The Report concludes with checklists to guide authors in study design and analysis considerations, as well as guidance on the reporting of key methodological details and characteristics of the samples under study. It is expected that rigorous and transparent recording and reporting of HR and HRV measures will strengthen inferences across the many applications of these metrics in psychophysiology. The prior Committee Reports on HR and HRV are several decades old. Since their appearance, technologies for human cardiac and vascular monitoring in laboratory and daily life (i.e., ambulatory) contexts have greatly expanded. This Committee Report was prepared for the Society for Psychophysiological Research to provide updated methodological and interpretive guidance, as well as to summarize best practices for reporting HR and HRV studies in humans.
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Affiliation(s)
- Karen S Quigley
- Department of Psychology, Northeastern University, Boston, Massachusetts, USA
| | - Peter J Gianaros
- Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Greg J Norman
- Department of Psychology, The University of Chicago, Chicago, Illinois, USA
| | - J Richard Jennings
- Department of Psychiatry & Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Gary G Berntson
- Department of Psychology & Psychiatry, The Ohio State University, Columbus, Ohio, USA
| | - Eco J C de Geus
- Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
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Du XJ, Huang YQ, Li XY, Liao Y, Jin HF, Du JB. Age and mean platelet volume-based nomogram for predicting the therapeutic efficacy of metoprolol in Chinese pediatric patients with vasovagal syncope. World J Pediatr 2024; 20:957-965. [PMID: 38613734 PMCID: PMC11422430 DOI: 10.1007/s12519-024-00802-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Accepted: 02/28/2024] [Indexed: 04/15/2024]
Abstract
BACKGROUND Vasovagal syncope (VVS) is the most common type of orthostatic intolerance in children. We investigated whether platelet-related factors related to treatment efficacy in children suffering from VVS treated with metoprolol. METHODS Metoprolol-treated VVS patients were recruited. The median duration of therapy was three months. Patients were followed and divided into two groups, treament-effective group and treatment-ineffective group. Logistic and least absolute shrinkage selection operator regressions were used to examine treatment outcome variables. Receiver-operating characteristic (ROC) curves, precision-recall (PR) curves, calibration plots, and decision curve analyses were used to evaluate the nomogram model. RESULTS Among the 72 patients who complete the follow-up, treatment-effective group and treatment-ineffective group included 42 (58.3%) and 30 (41.7%) cases, respectively. The patients in the treatment-effective group exhibited higher mean platelet volume (MPV) [(11.0 ± 1.0) fl vs. (9.8 ± 1.0) fl, P < 0.01] and platelet distribution width [12.7% (12.3%, 14.3%) vs. 11.3% (10.2%, 12.2%), P < 0.01] than those in the treatment-ineffective group. The sex ratio was significantly different (P = 0.046). A fit model comprising age [odds ratio (OR) = 0.766, 95% confidence interval (CI) = 0.594-0.987] and MPV (OR = 5.613, 95% CI = 2.297-13.711) might predict therapeutic efficacy. The area under the curve of the ROC and PR curves was computed to be 0.85 and 0.9, respectively. The P value of the Hosmer-Lemeshow test was 0.27. The decision curve analysis confirmed that managing children with VVS based on the predictive model led to a net advantage ranging from 0.01 to 0.58. The nomogram is convenient for clinical applications. CONCLUSION A novel nomogram based on age and MPV can predict the therapeutic benefits of metoprolol in children with VVS.
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Affiliation(s)
- Xiao-Juan Du
- Department of Pediatrics, Peking University First Hospital, No. 1 Xi'anmen Street, West District, Beijing, 100034, China
| | - Ya-Qian Huang
- Department of Pediatrics, Peking University First Hospital, No. 1 Xi'anmen Street, West District, Beijing, 100034, China
- State Key Laboratory of Vascular Homeostasis and Remodeling, Peking University, No. 38, Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Xue-Ying Li
- Department of Statistics, Peking University First Hospital, Beijing, 100034, China
| | - Ying Liao
- Department of Pediatrics, Peking University First Hospital, No. 1 Xi'anmen Street, West District, Beijing, 100034, China.
| | - Hong-Fang Jin
- Department of Pediatrics, Peking University First Hospital, No. 1 Xi'anmen Street, West District, Beijing, 100034, China.
- State Key Laboratory of Vascular Homeostasis and Remodeling, Peking University, No. 38, Xueyuan Road, Haidian District, Beijing, 100191, China.
| | - Jun-Bao Du
- Department of Pediatrics, Peking University First Hospital, No. 1 Xi'anmen Street, West District, Beijing, 100034, China.
- State Key Laboratory of Vascular Homeostasis and Remodeling, Peking University, No. 38, Xueyuan Road, Haidian District, Beijing, 100191, China.
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Helánová K, Šišáková M, Hnatkova K, Novotný T, Andršová I, Malik M. Development of autonomic heart rate modulations during childhood and adolescence. Pflugers Arch 2024; 476:1187-1207. [PMID: 38937370 PMCID: PMC11271370 DOI: 10.1007/s00424-024-02979-0] [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: 03/18/2024] [Revised: 05/05/2024] [Accepted: 06/10/2024] [Indexed: 06/29/2024]
Abstract
Autonomic control of heart rate is well known in adult subjects, but limited data are available on the development of the heart rate control during childhood and adolescence. Continuous 12-lead electrocardiograms were recorded in 1045 healthy children and adolescents (550 females) aged 4 to 19 years during postural manoeuvres involving repeated 10-min supine, unsupported sitting, and unsupported standing positions. In each position, heart rate was measured, and heart rate variability indices were evaluated (SDNN, RMSSD, and high (HF) and low (LF) frequency components were obtained). Quasi-normalized HF frequency components were defined as qnHF = HF/(HF + LF). These measurements were, among others, related to age using linear regressions. In supine position, heart rate decreases per year of age were significant in both sexes but lower in females than in males. In standing position, these decreases per year of age were substantially lowered. RMSSD and qnHF indices were independent of age in supine position but significantly decreased with age in sitting and standing positions. Correspondingly, LF/HF proportions showed steep increases with age in sitting and standing positions but not in the supine position. The study suggests that baseline supine parasympathetic influence shows little developmental changes during childhood and adolescence but that in young children, sympathetic branch is less responsive to vagal influence. While vagal influences modulate cardiac periods in young and older children equally, they are less able to suppress the sympathetic influence in younger children.
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Affiliation(s)
- Kateřina Helánová
- Department of Internal Medicine and Cardiology, University Hospital Brno, Jihlavská 20, 625 00, Brno, Czech Republic
- Department of Internal Medicine and Cardiology, Faculty of Medicine, Masaryk University, Jihlavská 20, 625 00, Brno, Czech Republic
| | - Martina Šišáková
- Department of Internal Medicine and Cardiology, University Hospital Brno, Jihlavská 20, 625 00, Brno, Czech Republic.
- Department of Internal Medicine and Cardiology, Faculty of Medicine, Masaryk University, Jihlavská 20, 625 00, Brno, Czech Republic.
| | - Katerina Hnatkova
- National Heart and Lung Institute, Imperial College, 72 Du Cane Rd, Shepherd's Bush, London, W12 0NN, England
| | - Tomáš Novotný
- Department of Internal Medicine and Cardiology, University Hospital Brno, Jihlavská 20, 625 00, Brno, Czech Republic
- Department of Internal Medicine and Cardiology, Faculty of Medicine, Masaryk University, Jihlavská 20, 625 00, Brno, Czech Republic
| | - Irena Andršová
- Department of Internal Medicine and Cardiology, University Hospital Brno, Jihlavská 20, 625 00, Brno, Czech Republic
- Department of Internal Medicine and Cardiology, Faculty of Medicine, Masaryk University, Jihlavská 20, 625 00, Brno, Czech Republic
| | - Marek Malik
- Department of Internal Medicine and Cardiology, Faculty of Medicine, Masaryk University, Jihlavská 20, 625 00, Brno, Czech Republic
- National Heart and Lung Institute, Imperial College, 72 Du Cane Rd, Shepherd's Bush, London, W12 0NN, England
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Yang S, van Twist E, van Heesch GG, de Jonge RC, Louter M, Tasker RC, Mathijssen IM, Joosten KF. Severe obstructive sleep apnea in children with syndromic craniosynostosis: analysis of pulse transit time. J Clin Sleep Med 2024; 20:1233-1240. [PMID: 38456822 PMCID: PMC11294133 DOI: 10.5664/jcsm.11112] [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: 05/12/2023] [Revised: 02/27/2024] [Accepted: 02/28/2024] [Indexed: 03/09/2024]
Abstract
STUDY OBJECTIVES We examined the association between pulse transit time (PTT) and obstructive sleep apnea (OSA) in children with syndromic craniosynostosis (SCS), where OSA is a common problem and may cause cardiorespiratory disturbance. METHODS A retrospective study of children (age < 18 years) with SCS and moderate-to-severe OSA (ie, obstructive apnea-hypopnea index ≥ 5) or no OSA (obstructive apnea-hypopnea index < 1) who underwent overnight polysomnography. Children without SCS and normal polysomnography were included as controls. Reference intervals for PTT were computed by nonparametric bootstrap analysis. Based on reference intervals of controls, the sensitivity and specificity of PTT to detect OSA were determined. In a linear mixed model, the explanatory variables assessed were sex, age, sleep stage, and time after obstructive events. RESULTS In all 68 included children (19 with SCS with OSA, 30 with SCS without OSA, 19 controls), obstructive events occurred throughout all sleep stages, most prominently during rapid eye movement (REM) sleep and non-REM sleep stages N1 and N2, with evident PTT changes. The greatest reductions were observed 4-8 seconds after an event (P < .05). In SCS with OSA, PTT reference intervals were lower during all sleep stages compared with SCS without OSA. The highest sensitivity was observed during N1 (55.5%), and the highest specificity during REM sleep (76.5%). The lowest PTT values were identified during N1. CONCLUSIONS Obstructive events occur throughout all sleep stages with transient reductions in PTT. However, PTT as a variable for OSA detection is limited by its sensitivity and specificity. CITATION Yang S, van Twist E, van Heesch GGM, et al. Severe obstructive sleep apnea in children with syndromic craniosynostosis: analysis of pulse transit time. J Clin Sleep Med. 2024;20(8):1233-1240.
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Affiliation(s)
- Sumin Yang
- Department of Plastic and Reconstructive Surgery and Hand Surgery, Erasmus MC Sophia Children’s Hospital, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Eris van Twist
- Department of Neonatal and Pediatric Intensive Care, Division of Pediatric Intensive Care, Erasmus MC Sophia Children’s Hospital, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Gwen G.M. van Heesch
- Department of Neonatal and Pediatric Intensive Care, Division of Pediatric Intensive Care, Erasmus MC Sophia Children’s Hospital, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Rogier C.J. de Jonge
- Department of Neonatal and Pediatric Intensive Care, Division of Pediatric Intensive Care, Erasmus MC Sophia Children’s Hospital, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Maartje Louter
- Department of Neurology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Robert C. Tasker
- Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children’s Hospital, Boston, Massachusetts
| | - Irene M.J. Mathijssen
- Department of Plastic and Reconstructive Surgery and Hand Surgery, Erasmus MC Sophia Children’s Hospital, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Koen F.M. Joosten
- Department of Neonatal and Pediatric Intensive Care, Division of Pediatric Intensive Care, Erasmus MC Sophia Children’s Hospital, Erasmus Medical Center, Rotterdam, The Netherlands
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Mao S, Qian G, Xiao K, Xu H, Zhou H, Guo X. Study on the relationship between body mass index and blood pressure indices in children aged 7-17 during COVID-19. Front Public Health 2024; 12:1409214. [PMID: 38962763 PMCID: PMC11220196 DOI: 10.3389/fpubh.2024.1409214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Accepted: 05/27/2024] [Indexed: 07/05/2024] Open
Abstract
Background To explore the relationship between body mass index (BMI), age, sex, and blood pressure (systolic blood pressure, SBP; diastolic blood pressure, DBP) in children during COVID-19, providing reference for the prevention and screening of hypertension in children. Methods This study adopted a large-scale cross-sectional design to investigate the association between BMI and blood pressure in 7-17-year-old students in City N, China, during COVID-19. Thirty-six primary and secondary schools in City N were sampled using a stratified cluster sampling method. A total of 11,433 students aged 7-17 years in City N, China, were selected for blood pressure (Diastolic blood pressure, DBP, Systolic blood pressure, SBP), height, and weight, Resting heart rate (RHR), chest circumference, measurements, and the study was written using the STROBE checklist. Data analysis was conducted using SPSS 26.0, calculating the mean and standard deviation of BMI and blood pressure for male and female students in different age groups. Regression analysis was employed to explore the impact of BMI, age, and sex on SBP and DBP, and predictive models were established. The model fit was evaluated using the model R2. Results The study included 11,287 primary and secondary school students, comprising 5,649 boys and 5,638 girls. It was found that with increasing age, BMI and blood pressure of boys and girls generally increased. There were significant differences in blood pressure levels between boys and girls in different age groups. In regression models, LC, Age, BMI, and chest circumference show significant positive linear relationships with SBP and DBP in adolescents, while RHR exhibits a negative linear relationship with SBP. These factors were individually incorporated into a stratified regression model, significantly enhancing the model's explanatory power. After including factors such as Age, Gender, and BMI, the adjusted R2 value showed a significant improvement, with Age and BMI identified as key predictive factors for SBP and DBP. The robustness and predictive accuracy of the model were further examined through K-fold cross-validation and independent sample validation methods. The validation results indicate that the model has a high accuracy and explanatory power in predicting blood pressure in children of different weight levels, especially among obese children, where the prediction accuracy is highest. Conclusion During COVID-19, age, sex, and BMI significantly influence blood pressure in children aged 7-17 years, and predictive models for SBP and DBP were established. This model helps predict blood pressure in children and reduce the risk of cardiovascular diseases. Confirmation of factors such as sex, age, and BMI provide a basis for personalized health plans for children, especially during large-scale infectious diseases, providing guidance for addressing health challenges and promoting the health and well-being of children.
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Affiliation(s)
- SuJie Mao
- Graduate Development, Harbin Sport University, Harbin, Heilongjiang, China
| | - GuoPing Qian
- Faculty of Sports Medicine, Gdansk University of Sport, Gdańsk, Poland
| | - KaiWen Xiao
- Discipline Development Office, Nanjing Sport Institute, Nanjing, Jiangsu, China
| | - Hong Xu
- College of Sports and Health, Sangmyung University, Seoul, Republic of Korea
| | - Hao Zhou
- Teaching Evaluation Center, Nanjing Police University, Nanjing, Jiangsu, China
| | - XiuJin Guo
- Discipline Development Office, Nanjing Sport Institute, Nanjing, Jiangsu, China
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10
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Doumparatzi M, Sotiriou P, Deligiannis A, Kouidi E. Electrocardiographic characteristics of pediatric and adolescent football players. SPORTS MEDICINE AND HEALTH SCIENCE 2024; 6:179-184. [PMID: 38708327 PMCID: PMC11067734 DOI: 10.1016/j.smhs.2023.12.004] [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: 06/17/2023] [Revised: 11/25/2023] [Accepted: 12/11/2023] [Indexed: 05/07/2024] Open
Abstract
Electrocardiographic characteristics of children and adolescents present differences compared to adults. The aim of our work was to study electrocardiograms (ECGs) of football male players from childhood to late adolescence and examine if the ECG parameters are influenced by systematic exercise. One thousand fifty-four football players participated and formed four groups. Group A included 89 players aged 5-7 years, group B 353 players aged 8-11 years, group C consisted of 355 football players 12-15 yearsold and group D of 257 players with 16-18 years of age. All participants underwent preparticipation screening, including 12-lead surface ECG. Heart rate (HR), PR, RR, QRS, QT, QTc intervals, QT dispersion (QTdisp) and QRS axis were calculated. All ECGs were evaluated according to the current preparticipation cardiac screening guidelines, that refer to athletes aged 12-35 years and do not include pediatric players. Eleven percent of the participants presented an ECG finding. Group D obtained the lowest values of HR, QTc and the highest of PR, RR, QRS, QT intervals and QTdisp, whereas no differences in QRS axis were reported. Incomplete Right Bandle Branch Block (RBBB) was the most frequent ECG peculiarity, detected in 7.3% of the participants. Years of training were statistically significantly correlated to HR, PR, RR, QRS and QT intervals. In conclusion, guidelines for ECG interpretation of athletes in childhood, early and late adolescence are needed.
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Affiliation(s)
- Maria Doumparatzi
- Sports Medicine Laboratory, School of Physical Education and Sports Science, Aristotle University of Thessaloniki, Thermi, GR, 57001, Greece
| | - Panagiota Sotiriou
- Sports Medicine Laboratory, School of Physical Education and Sports Science, Aristotle University of Thessaloniki, Thermi, GR, 57001, Greece
| | - Asterios Deligiannis
- Sports Medicine Laboratory, School of Physical Education and Sports Science, Aristotle University of Thessaloniki, Thermi, GR, 57001, Greece
| | - Evangelia Kouidi
- Sports Medicine Laboratory, School of Physical Education and Sports Science, Aristotle University of Thessaloniki, Thermi, GR, 57001, Greece
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11
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Šišáková M, Helánová K, Hnatkova K, Andršová I, Novotný T, Malik M. Speed of heart rate changes during postural provocations in children and adolescents. Sci Rep 2024; 14:11938. [PMID: 38789480 PMCID: PMC11126691 DOI: 10.1038/s41598-024-62000-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Accepted: 05/13/2024] [Indexed: 05/26/2024] Open
Abstract
Heart rate is under constant autonomic influence but the development of the influence in children is not fully understood. Continuous electrocardiograms were obtained in 1045 healthy school-age children (550 females) during postural provocations with body position changes between supine, sitting, standing, supine, standing, sitting and supine (in this order), 10 min in each position with position changes within 20 s. Heart rate was measured in each position and speed of heart rate changes between positions were assessed by regressions of rates versus timing of individual cardiac cycles. Supine heart rate was gradually decreasing with age: 82.32 ± 9.92, 74.33 ± 9.79, 67.43 ± 9.45 beats per minute (bpm) in tertile age groups < 11, 11-15, > 15 years, respectively (p < 0.0001), with no significant sex difference. Averaged speed of heart rate changes differed little between sexes and age groups but was significantly faster during rate deceleration than acceleration (e.g., supine ↔ standing: 2.99 ± 1.02 vs. 2.57 ± 0.68 bpm/s, p < 0.0001). The study suggests that in children, vagal heart rate control does not noticeably change between ages of approximately 6-19 years. The gradual resting heart rate decrease during childhood and adolescence is likely caused by lowering of cardiac sympathetic influence from sympathetic overdrive in small children to adult-like sympatho-vagal balance in older adolescents.
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Affiliation(s)
- Martina Šišáková
- Department of Internal Medicine and Cardiology, University Hospital Brno, Jihlavská 20, 625 00, Brno, Czech Republic
- Department of Internal Medicine and Cardiology, Faculty of Medicine, Masaryk University, Jihlavská 20, 625 00, Brno, Czech Republic
| | - Kateřina Helánová
- Department of Internal Medicine and Cardiology, University Hospital Brno, Jihlavská 20, 625 00, Brno, Czech Republic.
- Department of Internal Medicine and Cardiology, Faculty of Medicine, Masaryk University, Jihlavská 20, 625 00, Brno, Czech Republic.
| | - Katerina Hnatkova
- National Heart and Lung Institute, Imperial College, 72 Du Cane Rd, Shepherd's Bush, London, W12 0NN, England
| | - Irena Andršová
- Department of Internal Medicine and Cardiology, University Hospital Brno, Jihlavská 20, 625 00, Brno, Czech Republic
- Department of Internal Medicine and Cardiology, Faculty of Medicine, Masaryk University, Jihlavská 20, 625 00, Brno, Czech Republic
| | - Tomáš Novotný
- Department of Internal Medicine and Cardiology, University Hospital Brno, Jihlavská 20, 625 00, Brno, Czech Republic
- Department of Internal Medicine and Cardiology, Faculty of Medicine, Masaryk University, Jihlavská 20, 625 00, Brno, Czech Republic
| | - Marek Malik
- Department of Internal Medicine and Cardiology, Faculty of Medicine, Masaryk University, Jihlavská 20, 625 00, Brno, Czech Republic
- National Heart and Lung Institute, Imperial College, 72 Du Cane Rd, Shepherd's Bush, London, W12 0NN, England
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12
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Šišáková M, Helánová K, Hnatkova K, Andršová I, Novotný T, Malik M. Intra-Individual Relationship between Heart Rate Variability and the Underlying Heart Rate in Children and Adolescents. J Clin Med 2024; 13:2897. [PMID: 38792438 PMCID: PMC11121958 DOI: 10.3390/jcm13102897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Revised: 04/20/2024] [Accepted: 05/11/2024] [Indexed: 05/26/2024] Open
Abstract
Background/Objective: The relationship between heart rate and heart rate variability (HRV) indices has been repeatedly studied in adults but limited data are available on the relationship in paediatric populations. Methods: Continuous 12-lead electrocardiograms were recorded in 1016 healthy children and adolescents (534 females) aged 4 to 19 years during postural manoeuvres with rapid changes between 10-min positions of supine → sitting → standing → supine → standing → sitting → supine. In each position, the averaged RR interval was measured together with four HRV indices, namely the SDNN, RMSSD, quasi-normalised high-frequency components (qnHF), and the proportions of low- and high-frequency components (LF/HF). In each subject, the slope of the linear regression between the repeated HRV measurements and the corresponding RR interval averages was calculated. Results: The intra-subject regression slopes, including their confidence intervals, were related to the age and sex of the subjects. The SDNN/RR, RMSSD/RR, and qnHF/RR slopes were significantly steeper (p < 0.001) and the (LF/HF)/RR slopes were significantly shallower (p < 0.001) in younger children compared to older children and adolescents. Conclusions: The study suggests that sympathetic and vagal influences on heart rate are present in both younger and older children. With advancing age, the sympatho-vagal balance gradually develops and allows the vagal control to suppress the sympathetic drive towards higher heart rates seen in younger age children.
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Affiliation(s)
- Martina Šišáková
- Department of Internal Medicine and Cardiology, University Hospital Brno, Jihlavská 20, 625 00 Brno, Czech Republic; (M.Š.); (I.A.)
- Department of Internal Medicine and Cardiology, Faculty of Medicine, Masaryk University, 62 500 Brno, Czech Republic
| | - Kateřina Helánová
- Department of Internal Medicine and Cardiology, University Hospital Brno, Jihlavská 20, 625 00 Brno, Czech Republic; (M.Š.); (I.A.)
- Department of Internal Medicine and Cardiology, Faculty of Medicine, Masaryk University, 62 500 Brno, Czech Republic
| | - Katerina Hnatkova
- National Heart and Lung Institute, Imperial College, London SW3 6LY, UK; (K.H.); (M.M.)
| | - Irena Andršová
- Department of Internal Medicine and Cardiology, University Hospital Brno, Jihlavská 20, 625 00 Brno, Czech Republic; (M.Š.); (I.A.)
- Department of Internal Medicine and Cardiology, Faculty of Medicine, Masaryk University, 62 500 Brno, Czech Republic
| | - Tomáš Novotný
- Department of Internal Medicine and Cardiology, University Hospital Brno, Jihlavská 20, 625 00 Brno, Czech Republic; (M.Š.); (I.A.)
- Department of Internal Medicine and Cardiology, Faculty of Medicine, Masaryk University, 62 500 Brno, Czech Republic
| | - Marek Malik
- Department of Internal Medicine and Cardiology, Faculty of Medicine, Masaryk University, 62 500 Brno, Czech Republic
- National Heart and Lung Institute, Imperial College, London SW3 6LY, UK; (K.H.); (M.M.)
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13
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Peltenburg PJ, Gibson H, Wilde AAM, van der Werf C, Clur SAB, Blom NA. Prognosis and clinical management of asymptomatic family members with RYR2-mediated catecholaminergic polymorphic ventricular tachycardia: a review. Cardiol Young 2024:1-8. [PMID: 38653721 DOI: 10.1017/s1047951124000714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/25/2024]
Abstract
Despite its low prevalence, the potential diagnosis of catecholaminergic polymorphic ventricular tachycardia (CPVT) should be at the forefront of a paediatric cardiologists mind in children with syncope during exercise or emotions. Over the years, the number of children with a genetic diagnosis of CPVT due to a (likely) pathogenic RYR2 variant early in life and prior to the onset of symptoms has increased due to cascade screening programmes. Limited guidance for this group of patients is currently available. Therefore, we aimed to summarise currently available literature for asymptomatic patients with a (likely) pathogenic RYR2 variant, particularly the history of CPVT and its genetic architecture, the currently available diagnostic tests and their limitations, and the development of a CPVT phenotype - both electrocardiographically and symptomatic - of affected family members. Their risk of arrhythmic events is presumably low and a phenotype seems to develop in the first two decades of life. Future research should focus on this group in particular, to better understand the development of a phenotype over time, and therefore, to be able to better guide clinical management - including the frequency of diagnostic tests, the timing of the initiation of drug therapy, and lifestyle recommendations.
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Affiliation(s)
- Puck J Peltenburg
- Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Heart Failure and Arrhythmias, Amsterdam, UMC, University of Amsterdam, Heart Centre, Amsterdam, The Netherlands
- Department of Pediatric Cardiology, Amsterdam UMC, University of Amsterdam, Emma Children's Hospital, Amsterdam, The Netherlands
| | - Harry Gibson
- Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Heart Failure and Arrhythmias, Amsterdam, UMC, University of Amsterdam, Heart Centre, Amsterdam, The Netherlands
| | - Arthur A M Wilde
- Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Heart Failure and Arrhythmias, Amsterdam, UMC, University of Amsterdam, Heart Centre, Amsterdam, The Netherlands
| | - Christian van der Werf
- Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Heart Failure and Arrhythmias, Amsterdam, UMC, University of Amsterdam, Heart Centre, Amsterdam, The Netherlands
| | - Sally-Ann B Clur
- Department of Pediatric Cardiology, Amsterdam UMC, University of Amsterdam, Emma Children's Hospital, Amsterdam, The Netherlands
| | - Nico A Blom
- Department of Pediatric Cardiology, Amsterdam UMC, University of Amsterdam, Emma Children's Hospital, Amsterdam, The Netherlands
- Department of Pediatric Cardiology, Willem-Alexander Children's Hospital, Leiden University Medical Centre, Leiden, The Netherlands
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Zantvoord JB, Ensink JBM, Op den Kelder R, Diehle J, Lok A, Lindauer RJL. Autonomic nervous system function before and after trauma-focused psychotherapy in youth with (partial) posttraumatic stress disorder. Psychoneuroendocrinology 2024; 162:106945. [PMID: 38244488 DOI: 10.1016/j.psyneuen.2023.106945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 11/17/2023] [Accepted: 12/21/2023] [Indexed: 01/22/2024]
Abstract
While trauma-focused psychotherapies have been shown effective in youth with PTSD, the relationship between treatment response and alterations in the autonomic nervous system (ANS) associated with PTSD, remains incompletely understood. During neutral and personalized trauma script imagery heart rate (HR), pre-ejection period (PEP) and respiratory sinus arrhythmia (RSA) were recorded in youth aged 8-18 with PTSD or partial PTSD (n = 76) and trauma-exposed controls (TEC) (n = 27) to determine ANS activity and stress reactivity. Within the patient group, 77.6% met the full DSM-IV diagnostic criteria for PTSD, the remaining 22.4% met the criteria for partial PTSD. Youth with (partial) PTSD were subsequently treated with eight sessions of either trauma-focused cognitive behavioral therapy or eye movement desensitization and reprocessing. PTSD severity was assessed using the Clinician-Administered PTSD scale for Children and Adolescents to divide patients into responders and non-responders. Youth with (partial) PTSD relative to TEC had higher overall HR during both neutral and trauma imagery (p = .05). Youth with (partial) PTSD showed RSA decrease during trauma imagery relative to neutral imagery, the reverse of TEC (p = .01). Relative to non-responders, responders demonstrated a significant baseline to posttreatment increase of RSA response to stress only when employing a ≥ 50% response criterion (p = .05) and not with the primary ≥ 30% criterion (p = .12). Our results suggest overall higher HR and sympathetic nervous system activity as well as vagal withdrawal in response to stress in youth with (partial) PTSD and only provide partial support for normalization of the latter with successful trauma-focused psychotherapy.
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Affiliation(s)
- Jasper B Zantvoord
- Department of Psychiatry, Amsterdam University Medical Center, Amsterdam, the Netherlands; Department of Child and Adolescent Psychiatry, Amsterdam University Medical Center, Amsterdam, the Netherlands.
| | - Judith B M Ensink
- Department of Child and Adolescent Psychiatry, Amsterdam University Medical Center, Amsterdam, the Netherlands; Levvel, Academic Centre for Child and Adolescent Psychiatry, Amsterdam, the Netherlands
| | - Rosanne Op den Kelder
- Levvel, Academic Centre for Child and Adolescent Psychiatry, Amsterdam, the Netherlands
| | - Julia Diehle
- WODC-Research and Documentation Centre, The Hague, the Netherlands
| | - Anja Lok
- Department of Psychiatry, Amsterdam University Medical Center, Amsterdam, the Netherlands
| | - Ramon J L Lindauer
- Department of Child and Adolescent Psychiatry, Amsterdam University Medical Center, Amsterdam, the Netherlands; Levvel, Academic Centre for Child and Adolescent Psychiatry, Amsterdam, the Netherlands
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15
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Peoples SG, Davis EL, Brooker RJ. Variation in coupling across neural and cardiac systems of regulation is linked to markers of anxiety risk in preschool. Dev Psychopathol 2024:1-13. [PMID: 38487916 PMCID: PMC11401962 DOI: 10.1017/s0954579424000609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2024]
Abstract
Both cortical and parasympathetic systems are believed to regulate emotional arousal in the service of healthy development. Systemic coordination, or coupling, between putative regulatory functions begins in early childhood. Yet the degree of coupling between cortical and parasympathetic systems in young children remains unclear, particularly in relation to the development of typical or atypical emotion function. We tested whether cortical (ERN) and parasympathetic (respiratory sinus arrhythmia [RSA]) markers of regulation were coupled during cognitive challenge in preschoolers (N = 121). We found no main effect of RSA predicting ERN. We then tested children's typical and atypical emotion behavior (context-appropriate/context-inappropriate fear, anxiety symptoms, neuroendocrine reactivity) as moderators of early coupling in an effort to link patterns of coupling to adaptive emotional development. Negative coupling (i.e., smaller ERN, more RSA suppression or larger ERN, less RSA suppression) at age 3 was associated with greater atypical and less typical emotion behaviors, indicative of greater risk. Negative age 3 coupling was also visible for children who had greater Generalized Anxiety Disorder symptoms and blunted cortisol reactivity at age 5. Results suggest that negative coupling may reflect a maladaptive pattern across regulatory systems that is identifiable during the preschool years.
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Affiliation(s)
- Sarah G Peoples
- Department of Psychological and Brain Sciences, Texas A&M University, College Station, TX, USA
| | - Elizabeth L Davis
- Department of Psychology, University of California Riverside, Riverside, CA, USA
| | - Rebecca J Brooker
- Department of Psychological and Brain Sciences, Texas A&M University, College Station, TX, USA
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16
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Krzeczkowski JE, Hall M, Saint-Amour D, Oulhote Y, McGuckin T, Goodman CV, Green R, Muckle G, Lanphear B, Till C. Prenatal fluoride exposure, offspring visual acuity and autonomic nervous system function in 6-month-old infants. ENVIRONMENT INTERNATIONAL 2024; 183:108336. [PMID: 38064923 PMCID: PMC10981044 DOI: 10.1016/j.envint.2023.108336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 11/10/2023] [Accepted: 11/17/2023] [Indexed: 01/25/2024]
Abstract
BACKGROUND Prenatal fluoride exposure can have adverse effects on children's development; however, associations with visual and cardiac autonomic nervous system functioning are unknown. We examined associations between prenatal fluoride exposure and visual acuity and heart rate variability (HRV) in 6-month-old infants. METHODS We used data from Canadian mother-infant pairs participating in the Maternal-Infant Research on Environmental Chemicals (MIREC) cohort. We estimated prenatal fluoride exposure using: i) fluoride concentration in drinking water (mg/L), ii) maternal urinary fluoride adjusted for specific gravity (MUFSG; mg/L) and averaged across pregnancy, and iii) maternal fluoride intake (µg/kg/day) from consumption of water, tea, and coffee, adjusted for maternal body weight (kg). We used multivariable linear regression to examine associations between each measure of fluoride exposure and Teller Acuity Card visual acuity scores (n = 435) and assessed HRV (n = 400) using two measures: root mean square of successive differences (RMSSD) and the standard deviation of N-N intervals (SDNN) measured at 6-months of age. RESULTS Median (IQR) values for water fluoride, MUFSG, and daily fluoride intake were 0.20 (IQR: 0.13-0.56) mg/L; 0.44 (0.28-0.70) mg/L and 4.82 (2.58-10.83) µg/kg/day, respectively. After adjustment for confounding variables, water fluoride concentration was associated with poorer infant visual acuity (B = -1.51; 95 % CI: -2.14,-0.88) and HRV as indicated by lower RMSSD (B = -1.60; 95 % CI: -2.74,-0.46) but not SDNN. Maternal fluoride intake was also associated with poorer visual acuity (B = -0.82; 95 % CI: -1.35,-0.29) and lower RMSSD (B = -1.22; 95 % CI: -2.15,-0.30). No significant associations were observed between MUFSG and visual acuity or HRV. CONCLUSION Fluoride in drinking water was associated with reduced visual acuity and alterations in cardiac autonomic function in infancy, adding to the growing body of evidence suggesting fluoride's developmental neurotoxicity.
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Affiliation(s)
- John E Krzeczkowski
- Department of Health Sciences, Brock University, St. Catharines, Ontario, Canada.
| | - Meaghan Hall
- Department of Psychology, York University, Toronto, Ontario, Canada
| | - Dave Saint-Amour
- Faculté de médecine - Département d'ophtalmologie, Université de Montréal, Montréal, Québec, Canada
| | - Youssef Oulhote
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sina, New York, NY, USA
| | - Taylor McGuckin
- Department of Psychology, York University, Toronto, Ontario, Canada
| | - Carly V Goodman
- Department of Psychology, York University, Toronto, Ontario, Canada
| | - Rivka Green
- Department of Psychology, York University, Toronto, Ontario, Canada
| | - Gina Muckle
- Centre de recherche du CHU de Québec-Université Laval, Québec, Canada; École de Psychologie, Université Laval, Québec, Québec, Canada
| | - Bruce Lanphear
- Faculty of Health Sciences, Simon Fraser University, Vancouver, British Columbia, Canada
| | - Christine Till
- Department of Psychology, York University, Toronto, Ontario, Canada
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17
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Lundström A, Wiklund U, Winbo A, Eliasson H, Karlsson M, Rydberg A. Cardiac response to water activities in children with Long QT syndrome type 1. PLoS One 2023; 18:e0295431. [PMID: 38060596 PMCID: PMC10703314 DOI: 10.1371/journal.pone.0295431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 11/22/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Swimming is a genotype-specific trigger in long QT syndrome type 1 (LQT1). OBJECTIVE To examine the autonomic response to water activities in children and adolescents with LQT1. METHODS In this cross-sectional study, LQT1 patients were age and sex matched to one healthy control subject. Electrocardiograms (ECGs) were recorded during face immersion (FI), swimming, diving, and whole-body submersion (WBS). Heart rate (HR) and heart rate variability (HRV) was measured. The high frequency (HF) component of HRV was interpreted to reflect parasympathetic activity, while the low frequency (LF) component was interpreted as reflecting the combined influence of sympathetic and parasympathetic activity on autonomic nervous modulation of the heart. RESULTS Fifteen LQT1 patients (aged 7-19 years, all on beta-blocker therapy) and fifteen age and sex matched non-medicated controls were included. No significant ventricular arrhythmias were observed in the LQT1 population during the water activities. Out of these 15 matched pairs, 12 pairs managed to complete FI and WBS for more than 10 seconds and were subsequently included in HR and HRV analyses. In response to FI, the LQT1 group experienced a drop in HR of 48 bpm, compared to 67 bpm in the control group (p = 0.006). In response to WBS, HR decreased by 48 bpm in the LQT1 group and 70 bpm in the control group (p = 0.007). A significantly lower PTOT (p < 0.001) and HF (p = 0.011) component was observed before, during and after FI in LQT1 patients compared with the controls. Before, during and after WBS, a significantly lower total power (p < 0.001), LF (p = 0.002) and HF (p = 0.006) component was observed in the LQT1 patients. CONCLUSION A significantly lower HR decrease in response to water activities was observed in LQT1 subjects on beta-blocker therapy, compared to matched non-medicated controls. The data suggests an impaired parasympathetic response in LQT1 children and adolescents. An aberrant autonomic nervous system (ANS) response may cause an autonomic imbalance in this patient group.
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Affiliation(s)
- Anna Lundström
- Department of Clinical Sciences, Pediatrics, Umeå University, Umeå, Sweden
| | - Urban Wiklund
- Department of Radiation Sciences, Radiation Physics, Biomedical Engineering, Umeå University, Umeå, Sweden
| | - Annika Winbo
- Department of Clinical Sciences, Pediatrics, Umeå University, Umeå, Sweden
- Department of Physiology, University of Auckland, Auckland, New Zealand
| | - Håkan Eliasson
- Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm, Sweden
| | - Marcus Karlsson
- Department of Radiation Sciences, Radiation Physics, Biomedical Engineering, Umeå University, Umeå, Sweden
| | - Annika Rydberg
- Department of Clinical Sciences, Pediatrics, Umeå University, Umeå, Sweden
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18
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Muscatello RA, Pachol A, Romines A, Smith I, Corbett BA. Development and Parasympathetic Regulation in Male and Female Adolescents with Autism Spectrum Disorder: A Two-Timepoint Longitudinal Study. J Autism Dev Disord 2023; 53:3613-3626. [PMID: 35829945 PMCID: PMC9949914 DOI: 10.1007/s10803-022-05664-2] [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] [Accepted: 06/24/2022] [Indexed: 11/24/2022]
Abstract
Prolonged dysregulation of the autonomic nervous system (ANS) may increase propensity for physical or psychiatric illness. The current study examined differences in respiratory sinus arrhythmia (RSA) regulation in 215 adolescents with or without autism spectrum disorder (ASD) at Time 1 (T1; 10-13 years old) and 1 year later (Time 2; T2). Linear mixed effects models demonstrated lower RSA regulation in ASD, and a small interaction effect, showing blunted change in RSA from T1 to T2. Developmental differences in RSA regulation were particularly notable in females with ASD and those taking psychotropic medications. Results expand previous findings of reduced parasympathetic regulation in ASD by revealing a blunted developmental slope, indicating diagnostic differences may persist or worsen over time, particularly in females.
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Affiliation(s)
- Rachael A Muscatello
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Village at Vanderbilt, 1500 21st Avenue South, Nashville, TN, 37212, USA.
| | - Aaron Pachol
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Village at Vanderbilt, 1500 21st Avenue South, Nashville, TN, 37212, USA
| | - Alexandra Romines
- College of Arts and Sciences, Vanderbilt University, Nashville, TN, USA
| | - Ian Smith
- College of Arts and Sciences, Vanderbilt University, Nashville, TN, USA
| | - Blythe A Corbett
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Village at Vanderbilt, 1500 21st Avenue South, Nashville, TN, 37212, USA
- Vanderbilt Kennedy Center, Vanderbilt University Medical Center, Nashville, TN, USA
- Department of Psychology, Vanderbilt University, Nashville, TN, USA
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Yuksel D, Kiss O, Prouty D, Arra N, Volpe L, Baker FC, de Zambotti M. Stress, hypothalamic pituitary adrenal axis activity and autonomic nervous system function in adolescents with insomnia. Int J Psychophysiol 2023; 187:43-53. [PMID: 36822502 PMCID: PMC10041935 DOI: 10.1016/j.ijpsycho.2023.02.006] [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: 07/18/2022] [Revised: 02/14/2023] [Accepted: 02/16/2023] [Indexed: 02/23/2023]
Abstract
INTRODUCTION Abnormal stress responses have been linked to the etiology of insomnia. We investigated the relationship between insomnia, stress, hypothalamic-pituitary-adrenal (HPA) axis activity, and autonomic nervous system (ANS) function in adolescence. METHODS Forty-seven post-pubertal adolescents (16-20 years old, 28 female) with (N = 16; insomnia group) and without (N = 31; control group) DSM-5 insomnia symptoms were assessed for stress levels and stress reactivity and underwent a standardized stress protocol (Trier Social Stress Test (TSST)), after an overnight laboratory stay. Cortisol was measured upon awakening and 30-minutes later to calculate the cortisol awakening response (CAR). During the TSST, perceived stress, salivary cortisol (HPA activity), heart rate (HR) and blood pressure (BP) measures were collected. RESULTS Participants in the insomnia group reported more stress from school performance and work overload, with insomnia girls experiencing more stress from peer pressure and future uncertainty than control girls (p < 0.05). No group differences were detected in the CAR and pre-TSST stress levels. All participants showed significant increases in perceived stress (~19 %), HR (~33 %), systolic (~13 %), and diastolic (~15 %) BP in response to the TSST (p < 0.05). Overall HR stress response did not differ between groups, but was lower in boys with insomnia than in girls with insomnia (p < 0.05). Cortisol stress responses were inconclusive, possibly due to a masking effect of CAR, as the task was performed shortly after awakening and larger CARs were associated with blunted cortisol stress responses. DISCUSSION Results mostly show no group difference in physiological stress responses, although some interaction effects suggest a potential sex by insomnia interaction. Larger samples are needed to understand the physiological disturbances of insomnia in adolescence.
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Affiliation(s)
- Dilara Yuksel
- Center for Health Sciences, SRI International, Menlo Park, CA, USA
| | - Orsolya Kiss
- Center for Health Sciences, SRI International, Menlo Park, CA, USA
| | - Devin Prouty
- Center for Health Sciences, SRI International, Menlo Park, CA, USA
| | - Nicole Arra
- Center for Health Sciences, SRI International, Menlo Park, CA, USA
| | - Laila Volpe
- Center for Health Sciences, SRI International, Menlo Park, CA, USA
| | - Fiona C Baker
- Center for Health Sciences, SRI International, Menlo Park, CA, USA; Brain Function Research Group, School of Physiology, University of the Witwatersrand, Johannesburg, South Africa
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Abstract
Frameworks of emotional development have tended to focus on how environmental factors shape children's emotion understanding. However, individual experiences of emotion represent a complex interplay between both external environmental inputs and internal somatovisceral signaling. Here, we discuss the importance of afferent signals and coordination between central and peripheral mechanisms in affective response processing. We propose that incorporating somatovisceral theories of emotions into frameworks of emotional development can inform how children understand emotions in themselves and others. We highlight promising directions for future research on emotional development incorporating this perspective, namely afferent cardiac processing and interoception, immune activation, physiological synchrony, and social touch.
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Affiliation(s)
- Kelly E Faig
- Department of Psychology, Hamilton College, 198 College Hill Road, Clinton, NY 13502
| | - Karen E Smith
- Department of Psychology, the University of Wisconsin, 1500 Highland Blvd, Madison, WI, 53705
| | - Stephanie J Dimitroff
- Department of Psychology, Universität Konstanz, Universitätsstraße 10, 78464 Konstanz, Germany
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21
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Pham HT, Bendezú JJ, Wadsworth ME. HPA-SAM co-activation among racially diverse, economically disadvantaged early adolescents: Secondary analysis with a preliminary test of a multisystem, person-centered approach. Biol Psychol 2023; 179:108546. [PMID: 36990378 PMCID: PMC10175235 DOI: 10.1016/j.biopsycho.2023.108546] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 03/17/2023] [Accepted: 03/24/2023] [Indexed: 03/29/2023]
Abstract
Investigating the co-activation of hypothalamic-pituitary-adrenal (HPA) and sympathetic-adrenomedullary (SAM) responses to acute stress can provide insight into how risk might become biologically embedded during early adolescence and improve understanding of what distinguishes physiological dysregulation from normative/expected physiological responses to stress. Evidence has thus far been mixed as to whether symmetric or asymmetric co-activation patterns are associated with higher exposure to chronic stress and poorer mental health outcomes during adolescence. This study expands on a prior multisystem, person-centered analysis of lower-risk, racially homogenous youth by focusing on HPA-SAM co-activation patterns in a higher-risk, racially diverse sample of early adolescents from low-income families (N = 119, Mage=11.79 years, 55.5% female, 52.7% mono-racial Black). The present study was conducted by performing secondary analysis of data from the baseline assessment of an intervention efficacy trial. Participants and caregivers completed questionnaires; youth also completed the Trier Social Stress Test-Modified (TSST-M) and provided six saliva samples. Multitrajectory modeling (MTM) of salivary cortisol and alpha-amylase levels identified four HPA-SAM co-activation profiles. In accordance with the asymmetric-risk model, youth exhibiting Low HPA-High SAM (n = 46) and High HPA-Low SAM (n = 28) profiles experienced more stressful life events, posttraumatic stress, and emotional and behavioral problems relative to Low HPA-Low SAM (n = 30) and High HPA-High SAM (n = 15) youth. Findings highlight potential differences in biological embedding of risk during early adolescence based on individuals' exposure to chronic stress and illustrate the utility of multisystem and person-centered approaches in understanding how risk might get "underneath the skin" across systems.
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Affiliation(s)
- Holly T Pham
- Department of Psychology, 234 Moore Building, The Pennsylvania State University, University Park, PA 16802, United States.
| | - Jason José Bendezú
- Department of Psychology, 234 Moore Building, The Pennsylvania State University, University Park, PA 16802, United States
| | - Martha E Wadsworth
- Department of Psychology, 234 Moore Building, The Pennsylvania State University, University Park, PA 16802, United States
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22
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Mesaroli G, McLennan L, Friedrich Y, Stinson J, Sethna N, Logan D. Signs and symptoms of pediatric complex regional pain syndrome -type 1: A retrospective cohort study. Can J Pain 2023; 7:2179917. [PMID: 37091835 PMCID: PMC10116922 DOI: 10.1080/24740527.2023.2179917] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023] Open
Abstract
Background Complex regional pain syndrome (CRPS) presents with an array of symptoms that can vary from child to child, making it difficult to diagnose and differentiate from other pain conditions such as chronic musculoskeletal (MSK) pain. Thirteen symptoms and signs are outlined in the Budapest criteria for CRPS (developed and validated for adults) but have not been well described in pediatrics. Aims The aim of this study was to describe the signs and symptoms of pediatric CRPS type 1 (CRPS 1) and determine whether a cluster of symptoms can differentiate CRPS 1 from chronic MSK pain. Methods A retrospective cohort study of pediatric patients with CRPS 1 and MSK pain in a pediatric pain program was conducted. Descriptive statistics were used to report demographics and pain characteristics. The chi-square test was used to evaluate differences in signs and symptoms between patients with CRPS and MSK pain. A logistic regression model was used to evaluate whether a cluster of symptoms could predict a diagnosis of CRPS 1. Results The sample included 187 patients (99 with CRPS 1 and 88 with MSK pain); 81% were female with a mean age 14.1 years. The most prevalent CRPS symptoms were hyperalgesia (54%) and allodynia (52%). A cluster of symptoms (hyperalgesia, color changes, and range of motion) predicted the probability of a diagnosis of CRPS 1. Conclusions A cluster of symptoms may be critical in differentiating pediatric CRPS 1 and MSK pain. Future research is needed to determine if this model is valid in external populations and to explore whether a similar model can differentiate CRPS 1 from other pain conditions (e.g., neuropathic pain).
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Affiliation(s)
- Giulia Mesaroli
- Department of Physical Therapy, University of Toronto; Department of Rehabilitation and Child Health Evaluative Sciences, Research Institute, The Hospital for Sick Children, Toronto, ON, Canada
| | - Logan McLennan
- Department of Anesthesia, Perioperative and Pain Medicine, Boston Children’s Hospital, Boston, MA, USA
| | - Yvonne Friedrich
- Department of Clinical Psychology, Friedrich-Schiller University Jena, Germany
| | - Jennifer Stinson
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto and Child Health Evaluative Sciences, Research Institute, The Hospital for Sick Children, Toronto, ON, Canada
| | - Navil Sethna
- Department of Anesthesia, Perioperative and Pain Medicine, Mayo Family Pediatric Pain Rehabilitation Center, Boston Children’s Hospital, Boston, MA, USA
| | - Deirdre Logan
- Department of Anesthesia, Perioperative and Pain Medicine, Boston Children’s Hospital, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School
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23
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Zalas D, Bobkowski W, Piskorski J, Guzik P. Heart Rate Asymmetry in Healthy Children. J Clin Med 2023; 12:jcm12031194. [PMID: 36769841 PMCID: PMC9918166 DOI: 10.3390/jcm12031194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 01/25/2023] [Accepted: 01/31/2023] [Indexed: 02/05/2023] Open
Abstract
Heart rate asymmetry (HRA) is a physiological phenomenon characterized by an unequal contribution of heart rate decelerations and accelerations to different heart rate variability (HRV) features. While HRA has been demonstrated in adults' ECGs of different duration, a similar investigation in healthy children has not been conducted. This study investigated the variance- and number-based HRA features in 96 healthy children (50 girls and 46 boys, aged 3-18 years) using 24-h ECGs. Additionally, we studied sex differences in HRA. To quantify HRA, variance-based and relative contributions of heart rate decelerations to short-term (C1d), long-term (C2d), and total (CTd) HRV, and the number of all heartbeats (Nd) were computed. Heart rate decelerations contributed more to C1d, but less to C2d and CTd, and were less frequent than heart rate accelerations. Short-term HRA was better expressed in boys. The majority of children (93.7%) had short-term HRA, 88.5% had long-term HRA, 88.5% had total HRA, and 99.0% had more accelerations than decelerations. No sex differences were observed for the rate of various HRA features. Heart rate asymmetry is a common phenomenon in healthy children, as observed in 24-h ECGs. Our findings can be used as reference data for future clinical studies on HRA in children.
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Affiliation(s)
- Dominika Zalas
- Department of Pediatric Cardiology, Poznan University of Medical Sciences, 61-701 Poznań, Poland
| | - Waldemar Bobkowski
- Department of Pediatric Cardiology, Poznan University of Medical Sciences, 61-701 Poznań, Poland
| | - Jarosław Piskorski
- Institute of Physics, University of Zielona Gora, 65-516 Zielona Góra, Poland
| | - Przemysław Guzik
- Department of Cardiology-Intensive Therapy, Poznan University of Medical Sciences, 61-701 Poznań, Poland
- Correspondence:
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24
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Omboni S, Ballatore T, Rizzi F, Tomassini F, Campolo L, Panzeri E. Age-related patterns of ambulatory blood pressure in a large cohort of individuals referred to Italian community pharmacies: results from the templar project. J Hypertens 2023; 41:336-343. [PMID: 36453645 DOI: 10.1097/hjh.0000000000003337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
OBJECTIVES Ambulatory blood pressure monitoring (ABPM) provides extensive information on several BP parameters other than the average BP during daily life. Through this analysis of the TEMPLAR study, we sought to understand better the features of age-related changes in ABP patterns and phenotypes. METHODS ABPMs were obtained in 53 350 individuals visiting 866 Italian community pharmacies (age 3-101 years, 54.3% female individuals). ABPM patterns were assessed across 10-year age categories. RESULTS SBP steadily increased with age. DBP increased from the youth to the middle adulthood and then declined. Daytime BP was higher than night-time BP, but the difference narrowed with aging, reducing the prevalence of dippers. An enhanced SBP morning surge and increased prevalence of abnormal morning rise were observed with aging. SBP and DBP variabilities increased with age with a typical U or J shape, more evident in the case of DBP. The proportion of participants with ambulatory hypertension increased with age. However, an elevated daytime BP was more common in younger individuals and elevated night-time hypertension in older individuals. The prevalence of white-coat hypertension remained stable or slightly declined through the age groups, whereas that of masked hypertension steadily increased. CONCLUSION Our results confirm that ABP patterns interplay and change in a complex way with age. Such changes, particularly the age-related increase in BP variability and prevalence of nocturnal hypertension, nondipping, enhanced morning rise, and masked hypertension, may increase the risk of cardiovascular events and must be carefully considered by the physician when managing BP in the elderly.
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Affiliation(s)
- Stefano Omboni
- Clinical Research Unit, Italian Institute of Telemedicine, Varese, Italy
- Department of Cardiology, Sechenov First Moscow State Medical University, Moscow, Russia
| | - Tommaso Ballatore
- Clinical Research Unit, Italian Institute of Telemedicine, Varese, Italy
| | - Franco Rizzi
- Clinical Research Unit, Italian Institute of Telemedicine, Varese, Italy
| | - Fernanda Tomassini
- Clinical Research Unit, Italian Institute of Telemedicine, Varese, Italy
| | - Luca Campolo
- Clinical Research Unit, Italian Institute of Telemedicine, Varese, Italy
| | - Edoardo Panzeri
- Clinical Research Unit, Italian Institute of Telemedicine, Varese, Italy
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25
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F Pinto F. Changes in heart rate variability after ventricular septal defect closure in children. Where do we stand? Adaptation mechanism, sequela or complications? Rev Port Cardiol 2023; 42:49-52. [PMID: 36460272 DOI: 10.1016/j.repc.2022.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Affiliation(s)
- Fátima F Pinto
- Professora Auxiliar Convidada da Universidade NOVA de Lisboa, Lisboa, Portugal; Serviço de Cardiologia Pediátrica, CHULC, EPE - Hospital de Santa Marta, Lisboa, Portugal; Centro de Referência de Cardiopatias Congénitas, CHULC, EPE - Hospital de Santa Marta, Lisboa, Portugal; European Network Reference Heart Diseases (Guard-Heart).
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26
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Maternal Weight Gain during Pregnancy and the Developing Autonomic Nervous System-Possible Impact of GDM. Nutrients 2022; 14:nu14245220. [PMID: 36558379 PMCID: PMC9784678 DOI: 10.3390/nu14245220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 12/02/2022] [Accepted: 12/05/2022] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE The intrauterine environment is known to affect the offspring's long-term risk for obesity and diabetes. Previous data show that maternal metabolism and gestational weight gain (GWG) are associated with fetal autonomic nervous system (ANS) function, which can be assessed with heart rate variability (HRV). We investigated whether this association is also present in 2-year-old children and addressed the impact of gestational diabetes (GDM). RESEARCH DESIGN AND METHODS We examined the 2-year-old offspring of mothers who had undergone a 5-point, 75 g oral glucose tolerance test during pregnancy. To assess HRV, a 10-minute ECG was recorded, and time domain and frequency domain parameters were analyzed. Body composition was assessed using bioelectrical impedance testing. RESULTS We examined 67 children (33 girls, 34 boys), 30 of whom were born to mothers with treated GDM and normoglycemic pregnancies (NGT), respectively. No differences were found between the groups with regard to birth weight, weight at the age of 2 years, and body fat content. We observed that GWG was associated with heart rate and HRV, indicating that children of mothers with low GWG had a lower parasympathetic tone. This association was detected in NGT-exposed-but not in GDM-exposed-children. HR and HRV correlated with body fat and fat-free mass in children from normoglycemic pregnancies only. CONCLUSION We found that the impact of maternal GWG on offspring ANS function was missing in the presence of treated GDM. The balance of the ANS was related to offspring body composition in children from NGT pregnancies only. Our results suggest that maternal weight gain during pregnancy has a critical impact on the developing ANS, which might be disturbed in the presence of GDM.
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27
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Muacevic A, Adler JR. Autonomic Nervous System Monitoring: Cardiac Magnetic Resonance Imaging Data as a Surrogate for Autonomic Data in Children. Cureus 2022; 14:e32014. [PMID: 36589173 PMCID: PMC9797874 DOI: 10.7759/cureus.32014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/15/2022] [Indexed: 11/30/2022] Open
Abstract
Perioperative autonomic nervous system (ANS) measurements are evolving toward increasing import and utility. We present a three-year-old male with Down Syndrome who underwent ambulatory autonomic monitoring during surgery followed by cardiac magnetic resonance (CMR) imaging. Autonomic data from both environments are compared to age-related norms. We are the first to describe a method for acquiring and trending autonomic data from clinically indicated CMR scans in order to monitor autonomic function. These data are proof of concept for the use of routinely collected CMR data as a surrogate for autonomic data in children, noting differences in the autonomic effects of anesthetic techniques.
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Rieger MG, Tallon CM, Perkins DR, Smith KJ, Stembridge M, Piombo S, Radom-Aizik S, Cooper DM, Ainslie PN, McManus AM. Cardiopulmonary and cerebrovascular acclimatization in children and adults at 3800 m. J Physiol 2022; 600:4849-4863. [PMID: 36165275 DOI: 10.1113/jp283419] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 09/20/2022] [Indexed: 12/24/2022] Open
Abstract
Maturational differences exist in cardiopulmonary and cerebrovascular function at sea-level, but the impact of maturation on acclimatization responses to high altitude is unknown. Ten children (9.8 ± 2.5 years) and 10 adults (34.7 ± 7.1 years) were assessed at sea-level (BL), 3000 m and twice over 4 days at 3800 m (B1, B4). Measurements included minute ventilation ( V ̇ E ${\dot{V}}_{\rm{E}}$ ), end-tidal partial pressures of oxygen ( P ETO 2 ${P}_{{\rm{ETO}}_{\rm{2}}}$ ) and carbon dioxide, echocardiographic assessment of pulmonary artery systolic pressure (PASP) and stroke volume (SV) and ultrasound assessment of blood flow through the internal carotid and vertebral arteries was performed to calculate global cerebral blood flow (gCBF). At 3000 m, V ̇ E ${\dot{V}}_{\rm{E}}$ was increased from BL by 19.6 ± 19.1% (P = 0.031) in children, but not in adults (P = 0.835); SV was reduced in children (-11 ± 13%, P = 0.020) but not adults (P = 0.827), which was compensated for by a larger increase in heart rate in children (+26 beats min-1 vs. +13 beats min-1 , P = 0.019). Between B1 and B4, adults increased V ̇ E ${\dot{V}}_{\rm{E}}$ by 38.5 ± 34.7% (P = 0.006), while V ̇ E ${\dot{V}}_{\rm{E}}$ did not increase further in children. The rise in PASP was not different between groups; however, ∆PASP from BL was related to ∆ P ETO 2 ${P}_{{\rm{ETO}}_{\rm{2}}}$ in adults (R2 = 0.288, P = 0.022), but not children. At BL, gCBF was 43% higher in children than adults (P = 0.017), and this difference was maintained at high altitude, with a similar pattern and magnitude of change in gCBF between groups (P = 0.845). Despite V ̇ E ${\dot{V}}_{\rm{E}}$ increasing in children but not adults at a lower altitude, the pulmonary vascular and cerebrovascular responses to prolonged hypoxia are similar between children and adults. KEY POINTS: Children have different ventilatory and metabolic requirements from adults, which may present differently in the pulmonary and cerebral vasculature upon ascent to high altitude. Children (ages 7-14) and adults (ages 23-44) were brought from sea level to high altitude (3000 to 3800 m) and changes in ventilation, pulmonary artery systolic pressure (PASP) and cerebral blood flow (CBF) were assessed over 1 week. Significant increases in ventilation and decreases in left ventricle stroke volume were observed at a lower altitude in children than adults. PASP and CBF increased by a similar relative amount between children and adults at 3800 m. These results help us better understand age-related differences in compensatory responses to prolonged hypoxia in children, despite similar changes in pulmonary artery pressure and CBF between children and adults.
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Affiliation(s)
- M G Rieger
- Centre for Heart, Lung & Vascular Health, University of British Columbia, Kelowna, British Columbia, Canada
| | - C M Tallon
- Centre for Heart, Lung & Vascular Health, University of British Columbia, Kelowna, British Columbia, Canada
| | - D R Perkins
- Cardiff School of Sport & Health Sciences, Cardiff Metropolitan University, Cardiff, UK.,Youth Physical Development Centre, Cardiff School of Sport & Health Sciences, Cardiff Metropolitan University, Cardiff, UK
| | - K J Smith
- Cerebrovascular Health, Exercise, and Environmental Research Sciences, University of Victoria, Victoria, British Columbia, Canada
| | - M Stembridge
- Cardiff School of Sport & Health Sciences, Cardiff Metropolitan University, Cardiff, UK.,Youth Physical Development Centre, Cardiff School of Sport & Health Sciences, Cardiff Metropolitan University, Cardiff, UK
| | - S Piombo
- Pediatric Exercise and Genomics Research Center, University of California Irvine School of Medicine, Irvine, CA, USA
| | - S Radom-Aizik
- Pediatric Exercise and Genomics Research Center, University of California Irvine School of Medicine, Irvine, CA, USA
| | - D M Cooper
- Pediatric Exercise and Genomics Research Center, University of California Irvine School of Medicine, Irvine, CA, USA
| | - P N Ainslie
- Centre for Heart, Lung & Vascular Health, University of British Columbia, Kelowna, British Columbia, Canada
| | - A M McManus
- Centre for Heart, Lung & Vascular Health, University of British Columbia, Kelowna, British Columbia, Canada
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Bufo MR, Guidotti M, De Faria C, Mofid Y, Bonnet-Brilhault F, Wardak C, Aguillon-Hernandez N. Autonomic tone in children and adults: Pupillary, electrodermal and cardiac activity at rest. Int J Psychophysiol 2022; 180:68-78. [PMID: 35914548 DOI: 10.1016/j.ijpsycho.2022.07.009] [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: 03/14/2022] [Revised: 07/25/2022] [Accepted: 07/26/2022] [Indexed: 11/24/2022]
Abstract
Considering the suspected involvement of the autonomic nervous system (ANS) in several neurodevelopmental disorders, a description of its tonus in typical populations and of its maturation between childhood and adulthood is necessary. We aimed to arrive at a better understanding of the maturation of the sympathetic (SNS) and parasympathetic (PNS) tonus by comparing children and adults at rest, via recordings of multiple ANS indices. We recorded simultaneously pupil diameter, electrodermal activity (EDA) and cardiac activity (RR interval and HRV: heart rate variability) in 29 children (6-12 years old) and 30 adults (20-42 years old) during a 5-min rest period. Children exhibited lower RR intervals, higher LF peak frequencies, and lower LF/HF (low frequency/high frequency) ratios compared to adults. Children also produced more spontaneous EDA peaks, reflected in a larger EDA AUC (area under the curve), in comparison with adults. Finally, children displayed a larger median pupil diameter and a higher pupillary hippus frequency than adults. Our results converged towards higher SNS and PNS tones in children compared to adults. Childhood would thus be characterized by a high autonomic tone, possibly reflecting a physiological state compatible with developmental acquisitions.
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Affiliation(s)
- Maria Rosa Bufo
- UMR 1253, iBrain, Université de Tours, Inserm, Tours, France
| | - Marco Guidotti
- UMR 1253, iBrain, Université de Tours, Inserm, Tours, France; Centre universitaire de pédopsychiatrie, CHRU de Tours, Tours, France; Centre Hospitalier du Chinonais, Saint-Benoît-la-Forêt, France
| | - Cindie De Faria
- UMR 1253, iBrain, Université de Tours, Inserm, Tours, France
| | - Yassine Mofid
- UMR 1253, iBrain, Université de Tours, Inserm, Tours, France
| | - Frédérique Bonnet-Brilhault
- UMR 1253, iBrain, Université de Tours, Inserm, Tours, France; Centre universitaire de pédopsychiatrie, CHRU de Tours, Tours, France
| | - Claire Wardak
- UMR 1253, iBrain, Université de Tours, Inserm, Tours, France
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30
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Prediction of the Occurrence of the Oculocardiac Reflex Based on the Assessment of Heart Rate Variability. An Observational Study. Ophthalmol Ther 2022; 11:1857-1867. [PMID: 35913657 PMCID: PMC9437188 DOI: 10.1007/s40123-022-00549-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 06/30/2022] [Indexed: 11/08/2022] Open
Abstract
Introduction Ophthalmic surgery is assumed to be safe, but some operations require general anaesthesia which is associated with a number of potential complications. In addition, adverse cardiovascular symptoms, such as severe slowing of the heart rate and, in some cases, cardiac arrest may occur due to the surgical technique. The aim of this study was to determine whether it is possible to predict the occurrence of oculocardiac reflex (OCR) based on heart rate variability (HRV) analysis for autonomic nervous system (ANS) activity assessment measured prior to the induction of anaesthesia and immediately before eyeball traction. Methods Fifty-two adults of both sexes (age range 18–65 years) with American Society of Anesthesiologists (ASA) physical status class 1 and 2 were enrolled in this study. All patients had underwent episcleral buckling under general anaesthesia. High-frequency (HF) changes in HRV are thought to reflect parasympathetic impulse transmission, whereas low-frequency (LF) changes reflect both sympathetic and parasympathetic activity. However, in practice, LF changes can be considered to reflect sympathetic changes. Thus, the LF/HF ratio reflects the actual balance between sympathetic and parasympathetic activity. Based on that, frequency domain HRV parameters from 5-min Holter electrocardiogram recordings before anaesthesia induction and before eyeball traction were used for the analysis. The statistical analysis also included patient age, sex, ASA status and preanaesthesia and premanoeuvre heart rate and blood pressure. Results Data from 42 patients were analysed. Oculocardiac reflex was observed in 32 patients (76.2%). No difference was found in the analysed parameters between patients with and without oculocardiac reflex. There was no relationship between the incidence of the OCR and the analysed parameters. Conclusion The prediction of OCR based on initial ANS tone was not possible, and the initial heart rate, blood pressure, age, sex, and ASA status were not helpful for the identification of patients at risk of this reflex. Trial registration ClinicalTrials.gov identifier no.: NCT01714362
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31
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Diaz EC, Williams DK, Cotter M, Sims CR, Wolfe RR, Andres A, Børsheim E. Breastfeeding duration modifies the association between maternal weight status and offspring dietary palmitate oxidation. Am J Clin Nutr 2022; 116:404-414. [PMID: 35404455 PMCID: PMC9348976 DOI: 10.1093/ajcn/nqac097] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 04/06/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Offspring of obese rodents develop a metabolic phenotype that favors fat deposition. Data regarding the impact of maternal obesity programing of offspring fuel usage in humans is scarce. OBJECTIVE The objective of this study was to explore the association between maternal weight status and dietary palmitate oxidation (DPO) in 2-y-old offspring, taking into consideration potential confounders and modifiers. METHODS Women (n = 56) were enrolled by the first trimester of gestation. Maternal physical activity (PA; measured with accelerometers) at enrollment and gestational weight gain (GWG) were measured. Offspring sex, race, and breastfeeding (BF) duration were self-reported. Human milk (HM) composition was determined at 6 mo postpartum. At age 2 y, dietary quality [healthy eating index (HEI)] and parental feeding practices [Child Feeding Questionnaire (CFQ)] were assessed. DPO in 2-y-olds (2-yo-DPO) was measured using deuterated palmitic acid. Generalized linear regression analysis was used to model the associations of 2-yo-DPO with maternal weight status [normal weight (NW), BMI <25 (in kg/m2) compared with excessive weight (EW), BMI ≥25]. RESULTS DPO was higher in offspring of women with EW compared with NW (2.1 ± 1.2%/h compared with 1.4 ± 0.7%/h, P = 0.03). Maternal weight status interacted with BF duration in association with 2-yo-DPO (log ß: 0.05, P = 0.04). Specifically, 2-yo-DPO was higher in the EW compared with NW group if BF duration was ≥9 mo. HM insulin (log ß: 0.35, P = 0.002) and HM leptin (log ß: 0.81, P = 0.001) concentrations directly associated with 2-yo-DPO. PA (log ß: 0.06, P = 0.013), parental feeding restriction (log ß: 0.05, P < 0.0001), and male sex (log ß: 0.54, P < 0.001) were positively associated with 2-yo-DPO. HEI was negatively associated with 2-yo-DPO (log ß:-0.03, P < 0.0001). CONCLUSIONS Higher 2-yo-DPO in offspring of women with EW compared with NW were driven by BF duration. Higher HM insulin and leptin concentrations in women with EW may explain these finding. More studies are needed to confirm these results. This trial was registered at clinicaltrials.gov as NCT03281850.
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Affiliation(s)
- Eva C Diaz
- Arkansas Children's Nutrition Center, Little Rock, AR, USA
- Arkansas Children's Research Institute, Little Rock, AR, USA
- Department of Pediatrics, Little Rock, AR, USA
- Department of Biostatistics, Colleges of Medicine and Public Health, Little Rock, AR, USA
- UAMS, Little Rock, AR, USA
| | - David K Williams
- Arkansas Children's Nutrition Center, Little Rock, AR, USA
- Department of Biostatistics, Colleges of Medicine and Public Health, Little Rock, AR, USA
- UAMS, Little Rock, AR, USA
| | - Matthew Cotter
- Arkansas Children's Nutrition Center, Little Rock, AR, USA
- Arkansas Children's Research Institute, Little Rock, AR, USA
| | - Clark R Sims
- Arkansas Children's Nutrition Center, Little Rock, AR, USA
- UAMS, Little Rock, AR, USA
| | - Robert R Wolfe
- UAMS, Little Rock, AR, USA
- Department of Geriatrics/Reynolds Institute on Aging, Colleges of Medicine and Public Health, University of Arkansas for Medical Sciences, Little Rock, AR, USA, Little Rock, AR, USA
| | - Aline Andres
- Arkansas Children's Nutrition Center, Little Rock, AR, USA
- Department of Pediatrics, Little Rock, AR, USA
- UAMS, Little Rock, AR, USA
| | - Elisabet Børsheim
- Arkansas Children's Nutrition Center, Little Rock, AR, USA
- Arkansas Children's Research Institute, Little Rock, AR, USA
- Department of Pediatrics, Little Rock, AR, USA
- UAMS, Little Rock, AR, USA
- Department of Geriatrics/Reynolds Institute on Aging, Colleges of Medicine and Public Health, University of Arkansas for Medical Sciences, Little Rock, AR, USA, Little Rock, AR, USA
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Poli A, Gemignani A, Chiorri C, Miccoli M. A critical period for experience-dependent development of the feelings of safety during early infancy: A polyvagal perspective on anger and psychometric tools to assess perceived safety. Front Integr Neurosci 2022; 16:915170. [PMID: 35924118 PMCID: PMC9339984 DOI: 10.3389/fnint.2022.915170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 06/27/2022] [Indexed: 11/13/2022] Open
Affiliation(s)
- Andrea Poli
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
- *Correspondence: Andrea Poli
| | - Angelo Gemignani
- Department of Surgical, Medical and Molecular Pathology and of Critical Care Medicine, University of Pisa, Pisa, Italy
| | - Carlo Chiorri
- Department of Educational Sciences, University of Genoa, Genoa, Italy
| | - Mario Miccoli
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
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An Observational Study of Heart Rate Variability Using Wearable Sensors Provides a Target for Therapeutic Monitoring of Autonomic Dysregulation in Patients with Rett Syndrome. Biomedicines 2022; 10:biomedicines10071684. [PMID: 35884989 PMCID: PMC9312701 DOI: 10.3390/biomedicines10071684] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Revised: 06/29/2022] [Accepted: 07/06/2022] [Indexed: 11/17/2022] Open
Abstract
Rett Syndrome (RTT) is a complex neurodevelopmental disorder that has multi-system involvement with co-occurring epilepsy, breathing problems and autonomic dysregulation. Autonomic dysregulation can increase the risk of cardiorespiratory vulnerability in this patient group. Assessment of heart rate variability (HRV) provides an overview of autonomic health in RTT and offers insight into how the sympathetic and parasympathetic components of the nervous system function. However, to our knowledge, no study has evaluated HRV in Rett patients to assess how the dynamics of autonomic function vary with age and changes during the day and/or night. Using non-invasive wearable sensors, we measured HRV in 45 patients with RTT and examined the time and frequency domain sympathetic and parasympathetic indices. Among the HRV indices assessed, heart rate decreases with age and is lower in the night across all ages studied. The sympathetic index (SDNN) and the parasympathetic indices (RMSSD and pNN50) are not seen to change with age. Nevertheless, these indices were all higher during the day when compared to the night. Our findings appear to show that Rett patients are less adaptable to autonomic changes during the night. In the clinical setting, this might be more relevant for patients with severe psychopathology.
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Sinton JW, Cooper DS, Wiley S. Down syndrome and the autonomic nervous system, an educational review for the anesthesiologist. Paediatr Anaesth 2022; 32:609-616. [PMID: 35156260 PMCID: PMC9355312 DOI: 10.1111/pan.14416] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 02/01/2022] [Accepted: 02/04/2022] [Indexed: 11/29/2022]
Abstract
Approximately one in every 700 babies in the United States is born with Down syndrome, or 0.14%. Children with Down syndrome have cognitive impairment and congenital malformations necessitating frequent occurrences of general anesthesia and surgery. The thoughtful perioperative care of children with Down syndrome is relevant and acutely complex for the pediatric anesthesiologist. Behavior, sedation, hypotonia, upper airway obstruction, venous access, and bradycardia are omnipresent concerns apart from the surgical pathology. Down syndrome is also associated with autonomic nervous system dysfunction, a comorbidity that is overlooked in discussions of perioperative care and is described thus far in adults. Autonomic nervous system function or dysfunction may explain the phenotypical features of the perioperative challenges listed above. For this reason, understanding the development and measurement of autonomic nervous system function is important for the pediatric anesthesiologist. Definition and quantification of sympathetic and parasympathetic function will be reviewed.
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Affiliation(s)
- Jamie W. Sinton
- Department of Anesthesiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, USA
| | - David S. Cooper
- Department of Pediatrics, The Heart Institute, Cincinnati Children’s Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Susan Wiley
- Division of Developmental and Behavioral Pediatrics, Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, University of Cincinnati, Cincinnati, Ohio, USA
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Yuan P, Lian Z, Wang Y, Wang Y, Zhang C, Du J, Huang Y, Liao Y. Poincaré Plot Is Useful for Distinguishing Vasovagal Syncope From Postural Tachycardia Syndrome in Children. Front Pediatr 2022; 10:758100. [PMID: 35372154 PMCID: PMC8965582 DOI: 10.3389/fped.2022.758100] [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: 08/13/2021] [Accepted: 02/09/2022] [Indexed: 11/13/2022] Open
Abstract
Objectives To explore the role of the Poincaré plot derived from a 24-hour Holter recording in distinguishing vasovagal syncope (VVS) from postural tachycardia syndrome (POTS) in pediatric patients. Materials and Methods Pediatric patients with VVS or POTS, hospitalized in Peking University First Hospital between January 2012 and December 2018, were included in a derivation study. The transverse axis (T), longitudinal axis (L), T/L ratio, product T × L, distance between the origin and the proximal end of the longitudinal axis (pro-D), and distance between the origin and distal end of the longitudinal axis (dis-D) of the Poincaré plot were compared between the VVS and POTS groups, and the differential diagnostic performance of the above-mentioned graphic parameters was evaluated using receiver operating characteristic curve analysis. A validation study was conducted in pediatric patients hospitalized between January 2019 and December 2020. Results In school-aged children, the T, L, T/L, T × L, and dis-D values of patients with VVS were greater than those of patients with POTS; in adolescents, the T, T/L, T × L, and pro-D values of patients with VVS were greater than those of patients with POTS. Using a T/L cut-off value of 0.3 to distinguish between the two diseases, the sensitivity and specificity were 91.0 and 90.5%, respectively, for the total participants; 91.6 and 88.9%, respectively, for the school-aged children; and 82.1 and 95.7%, respectively, for the adolescents. In the validation study, a T/L cut-off value of 0.3 yielded an accuracy, sensitivity, and specificity of 81.8, 87.2, and 77.6%, respectively, in the total participants; 76.5, 82.6, and 71.4%, respectively, in the school-aged children; and 89.2, 93.8, and 85.7%, respectively, in the adolescents, in distinguishing VVS from POTS validated by clinical diagnosis. Conclusions The graphic parameters of the Poincaré plot are significantly different between VVS and POTS in pediatric patients, and the T/L of the Poincaré plot may be a useful measure to help differentiate VVS from POTS in children and adolescents.
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Affiliation(s)
- Piaoliu Yuan
- Department of Pediatrics, Peking University First Hospital, Beijing, China
| | - Zhouhui Lian
- Wang Xuan Institute of Computer Science, Peking University, Beijing, China
| | - Yuanyuan Wang
- Department of Pediatrics, Peking University First Hospital, Beijing, China
| | - Yaru Wang
- Department of Pediatrics, Peking University First Hospital, Beijing, China
| | - Chunyu Zhang
- Department of Pediatrics, Peking University First Hospital, Beijing, China
| | - Junbao Du
- Department of Pediatrics, Peking University First Hospital, Beijing, China
- Key Laboratory of Molecular Cardiovascular Sciences, Ministry of Education, Beijing, China
| | - Yaqian Huang
- Department of Pediatrics, Peking University First Hospital, Beijing, China
| | - Ying Liao
- Department of Pediatrics, Peking University First Hospital, Beijing, China
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Ugarte E, Johnson LE, Robins RW, Guyer AE, Hastings PD. The impact of social disadvantage on autonomic physiology of latinx adolescents: The role of environmental risks. New Dir Child Adolesc Dev 2022; 2022:91-124. [PMID: 35634899 PMCID: PMC9492630 DOI: 10.1002/cad.20462] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
The experience of poverty embodies complex, multidimensional stressors that may adversely affect physiological and psychological domains of functioning. Compounded by racial/ethnic discrimination, the financial aspect of family poverty typically coincides with additional social and physical environmental risks such as pollution exposure, housing burden, elevated neighborhood unemployment, and lower neighborhood education levels. In this study, we investigated the associations of multidimensional social disadvantage throughout adolescence with autonomic nervous system (ANS) functioning at 17 years. Two hundred and twenty nine low-income Mexican-American adolescents (48.6% female) and their parents were assessed annually between the ages of 10 and 16. Participants' census tracts were matched with corresponding annual administrative data of neighborhood housing burden, education, unemployment, drinking water quality, and fine particulate matter. We combined measures of adolescents' electrodermal response and respiratory sinuses arrhythmia at rest and during a social exclusion challenge (Cyberball) to use as ANS indices of sympathetic and parasympathetic activity, respectively. Controlling for family income-to-needs, youth exposed to greater cumulative water and air pollution from ages 10-16 displayed altered patterns of autonomic functioning at rest and during the social challenge. Conversely, youth living in areas with higher housing burden displayed healthy patterns of autonomic functioning. Altogether, results suggest that toxin exposure in youths' physical environments disrupts the ANS, representing a plausible mechanism by which pollutants and social disadvantage influence later physical and mental health.
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Affiliation(s)
- Elisa Ugarte
- Department of Human Ecology, University of California, Davis
- Center for Mind & Brain, University of California Davis
| | - Lisa E. Johnson
- Center for Mind & Brain, University of California Davis
- Department of Psychology, University of California, Davis
| | | | - Amanda E. Guyer
- Department of Human Ecology, University of California, Davis
- Center for Mind & Brain, University of California Davis
| | - Paul D. Hastings
- Center for Mind & Brain, University of California Davis
- Department of Psychology, University of California, Davis
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37
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Barbier A, Chen JH, Huizinga JD. Autism Spectrum Disorder in Children Is Not Associated With Abnormal Autonomic Nervous System Function: Hypothesis and Theory. Front Psychiatry 2022; 13:830234. [PMID: 35370829 PMCID: PMC8964964 DOI: 10.3389/fpsyt.2022.830234] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 02/10/2022] [Indexed: 12/20/2022] Open
Abstract
The quest to understand the pathophysiology of autism spectrum disorder (ASD) has led to extensive literature that purports to provide evidence for autonomic dysfunction based on heart rate and heart rate variability (HRV), in particular respiratory sinus arrhythmia (RSA), a measure of parasympathetic functioning. Many studies conclude that autism is associated with vagal withdrawal and sympathetic hyperactivation based on HRV and electrodermal analyses. We will argue that a critical analysis of the data leads to the hypothesis that autonomic nervous system dysfunction is not a dominant feature of autism. Most children with ASD have normal parasympathetic baseline values and normal autonomic responses to social stimuli. The existing HRV and electrodermal data cannot lead to the conclusion of an over-excitation of the sympathetic nervous system. A small subgroup of ASD children in experimental settings has relatively low RSA values and relatively high heart rates. The data suggest that this is likely associated with a relatively high level of anxiety during study conditions, associated with co-morbidities such as constipation, or due to the use of psychoactive medication. Many studies interpret their data to conform with a preferred hypothesis of autonomic dysfunction as a trait of autism, related to the polyvagal theory, but the HRV evidence is to the contrary. HRV analysis may identify children with ASD having autonomic dysfunction due to co-morbidities.
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Affiliation(s)
- Ashley Barbier
- Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - Ji-Hong Chen
- Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - Jan D Huizinga
- Department of Medicine, McMaster University, Hamilton, ON, Canada
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Calibration and recalibration of stress response systems across development: Implications for mental and physical health. ADVANCES IN CHILD DEVELOPMENT AND BEHAVIOR 2022; 63:35-69. [DOI: 10.1016/bs.acdb.2022.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Bona Olexova L, Visnovcova Z, Ferencova N, Jurko A, Tonhajzerova I. Complex sympathetic regulation in adolescent mitral valve prolapse. Physiol Res 2021; 70:S317-S325. [PMID: 35099250 DOI: 10.33549/physiolres.934830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Mitral valve prolapse (MVP) belongs to cardiac disorders characterized by impaired closure of mitral leaflets. We studied adolescent group of patients with MVP suffering from symptomatology that cannot be explained by mitral regurgitation alone. Several studies suggested that symptoms can be explained by autonomic, in particular sympathetic-linked dysfunction. Thus, we assessed non-invasive sympathetic indices of blood pressure and heart rate variability and electrodermal activity (EDA). Fifty-three adolescents with MVP (age: 15.1+/-0.4 years) and 43 healthy age- and gender-matched adolescents (age: 14.9+/-0.4 years) were examined. Blood pressure, heart rate and EDA were continuously recorded during 6-min rest. Evaluated parameters were: low frequency band of systolic blood pressure variability, systolic, diastolic and mean blood pressure, mean RR interval, cardiac sympathetic indices: symbolic dynamics (0V%), left ventricular ejection time (LVET), pre-ejection period (PEP), and EDA. Our findings revealed significantly higher systolic, diastolic, and mean blood pressure values, shortened mean RR interval, increased 0V%, and shortened LVET in MVP patients vs. controls (p=0.028, p<0.001, p=0.002, p<0.001, p=0.050, p<0.001; respectively). Our study revealed enhanced cardiovascular sympathetic regulation in adolescent MVP patients. We suggest that evaluation of non-invasive sympathetic parameters could represent potential biomarkers for early diagnosis of cardiovascular complications associated with MVP already at adolescent age.
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Affiliation(s)
- L Bona Olexova
- Department of Physiology and Biomedical Centre Martin, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovak Republic.
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Fry CM, Ram N, Gatzke-Kopp LM. Integrating dynamic and developmental time scales: Emotion-specific autonomic coordination predicts baseline functioning over time. Int J Psychophysiol 2021; 171:29-37. [PMID: 34906622 DOI: 10.1016/j.ijpsycho.2021.12.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 10/25/2021] [Accepted: 12/01/2021] [Indexed: 11/27/2022]
Abstract
Autonomic nervous system activity flexibly shifts and modulates behavior at multiple time scales, with some work suggesting that patterns of short-term reactivity contribute to long-term developmental change. However, previous work has largely considered sympathetic and parasympathetic systems independently, even though both systems contribute dynamically to the regulation of physiological arousal. Using physiological data obtained from 313 children in kindergarten, 1st, and 2nd grade we examined whether within-person autonomic coordination during an emotion-inducing film task in kindergarten was associated with developmental change in resting autonomic activity. On average, these kindergarteners exhibited reciprocal coordination during the approach-oriented emotion (angry, happy) condition and a lack of coordination during the avoidance-oriented emotion (fear, sad) condition. Alignment with these patterns was associated with more typical autonomic development, specifically an increase in resting respiratory sinus arrhythmia (RSA) and a decrease in resting skin conductance (SCR) from kindergarten to 2nd grade; while lack of coordination during the approach condition was associated with a relatively delayed increase in resting RSA and a steeper decline in SCR, and reciprocal coordination during the avoidance condition was associated with a lack of RSA increase. Findings highlight the need for additional consideration of how moment-to-moment dynamics of autonomic coordination influence longer-term development, and suggest that early patterns of atypical arousal may portend dysregulation of developing physiological systems.
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Affiliation(s)
- Cassidy M Fry
- Department of Human Development and Family Studies, Pennsylvania State University, 115 Health & Human Development Building, University Park, PA 16802, USA.
| | - Nilam Ram
- Departments of Psychology and Communication, Stanford University, 450 Jane Stanford Way, Building 120, Stanford, CA 94305, USA.
| | - Lisa M Gatzke-Kopp
- Department of Human Development and Family Studies, Pennsylvania State University, 115 Health & Human Development Building, University Park, PA 16802, USA.
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41
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de Looff PC, Cornet LJM, de Kogel CH, Fernández-Castilla B, Embregts PJCM, Didden R, Nijman HLI. Heart Rate and Skin Conductance Associations with Physical Aggression, Psychopathy, Antisocial Personality Disorder and Conduct Disorder: An Updated Meta-Analysis. Neurosci Biobehav Rev 2021; 132:553-582. [PMID: 34774587 DOI: 10.1016/j.neubiorev.2021.11.003] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 10/14/2021] [Accepted: 11/03/2021] [Indexed: 01/06/2023]
Abstract
The associations between physiological measures (i.e., heart rate and skin conductance) of autonomic nervous system (ANS) activity and severe antisocial spectrum behavior (AB) were meta-analyzed. We used an exhaustive partitioning of variables relevant to the ANS-AB association and investigated four highly relevant questions (on declining effect sizes, psychopathy subscales, moderators, and ANS measures) that are thought to be transformative for future research on AB. We investigated a broad spectrum of physiological measures (e.g., heart rate (variability), pre-ejection period) in relation to AB. The search date for the current meta-analysis was on January 1st, 2020, includes 101 studies and 769 effect sizes. Results indicate that effect sizes are heterogeneous and bidirectional. The careful partitioning of variables sheds light on the complex associations that were obscured in previous meta-analyses. Effects are largest for the most violent offenders and for psychopathy and are dependent on the experimental tasks used, parameters calculated, and analyses run. Understanding the specificity of physiological reactions may be expedient for differentiating between (and within) types of AB.
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Affiliation(s)
- Peter C de Looff
- Behavioural Science Institute, Radboud University, Nijmegen, the Netherlands; Fivoor, Science and Treatment Innovation, Den Dolder, the Netherlands; Expertcentre "De Borg", Den Dolder, the Netherlands.
| | - Liza J M Cornet
- Institute of Education and Child Studies, Leiden University, Leiden, the Netherlands
| | - Catharina H de Kogel
- Research and Documentation Centre (WODC), Ministry of Justice and Security, The Hague, the Netherlands
| | | | - Petri J C M Embregts
- Department of Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, the Netherlands
| | - Robert Didden
- Behavioural Science Institute, Radboud University, Nijmegen, the Netherlands; Expertcentre "De Borg", Den Dolder, the Netherlands; Trajectum, Specialized and Forensic Care, Zwolle, the Netherlands
| | - Henk L I Nijman
- Behavioural Science Institute, Radboud University, Nijmegen, the Netherlands; Fivoor, Science and Treatment Innovation, Den Dolder, the Netherlands; Expertcentre "De Borg", Den Dolder, the Netherlands
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42
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Sousa R, Petrocchi N, Gilbert P, Rijo D. HRV patterns associated with different affect regulation systems: Sex differences in adolescents. Int J Psychophysiol 2021; 170:156-167. [PMID: 34673123 DOI: 10.1016/j.ijpsycho.2021.10.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 09/19/2021] [Accepted: 10/14/2021] [Indexed: 01/28/2023]
Abstract
Evolutionary perspectives of human behavior propose the existence of three emotion regulation systems (i.e., threat, drive and soothing systems). An unbalanced functioning of the systems represents greater risk for emotion dysregulation and psychopathology. In recent years, heart rate variability (HRV) has been reported as an accurate index of emotion regulation, and although adolescence is characterized by multiple neurophysiological, psychological and social changes, there is no study exploring the HRV patterns of each emotion regulation system in this developmental stage. In Study 1, a standardized procedure (SP) aiming to elicit the three different systems was developed and validated by experts (n = 14) and community adolescents (n = 31). In study 2, differences in HRV patterns across the three emotion regulation systems and across sex, were investigated in a sample of community adolescents (n = 155; 70 males), aged between 14 and 18 years old. Results showed that the threat and drive systems were associated with decreases in HRV, while the soothing system was associated with decreased heart rate. Sex differences were found for the activation of the threat system: while males maintained a decreasing trend in HRV indexes, from resting to recovery, females did not show a decrease in HRV during the activation of this system. Overall, physiological correlates of each specific emotion regulation system corroborate the theoretical assumptions. Moreover, a SP able to trigger each system independently while measuring physiological data is now available and can be used in future research.
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Affiliation(s)
- Rúben Sousa
- University of Coimbra, Center for Research in Neuropsychology and Cognitive Behavioral Intervention, Faculty of Psychology and Educational Sciences of the University of Coimbra, Portugal.
| | - Nicola Petrocchi
- Department of Economics and Social Sciences, John Cabot University, Rome, Italy
| | - Paul Gilbert
- University of Derby, School of Allied Health and Social Care, United Kingdom
| | - Daniel Rijo
- University of Coimbra, Center for Research in Neuropsychology and Cognitive Behavioral Intervention, Faculty of Psychology and Educational Sciences of the University of Coimbra, Portugal
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43
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Harteveld LM, Nederend I, Ten Harkel ADJ, Schutte NM, de Rooij SR, Vrijkotte TGM, Oldenhof H, Popma A, Jansen LMC, Suurland J, Swaab H, de Geus EJC. Maturation of the Cardiac Autonomic Nervous System Activity in Children and Adolescents. J Am Heart Assoc 2021; 10:e017405. [PMID: 33525889 PMCID: PMC7955328 DOI: 10.1161/jaha.120.017405] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Background Despite the increasing interest in cardiac autonomic nervous activity, the normal development is not fully understood. The main aim was to determine the maturation of different cardiac sympathetic‐(SNS) and parasympathetic nervous system (PNS) activity parameters in healthy patients aged 0.5 to 20 years. A second aim was to determine potential sex differences. Methods and Results Five studies covering the 0.5‐ to 20‐year age range provided impedance‐ and electrocardiography recordings from which heart rate, different PNS‐parameters (eg, respiratory sinus arrhythmia) and an SNS‐parameter (pre‐ejection period) were collected. Age trends were computed in the mean values across 12 age‐bins and in the age‐specific variances. Age was associated with changes in mean and variance of all parameters. PNS‐activity followed a cubic trend, with an exponential increase from infancy, a plateau phase during middle childhood, followed by a decrease to adolescence. SNS‐activity showed a more linear trend, with a gradual decrease from infancy to adolescence. Boys had higher SNS‐activity at ages 11 to 15 years, while PNS‐activity was higher at 5 and 11 to 12 years with the plateau level reached earlier in girls. Interindividual variation was high at all ages. Variance was reasonably stable for SNS‐ and the log‐transformed PNS‐parameters. Conclusions Cardiac PNS‐ and SNS‐activity in childhood follows different maturational trajectories. Whereas PNS‐activity shows a cubic trend with a plateau phase during middle childhood, SNS‐activity shows a linear decrease from 0.5 to 20 years. Despite the large samples used, clinical use of the sex‐specific centile and percentile normative values is modest in view of the large individual differences, even within narrow age bands.
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Affiliation(s)
- Lisette M Harteveld
- Department of Pediatric Cardiology Leiden University Medical Center Leiden The Netherlands
| | - Ineke Nederend
- Department of Pediatric Cardiology Leiden University Medical Center Leiden The Netherlands.,Department of Biological Psychology Faculty of Human Behavioral and Movement Sciences Vrije Universiteit AmsterdamAmsterdam Public Health Research Institute Amsterdam The Netherlands
| | - Arend D J Ten Harkel
- Department of Pediatric Cardiology Leiden University Medical Center Leiden The Netherlands
| | - Nienke M Schutte
- Department of Biological Psychology Faculty of Human Behavioral and Movement Sciences Vrije Universiteit AmsterdamAmsterdam Public Health Research Institute Amsterdam The Netherlands
| | - Susanne R de Rooij
- Department of Clinical Epidemiology, Biostatistics and Bioinformatics Amsterdam University Medical CenterAcademic Medical Center Amsterdam The Netherlands.,Department of Public Health Amsterdam Public Health Research InstituteAmsterdam University Medical CenterUniversity of Amsterdam Amsterdam The Netherlands
| | - Tanja G M Vrijkotte
- Department of Public Health Amsterdam Public Health Research InstituteAmsterdam University Medical CenterUniversity of Amsterdam Amsterdam The Netherlands
| | - Helena Oldenhof
- Department of Child and Adolescent Psychiatry Amsterdam University Medical CenterVU University Medical Centre Amsterdam The Netherlands
| | - Arne Popma
- Department of Child and Adolescent Psychiatry Amsterdam University Medical CenterVU University Medical Centre Amsterdam The Netherlands
| | - Lucres M C Jansen
- Department of Child and Adolescent Psychiatry Amsterdam University Medical CenterVU University Medical Centre Amsterdam The Netherlands
| | - Jill Suurland
- Department of Clinical Child and Adolescent Studies and Leiden Institute for Brain and Cognition Leiden University Leiden The Netherlands
| | - Hanna Swaab
- Department of Clinical Child and Adolescent Studies and Leiden Institute for Brain and Cognition Leiden University Leiden The Netherlands
| | - Eco J C de Geus
- Department of Biological Psychology Faculty of Human Behavioral and Movement Sciences Vrije Universiteit AmsterdamAmsterdam Public Health Research Institute Amsterdam The Netherlands
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