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Hurvitz N, Elkhateeb N, Sigawi T, Rinsky-Halivni L, Ilan Y. Improving the effectiveness of anti-aging modalities by using the constrained disorder principle-based management algorithms. FRONTIERS IN AGING 2022; 3:1044038. [PMID: 36589143 PMCID: PMC9795077 DOI: 10.3389/fragi.2022.1044038] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 11/22/2022] [Indexed: 12/15/2022]
Abstract
Aging is a complex biological process with multifactorial nature underlined by genetic, environmental, and social factors. In the present paper, we review several mechanisms of aging and the pre-clinically and clinically studied anti-aging therapies. Variability characterizes biological processes from the genome to cellular organelles, biochemical processes, and whole organs' function. Aging is associated with alterations in the degrees of variability and complexity of systems. The constrained disorder principle defines living organisms based on their inherent disorder within arbitrary boundaries and defines aging as having a lower variability or moving outside the boundaries of variability. We focus on associations between variability and hallmarks of aging and discuss the roles of disorder and variability of systems in the pathogenesis of aging. The paper presents the concept of implementing the constrained disease principle-based second-generation artificial intelligence systems for improving anti-aging modalities. The platform uses constrained noise to enhance systems' efficiency and slow the aging process. Described is the potential use of second-generation artificial intelligence systems in patients with chronic disease and its implications for the aged population.
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Affiliation(s)
- Noa Hurvitz
- Faculty of Medicine, Hebrew University and Department of Medicine, Hadassah Medical Center, Jerusalem, Israel
| | - Narmine Elkhateeb
- Faculty of Medicine, Hebrew University and Department of Medicine, Hadassah Medical Center, Jerusalem, Israel
| | - Tal Sigawi
- Faculty of Medicine, Hebrew University and Department of Medicine, Hadassah Medical Center, Jerusalem, Israel
| | - Lilah Rinsky-Halivni
- Braun School of Public Health, Hebrew University of Jerusalem, Jerusalem, Israel,Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Yaron Ilan
- Faculty of Medicine, Hebrew University and Department of Medicine, Hadassah Medical Center, Jerusalem, Israel,*Correspondence: Yaron Ilan,
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Foucré C, Schulz S, Stritter W, von Mackensen I, Luchte J, Ivaki P, Voss A, Ghadjar P, Seifert G. Randomized Pilot Trial Using External Yarrow Liver Compress Applications With Metastatic Cancer Patients Suffering From Fatigue: Evaluation of Sympathetic Modulation by Heart Rate Variability Analysis. Integr Cancer Ther 2022; 21:15347354221081253. [PMID: 35430924 PMCID: PMC9019351 DOI: 10.1177/15347354221081253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Background: Liver compresses are commonly applied in complementary medicine during cancer treatment and are believed to have an energizing effect. We conducted a pilot study to investigate the influence of external application of yarrow liver compresses on the autonomous nervous system by analyzing the heart rate variability (HRV) in metastatic cancer patients undergoing radiation therapy and suffering from cancer-related fatigue (CRF). Methods: A randomized pilot trial was undertaken with patients suffering from CRF receiving palliative radiation therapy for bone or brain metastasis over 2 weeks. CRF patients were randomized into an intervention group receiving yarrow liver compresses and a control group receiving no external application. HRV was analyzed at the beginning (T1) and end (T2) period of the study during daytime (d) and nighttime (n) in both groups and quantified using time-, frequency-, and nonlinear dynamics domains. Results: A total of 39 patients were randomized between September 2017 and August 2019 and a total of 20 patients (10 per group) were available for analysis. For both groups, significant differences in HRV analyses were found in the comparison over the timeline between the first and second measurement (T1d→T2d) during daytime. Specifically, the intervention group showed decreased HRV and complexity of heart rate regulation, indicating increased sympathetic activity at time T2d, whereas the control group showed increased HRV and complexity of heart rate regulation, indicating increased vagal activity at time T2d. Furthermore, the observed HRV analyses showed almost no significant differences between the 2 groups in a direct comparison at the beginning and the end of the study (exception: T2d). Conclusions: Yarrow liver compresses led to increased sympathetic activity during daytime in the intervention group, whereas in the control group, which did not receive any external application, increased parasympathetic activity was observed.
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Affiliation(s)
- Clara Foucré
- Charité—Universitätsmedizin Berlin, Berlin, Germany
| | | | | | | | | | - Pune Ivaki
- Charité—Universitätsmedizin Berlin, Berlin, Germany
| | - Andreas Voss
- University of Technology Ilmenau, Ilmenau, Germany
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Sato M, Betriana F, Tanioka R, Osaka K, Tanioka T, Schoenhofer S. Balance of Autonomic Nervous Activity, Exercise, and Sleep Status in Older Adults: A Review of the Literature. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182412896. [PMID: 34948506 PMCID: PMC8701130 DOI: 10.3390/ijerph182412896] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 12/03/2021] [Accepted: 12/05/2021] [Indexed: 11/16/2022]
Abstract
While older people are frequently known to experience sleep disturbances, there are also many older people who have a good quality of sleep. However, little is known about the balance of autonomic nervous activity, exercise habits, and sleep status in healthy older adults. This study reviews the literature regarding balance of the autonomic nervous activity, exercise, and sleep in healthy older adults. Relevant articles were searched from electronic databases using the combination of the following keywords: "Autonomic nervous activity", "sleep status", "sleep", "healthy older adults", "aging", "heart rate variability (HRV)" and "exercise". Articles were included if they met inclusion criteria: (1) Published in English, (2) Article types: research and review articles, (3) Main outcome was related to the autonomic nervous activity, lifestyle, sleep, and/or healthy aging, and (4) Fully accessed. From 877 articles that were identified, 16 articles were included for review. Results showed that the autonomic nervous activity changes with increasing age, particularly a constant decline in cardiac vagal modulation due to the significant decrease in the nocturnal parasympathetic activity. In addition, the autonomic nervous activity was also related to sleep status and lifestyle, particularly the capability to exercise. In preparing older people toward a healthy aging, maintaining good sleep quality and exercise is suggested.
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Affiliation(s)
- Miki Sato
- Department of Clinical Nursing, Kochi Medical School, Kochi University, Nankoku 783-8505, Japan;
- Correspondence: ; Tel.: +81-88-880-2555
| | - Feni Betriana
- Graduate School of Health Sciences, Tokushima University, Tokushima 770-8509, Japan; (F.B.); (R.T.)
| | - Ryuichi Tanioka
- Graduate School of Health Sciences, Tokushima University, Tokushima 770-8509, Japan; (F.B.); (R.T.)
| | - Kyoko Osaka
- Department of Clinical Nursing, Kochi Medical School, Kochi University, Nankoku 783-8505, Japan;
| | - Tetsuya Tanioka
- Institute of Biomedical Sciences, Graduate School, Tokushima University, Tokushima 770-8509, Japan;
- Anne Boykin Institute, Florida Atlantic University, Boca Raton, FL 33431, USA;
| | - Savina Schoenhofer
- Anne Boykin Institute, Florida Atlantic University, Boca Raton, FL 33431, USA;
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Ponomarenko VI, Karavaev AS, Borovkova EI, Hramkov AN, Kiselev AR, Prokhorov MD, Penzel T. Decrease of coherence between the respiration and parasympathetic control of the heart rate with aging. CHAOS (WOODBURY, N.Y.) 2021; 31:073105. [PMID: 34340353 DOI: 10.1063/5.0056624] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 06/16/2021] [Indexed: 06/13/2023]
Abstract
The study of coordinated behavior between different systems of the human body provides useful information on the functioning of the body. The peculiarities of interaction and coordinated dynamics of the heart rate and respiration are of particular interest. We investigated the coherence of the processes of respiration and autonomic control of the heart rate for people of different ages in the awake state, in sleep with rapid eye movement, and in deep sleep. Our analysis revealed a monotonic decrease in the coherence of these processes with increasing age. This can be explained by age-related changes in the system of autonomic control of circulation. For all age groups, we found a qualitatively similar dynamics of the coherence between the studied processes during a transition from the awake state to sleep.
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Affiliation(s)
- V I Ponomarenko
- Kotelnikov Institute of Radioengineering and Electronics of Russian Academy of Sciences, Saratov Branch, Zelyonaya Street, 38, Saratov 410019, Russia
| | - A S Karavaev
- Kotelnikov Institute of Radioengineering and Electronics of Russian Academy of Sciences, Saratov Branch, Zelyonaya Street, 38, Saratov 410019, Russia
| | - E I Borovkova
- Institute of Physics, Saratov State University, Astrakhanskaya Street, 83, Saratov 410012, Russia
| | - A N Hramkov
- Institute of Physics, Saratov State University, Astrakhanskaya Street, 83, Saratov 410012, Russia
| | - A R Kiselev
- Institute of Cardiological Research, Saratov State Medical University, B. Kazachaya Street, 112, Saratov 410012, Russia
| | - M D Prokhorov
- Kotelnikov Institute of Radioengineering and Electronics of Russian Academy of Sciences, Saratov Branch, Zelyonaya Street, 38, Saratov 410019, Russia
| | - T Penzel
- Institute of Physics, Saratov State University, Astrakhanskaya Street, 83, Saratov 410012, Russia
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Kortekaas K, Kotrschal K. Social Context Influences Resting Physiology in Dogs. Animals (Basel) 2020; 10:E2214. [PMID: 33255961 PMCID: PMC7760264 DOI: 10.3390/ani10122214] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 11/17/2020] [Accepted: 11/20/2020] [Indexed: 12/05/2022] Open
Abstract
Domestication has affected the social life of dogs. They seem to be less dependent on their pack members than wolves, potentially causing dogs to be more alert towards their environment, especially when resting. Such a response has been found in dogs resting alone compared to wolves in the same situation. However, as this may be influenced by social context, we compared alertness (i.e., degree of activation along the sleep-wake continuum-measured via cardiac parameters) of pack-living and enclosure-kept dogs in two conditions: (1) alone, and (2) with pack members, and in two states of activation: (1) inactive wakefulness, and (2) resting. We found that when dogs were resting alone, alertness was higher than when resting in the pack; individual alertness was potentially influenced by social rank. However, alertness was similar in the two conditions during inactive wakefulness. Thus, depending on social context, familiar conspecifics may still provide support in dogs; i.e., domestication has probably only partly shifted the social orientation of dogs from conspecifics to humans. We suggest that cardiac responses of dogs may be more flexible than those of wolves because of their adaptation to the more variable presence of humans and conspecifics in their environment.
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Affiliation(s)
- Kim Kortekaas
- Department of Cognitive Biology, University of Vienna, Althanstrasse 14, 1090 Vienna, Austria
- Department of Behavioral Biology, University of Vienna, Althanstrasse 14, 1090 Vienna, Austria;
- Wolf Science Center, Domestication Lab, Konrad-Lorenz Institute of Ethology, University of Veterinary Medicine, Savoyenstrasse 1a, 1160 Vienna, Austria
| | - Kurt Kotrschal
- Department of Behavioral Biology, University of Vienna, Althanstrasse 14, 1090 Vienna, Austria;
- Wolf Science Center, Domestication Lab, Konrad-Lorenz Institute of Ethology, University of Veterinary Medicine, Savoyenstrasse 1a, 1160 Vienna, Austria
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Weiss C, Woods K, Filipowicz A, Ingram KK. Sleep Quality, Sleep Structure, and PER3 Genotype Mediate Chronotype Effects on Depressive Symptoms in Young Adults. Front Psychol 2020; 11:2028. [PMID: 32982844 PMCID: PMC7479229 DOI: 10.3389/fpsyg.2020.02028] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Accepted: 07/21/2020] [Indexed: 11/13/2022] Open
Abstract
Depression and its related mood disorders are a major global health issue that disproportionately affects young adults. A number of factors that influence depressive symptoms are particularly relevant to the young adult developmental stage, including sleep loss, poor sleep quality, and the tendency toward eveningness in circadian preferences. However, relatively few studies have examined the relationship between sleep and circadian phenotypes, and their respective influences on mood, or considered potential molecular mechanisms driving these associations. Here, we use a multi-year, cross-sectional study of 806 primarily undergraduates to examine the relationships between sleep-wake chronotype, sleep disturbance, depression and genotypes associated with the PER3 variable number of tandom repeats (VNTR) polymorphism-circadian gene variants associated with both chronotype and sleep homeostatic drive. In addition, we use objective, Fitbit-generated sleep structure data on a subset of these participants (n = 67) to examine the relationships between chronotype, depression scores, actual measures of sleep duration, social jetlag, and the percent of deep and rapid eye movement (REM) sleep per night. In this population, chronotype is weakly associated with depressive symptoms and moderately correlated with self-reported sleep disturbance. Sleep disturbance is significantly associated with depression scores, but objective sleep parameters are not directly correlated with Beck Depression Inventory (BDI-II) scores, with the exceptions of a moderate correlation between social jetlag and depression scores in females and a marginal correlation between sleep duration and depression scores. Multiple regression and path analyses reveal that chronotype effects on depressive symptoms in this population are mediated largely by sleep disturbance. The PER3 VNTR genotype significantly predicts depressive symptoms in a model with objective sleep parameters, but it does not significantly predict depressive symptoms in a model with chronotype or subjective sleep disturbance. Interestingly, PER35,5 genotypes, in males only, are independently related to chronotype and depression scores. Our results support hypotheses linking subjective sleep quality and chronotype and provide a first step in understanding how objective sleep structure may be linked to chronotype and depressive symptoms. Our results also suggest that circadian gene variants may show sex-specific effects linking sleep duration and sleep structure to depression.
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Affiliation(s)
- Chloe Weiss
- Department of Biology, Colgate University, Hamilton, NY, United States
| | - Kerri Woods
- Department of Biology, Colgate University, Hamilton, NY, United States
| | - Allan Filipowicz
- Samuel Curtis Johnson Graduate School of Management, Cornell University, Ithaca, NY, United States
| | - Krista K. Ingram
- Department of Biology, Colgate University, Hamilton, NY, United States
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Porta A, Valencia JF, Cairo B, Bari V, De Maria B, Gelpi F, Barbic F, Furlan R. Are Strategies Favoring Pattern Matching a Viable Way to Improve Complexity Estimation Based on Sample Entropy? ENTROPY 2020; 22:e22070724. [PMID: 33286495 PMCID: PMC7517267 DOI: 10.3390/e22070724] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 06/26/2020] [Accepted: 06/29/2020] [Indexed: 11/16/2022]
Abstract
It has been suggested that a viable strategy to improve complexity estimation based on the assessment of pattern similarity is to increase the pattern matching rate without enlarging the series length. We tested this hypothesis over short simulations of nonlinear deterministic and linear stochastic dynamics affected by various noise amounts. Several transformations featuring a different ability to increase the pattern matching rate were tested and compared to the usual strategy adopted in sample entropy (SampEn) computation. The approaches were applied to evaluate the complexity of short-term cardiac and vascular controls from the beat-to-beat variability of heart period (HP) and systolic arterial pressure (SAP) in 12 Parkinson disease patients and 12 age- and gender-matched healthy subjects at supine resting and during head-up tilt. Over simulations, the strategies estimated a larger complexity over nonlinear deterministic signals and a greater regularity over linear stochastic series or deterministic dynamics importantly contaminated by noise. Over short HP and SAP series the techniques did not produce any practical advantage, with an unvaried ability to discriminate groups and experimental conditions compared to the traditional SampEn. Procedures designed to artificially increase the number of matches are of no methodological and practical value when applied to assess complexity indexes.
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Affiliation(s)
- Alberto Porta
- Department of Biomedical Sciences for Health, University of Milan, 20133 Milan, Italy;
- Department of Cardiothoracic, Vascular Anesthesia and Intensive Care, IRCCS Policlinico San Donato, San Donato Milanese, 20097 Milan, Italy; (V.B.); (F.G.)
- Correspondence: ; Tel.: +39-02-5277-4382
| | - José Fernando Valencia
- Department of Electronic Engineering, Universidad de San Buenaventura, Cali 760033, Colombia;
| | - Beatrice Cairo
- Department of Biomedical Sciences for Health, University of Milan, 20133 Milan, Italy;
| | - Vlasta Bari
- Department of Cardiothoracic, Vascular Anesthesia and Intensive Care, IRCCS Policlinico San Donato, San Donato Milanese, 20097 Milan, Italy; (V.B.); (F.G.)
| | | | - Francesca Gelpi
- Department of Cardiothoracic, Vascular Anesthesia and Intensive Care, IRCCS Policlinico San Donato, San Donato Milanese, 20097 Milan, Italy; (V.B.); (F.G.)
| | - Franca Barbic
- Department of Internal Medicine, IRCCS Humanitas Clinical and Research Center, Humanitas University, 20089 Rozzano, Italy; (F.B.); (R.F.)
| | - Raffaello Furlan
- Department of Internal Medicine, IRCCS Humanitas Clinical and Research Center, Humanitas University, 20089 Rozzano, Italy; (F.B.); (R.F.)
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Cairo B, Bari V, De Maria B, Vaini E, Guaraldi P, Lucini D, Pagani M, Provini F, Buonaura GC, Cortelli P, Porta A. Assessing Synergy/Redundancy of Baroreflex and Non-Baroreflex Components of the Cardiac Control during Sleep. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2020; 2019:4953-4956. [PMID: 31946971 DOI: 10.1109/embc.2019.8856887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Cardiovascular regulation and autonomic function change across sleep stages and compared to wake. Little information is present in literature about cardiac control during sleep especially in relation to new information-theoretic quantities such as synergy and redundancy. In the present work we compute synergy and redundancy of baroreflex and non-baroreflex components of the cardiac control according to two information-theoretic approaches, namely predictive information decomposition (PID) and minimal mutual information (MMI) methods. We applied a bivariate approach to heart period (HP) and systolic arterial pressure (SAP) beat-to-beat variability series during sleep in a healthy subject. PID approach computes the net balance between synergy and redundancy, while MMI calculates the two quantities as separate entities. Results suggested that: i) redundancy was dominant over synergy during NREM phases; ii) redundancy increased during NREM phase; iii) synergy did not change across the sleep stages. We interpret this result as a consequence of the vagal enhancement, slowing and deepening of respiration during NREM phases. These preliminary findings support the potential of assessing redundancy/synergy of baroreflex-related and unrelated regulations during sleep to improve our knowledge about physiological mechanisms.
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Byun S, Kim AY, Jang EH, Kim S, Choi KW, Yu HY, Jeon HJ. Entropy analysis of heart rate variability and its application to recognize major depressive disorder: A pilot study. Technol Health Care 2020; 27:407-424. [PMID: 31045557 PMCID: PMC6597986 DOI: 10.3233/thc-199037] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND The current method to evaluate major depressive disorder (MDD) relies on subjective clinical interviews and self-questionnaires. OBJECTIVE Autonomic imbalance in MDD patients is characterized using entropy measures of heart rate variability (HRV). A machine learning approach for screening depression based on the entropy is demonstrated. METHODS The participants experience five experimental phases: baseline (BASE), stress task (MAT), stress task recovery (REC1), relaxation task (RLX), and relaxation task recovery (REC2). The four entropy indices, approximate entropy, sample entropy, fuzzy entropy, and Shannon entropy, are extracted for each phase, and a total of 20 features are used. A support vector machine classifier and recursive feature elimination are employed for classification. RESULTS The entropy features are lower in the MDD group; however, the disease does not have a significant effect. Experimental tasks significantly affect the features. The entropy did not recover during REC1. The differences in the entropy features between the two groups increased after MAT and showed the largest gap in REC2. We achieved 70% accuracy, 64% sensitivity, and 76% specificity with three optimal features during RLX and REC2. CONCLUSION Monitoring of HRV complexity changes when a subject experiences autonomic arousal and recovery can potentially facilitate objective depression recognition.
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Affiliation(s)
- Sangwon Byun
- Department of Electronics Engineering, Incheon National University, Incheon 22012, Korea
| | - Ah Young Kim
- Bio-Medical IT Convergence Research Division, Electronics and Telecommunications Research Institute, Daejeon 34129, Korea
| | - Eun Hye Jang
- Bio-Medical IT Convergence Research Division, Electronics and Telecommunications Research Institute, Daejeon 34129, Korea
| | - Seunghwan Kim
- Bio-Medical IT Convergence Research Division, Electronics and Telecommunications Research Institute, Daejeon 34129, Korea
| | - Kwan Woo Choi
- Department of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea.,Department of Psychiatry, Korea University Anam Hospital, Korea University College of Medicine, Seoul 02841, Korea
| | - Han Young Yu
- Bio-Medical IT Convergence Research Division, Electronics and Telecommunications Research Institute, Daejeon 34129, Korea
| | - Hong Jin Jeon
- Department of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea
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Park J, Park CH, Jun SE, Lee EJ, Kang SW, Kim N. Effects of biofeedback-based sleep improvement program on urinary symptoms and sleep patterns of elderly Korean women with overactive bladder syndrome. BMC Urol 2019; 19:109. [PMID: 31703581 PMCID: PMC6839159 DOI: 10.1186/s12894-019-0540-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2019] [Accepted: 10/20/2019] [Indexed: 11/29/2022] Open
Abstract
Background The prevalence of overactive bladder syndrome (OAB) increases with age. Sleep disturbances in elderly individuals with OAB is a common problem. The purpose of this study was to examine the effects of a biofeedback-based sleep improvement (BBSI) program on urinary symptoms and sleep patterns in elderly Korean women with OAB. Methods A non-equivalent control group pre−/post-test design was used. Elderly women with OAB were assigned to an intervention group (n = 20) or a control group (n = 18). The BBSI program was implemented in the intervention group for 12 weeks, while two educational sessions of general sleep hygiene and lifestyle modification were provided to the control group. Using SPSS 23.0, the data were analyzed by descriptive analysis using the chi-square test, Fisher’s exact test, Mann-Whitney test, and Wilcoxon test. Results After the 12-week BBSI program, significant improvements were found in the intervention group’s the square root of the mean squared differences of successive R-R intervals (p = 0.025), low frequency/high frequency ratio (p = 0.006), and epinephrine (p = 0.039). We also observed a significant difference in urinary symptoms, sleep efficiency, wake after sleep onset, number of awakenings, and number of awakenings within 3 h after sleep onset (p < 0.001, p = 0.004, p = 0.001, p = 0.001, and p = 0.048, respectively). However, no significant changes were found in these variables in the control group. Conclusions The BBSI program effectively improved urinary symptoms and sleep patterns of elderly Korean women with OAB. Further longitudinal research is required to investigate the sustainability and effects of the BBSI program. Trial registration KCT0003882. Date of registration: 02/05/2019. Retrospectively registered.
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Affiliation(s)
- Jooyeon Park
- College of Nursing, Keimyung University, Daegu, Republic of Korea
| | - Choal Hee Park
- Department of Urology, Keimyung University School of Medicine, Daegu, Republic of Korea
| | - Sang-Eun Jun
- College of Nursing, Keimyung University, Daegu, Republic of Korea
| | - Eun-Ju Lee
- College of Nursing, Keimyung University, Daegu, Republic of Korea
| | - Seung Wan Kang
- College of Nursing, Seoul National University, Seoul, Republic of Korea
| | - Nahyun Kim
- College of Nursing, Keimyung University, Daegu, Republic of Korea.
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Kortekaas K, Kotrschal K. Does socio-ecology drive differences in alertness between wolves and dogs when resting? Behav Processes 2019; 166:103877. [PMID: 31153928 DOI: 10.1016/j.beproc.2019.05.024] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Revised: 01/24/2019] [Accepted: 05/29/2019] [Indexed: 11/23/2022]
Abstract
Variation in resting behaviour across animals may be driven by adaptations towards their environment. Wolves and dogs seem promising models to examine this idea as they share a common ancestor, but occupy different socio-ecological niches. While wolves generally avoid humans, hunt, defend their territory, and raise offspring cooperatively, most dogs live in human-shaped environments. Hence, we hypothesized wolves to be more alert towards their environment than dogs, i.e. the degree of activation along the sleep-wake continuum (alertness) should be greater in wolves than in dogs. We estimated alertness via cardiac output. We tested similarly raised and kept pack-living wolves and dogs in two different behavioural conditions: (1) inactive wakefulness: animal is lying, head in an upward position with eyes opened, (2) resting: animal is lying, head in downward position with eyes mainly closed. In contrast to our expectations, we found that in both conditions wolves had a lower heart rate and higher heart rate variability than dogs, i.e. wolves might be less alert/more relaxed than dogs. Although our results are preliminary, we suggest that the higher alertness of dogs compared to wolves is potentially driven by differences in their socio-ecology (i.e. domestication) causing greater attention of dogs to human behaviour.
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Affiliation(s)
- Kim Kortekaas
- Department of Cognitive Biology, University of Vienna, Althanstrasse 14, 1090, Vienna, Austria; Department of Behavioural Biology, University of Vienna, Althanstrasse 14, 1090, Vienna, Austria; Wolf Science Center, Messerli Research Institute, University of Veterinary Medicine Vienna, Veterinärplatz 1, 1210, Vienna, Austria.
| | - Kurt Kotrschal
- Department of Behavioural Biology, University of Vienna, Althanstrasse 14, 1090, Vienna, Austria; Wolf Science Center, Messerli Research Institute, University of Veterinary Medicine Vienna, Veterinärplatz 1, 1210, Vienna, Austria; Konrad Lorenz Research Station, Core Facility University of Vienna, Fischerau 11, 4645, Grünau im Almtal, Austria
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12
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González C, Jensen E, Gambús P, Vallverdú M. Entropy Measures as Descriptors to Identify Apneas in Rheoencephalographic Signals. ENTROPY 2019; 21:e21060605. [PMID: 33267319 PMCID: PMC7515089 DOI: 10.3390/e21060605] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/27/2019] [Revised: 06/09/2019] [Accepted: 06/15/2019] [Indexed: 11/30/2022]
Abstract
Rheoencephalography (REG) is a simple and inexpensive technique that intends to monitor cerebral blood flow (CBF), but its ability to reflect CBF changes has not been extensively proved. Based on the hypothesis that alterations in CBF during apnea should be reflected in REG signals under the form of increased complexity, several entropy metrics were assessed for REG analysis during apnea and resting periods in 16 healthy subjects: approximate entropy (ApEn), sample entropy (SampEn), fuzzy entropy (FuzzyEn), corrected conditional entropy (CCE) and Shannon entropy (SE). To compute these entropy metrics, a set of parameters must be defined a priori, such as, for example, the embedding dimension m, and the tolerance threshold r. A thorough analysis of the effects of parameter selection in the entropy metrics was performed, looking for the values optimizing differences between apnea and baseline signals. All entropy metrics, except SE, provided higher values for apnea periods (p-values < 0.025). FuzzyEn outperformed all other metrics, providing the lowest p-value (p = 0.0001), allowing to conclude that REG signals during apnea have higher complexity than in resting periods. Those findings suggest that REG signals reflect CBF changes provoked by apneas, even though further studies are needed to confirm this hypothesis.
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Affiliation(s)
- Carmen González
- Biomedical Engineering Research Centre, Universitat Politècnica de Catalunya, CIBER of Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), 08028 Barcelona, Spain
- Quantium Medical, Research and Development Department, 08302 Mataró, Spain
- Correspondence: ; Tel.: +34-93-702-1950
| | - Erik Jensen
- Quantium Medical, Research and Development Department, 08302 Mataró, Spain
| | - Pedro Gambús
- Systems Pharmacology Effect Control & Modeling (SPEC-M) Research Group, Department of Anesthesia, Hospital CLINIC de Barcelona, 08036 Barcelona, Spain
- Department of Anesthesia and Perioperative Care, University of California San Francisco (UCSF), San Francisco, CA 94143, USA
| | - Montserrat Vallverdú
- Biomedical Engineering Research Centre, Universitat Politècnica de Catalunya, CIBER of Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), 08028 Barcelona, Spain
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Estévez-Báez M, Machado C, García-Sánchez B, Rodríguez V, Alvarez-Santana R, Leisman G, Carrera JME, Schiavi A, Montes-Brown J, Arrufat-Pié E. Autonomic impairment of patients in coma with different Glasgow coma score assessed with heart rate variability. Brain Inj 2019; 33:496-516. [PMID: 30755043 DOI: 10.1080/02699052.2018.1553312] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
PRIMARY OBJECTIVE The objective of this study is to assess the functional state of the autonomic nervous system in healthy individuals and in individuals in coma using measures of heart rate variability (HRV) and to evaluate its efficiency in predicting mortality. DESIGN AND METHODS Retrospective group comparison study of patients in coma classified into two subgroups, according to their Glasgow coma score, with a healthy control group. HRV indices were calculated from 7 min of artefact-free electrocardiograms using the Hilbert-Huang method in the spectral range 0.02-0.6 Hz. A special procedure was applied to avoid confounding factors. Stepwise multiple regression logistic analysis (SMLRA) and ROC analysis evaluated predictions. RESULTS Progressive reduction of HRV was confirmed and was associated with deepening of coma and a mortality score model that included three spectral HRV indices of absolute power values of very low, low and very high frequency bands (0.4-0.6 Hz). The SMLRA model showed sensitivity of 95.65%, specificity of 95.83%, positive predictive value of 95.65%, and overall efficiency of 95.74%. CONCLUSIONS HRV is a reliable method to assess the integrity of the neural control of the caudal brainstem centres on the hearts of patients in coma and to predict patient mortality.
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Affiliation(s)
- Mario Estévez-Báez
- a Department of Clinical Neurophysiology , Institute of Neurology and Neurosurgery , Havana , Cuba
| | - Calixto Machado
- a Department of Clinical Neurophysiology , Institute of Neurology and Neurosurgery , Havana , Cuba
| | | | | | | | - Gerry Leisman
- d Faculty of Health Sciences , University of Haifa , Haifa , Israel
| | | | - Adam Schiavi
- e Anesthesiology and Critical Care Medicine, Neurosciences Critical Care Division , Johns Hopkins Hospital , Baltimore , MD , USA
| | - Julio Montes-Brown
- f Department of Medicine & Health Science , University of Sonora , Sonora , Mexico
| | - Eduardo Arrufat-Pié
- g Institute of Basic and Preclinical Sciences, "Victoria de Girón" , Havana , Cuba
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Kwon HB, Yoon H, Choi SH, Choi JW, Lee YJ, Park KS. Heart rate variability changes in major depressive disorder during sleep: Fractal index correlates with BDI score during REM sleep. Psychiatry Res 2019; 271:291-298. [PMID: 30513461 DOI: 10.1016/j.psychres.2018.11.021] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Revised: 11/10/2018] [Accepted: 11/10/2018] [Indexed: 02/06/2023]
Abstract
We investigated the relationship between autonomic nervous system activity during each sleep stage and the severity of depressive symptoms in patients with major depressive disorder (MDD) and healthy control subjects. Thirty patients with MDD and thirty healthy control subjects matched for sex, age, and body mass index completed standard overnight polysomnography. Depression severity was assessed using the Beck Depression Inventory (BDI). Time- and frequency-domain, and fractal HRV parameters were derived from 5-min electrocardiogram segments during light sleep, deep sleep, rapid eye movement (REM) sleep, and the pre- and post-sleep wake periods. Detrended fluctuation analysis (DFA) alpha-1 values during REM sleep were significantly higher in patients with MDD than in control subjects, and a significant correlation existed between DFA alpha-1 and BDI score in all subjects. DFA alpha-1 was the strongest predictor for the BDI score, along with REM density as a covariate. This study found that compared with controls, patients with MDD show reduced complexity in heart rate during REM sleep, which may represent lower cardiovascular adaptability in these patients, and could lead to cardiac disease. Moreover, DFA alpha-1 values measured during REM sleep may be useful as an indicator for the diagnosis and monitoring of depression.
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Affiliation(s)
- Hyun Bin Kwon
- Interdisciplinary Program in Bioengineering, Seoul National University, Seoul 03080, Republic of Korea; Institute of Medical and Biological Engineering, Medical Research Center, Seoul National University, Seoul 03080, Republic of Korea
| | - Heenam Yoon
- Interdisciplinary Program in Bioengineering, Seoul National University, Seoul 03080, Republic of Korea
| | - Sang Ho Choi
- Interdisciplinary Program in Bioengineering, Seoul National University, Seoul 03080, Republic of Korea
| | - Jae-Won Choi
- Department of Neuropsychiatry, Eulji University School of Medicine, Eulji General Hospital, Seoul 01830, Republic of Korea
| | - Yu Jin Lee
- Department of Neuropsychiatry and the Center for Sleep and Chronobiology, Seoul National University Hospital, Seoul 03080, Republic of Korea
| | - Kwang Suk Park
- Department of Biomedical Engineering, College of Medicine, Seoul National University, Seoul 03080, Republic of Korea; Institute of Medical and Biological Engineering, Medical Research Center, Seoul National University, Seoul 03080, Republic of Korea.
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Schulz S, Haueisen J, Bär KJ, Voss A. Multivariate assessment of the central-cardiorespiratory network structure in neuropathological disease. Physiol Meas 2018; 39:074004. [PMID: 29933248 DOI: 10.1088/1361-6579/aace9b] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECTIVE The new interdisciplinary field of network physiology is increasingly becoming a focus of interest in medicine. Autonomic nervous system (ANS) dysfunction is well described in schizophrenia (SZO). However, the linear and nonlinear coupling between the ANS and central nervous system (CNS) has only been partly addressed until now. This coupling can be assumed to be a feedback-feedforward network, reacting with flexible and adaptive responses to internal and external factors. APPROACH For the first time, in this study we investigated linear and nonlinear short-term central-cardiorespiratory coupling of 17 patients suffering from paranoid SZO in comparison to 17 age-gender matched healthy subjects analyzing heart rate (HR), respiration (RESP), and the power of frontal electroencephalogram (EEG) activity (P EEG). The objective is to determine how the different regulatory aspects of the CNS-ANS affect the central-cardiorespiratory network (CCRN). To quantify these couplings within the CCRN normalized short time partial directed coherence and the new multivariate high-resolution joint symbolic dynamics were applied. MAIN RESULTS We found that the CCRN in SZO can be characterized as a bidirectional one, with stronger central driving mechanisms (P EEG → HR) towards HR regulation than vice versa, and with stronger respiratory influence (RESP → P EEG) on central activity than vice versa. This suggests that the central-cardiorespiratory process (closed-loop) is mainly focused on adapting the HR via the sinoatrial node than focusing on respiratory regulation. On the other hand, the feedback-loop from ANS to CNS is strongly dominated via respiratory activity. SIGNIFICANCE We demonstrated a considerably significantly different CCRN structure in SZO with a strong central influence on the cardiac system and a strong respiratory influence on the CNS. Moreover, this study provides a more in-depth understanding of the interplay of the central and autonomic regulatory network in healthy subjects and SZO patients.
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Affiliation(s)
- Steffen Schulz
- Institute of Innovative Health Technologies, Ernst-Abbe-Hochschule Jena, Jena, Germany. Department of Pediatrics, Division of Oncology and Hematology, Charité Universitätsmedizin, Berlin, Germany
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16
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Hayano J, Ohashi K, Yoshida Y, Yuda E, Nakamura T, Kiyono K, Yamamoto Y. Increase in random component of heart rate variability coinciding with developmental and degenerative stages of life. Physiol Meas 2018; 39:054004. [PMID: 29693554 DOI: 10.1088/1361-6579/aac007] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE To adapt to a new environment or situation, biological systems explore the most convenient state while moving between attractors by the force of random fluctuation. From this concept, the random component in physiological signals is assumed to increase during developmental and degenerative stages of life. To examine this hypothesis, we measured the age-dependent changes in the random component of heart rate variability (HRV) in 24-h electrocardiography (ECG) big data and in patients with a developmental disorder (DD). APPROACH We measured separately regulated and random components of HRV with autoregressive (AR) model fitting, by which the ratio of random component as the fractional variance of AR residual time series. From the ALLSTAR database of about 304 000 ambulatory 24-h ECGs, we randomly extracted the data of 1930 men and 1987 women uniformly for all ages from 0 to 100 years old (100 cases per 5-year strata for each sex). Data were also obtained from male pediatric patients with DD (age 10-15 years). MAIN RESULTS While the variance of the regulated component of HRV increased from age 0 to 20, decreased with age until 40, and reached a plateau in both sexes, the ratio of the random component was high at birth, decreased with age until 35 in men and 30 in women, and increased again after 75 in men and 85 in women (P < 0.0001 for all). In patients with a DD, the ratio of the random component was significantly lower than that in age-and-sex matched subjects in the database. SIGNIFICANCE We found that the ratio of the random component of HRV is increased during developmental and degenerative stages of life and that it may be reduced in DD patients during their development.
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Affiliation(s)
- Junichiro Hayano
- Department of Medical Education, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan. Department of Medical Education, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi Mizuho-cho Mizuho-ku, Nagoya 467-8602, Japan. J Hayano and K Ohashi contributed equally to this study
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17
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Tobaldini E, Toschi-Dias E, Trimarchi PD, Brena N, Comanducci A, Casarotto S, Montano N, Devalle G. Cardiac autonomic responses to nociceptive stimuli in patients with chronic disorders of consciousness. Clin Neurophysiol 2018; 129:1083-1089. [DOI: 10.1016/j.clinph.2018.01.068] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Revised: 12/07/2017] [Accepted: 01/06/2018] [Indexed: 11/15/2022]
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18
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Makowiec D, Wejer D, Graff B, Struzik ZR. Dynamical Pattern Representation of Cardiovascular Couplings Evoked by Head-up Tilt Test. ENTROPY 2018; 20:e20040235. [PMID: 33265326 PMCID: PMC7512750 DOI: 10.3390/e20040235] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Revised: 03/23/2018] [Accepted: 03/23/2018] [Indexed: 11/17/2022]
Abstract
Shannon entropy (ShE) is a recognised tool for the quantization of the temporal organization of time series. Transfer entropy (TE) provides insight into the dependence between coupled systems. Here, signals are analysed that were produced by the cardiovascular system when a healthy human underwent a provocation test using the head-up tilt (HUT) protocol. The information provided by ShE and TE is evaluated from two aspects: that of the algorithmic stability and that of the recognised physiology of the cardiovascular response to the HUT test. To address both of these aspects, two types of symbolization of three-element subsequent values of a signal are considered: one, well established in heart rate research, referring to the variability in a signal, and a novel one, revealing primarily the dynamical trends. The interpretation of ShE shows a strong dependence on the method that was used in signal pre-processing. In particular, results obtained from normalized signals turn out to be less conclusive than results obtained from non-normalized signals. Systematic investigations based on surrogate data tests are employed to discriminate between genuine properties—in particular inter-system coupling—and random, incidental fluctuations. These properties appear to determine the occurrence of a high percentage of zero values of TE, which strongly limits the reliability of the couplings measured. Nevertheless, supported by statistical corroboration, we identify distinct timings when: (i) evoking cardiac impact on the vascular system, and (ii) evoking vascular impact on the cardiac system, within both the principal sub-systems of the baroreflex loop.
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Affiliation(s)
- Danuta Makowiec
- Institute of Theoretical Physics and Astrophysics, Faculty of Mathematics, Physics and Informatics, University of Gdańsk, Wita Stwosza 57, 80-308 Gdańsk, Poland
| | - Dorota Wejer
- Institute of Experimental Physics, Faculty of Mathematics, Physics and Informatics, University of Gdańsk, Wita Stwosza 57, 80-308 Gdańsk, Poland
| | - Beata Graff
- Department of Hypertension and Diabetology, Medical University of Gdańsk, M. Skłodowskiej-Curie 3a, 80-210 Gdańsk, Poland
| | - Zbigniew R. Struzik
- Graduate School of Education, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
- RIKEN, Brain Science Institute, 2-1 Hirosawa, Wako-shi 351-0198, Japan
- Correspondence: or ; Tel.: +81-48-462-1111
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Tobaldini E, Covassin N, Calvin A, Singh P, Bukartyk J, Wang S, Montano N, Somers VK. Cardiac autonomic control and complexity during sleep are preserved after chronic sleep restriction in healthy subjects. Physiol Rep 2017; 5:e13197. [PMID: 28408635 PMCID: PMC5392506 DOI: 10.14814/phy2.13197] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2017] [Accepted: 02/13/2017] [Indexed: 11/29/2022] Open
Abstract
Acute sleep deprivation (SD) alters cardiovascular autonomic control (CAC) and is associated with an increased risk of cardiovascular disorders. However, the effects of partial SD on CAC are unclear. Thus, we aimed to investigate the effects of partial SD on CAC during sleep. We randomized seventeen healthy subjects to a restriction group (RES, n = 8, subjects slept two-thirds of normal sleep time based on individual habitual sleep duration for 8 days and 8 nights) or a Control group (CON, n = 9, subjects were allowed to sleep their usual sleep time). Attended polysomnographic (PSG) studies were performed every night; a subset of them was selected for the analysis at baseline (day 3-D3), the first night after sleep restriction (day 5-D5), at the end of sleep restriction period (day 11-D11), and at the end of recovery phase (day 14-D14). We extracted electrocardiogram (ECG) and respiration from the PSG and divided into wakefulness (W), nonrapid eye movements (REM) sleep (N2 and N3) and REM sleep. CAC was evaluated by means of linear spectral analysis, nonlinear symbolic analysis and complexity indexes. In both RES and CON groups, sympathetic modulation decreased and parasympathetic modulation increased during N2 and N3 compared to W and REM at D3, D5, D11, D14. Complexity analysis revealed a reduction in complexity during REM compared to NREM sleep in both DEP and CON After 8 days of moderate SD, cardiac autonomic dynamics, characterized by decreased sympathetic, and increased parasympathetic modulation, and higher cardiac complexity during NREM sleep, compared to W and REM, are preserved.
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Affiliation(s)
- Eleonora Tobaldini
- Department of Internal Medicine, Fondazione IRCSS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
- Department of Clinical Sciences and Community of Health, University of Milan, Milan, Italy
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Naima Covassin
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Andrew Calvin
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Prachi Singh
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Jan Bukartyk
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Shiang Wang
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Nicola Montano
- Department of Internal Medicine, Fondazione IRCSS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
- Department of Clinical Sciences and Community of Health, University of Milan, Milan, Italy
| | - Virend K Somers
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA
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Penzel T, Kantelhardt JW, Bartsch RP, Riedl M, Kraemer JF, Wessel N, Garcia C, Glos M, Fietze I, Schöbel C. Modulations of Heart Rate, ECG, and Cardio-Respiratory Coupling Observed in Polysomnography. Front Physiol 2016; 7:460. [PMID: 27826247 PMCID: PMC5078504 DOI: 10.3389/fphys.2016.00460] [Citation(s) in RCA: 99] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Accepted: 09/23/2016] [Indexed: 11/13/2022] Open
Abstract
The cardiac component of cardio-respiratory polysomnography is covered by ECG and heart rate recordings. However, their evaluation is often underrepresented in summarizing reports. As complements to EEG, EOG, and EMG, these signals provide diagnostic information for autonomic nervous activity during sleep. This review presents major methodological developments in sleep research regarding heart rate, ECG, and cardio-respiratory couplings in a chronological (historical) sequence. It presents physiological and pathophysiological insights related to sleep medicine obtained by new technical developments. Recorded nocturnal ECG facilitates conventional heart rate variability (HRV) analysis, studies of cyclical variations of heart rate, and analysis of ECG waveform. In healthy adults, the autonomous nervous system is regulated in totally different ways during wakefulness, slow-wave sleep, and REM sleep. Analysis of beat-to-beat heart-rate variations with statistical methods enables us to estimate sleep stages based on the differences in autonomic nervous system regulation. Furthermore, up to some degree, it is possible to track transitions from wakefulness to sleep by analysis of heart-rate variations. ECG and heart rate analysis allow assessment of selected sleep disorders as well. Sleep disordered breathing can be detected reliably by studying cyclical variation of heart rate combined with respiration-modulated changes in ECG morphology (amplitude of R wave and T wave).
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Affiliation(s)
- Thomas Penzel
- Interdisziplinäres Schlafmedizinisches Zentrum, Charité – Universitätsmedizin BerlinBerlin, Germany
- International Clinical Research Center, St. Anne's University Hospital BrnoBrno, Czech Republic
| | - Jan W. Kantelhardt
- Naturwissenschaftliche Fakultät II – Chemie, Physik und Mathematik, Institut für Physik, Martin-Luther Universität Halle-WittenbergHalle, Germany
- Kardiovaskuläre Physik, Arbeitsgruppe Nichtlineare Dynamik, Fachbereich Physik, Humboldt-Universität BerlinBerlin, Germany
| | | | - Maik Riedl
- Kardiovaskuläre Physik, Arbeitsgruppe Nichtlineare Dynamik, Fachbereich Physik, Humboldt-Universität BerlinBerlin, Germany
| | - Jan F. Kraemer
- Kardiovaskuläre Physik, Arbeitsgruppe Nichtlineare Dynamik, Fachbereich Physik, Humboldt-Universität BerlinBerlin, Germany
| | - Niels Wessel
- Kardiovaskuläre Physik, Arbeitsgruppe Nichtlineare Dynamik, Fachbereich Physik, Humboldt-Universität BerlinBerlin, Germany
| | - Carmen Garcia
- Interdisziplinäres Schlafmedizinisches Zentrum, Charité – Universitätsmedizin BerlinBerlin, Germany
| | - Martin Glos
- Interdisziplinäres Schlafmedizinisches Zentrum, Charité – Universitätsmedizin BerlinBerlin, Germany
| | - Ingo Fietze
- Interdisziplinäres Schlafmedizinisches Zentrum, Charité – Universitätsmedizin BerlinBerlin, Germany
| | - Christoph Schöbel
- Interdisziplinäres Schlafmedizinisches Zentrum, Charité – Universitätsmedizin BerlinBerlin, Germany
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Porta A, De Maria B, Bari V, Marchi A, Faes L. Are Nonlinear Model-Free Conditional Entropy Approaches for the Assessment of Cardiac Control Complexity Superior to the Linear Model-Based One? IEEE Trans Biomed Eng 2016; 64:1287-1296. [PMID: 27541327 DOI: 10.1109/tbme.2016.2600160] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE We test the hypothesis that the linear model-based (MB) approach for the estimation of conditional entropy (CE) can be utilized to assess the complexity of the cardiac control in healthy individuals. METHODS An MB estimate of CE was tested in an experimental protocol (i.e., the graded head-up tilt) known to produce a gradual decrease of cardiac control complexity as a result of the progressive vagal withdrawal and concomitant sympathetic activation. The MB approach was compared with traditionally exploited nonlinear model-free (MF) techniques such as corrected approximate entropy, sample entropy, corrected CE, two k -nearest-neighbor CE procedures and permutation CE. Electrocardiogram was recorded in 17 healthy subjects at rest in supine position and during head-up tilt with table angles of 15°, 30°, 45°, 60°, and 75°. Heart period (HP) was derived as the temporal distance between two consecutive R-wave peaks and analysis was carried out over stationary sequences of 256 successive HPs. RESULTS The performance of the MB method in following the progressive decrease of HP complexity with tilt table angles was in line with those of MF approaches and the MB index was remarkably correlated with the MF ones. CONCLUSION The MB approach can be utilized to monitor the changes of the complexity of the cardiac control, thus speeding up dramatically the CE calculation. SIGNIFICANCE The remarkable performance of the MB approach challenges the notion, generally assumed in cardiac control complexity analysis based on CE, about the need of MF techniques and could allow real-time applications.
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Cabiddu R, Borghi-Silva A, Trimer R, Trimer V, Ricci PA, Italiano Monteiro C, Camargo Magalhães Maniglia M, Silva Pereira AM, Rodrigues das Chagas G, Carvalho EM. Hippotherapy acute impact on heart rate variability non-linear dynamics in neurological disorders. Physiol Behav 2016; 159:88-94. [PMID: 26988283 DOI: 10.1016/j.physbeh.2016.03.012] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Revised: 02/24/2016] [Accepted: 03/12/2016] [Indexed: 10/22/2022]
Abstract
Neurological disorders are associated with autonomic dysfunction. Hippotherapy (HT) is a therapy treatment strategy that utilizes a horse in an interdisciplinary approach for the physical and mental rehabilitation of people with physical, mental and/or psychological disabilities. However, no studies have been carried out which evaluated the effects of HT on the autonomic control in these patients. Therefore, the objective of the present study was to investigate the effects of a single HT session on cardiovascular autonomic control by time domain and non-linear analysis of heart rate variability (HRV). The HRV signal was recorded continuously in twelve children affected by neurological disorders during a HT session, consisting in a 10-minute sitting position rest (P1), a 15-minute preparatory phase sitting on the horse (P2), a 15-minute HT session (P3) and a final 10-minute sitting position recovery (P4). Time domain and non-linear HRV indices, including Sample Entropy (SampEn), Lempel-Ziv Complexity (LZC) and Detrended Fluctuation Analysis (DFA), were calculated for each treatment phase. We observed that SampEn increased during P3 (SampEn=0.56±0.10) with respect to P1 (SampEn=0.40±0.14, p<0.05), while DFA decreased during P3 (DFA=1.10±0.10) with respect to P1 (DFA=1.26±0.14, p<0.05). A significant SDRR increase (p<0.05) was observed during the recovery period P4 (SDRR=50±30ms) with respect to the HT session period P3 (SDRR=30±10ms). Our results suggest that HT might benefit children with disabilities attributable to neurological disorders by eliciting an acute autonomic response during the therapy and during the recovery period.
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Affiliation(s)
- Ramona Cabiddu
- Cardiopulmonary Physiotherapy Laboratory, Federal University of São Carlos, Rodovia Washington Luís, Km 235, Jardim Guanabara, 13565-905 São Carlos, São Paulo, Brazil.
| | - Audrey Borghi-Silva
- Cardiopulmonary Physiotherapy Laboratory, Federal University of São Carlos, Rodovia Washington Luís, Km 235, Jardim Guanabara, 13565-905 São Carlos, São Paulo, Brazil
| | - Renata Trimer
- Cardiopulmonary Physiotherapy Laboratory, Federal University of São Carlos, Rodovia Washington Luís, Km 235, Jardim Guanabara, 13565-905 São Carlos, São Paulo, Brazil
| | - Vitor Trimer
- Cardiopulmonary Physiotherapy Laboratory, Federal University of São Carlos, Rodovia Washington Luís, Km 235, Jardim Guanabara, 13565-905 São Carlos, São Paulo, Brazil
| | - Paula Angélica Ricci
- Cardiopulmonary Physiotherapy Laboratory, Federal University of São Carlos, Rodovia Washington Luís, Km 235, Jardim Guanabara, 13565-905 São Carlos, São Paulo, Brazil
| | - Clara Italiano Monteiro
- Cardiopulmonary Physiotherapy Laboratory, Federal University of São Carlos, Rodovia Washington Luís, Km 235, Jardim Guanabara, 13565-905 São Carlos, São Paulo, Brazil
| | - Marcela Camargo Magalhães Maniglia
- Faculty of Physical Education, Federal University of Uberlândia, Rua João Naves de Ávila, 2121, Santa Mônica, 38408-100 Uberlândia, Minas Gerais, Brazil
| | - Ana Maria Silva Pereira
- Faculty of Physical Education, Federal University of Uberlândia, Rua João Naves de Ávila, 2121, Santa Mônica, 38408-100 Uberlândia, Minas Gerais, Brazil
| | - Gustavo Rodrigues das Chagas
- Faculty of Physical Education, Federal University of Uberlândia, Rua João Naves de Ávila, 2121, Santa Mônica, 38408-100 Uberlândia, Minas Gerais, Brazil
| | - Eliane Maria Carvalho
- Faculty of Physical Education, Federal University of Uberlândia, Rua João Naves de Ávila, 2121, Santa Mônica, 38408-100 Uberlândia, Minas Gerais, Brazil
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Dimitriev DA, Saperova EV, Dimitriev AD. State Anxiety and Nonlinear Dynamics of Heart Rate Variability in Students. PLoS One 2016; 11:e0146131. [PMID: 26807793 PMCID: PMC4726749 DOI: 10.1371/journal.pone.0146131] [Citation(s) in RCA: 56] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Accepted: 12/14/2015] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVES Clinical and experimental research studies have demonstrated that the emotional experience of anxiety impairs heart rate variability (HRV) in humans. The present study investigated whether changes in state anxiety (SA) can also modulate nonlinear dynamics of heart rate. METHODS A group of 96 students volunteered to participate in the study. For each student, two 5-minute recordings of beat intervals (RR) were performed: one during a rest period and one just before a university examination, which was assumed to be a real-life stressor. Nonlinear analysis of HRV was performed. The Spielberger's State-Trait Anxiety Inventory was used to assess the level of SA. RESULTS Before adjusting for heart rate, a Wilcoxon matched pairs test showed significant decreases in Poincaré plot measures, entropy, largest Lyapunov exponent (LLE), and pointwise correlation dimension (PD2), and an increase in the short-term fractal-like scaling exponent of detrended fluctuation analysis (α1) during the exam session, compared with the rest period. A Pearson analysis indicated significant negative correlations between the dynamics of SA and Poincaré plot axes ratio (SD1/SD2), and between changes in SA and changes in entropy measures. A strong negative correlation was found between the dynamics of SA and LLE. A significant positive correlation was found between the dynamics of SA and α1. The decreases in Poincaré plot measures (SD1, complex correlation measure), entropy measures, and LLE were still significant after adjusting for heart rate. Corrected α1 was increased during the exam session. As before, the dynamics of adjusted LLE was significantly correlated with the dynamics of SA. CONCLUSIONS The qualitative increase in SA during academic examination was related to the decrease in the complexity and size of the Poincaré plot through a reduction of both the interbeat interval and its variation.
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Affiliation(s)
- Dimitriy A. Dimitriev
- Department of Biology, Chuvash State Pedagogical University, Chuvash Republic, Russia
- * E-mail:
| | - Elena V. Saperova
- Department of Biology, Chuvash State Pedagogical University, Chuvash Republic, Russia
| | - Aleksey D. Dimitriev
- Department of Biology, Chuvash State Pedagogical University, Chuvash Republic, Russia
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Altered autonomic regulation as a cardiovascular risk marker for patients with sudden sensorineural hearing loss. Otol Neurotol 2015; 35:1720-9. [PMID: 25299829 DOI: 10.1097/mao.0000000000000622] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES To measure autonomic nervous system function after idiopathic sudden sensorineural hearing loss (ISSHL). STUDY DESIGN Diagnostic prospective cohort single-center study. SETTING Tertiary referral university hospital. PATIENTS Twenty-three adult patients with ISSHL and 10 normal-hearing control patients without ISSHL (CON) matched with respect to age, sex, hypertension, and medication. MAIN OUTCOME MEASURES Bivariate analysis of autonomic regulation (ISSHL versus CON) using 30-minute heart rate (HR) and systolic and diastolic blood pressure (BP) time series at baseline, based on cardiovascular coupling, HR and BP regulatory patterns, high-resolution coupling analysis based on joint symbolic dynamics (High-Resolution Joint Symbolic Dynamics). INTERVENTION No intervention. RESULTS Multivariate discrimination between ISSHL and CON achieved values of area under the receiver operator characteristic curve = 95.5, sensitivity = 90.9%, and specificity = 88.9%. Independent from medication and hypertension increased the complexity of nonlinear HR regulation and reduced cardiovascular coupling of ISSHL patients and independent from hypertension altered nonlinear systolic and diastolic BP regulation. Coupling patterns are characterized by a less pronounced strong and fast decrease of systolic BP when HR increases and rapidly changes in ISSHL patients. Disturbed BP modulation and complexity by impaired baroreflex activities resulting in short-term BP fluctuations, altered peripheral resistance, and reduced cochlear blood flow. Increased values for the pulse wave velocity in the aorta and carotid-femoral were early indicators that the elasticity of the arteries might be restricted in ISSHL patients. CONCLUSION ISSHL patients show an altered autonomic regulation. At least a subgroup of ISSHL patients seems to exist where a vascular impairment might play an important role in the pathogenesis of this disease.
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Makowiec D, Wejer D, Kaczkowska A, Żarczyńska-Buchowiecka M, Struzik ZR. Chronographic Imprint of Age-Induced Alterations in Heart Rate Dynamical Organization. Front Physiol 2015; 6:201. [PMID: 26236241 PMCID: PMC4501288 DOI: 10.3389/fphys.2015.00201] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2014] [Accepted: 06/16/2015] [Indexed: 11/20/2022] Open
Abstract
Beat-to-beat changes in the heart period are transformed into a network of increments between subsequent RR-intervals, which enables graphical descriptions of short-term heart period variability. Three types of such descriptions are considered: (1) network graphs arising from a set of vertices and directed edges, (2) contour plots of adjacency matrices A, representing the networks and transition matrices T, resulting from A, and (3) vector plots of gradients of the matrices A and T. Two indices are considered which summarize properties of A and T: the approximate deceleration capacity and the entropy rate. The method, applied to time series of nocturnal RR-intervals recorded from healthy subjects of different ages, reveals important aspect of changes in the autonomic activity caused by biological aging. Independent of the subject’s age, following accelerations, a pendulum-like dynamics appears. With decelerations, this dynamics develops in line with the subject’s age. This aging transition can be graphically visualized by vectors connecting the maxima of the transition probabilities of T, which, metaphorically, resemble a chronometer or the hands of a clock.
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Affiliation(s)
- Danuta Makowiec
- Institute of Theoretical Physics and Astrophysics, University of Gdańsk , Gdańsk , Poland
| | - Dorota Wejer
- Institute of Theoretical Physics and Astrophysics, University of Gdańsk , Gdańsk , Poland
| | - Agnieszka Kaczkowska
- Faculty of Applied Physics and Mathematics, Gdańsk University of Technology , Gdańsk , Poland
| | | | - Zbigniew R Struzik
- Institute of Theoretical Physics and Astrophysics, University of Gdańsk , Gdańsk , Poland ; RIKEN Brain Science Institute , Wako-shi , Japan ; Graduate School of Education, The University of Tokyo , Tokyo , Japan
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Cabiddu R, Trimer R, Borghi-Silva A, Migliorini M, Mendes RG, Oliveira Jr. AD, Costa FSM, Bianchi AM. Are Complexity Metrics Reliable in Assessing HRV Control in Obese Patients During Sleep? PLoS One 2015; 10:e0124458. [PMID: 25893856 PMCID: PMC4404104 DOI: 10.1371/journal.pone.0124458] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2014] [Accepted: 03/03/2015] [Indexed: 11/30/2022] Open
Abstract
Obesity is associated with cardiovascular mortality. Linear methods, including time domain and frequency domain analysis, are normally applied on the heart rate variability (HRV) signal to investigate autonomic cardiovascular control, whose imbalance might promote cardiovascular disease in these patients. However, given the cardiac activity non-linearities, non-linear methods might provide better insight. HRV complexity was hereby analyzed during wakefulness and different sleep stages in healthy and obese subjects. Given the short duration of each sleep stage, complexity measures, normally extracted from long-period signals, needed be calculated on short-term signals. Sample entropy, Lempel-Ziv complexity and detrended fluctuation analysis were evaluated and results showed no significant differences among the values calculated over ten-minute signals and longer durations, confirming the reliability of such analysis when performed on short-term signals. Complexity parameters were extracted from ten-minute signal portions selected during wakefulness and different sleep stages on HRV signals obtained from eighteen obese patients and twenty controls. The obese group presented significantly reduced complexity during light and deep sleep, suggesting a deficiency in the control mechanisms integration during these sleep stages. To our knowledge, this study reports for the first time on how the HRV complexity changes in obesity during wakefulness and sleep. Further investigation is needed to quantify altered HRV impact on cardiovascular mortality in obesity.
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Affiliation(s)
- Ramona Cabiddu
- DEIB, Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, Milano, Italy
- * E-mail:
| | - Renata Trimer
- Cardiopulmonary Physiotherapy Laboratory, Federal University of São Carlos, São Carlos, São Paulo, Brazil
| | - Audrey Borghi-Silva
- Cardiopulmonary Physiotherapy Laboratory, Federal University of São Carlos, São Carlos, São Paulo, Brazil
| | - Matteo Migliorini
- DEIB, Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, Milano, Italy
| | - Renata G. Mendes
- Cardiopulmonary Physiotherapy Laboratory, Federal University of São Carlos, São Carlos, São Paulo, Brazil
| | | | | | - Anna M. Bianchi
- DEIB, Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, Milano, Italy
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Tobaldini E, Proserpio P, Sambusida K, Lanza A, Redaelli T, Frigerio P, Fratticci L, Rosa S, Casali KR, Somers VK, Nobili L, Montano N. Preserved cardiac autonomic dynamics during sleep in subjects with spinal cord injuries. Sleep Med 2015; 16:779-84. [PMID: 25953303 DOI: 10.1016/j.sleep.2014.12.023] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2014] [Revised: 12/11/2014] [Accepted: 12/17/2014] [Indexed: 10/23/2022]
Abstract
BACKGROUND Spinal cord injuries (SCI) are associated with altered cardiovascular autonomic control (CAC). Sleep is characterized by modifications of autonomic control across sleep stages; however, no data are available in SCI subjects on CAC during sleep. We aim to assess cardiac autonomic modulation during sleep in subjects with SCI. PATIENTS AND METHODS 27 participants with a neurological and radiological diagnosis of cervical (Cerv, n = 12, ie, tetraplegic) and thoracic SCI (Thor, n = 15, ie, paraplegic) and healthy subjects (Controls) were enrolled. Overnight polysomnographic (PSG) recordings were obtained in all participants. Electrocardiography and respiration were extracted from PSG, divided into sleep stages [wakefulness (W), non-REM sleep (NREM) and REM] for assessment of CAC, using symbolic analysis (SA) and corrected conditional entropy (CCE). SA identified indices of sympathetic and parasympathetic modulation and CCE evaluated the degree of complexity of the heart period time series. RESULTS SA revealed a reduction of sympathetic and predominant parasympathetic control during NREM compared to W and REM in SCI patients, independent of the level of the lesion, similar to the Controls. In all three groups, complexity of autonomic regulation was higher in NREM compared to W and REM. CONCLUSIONS In subjects with SCI, cardiac autonomic control changed across sleep stages, with a reduction of sympathetic and an increase of parasympathetic modulation during NREM compared to W and REM, and a parallel increase of complexity during NREM, which was similar to the Controls. Cardiac autonomic dynamics during sleep are maintained in SCI, independent of the level of the lesion.
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Affiliation(s)
- Eleonora Tobaldini
- Department of Internal Medicine, Ca' Granda IRCCS Foundation, Ospedale Maggiore Policlinico, Milan, Italy; Cardiovascular Neuroscience Laboratory, Department of Biomedical and Clinical Sciences 'L. Sacco', University of Milan, Milan, Italy; Division of Cardiovascular Diseases, Department of Internal Medicine, Mayo Clinic and Foundation, Rochester, MN, USA
| | - Paola Proserpio
- Department of Neuroscience, "Niguarda Ca' Granda" Hospital, Milan, Italy
| | - Katrina Sambusida
- Department of Neuroscience, "Niguarda Ca' Granda" Hospital, Milan, Italy
| | - Andrea Lanza
- Department of Neuroscience, "Niguarda Ca' Granda" Hospital, Milan, Italy
| | - Tiziana Redaelli
- Department of Neuroscience, "Niguarda Ca' Granda" Hospital, Milan, Italy
| | - Pamela Frigerio
- Department of Neuroscience, "Niguarda Ca' Granda" Hospital, Milan, Italy
| | - Lara Fratticci
- Department of Neuroscience, "Niguarda Ca' Granda" Hospital, Milan, Italy
| | - Silvia Rosa
- Neurology Unit, L. Sacco Hospital, Milan, Italy
| | - Karina R Casali
- Department of Science and Technology, Science and Technology Institute, Federal University of São Paulo, São José dos Campos, São Paulo, Brazil
| | - Virend K Somers
- Division of Cardiovascular Diseases, Department of Internal Medicine, Mayo Clinic and Foundation, Rochester, MN, USA
| | - Lino Nobili
- Department of Neuroscience, "Niguarda Ca' Granda" Hospital, Milan, Italy
| | - Nicola Montano
- Department of Internal Medicine, Ca' Granda IRCCS Foundation, Ospedale Maggiore Policlinico, Milan, Italy; Cardiovascular Neuroscience Laboratory, Department of Biomedical and Clinical Sciences 'L. Sacco', University of Milan, Milan, Italy.
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Effect of the Postural Challenge on the Dependence of the Cardiovascular Control Complexity on Age. ENTROPY 2014. [DOI: 10.3390/e16126686] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Chouchou F, Desseilles M. Heart rate variability: a tool to explore the sleeping brain? Front Neurosci 2014; 8:402. [PMID: 25565936 PMCID: PMC4263095 DOI: 10.3389/fnins.2014.00402] [Citation(s) in RCA: 90] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2014] [Accepted: 11/19/2014] [Indexed: 12/17/2022] Open
Abstract
Sleep is divided into two main sleep stages: (1) non-rapid eye movement sleep (non-REMS), characterized among others by reduced global brain activity; and (2) rapid eye movement sleep (REMS), characterized by global brain activity similar to that of wakefulness. Results of heart rate variability (HRV) analysis, which is widely used to explore autonomic modulation, have revealed higher parasympathetic tone during normal non-REMS and a shift toward sympathetic predominance during normal REMS. Moreover, HRV analysis combined with brain imaging has identified close connectivity between autonomic cardiac modulation and activity in brain areas such as the amygdala and insular cortex during REMS, but no connectivity between brain and cardiac activity during non-REMS. There is also some evidence for an association between HRV and dream intensity and emotionality. Following some technical considerations, this review addresses how brain activity during sleep contributes to changes in autonomic cardiac activity, organized into three parts: (1) the knowledge on autonomic cardiac control, (2) differences in brain and autonomic activity between non-REMS and REMS, and (3) the potential of HRV analysis to explore the sleeping brain, and the implications for psychiatric disorders.
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Affiliation(s)
- Florian Chouchou
- NeuroPain Unit, Lyon Neuroscience Research Centre, CRNL - INSERM U 1028/CNRS UMR 5292, University of Lyon France ; Department of Psychology, University of Namur Namur, Belgium
| | - Martin Desseilles
- Department of Psychology, University of Namur Namur, Belgium ; Cyclotron Research Centre, University of Liège Liège, Belgium
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Trimer R, Cabidu R, Sampaio LLM, Stirbulov R, Poiares D, Guizilini S, Bianchi AM, Costa FSM, Mendes RG, Delfino A, Arena R, Borghi-Silva A. Heart rate variability and cardiorespiratory coupling in obstructive sleep apnea: elderly compared with young. Sleep Med 2014; 15:1324-31. [PMID: 25216958 DOI: 10.1016/j.sleep.2014.05.028] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2014] [Revised: 05/08/2014] [Accepted: 05/16/2014] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Aging is known to be a major contributing factor to the increased risk of obstructive sleep apnea (OSA). With aging, breathing undergoes significant changes during sleep, increasing the prevalence of apnea events, which affects heart rate variability (HRV) and cardiorespiratory coupling (CRC). OBJECTIVES To compare HRV and CRC during wakefulness and sleep between young and elderly patients with and without OSA; and to determine whether the presence of OSA in young and elderly patients has a different impact on HRV and CRC during sleep. METHODS One hundred subjects, 50 young (mean age, 27 ± 9; 20 normal and 30 OSA) and 50 elderly (mean age, 65 ± 7; 20 normal and 30 OSA), underwent polysomnography. Spectral, cross-spectrum, and HRV parameters were analyzed during wakefulness and sleep. RESULTS The spectral analysis indicated that age affected HRV, with higher values of low frequency (P < 0.05) in elderly subjects during wakefulness and an interaction between the presence of OSA and age. OSA influenced HRV during sleep with lower LF/HF ratios during stage 2 (S2) and rapid eye movement (REM) sleep (P <0.05), with an interaction between the presence of OSA and age in REM sleep. Elderly patients had significantly lower percent tachogram power coherent with respiration (%TPCR) during wakefulness (P < 0.05), and OSA led to lower %TPCR during S2. CONCLUSIONS Age and OSA have an unfavorable impact on HRV, with reduced autonomic modulation during wakefulness, S2, and REM sleep. Age affects CRC during wakefulness and the presence of OSA affects CRC during sleep.
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Affiliation(s)
- R Trimer
- Cardiopulmonary Physiotherapy Laboratory, Physiotherapy Department, Federal University of São Carlos (UFSCar), Rodovia Washington Luís, São Carlos, Brazil.
| | - R Cabidu
- Politecnico di Milano, Division Dipartimento di Elettronica, Informazione e Bioingegneria, Milan, Italy
| | | | - R Stirbulov
- University at Santa Casa de Misericórdia of São Paulo, São Paulo, Brazil
| | - D Poiares
- Sleep Medicine and Biology Discipline, Psychobiology Department, Federal University of São Paulo, São Paulo, Brazil
| | - S Guizilini
- Department of Human Motion Sciences, Physical Therapy School, Federal University of São Paulo, São Paulo, Brazil
| | - A M Bianchi
- Politecnico di Milano, Division Dipartimento di Elettronica, Informazione e Bioingegneria, Milan, Italy
| | - F S M Costa
- Sleep Institute of São Carlos, São Carlos, Brazil
| | - R G Mendes
- Cardiopulmonary Physiotherapy Laboratory, Physiotherapy Department, Federal University of São Carlos (UFSCar), Rodovia Washington Luís, São Carlos, Brazil
| | - A Delfino
- Sleep Institute of São Carlos, São Carlos, Brazil
| | - R Arena
- Department of Physical Therapy and Integrative Physiology Laboratory, College of Applied Health Sciences, University of Illinois - Chicago, Chicago, IL, USA
| | - A Borghi-Silva
- Cardiopulmonary Physiotherapy Laboratory, Physiotherapy Department, Federal University of São Carlos (UFSCar), Rodovia Washington Luís, São Carlos, Brazil
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Role of cardiorespiratory synchronization and sleep physiology: effects on membrane potential in the restorative functions of sleep. Sleep Med 2014; 15:279-88. [DOI: 10.1016/j.sleep.2013.10.017] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2013] [Revised: 10/18/2013] [Accepted: 10/19/2013] [Indexed: 01/26/2023]
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Porta A, Faes L, Bari V, Marchi A, Bassani T, Nollo G, Perseguini NM, Milan J, Minatel V, Borghi-Silva A, Takahashi ACM, Catai AM. Effect of age on complexity and causality of the cardiovascular control: comparison between model-based and model-free approaches. PLoS One 2014; 9:e89463. [PMID: 24586796 PMCID: PMC3933610 DOI: 10.1371/journal.pone.0089463] [Citation(s) in RCA: 73] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2013] [Accepted: 01/20/2014] [Indexed: 12/19/2022] Open
Abstract
The proposed approach evaluates complexity of the cardiovascular control and causality among cardiovascular regulatory mechanisms from spontaneous variability of heart period (HP), systolic arterial pressure (SAP) and respiration (RESP). It relies on construction of a multivariate embedding space, optimization of the embedding dimension and a procedure allowing the selection of the components most suitable to form the multivariate embedding space. Moreover, it allows the comparison between linear model-based (MB) and nonlinear model-free (MF) techniques and between MF approaches exploiting local predictability (LP) and conditional entropy (CE). The framework was applied to study age-related modifications of complexity and causality in healthy humans in supine resting (REST) and during standing (STAND). We found that: 1) MF approaches are more efficient than the MB method when nonlinear components are present, while the reverse situation holds in presence of high dimensional embedding spaces; 2) the CE method is the least powerful in detecting age-related trends; 3) the association of HP complexity on age suggests an impairment of cardiac regulation and response to STAND; 4) the relation of SAP complexity on age indicates a gradual increase of sympathetic activity and a reduced responsiveness of vasomotor control to STAND; 5) the association from SAP to HP on age during STAND reveals a progressive inefficiency of baroreflex; 6) the reduced connection from HP to SAP with age might be linked to the progressive exploitation of Frank-Starling mechanism at REST and to the progressive increase of peripheral resistances during STAND; 7) at REST the diminished association from RESP to HP with age suggests a vagal withdrawal and a gradual uncoupling between respiratory activity and heart; 8) the weakened connection from RESP to SAP with age might be related to the progressive increase of left ventricular thickness and vascular stiffness and to the gradual decrease of respiratory sinus arrhythmia.
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Affiliation(s)
- Alberto Porta
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
- Galeazzi Orthopedic Institute, Milan, Italy
- * E-mail:
| | - Luca Faes
- Department of Physics and BIOtech, University of Trento, Trento, Italy
| | - Vlasta Bari
- Gruppo Ospedaliero San Donato Foundation, Milan, Italy
- Department of Electronics Information and Bioengineering, Politecnico di Milano, Milan, Italy
| | - Andrea Marchi
- Department of Electronics Information and Bioengineering, Politecnico di Milano, Milan, Italy
- Department of Anesthesia and Intensive Care, Humanitas Clinical and Research Center, Rozzano, Italy
| | - Tito Bassani
- Humanitas Clinical and Research Center, Rozzano, Italy
| | - Giandomenico Nollo
- BIOtech, Department of Industrial Engineering, University of Trento, Trento, Italy
- IRCS PAT-FBK, Trento, Italy
| | - Natália Maria Perseguini
- Department of Physiotherapy, Federal University of São Carlos, São Carlos, São Paulo State, Brazil
| | - Juliana Milan
- Department of Physiotherapy, Federal University of São Carlos, São Carlos, São Paulo State, Brazil
| | - Vinícius Minatel
- Department of Physiotherapy, Federal University of São Carlos, São Carlos, São Paulo State, Brazil
| | - Audrey Borghi-Silva
- Department of Physiotherapy, Federal University of São Carlos, São Carlos, São Paulo State, Brazil
| | - Anielle C. M. Takahashi
- Department of Physiotherapy, Federal University of São Carlos, São Carlos, São Paulo State, Brazil
| | - Aparecida M. Catai
- Department of Physiotherapy, Federal University of São Carlos, São Carlos, São Paulo State, Brazil
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Faes L, Porta A. Conditional Entropy-Based Evaluation of Information Dynamics in Physiological Systems. UNDERSTANDING COMPLEX SYSTEMS 2014. [DOI: 10.1007/978-3-642-54474-3_3] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Schulz S, Ritter J, Oertel K, Witt K, Bär KJ, Guntinas-Lichius O, Voss A. Quantification of autonomic regulation in patients with sudden sensorineural hearing loss. Auton Neurosci 2013; 178:9-14. [DOI: 10.1016/j.autneu.2013.02.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2012] [Revised: 12/17/2012] [Accepted: 02/04/2013] [Indexed: 11/29/2022]
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Tobaldini E, Nobili L, Strada S, Casali KR, Braghiroli A, Montano N. Heart rate variability in normal and pathological sleep. Front Physiol 2013; 4:294. [PMID: 24137133 PMCID: PMC3797399 DOI: 10.3389/fphys.2013.00294] [Citation(s) in RCA: 176] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2013] [Accepted: 09/26/2013] [Indexed: 01/15/2023] Open
Abstract
Sleep is a physiological process involving different biological systems, from molecular to organ level; its integrity is essential for maintaining health and homeostasis in human beings. Although in the past sleep has been considered a state of quiet, experimental and clinical evidences suggest a noteworthy activation of different biological systems during sleep. A key role is played by the autonomic nervous system (ANS), whose modulation regulates cardiovascular functions during sleep onset and different sleep stages. Therefore, an interest on the evaluation of autonomic cardiovascular control in health and disease is growing by means of linear and non-linear heart rate variability (HRV) analyses. The application of classical tools for ANS analysis, such as HRV during physiological sleep, showed that the rapid eye movement (REM) stage is characterized by a likely sympathetic predominance associated with a vagal withdrawal, while the opposite trend is observed during non-REM sleep. More recently, the use of non-linear tools, such as entropy-derived indices, have provided new insight on the cardiac autonomic regulation, revealing for instance changes in the cardiovascular complexity during REM sleep, supporting the hypothesis of a reduced capability of the cardiovascular system to deal with stress challenges. Interestingly, different HRV tools have been applied to characterize autonomic cardiac control in different pathological conditions, from neurological sleep disorders to sleep disordered breathing (SDB). In summary, linear and non-linear analysis of HRV are reliable approaches to assess changes of autonomic cardiac modulation during sleep both in health and diseases. The use of these tools could provide important information of clinical and prognostic relevance.
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Affiliation(s)
- Eleonora Tobaldini
- Division of Medicine and Pathophysiology, Department of Biomedical and Clinical Sciences "L. Sacco," L. Sacco Hospital, University of Milan Milan, Italy
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Tobaldini E, Brugada J, Benito B, Molina I, Montserrat J, Kara T, Leinveber P, Porta A, Macedo PG, Montano N, Somers VK. Cardiac autonomic control in Brugada syndrome patients during sleep: the effects of sleep disordered breathing. Int J Cardiol 2013; 168:3267-72. [PMID: 23669108 PMCID: PMC3851035 DOI: 10.1016/j.ijcard.2013.04.137] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2012] [Revised: 12/28/2012] [Accepted: 04/06/2013] [Indexed: 01/08/2023]
Abstract
AIMS Brugada syndrome is characterized by typical ECG features, ventricular arrhythmias and sudden cardiac death (SCD), more frequent during nighttime. Autonomic cardiovascular control has been implicated in triggering the ventricular arrhythmias. Sleep-disordered breathing (SDB) elicits marked autonomic changes during sleep and is also associated with an increased risk of nighttime SCD. Brugada patients may have a higher likelihood of SDB compared to controls. However, no data are available on cardiac autonomic control in Brugada patients, particularly with regard to the comorbidity of SDB. METHODS We evaluated autonomic cardiovascular control in Brugada patients with SDB (BRU-SDB, n=9), without SDB (BRU, n=9), in controls (CON, n=8) and in non-Brugada patients with SDB (n=6), during wakefulness and sleep (N2, N3 and REM). Linear spectral and entropy-derived measures of heart rate variability (HRV) were performed during apnea-free stable breathing epochs. RESULTS Total HRV was attenuated in BRU-SDB compared to CON and BRU. During N2 and REM, in BRU-SDB patients sympathetic modulation decreased compared to BRU and CON, while during REM, they showed an increased parasympathetic modulation, compared to the other two groups. BRU-SDB and SDB were similar in terms of spectral components. Entropy-derived indices showed preserved dynamic changes in Brugada patients compared to controls through the different sleep stages. CONCLUSION Brugada syndrome per se does not appear associated with an altered autonomic cardiovascular control during wakefulness and sleep. The comorbidity with SDB may contribute to disrupted autonomic cardiovascular regulation during sleep, possibly predisposing to the increased likelihood of sleep-related ventricular tachyarrhythmias and SCD.
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Affiliation(s)
- Eleonora Tobaldini
- Department of Biomedical and Clinical Sciences, Internal Medicine II, L. Sacco Hospital, University of Milan, Italy
| | - Josep Brugada
- Cardiology Department, Thorax Institute, Hospital Clínic, Barcelona, Spain
| | - Begona Benito
- Cardiology Department, Thorax Institute, Hospital Clínic, Barcelona, Spain
| | - Irma Molina
- Cardiology Department, Thorax Institute, Hospital Clínic, Barcelona, Spain
| | - Josep Montserrat
- Pneumology Department, Hospital Clínic, IDIBAPS. Barcelona, CIBERES
| | - Tomas Kara
- Department of Cardiovascular Diseases, Department of Internal Medicine, Mayo Clinic and Foundation, Rochester, MN and St. Anne’s hospital, ICRC-Department of Cardiovascular Diseases, St. Anne’s University Hospital Brno, Czech Republic
| | - Pavel Leinveber
- International Clinical Research Center - Center of Biomedical Engineering, St. Anne’s University Hospital Brno, Brno, Czech Republic
| | - Alberto Porta
- Department of Biomedical Sciences for Health, Galeazzi Orthopedic Institute, University of Milan, Milan, Italy
| | - Paula G. Macedo
- Department of Cardiology, Hospital de Base do Distrito Federal, Brasília, Brazil and Division of Cardiovascular Diseases, Department of Internal Medicine, Mayo Clinic and Foundation, Rochester, MN
| | - Nicola Montano
- Department of Biomedical and Clinical Sciences, Internal Medicine II, L. Sacco Hospital, University of Milan, Italy
| | - Virend K Somers
- Division of Cardiovascular Diseases, Department of Internal Medicine, Mayo Clinic and Foundation, Rochester, MN
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Cabiddu R, Aletti F, Duarte Souza V, Peres Costa I, Stirbulov R, Borghi Silva A, Bianchi AM, de Oliveira LVF, Cerutti S, Malosa Sampaio L. Cardiorespiratory coupling during sleep in difficult-to-control asthmatic patients. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2013; 2012:3652-5. [PMID: 23366719 DOI: 10.1109/embc.2012.6346758] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Heart rate variability (HRV) and respiration recorded during sleep from 8 patients suffering from difficult-to-control asthma were studied to investigate autonomic nervous system control of cardiac and respiratory activities, and of cardio-respiratory coupling during different sleep stages.
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Affiliation(s)
- Ramona Cabiddu
- Dipartimento di Ingegneria Biomedica, Politecnico di Milano, Piazza Leonardo da Vinci, 32, 20133, Milano, Italy
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Mendes RG, Simões RP, Costa FDSM, Pantoni CBF, Di Thommazo-Luporini L, Luzzi S, Amaral-Neto O, Arena R, Catai AM, Borghi-Silva A. Is applying the same exercise-based inpatient program to normal and reduced left ventricular function patients the best strategy after coronary surgery? A focus on autonomic cardiac response. Disabil Rehabil 2013; 36:155-62. [PMID: 23651129 DOI: 10.3109/09638288.2013.782362] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE To assess whether the same exercise-based inpatient program applied to patients with normal and reduced left ventricular function (LVF) evokes a similar cardiac autonomic response after coronary artery bypass graft (CABG). METHOD Forty-four patients post-CABG, subgrouped according to normal LVF [LVFN: n = 23; left ventricular ejection fraction (LVEF) ≥ 55%] and reduced LVF (LVFR: n = 21; LVEF 35-54%), were included. All initiated the exercise protocol on post-operative day 1 (PO1), following a whole progressive program until discharge. Cardiac autonomic response was assessed by the indices of heart rate variability (HRV) at rest and during exercise (extremity range of motion and ambulation). RESULTS During ambulation, lower values of HRV indices were found in the LVFR group compared with the LVFN group [standard deviation of all RR (STDRR; 6.1 ± 2.7 versus 8.9 ± 4.7 ms), baseline width of the RR histogram (TINN; 30.6 ± 14.8 versus 45.8 ± 24.9 ms), SD2 (14.8 ± 8.0 versus 21.3 ± 9.0 ms), Shannon entropy (3.6 ± 0.5 versus 3.9 ± 0.4) and correlation dimension (0.08 ± 0.2 versus 0.2 ± 0.2)]. Also, when comparing the ambulation to rest change, lower values were observed in the LVFR group for linear (STDRR, TINN, RR TRI, rMSSD) and non-linear (SD2 and correlation dimension) HRV indices (p < 0.05). On PO1, we observed only intra-group differences between rest and exercise (extremity range of motion), for mean intervals between heart beats and heart rate. CONCLUSION For patients with LVFN, the same inpatient exercise protocol triggered a more attenuated autonomic response compared with patients with LVFR. These findings have implications as to how exercise should be prescribed according to LVF in the early stages following recovery from CABG. Implications for Rehabilitation Exercise-based inpatient program, performed by post-CABG patients who have normal left ventricular function, triggered a more attenuated cardiac autonomic response compared with patients with reduced left ventricular function. Volume of the inpatient exercises should be prescribed according to the left ventricular function in the early stages following recovery from CABG.
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Affiliation(s)
- Renata Gonçalves Mendes
- Cardiopulmonary Physiotherapy Laboratory, Nucleus of Research in Physical Exercise, Federal University of Sao Carlos , Sao Paulo , Brazil
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Machado-Ferrer Y, Estévez M, Machado C, Hernández-Cruz A, Carrick FR, Leisman G, Melillo R, DeFina P, Chinchilla M, Machado Y. Heart rate variability for assessing comatose patients with different Glasgow Coma Scale scores. Clin Neurophysiol 2013; 124:589-97. [DOI: 10.1016/j.clinph.2012.09.008] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2012] [Revised: 08/11/2012] [Accepted: 09/03/2012] [Indexed: 11/30/2022]
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Porta A, Castiglioni P, Rienzo MD, Bari V, Bassani T, Marchi A, Takahashi ACM, Tobaldini E, Montano N, Catai AM, Barbic F, Furlan R, Cividjian A, Quintin L. Short-term complexity indexes of heart period and systolic arterial pressure variabilities provide complementary information. J Appl Physiol (1985) 2012; 113:1810-20. [DOI: 10.1152/japplphysiol.00755.2012] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
It is unclear whether the complexity of the variability of the systolic arterial pressure (SAP) provides complementary information to that of the heart period (HP). The complexity of HP and SAP variabilities was assessed from short beat-to-beat recordings (i.e., 256 cardiac beats). The evaluation was made during a pharmacological protocol that induced vagal blockade with atropine or a sympathetic blockade (beta-adrenergic blockade with propranolol or central sympathetic blockade with clonidine) alone or in combination, during a graded head-up tilt, and in patients with Parkinson's disease (PD) without orthostatic hypotension undergoing orthostatic challenge. Complexity was quantified according to the mean square prediction error (MSPE) derived from univariate autoregressive (AR) and multivariate AR (MAR) models. We found that: 1) MSPEMAR did not provide additional information to that of MSPEAR; 2) SAP variability was less complex than that of HP; 3) because HP complexity was reduced by either vagal blockade or vagal withdrawal induced by head-up tilt and was unaffected by beta-adrenergic blockade, HP was under vagal control; 4) because SAP complexity was increased by central sympathetic blockade and was unmodified by either vagal blockade or vagal withdrawal induced by head-up tilt, SAP was under sympathetic control; 5) SAP complexity was increased in patients with PD; and 6) during orthostatic challenge, the complexity of both HP and SAP variabilities in patients with PD remained high, thus indicating both vagal and sympathetic impairments. Complexity indexes derived from short HP and SAP beat-to-beat series provide complementary information and are helpful in detecting early autonomic dysfunction in patients with PD well before circulatory symptoms become noticeable.
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Affiliation(s)
- A. Porta
- Department of Biomedical Sciences for Health, Galeazzi Orthopedic Institute, University of Milan, Milan, Italy
| | | | | | - V. Bari
- Gruppo Ospedaliero San Donato Foundation, Milan, Italy
- Department of Bioengineering, Politecnico di Milano, Milan, Italy
| | - T. Bassani
- Department of Biomedical Sciences for Health, Galeazzi Orthopedic Institute, University of Milan, Milan, Italy
| | - A. Marchi
- Department of Emergency, L. Sacco Hospital, Milan, Italy
| | - A. C. M. Takahashi
- Department of Physiotherapy, Federal University of São Carlos, São Carlos, Brazil
| | - E. Tobaldini
- Department of Biomedical and Clinical Sciences, Internal Medicine II, L. Sacco Hospital, University of Milan, Milan, Italy
| | - N. Montano
- Department of Biomedical and Clinical Sciences, Internal Medicine II, L. Sacco Hospital, University of Milan, Milan, Italy
| | - A. M. Catai
- Department of Physiotherapy, Federal University of São Carlos, São Carlos, Brazil
| | - F. Barbic
- Medical Clinics, Istituto Clinico Humanitas, Rozzano, Milan, Italy
| | - R. Furlan
- Department of Medical Biotechnologies and Translation Medicine, Medical Clinics, Istituto Clinico Humanitas, University of Milan, Rozzano, Milan, Italy; and
| | - A. Cividjian
- Physiology (EA 4612: Neurocardiology), University of Lyon, Lyon, France
| | - L. Quintin
- Physiology (EA 4612: Neurocardiology), University of Lyon, Lyon, France
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Beuchée A, Hernández AI, Duvareille C, Daniel D, Samson N, Pladys P, Praud JP. Influence of hypoxia and hypercapnia on sleep state-dependent heart rate variability behavior in newborn lambs. Sleep 2012; 35:1541-9. [PMID: 23115403 DOI: 10.5665/sleep.2206] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
STUDY OBJECTIVES Although hypercapnia and/or hypoxia are frequently present during chronic lung disease of infancy and have also been implicated in sudden infant death syndrome (SIDS), their effect on cardiac autonomic regulation remains unclear. The authors' goal is to test that hypercapnia and hypoxia alter sleep-wake cycle-dependent heart rate variability (HRV) in the neonatal period. DESIGN Experimental study measuring HRV during sleep states in lambs randomly exposed to hypercapnia, hypoxia, or air. SETTING University center for perinatal research in ovines (Sherbrooke, Canada). INSERM-university research unit for signal processing (Rennes, France). PARTICIPANTS Six nonsedated, full-term lambs. INTERVENTIONS Each lamb underwent polysomnographic recordings while in a chamber flowed with either air or 21% O(2) + 5% CO(2) (hypercapnia) or 10% O(2) + 0% CO(2) (hypoxia) on day 3, 4, and 5 of postnatal age. MEASUREMENTS AND RESULTS Hypercapnia increased the time spent in wakefulness and hypoxia the time spent in quiet sleep (QS). The state of alertness was the major determinant of HRV characterized with linear or nonlinear methods. Compared with QS, active sleep (AS) was associated with an overall increase in HRV magnitude and short-term self-similarity and a decrease in entropy of cardiac cycle length in air. This AS-related HRV pattern persisted in hypercapnia and was even more pronounced in hypoxia. CONCLUSION Enhancement of AS-related sympathovagal coactivation in hypoxia, together with increased heart rate regularity, may be evidence that AS + hypoxia represent a particularly vulnerable state in early life. This should be kept in mind when deciding the optimal arterial oxygenation target in newborns and when investigating the potential involvement of hypoxia in SIDS pathogenesis.
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Cabiddu R, Cerutti S, Viardot G, Werner S, Bianchi AM. Modulation of the Sympatho-Vagal Balance during Sleep: Frequency Domain Study of Heart Rate Variability and Respiration. Front Physiol 2012; 3:45. [PMID: 22416233 PMCID: PMC3299415 DOI: 10.3389/fphys.2012.00045] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2011] [Accepted: 02/20/2012] [Indexed: 11/13/2022] Open
Abstract
Sleep is a complex state characterized by important changes in the autonomic modulation of the cardiovascular activity. Heart rate variability (HRV) greatly changes during different sleep stages, showing a predominant parasympathetic drive to the heart during non-rapid eye movement (NREM) sleep and an increased sympathetic activity during rapid eye movement (REM) sleep. Respiration undergoes important modifications as well, becoming deeper and more regular with deep sleep and shallower and more frequent during REM sleep. The aim of the present study is to assess both autonomic cardiac regulation and cardiopulmonary coupling variations during different sleep stages in healthy subjects, using spectral and cross-spectral analysis of the HRV and respiration signals. Polysomnographic sleep recordings were performed in 11 healthy women and the HRV signal and the respiration signal were obtained. The spectral and cross-spectral parameters of the HRV signal and of the respiration signal were computed at low frequency and at breathing frequency (high frequency, HF) during different sleep stages. Results attested a sympatho-vagal balance shift toward parasympathetic modulation during NREM sleep and toward sympathetic modulation during REM sleep. Spectral analysis of the HRV signal and of the respiration signal indicated a higher respiration regularity during deep sleep, and a higher parasympathetic drive was also confirmed by an increase in the coherence between the HRV and the respiration signal in the HF band during NREM sleep. Our findings about sleep stage-dependent variations in the HRV signal and in the respiratory activity are in line with previous evidences and confirm spectral analysis of the HRV and the respiration signal to be a suitable tool for investigating cardiac autonomic modulation and cardio-respiratory coupling during sleep.
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Affiliation(s)
- Ramona Cabiddu
- Department of Biomedical Engineering, Politecnico di Milano Milano, Italy
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