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Farhat K, Po SS, Stavrakis S. Non-invasive Neuromodulation of Arrhythmias. Card Electrophysiol Clin 2024; 16:307-314. [PMID: 39084723 PMCID: PMC11292161 DOI: 10.1016/j.ccep.2023.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/02/2024]
Abstract
The autonomic nervous system plays a central role in the pathogenesis of arrhythmias. Preclinical and clinical studies have demonstrated the therapeutic effect of neuromodulation at multiple anatomic targets across the neurocardiac axis for the treatment of arrhythmias. In this review, we discuss the rationale and clinical application of noninvasive neuromodulation techniques in treating arrhythmias and explore associated barriers and future directions, including optimization of stimulation parameters and patient selection.
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Affiliation(s)
| | - Sunny S Po
- University of Oklahoma Health Sciences Center
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Cao LL, Liu HR, Ji YJ, Zhang YT, Wang BQ, Xue XH, Wang P, Luo ZH, Wu HG. Research Progress of Vagal Nerve Regulation Mechanism in Acupuncture Treatment of Atrial Fibrillation. Chin J Integr Med 2024:10.1007/s11655-024-3660-5. [PMID: 38990478 DOI: 10.1007/s11655-024-3660-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/08/2023] [Indexed: 07/12/2024]
Abstract
Atrial fibrillation (AF) is the most common arrhythmia in clinical practice. It has a high prevalence and poor prognosis. The application of antiarrhythmic drugs and even surgery cannot completely treat the disease, and there are many sequelae. AF can be classified into the category of "palpitation" in Chinese medicine according to its symptoms. Acupuncture has a significant effect on AF. The authors find that an important mechanism of acupuncture in AF treatment is to regulate the cardiac vagus nerve. Therefore, this article intends to review the distribution and function of vagus nerve in the heart, the application and the regulatroy effect for the treatment of AF.
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Affiliation(s)
- Lu-Lu Cao
- Immunology Laboratory, Shanghai Research Institute of Acupuncture and Meridian, Shanghai, 200232, China
| | - Hui-Rong Liu
- Immunology Laboratory, Shanghai Research Institute of Acupuncture and Meridian, Shanghai, 200232, China
| | - Ya-Jie Ji
- Breast Disease Department, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, 200437, China
| | - Yin-Tao Zhang
- Graduate College, Tianjin University of Traditional Chinese Medicine, Tianjin, 301617, China
| | - Bing-Quan Wang
- Department of Acupuncture and Moxibusion Tuina Traumatology, Shanghai Sixth People's Hospital, Shanghai, 200233, China
| | - Xiao-Hong Xue
- Breast Disease Department, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, 200437, China
| | - Pei Wang
- Graduate College, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China
| | - Zhi-Hui Luo
- Graduate College, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China
| | - Huan-Gan Wu
- Immunology Laboratory, Shanghai Research Institute of Acupuncture and Meridian, Shanghai, 200232, China.
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Kang D, Choi Y, Lee J, Park E, Kim IY. Analysis of taVNS effects on autonomic and central nervous systems in healthy young adults based on HRV, EEG parameters. J Neural Eng 2024; 21:046012. [PMID: 38941990 DOI: 10.1088/1741-2552/ad5d16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 06/28/2024] [Indexed: 06/30/2024]
Abstract
Objective.Transcutaneous auricular vagus nerve stimulation (taVNS), a non-invasive method of stimulating the vagus nerve, simultaneously affects the autonomic nervous system (ANS) and central nervous system (CNS) through efferent and afferent pathways. The purpose of this study is to analyze the effect of taVNS on the ANS and CNS through heart rate variability (HRV) and electroencephalography (EEG) parameters of identified responders.Approach.Two sets of data were collected from each of 10 healthy adult male subjects in their 20 s, and five HRV parameters from the time domain (RMSSD, pNN50, pNN30, pNN20, ppNNx) and two EEG parameters (power of alpha band, power of delta band) were extracted.Main results.Based on pNN50, responders to taVNS were identified; among them, pNN50 (p= 0.0041) and ppNNx (p= 0.0037) showed significant differences before and after taVNS. At the same time, for alpha power and delta power of EEG, significant difference (p< 0.05) was observed in most channels after taVNS compared to before stimulation.Significance.This study demonstrated the validity of identifying responders using pNN50 and the influence of taVNS on both the ANS and CNS. We conclude that taVNS can be used to treat a variety of diseases and as a tool to help control the ANS and CNS.
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Affiliation(s)
- Donghun Kang
- Department of Biomedical Engineering, Hanyang University, Seoul, Republic of Korea
| | - Youngseok Choi
- Department of Electronic Engineering, Hanyang University, Seoul, Republic of Korea
| | - Jongshill Lee
- Department of Biomedical Engineering, Hanyang University, Seoul, Republic of Korea
| | - Eunkyoung Park
- Department of Biomedical Engineering, Soonchunhyang University, Asan, Republic of Korea
| | - In Young Kim
- Department of Biomedical Engineering, Hanyang University, Seoul, Republic of Korea
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Zhou H, Xiong T, Dai Z, Zou H, Wang X, Tang H, Huang Y, Sun H, You W, Yao Z, Lu Q. Brain-heart interaction disruption in major depressive disorder: disturbed rhythm modulation of the cardiac cycle on brain transient theta bursts. Eur Arch Psychiatry Clin Neurosci 2024; 274:595-607. [PMID: 37318589 DOI: 10.1007/s00406-023-01628-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 05/22/2023] [Indexed: 06/16/2023]
Abstract
Brain neurons support arousal and cognitive activity in the form of spectral transient bursts and cooperate with the peripheral nervous system to adapt to the surrounding environment. However, the temporal dynamics of brain-heart interactions have not been confirmed, and the mechanism of brain-heart interactions in major depressive disorder (MDD) remains unclear. This study aimed to provide direct evidence for brain-heart synchronization in temporal dynamics and clarify the mechanism of brain-heart interaction disruption in MDD. Eight-minute resting-state (closed eyes) electroencephalograph and electrocardiogram signals were acquired simultaneously. The Jaccard index (JI) was used to measure the temporal synchronization between cortical theta transient bursts and cardiac cycle activity (diastole and systole) in 90 MDD patients and 44 healthy controls (HCs) at rest. The deviation JI was used to reflect the equilibrium of brain activity between diastole and systole. The results showed that the diastole JI was higher than the systole JI in both the HC and MDD groups; compared to HCs, the deviation JI attenuated at F4, F6, FC2, and FC4 in the MDD patients. The eccentric deviation JI was negatively correlated with the despair factor scores of the HAMD, and after 4 weeks of antidepressant treatment, the eccentric deviation JI was positively correlated with the despair factor scores of the HAMD. It was concluded that brain-heart synchronization existed in the theta band in healthy individuals and that disturbed rhythm modulation of the cardiac cycle on brain transient theta bursts at right frontoparietal sites led to brain-heart interaction disruption in MDD.
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Affiliation(s)
- Hongliang Zhou
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, 210029, People's Republic of China
| | - Tingting Xiong
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, 210029, People's Republic of China
| | - Zhongpeng Dai
- School of Biological Sciences and Medical Engineering, Southeast University, Nanjing, 210096, People's Republic of China
| | - Haowen Zou
- Nanjing Brain Hospital, Medical School of Nanjing University, Nanjing, 210093, People's Republic of China
| | - Xvmiao Wang
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, 210029, People's Republic of China
| | - Hao Tang
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, 210029, People's Republic of China
| | - Yinghong Huang
- Nanjing Brain Hospital, Medical School of Nanjing University, Nanjing, 210093, People's Republic of China
| | - Hao Sun
- Nanjing Brain Hospital, Medical School of Nanjing University, Nanjing, 210093, People's Republic of China
| | - Wei You
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, 210029, People's Republic of China
| | - Zhijian Yao
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, 210029, People's Republic of China.
- Nanjing Brain Hospital, Medical School of Nanjing University, Nanjing, 210093, People's Republic of China.
| | - Qing Lu
- School of Biological Sciences and Medical Engineering, Southeast University, Nanjing, 210096, People's Republic of China.
- Child Development and Learning Science, Key Laboratory of Ministry of Education, Nanjing, People's Republic of China.
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Konakoğlu G, Özden AV, Solmaz H, Bildik C. The effect of auricular vagus nerve stimulation on electroencephalography and electromyography measurements in healthy persons. Front Physiol 2023; 14:1215757. [PMID: 37528897 PMCID: PMC10390310 DOI: 10.3389/fphys.2023.1215757] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 07/04/2023] [Indexed: 08/03/2023] Open
Abstract
Objectives: Auricular vagus nerve stimulation (VNS) is a non-invasive treatment modality. Opinions that it can be used in the treatment of various clinical problems have gained importance in recent years. In this study, it was aimed to lay the groundwork for the use of the auricular VNS in different ears. Methods: Healthy individuals (n = 90) were divided into three groups: unilateral left (n = 30), unilateral right (n = 30), and bilateral (n = 30) auricular VNS. Electroencephalography (EEG) and electromyography (EMG) measurements were performed before and after auricular VNS (10 Hz, 300 µs, 20 min) for a single session. Results: An increase in wrist extensor muscles activation was detected on the contralateral side of the auricular VNS application side. It has been observed that there is a general decrease in the power of high-frequency waves and an increase in the power of lower-medium frequency waves in various parts of the brain. Conclusion: Our findings suggest that the projection of the auricular VNS in the central nervous system may also affect the corticospinal tracts.
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Affiliation(s)
- Gülşah Konakoğlu
- Faculty of Health Sciences, Istanbul Gelisim University, Istanbul, Türkiye
| | - Ali Veysel Özden
- Faculty of Health Sciences, Bahçeşehir University, Istanbul, Türkiye
| | - Hakan Solmaz
- Faculty of Engineering and Natural Sciences Biomedical Engineering Department, Bahçeşehir University, Istanbul, Türkiye
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Lehnertz H, Broehl T, Rings T, von Wrede R, Lehnertz K. Modifying functional brain networks in focal epilepsy by manual visceral-osteopathic stimulation of the vagus nerve at the abdomen. FRONTIERS IN NETWORK PHYSIOLOGY 2023; 3:1205476. [PMID: 37520657 PMCID: PMC10374317 DOI: 10.3389/fnetp.2023.1205476] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 07/04/2023] [Indexed: 08/01/2023]
Abstract
Non-invasive transcutaneous vagus nerve stimulation elicits similar therapeutic effects as invasive vagus nerve stimulation, offering a potential treatment alternative for a wide range of diseases, including epilepsy. Here, we present a novel, non-invasive stimulation of the vagus nerve, which is performed manually viscero-osteopathically on the abdomen (voVNS). We explore the impact of short-term voVNS on various local and global characteristics of EEG-derived, large-scale evolving functional brain networks from a group of 20 subjects with and without epilepsy. We observe differential voVNS-mediated alterations of these characteristics that can be interpreted as a reconfiguration and modification of networks and their stability and robustness properties. Clearly, future studies are necessary to assess the impact of such a non-pharmaceutical intervention on clinical decision-making in the treatment of epilepsy. However, our findings may add to the current discussion on the importance of the gut-brain axis in health and disease. Clinical Trial Registration: https://drks.de/search/en/trial/DRKS00029914, identifier DRKS00029914.
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Affiliation(s)
- Hendrik Lehnertz
- BMT Internationale Akademie für Biodynamische Manuelle Therapie GmbH, Bühler, Switzerland
| | - Timo Broehl
- Department of Epileptology, University of Bonn Medical Centre, Bonn, Germany
- Helmholtz Institute for Radiation and Nuclear Physics, University of Bonn, Bonn, Germany
| | - Thorsten Rings
- Department of Epileptology, University of Bonn Medical Centre, Bonn, Germany
- Helmholtz Institute for Radiation and Nuclear Physics, University of Bonn, Bonn, Germany
| | - Randi von Wrede
- Department of Epileptology, University of Bonn Medical Centre, Bonn, Germany
| | - Klaus Lehnertz
- Department of Epileptology, University of Bonn Medical Centre, Bonn, Germany
- Helmholtz Institute for Radiation and Nuclear Physics, University of Bonn, Bonn, Germany
- Interdisciplinary Center for Complex Systems, University of Bonn, Bonn, Germany
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De Smet S, Ottaviani C, Verkuil B, Kappen M, Baeken C, Vanderhasselt MA. Effects of non-invasive vagus nerve stimulation on cognitive and autonomic correlates of perseverative cognition. Psychophysiology 2023; 60:e14250. [PMID: 36683127 DOI: 10.1111/psyp.14250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 01/03/2023] [Accepted: 01/03/2023] [Indexed: 01/24/2023]
Abstract
Perseverative cognitions can provoke psychophysiological stress in the absence of an actual stressor and are considered important transdiagnostic vulnerability factors for several (mental) health issues. These stress-related cognitive processes are reflected by both cognitive (assessed by self-reports) and autonomic inflexibility (assessed by heart rate variability; HRV), with a key role attributed to the vagus nerve. Interestingly, modulation of the afferent branches of the vagus can be achieved with transcutaneous auricular vagus nerve stimulation (taVNS), a non-invasive technique that employs a low-intensity electrical current applied to the ear. In a sample of healthy individuals, we investigated the effects of taVNS of the left concha, compared to sham (earlobe) stimulation, on the cognitive and autonomic correlates of perseverative cognition following a psychosocial stress task. Interestingly, taVNS significantly reduced cognitive rigidity, reflected by reduced subjective perseverative thinking after psychosocial stress. Although there were no direct effects on autonomic correlates of perseverative cognition, individual differences in perseverative thinking after the stressor significantly affected the effects of taVNS on HRV. Specifically, more autonomic inflexibility during the stress task (i.e., reduced HRV) was associated with increases in perseverative thinking afterward for the sham condition, but not the active taVNS condition. Additional exploratory analyses revealed no significant moderation of stimulation intensity. Overall, the study findings endorse the association between perseverative cognitions and vagus nerve functioning.
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Affiliation(s)
- Stefanie De Smet
- Department of Head and Skin, Psychiatry and Medical Psychology, Ghent University Hospital, Ghent University, Ghent, Belgium.,Ghent Experimental Psychiatry (GHEP) Lab, Ghent, Belgium
| | - Cristina Ottaviani
- Department of Psychology, Sapienza University of Rome, Rome, Italy.,IRCCS Santa Lucia Foundation, Rome, Italy
| | - Bart Verkuil
- Department of Clinical Psychology, Leiden University, Leiden, the Netherlands.,Leiden Institute for Brain and Cognition (LIBC), Leiden, the Netherlands
| | - Mitchel Kappen
- Department of Head and Skin, Psychiatry and Medical Psychology, Ghent University Hospital, Ghent University, Ghent, Belgium.,Ghent Experimental Psychiatry (GHEP) Lab, Ghent, Belgium
| | - Chris Baeken
- Department of Head and Skin, Psychiatry and Medical Psychology, Ghent University Hospital, Ghent University, Ghent, Belgium.,Ghent Experimental Psychiatry (GHEP) Lab, Ghent, Belgium.,Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium.,Department of Psychiatry, Brussels University Hospital, Brussels, Belgium.,Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands
| | - Marie-Anne Vanderhasselt
- Department of Head and Skin, Psychiatry and Medical Psychology, Ghent University Hospital, Ghent University, Ghent, Belgium.,Ghent Experimental Psychiatry (GHEP) Lab, Ghent, Belgium.,Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
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Jang SH, Cho MJ. Transcutaneous auricular vagus nerve stimulation in disorders of consciousness: A mini-narrative review. Medicine (Baltimore) 2022; 101:e31808. [PMID: 36550876 PMCID: PMC9771208 DOI: 10.1097/md.0000000000031808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
In this mini review, 6 studies that investigated the effects of transcutaneous auricular vagus nerve stimulation (taVNS) in patients with disorders of consciousness (DOC) were reviewed. Generally, the application of taVNS in patients with DOC appears to be effective (positive results in 5 of 6 studies) and safe. Furthermore, 4 studies that evaluated changes in the brain following taVNS reported positive results (2 studies, functional magnetic resonance imaging and 2 studies, electroencephalography). Based on our review of the 6 studies, we believe that research and clinical application of taVNS in DOC are in the initial stages and have the following limitations. First, there is a shortage of studies on this topic, with only 6 studies, 2 of which were case reports. Second, 5 studies were performed without control or sham groups. Third, there was no standardization of treatment schedules and electrical stimulation parameters. Therefore, further studies to overcome the above limitations should be encouraged; further original studies involving a larger number of patients in the control or sham groups are needed. However, studies on the optimal conditions (treatment schedule and electrical stimulation parameters) for taVNS in patients with DOC are necessary. Furthermore, neuroimaging studies should be undertaken to elucidate the neurological mechanisms for the recovery of impaired consciousness in DOC and the lasting effects of taVNS on the brain.
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Affiliation(s)
- Sung Ho Jang
- Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, Namku, Taegu, Republic of Korea
| | - Min Jye Cho
- Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, Namku, Taegu, Republic of Korea
- * Correspondence: Min Jye Cho, Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, 317-1, Daemyung dong, Namgu, Daegu 705-717, Republic of Korea (e-mail: )
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Chen CC, Chung CR, Tsai MC, Wu EHK, Chiu PR, Tsai PY, Yeh SC. Impaired Brain-Heart Relation in Patients With Methamphetamine Use Disorder During VR Induction of Drug Cue Reactivity. IEEE JOURNAL OF TRANSLATIONAL ENGINEERING IN HEALTH AND MEDICINE 2022; 12:1-9. [PMID: 38059128 PMCID: PMC10697298 DOI: 10.1109/jtehm.2022.3206333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 07/12/2022] [Accepted: 09/08/2022] [Indexed: 12/08/2023]
Abstract
Methamphetamine use disorder (MUD) is an illness associated with severe health consequences. Virtual reality (VR) is used to induce the drug-cue reactivity and significant EEG and ECG abnormalities were found in MUD patients. However, whether a link exists between EEG and ECG abnormalities in patients with MUD during exposure to drug cues remains unknown. This is important from the therapeutic viewpoint because different treatment strategies may be applied when EEG abnormalities and ECG irregularities are complications of MUD. We designed a VR system with drug cues and EEG and ECG were recorded during VR exposure. Sixteen patients with MUD and sixteen healthy subjects were recruited. Statistical tests and Pearson correlation were employed to analyze the EEG and ECG. The results showed that, during VR induction, the patients with MUD but not healthy controls showed significant [Formula: see text] and [Formula: see text] power increases when the stimulus materials were most intense. This finding indicated that the stimuli are indiscriminate to healthy controls but meaningful to patients with MUD. Five heart rate variability (HRV) indexes significantly differed between patients and controls, suggesting abnormalities in the reaction of patient's autonomic nervous system. Importantly, significant relations between EEG and HRV indexes changes were only identified in the controls, but not in MUD patients, signifying a disruption of brain-heart relations in patients. Our findings of stimulus-specific EEG changes and the impaired brain-heart relations in patients with MUD shed light on the understanding of drug-cue reactivity and may be used to design diagnostic and/or therapeutic strategies for MUD.
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Affiliation(s)
- Chun-Chuan Chen
- Department of Biomedical Sciences and EngineeringNational Central UniversityTaoyuan City320317Taiwan
| | - Chia-Ru Chung
- Computer Science and Information Engineering DepartmentNational Central UniversityTaoyuan City320317Taiwan
| | - Meng-Chang Tsai
- Department of PsychiatryKaohsiung Chang Gung Memorial HospitalKaohsiung City83301Taiwan
- Department of PsychiatryChang Gung University College of MedicineKaohsiung City83301Taiwan
| | - Eric Hsiao-Kuang Wu
- Computer Science and Information Engineering DepartmentNational Central UniversityTaoyuan City320317Taiwan
| | - Po-Ru Chiu
- Department of Biomedical Sciences and EngineeringNational Central UniversityTaoyuan City320317Taiwan
| | - Po-Yi Tsai
- Department of Physical Medicine and RehabilitationTaipei Veterans General HospitalTaipei112201Taiwan
| | - Shih-Ching Yeh
- Computer Science and Information Engineering DepartmentNational Central UniversityTaoyuan City320317Taiwan
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Correlation between Palpitations below the Heart in Traditional Chinese Medicine and Autonomic Nerve Function Based on Heart Rate Variability: A Case-Control Study. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2021; 2021:1945488. [PMID: 34754310 PMCID: PMC8572591 DOI: 10.1155/2021/1945488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 10/15/2021] [Indexed: 11/17/2022]
Abstract
Objective To explore the autonomic nerve rhythm and the correlation between palpitations below the heart (PBTH) and autonomic nerve function in patients with PBTH based on heart rate variability (HRV). Methods The outpatients or ward patients of Wenzhou Hospital of Traditional Chinese Medicine were collected and divided into two groups: the PBTH group and the normal group. The HRV of each group was detected. Single-factor statistical methods, Spearman correlation analysis, and logistic regression were used to describe and analyze the rhythm and characteristics of autonomic nerves in patients with PBTH and the correlation between PBTH and autonomic nerve function. Results (1) In the comparison of HRV in different time periods in the same group, the SDNN, RMSSD, pNN50, TP, and HF in the PBTH group at night were significantly higher than those in the daytime (P < 0.01), while the LF/HF ratio was significantly lower than that in the daytime (P < 0.01). (2) In the comparison of HRV between the two groups in the same time period, the RMSSD and pNN50 of the PBTH group during the daytime period were significantly higher than those of the normal control group (P < 0.05), and the LF/HF was significantly lower than that of the normal group (P < 0.05). (3) In the Spearman correlation analysis, PBTH was significantly correlated with RMSSD, pNN50, and LF/HF ratio in the daytime period, with correlation coefficients of 0.424, 0.462, and -0.524, respectively (P < 0.05). (4) Logistic regression analysis showed that the decrease of LF/HF ratio during the daytime period was an independent risk factor for PBTH in TCM (OR = 0.474, 95% CI: 0.230-0.977, P < 0.05). Conclusions The changes in parasympathetic nerve function in patients with PBTH have a circadian rhythm, which is characterized by increased activity during the nighttime. At the same time, the autonomic nerve activity of people with PBTH during the daytime is unbalanced, and the decrease of LF/HF ratio during the day is an independent high risk factor for PBTH.
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