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Leoncini S, Boasiako L, Di Lucia S, Beker A, Scandurra V, Vignoli A, Canevini MP, Prato G, Nobili L, Nicotera AG, Di Rosa G, Chiarini MBT, Cutrera R, Grosso S, Lazzeri G, Tongiorgi E, Morano P, Botteghi M, Barducci A, De Felice C. 24-h continuous non-invasive multiparameter home monitoring of vitals in patients with Rett syndrome by an innovative wearable technology: evidence of an overlooked chronic fatigue status. Front Neurol 2024; 15:1388506. [PMID: 38952469 PMCID: PMC11215834 DOI: 10.3389/fneur.2024.1388506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Accepted: 05/13/2024] [Indexed: 07/03/2024] Open
Abstract
Background Sleep is disturbed in Rett syndrome (RTT), a rare and progressive neurodevelopmental disorder primarily affecting female patients (prevalence 7.1/100,000 female patients) linked to pathogenic variations in the X-linked methyl-CpG-binding protein 2 (MECP2) gene. Autonomic nervous system dysfunction with a predominance of the sympathetic nervous system (SNS) over the parasympathetic nervous system (PSNS) is reported in RTT, along with exercise fatigue and increased sudden death risk. The aim of the present study was to test the feasibility of a continuous 24 h non-invasive home monitoring of the biological vitals (biovitals) by an innovative wearable sensor device in pediatric and adolescent/adult RTT patients. Methods A total of 10 female patients (mean age 18.3 ± 9.4 years, range 4.7-35.5 years) with typical RTT and MECP2 pathogenic variations were enrolled. Clinical severity was assessed by validated scales. Heart rate (HR), respiratory rate (RR), and skin temperature (SkT) were monitored by the YouCare Wearable Medical Device (Accyourate Group SpA, L'Aquila, Italy). The average percentage of maximum HR (HRmax%) was calculated. Heart rate variability (HRV) was expressed by consolidated time-domain and frequency-domain parameters. The HR/LF (low frequency) ratio, indicating SNS activation under dynamic exercise, was calculated. Simultaneous continuous measurement of indoor air quality variables was performed and the patients' contributions to the surrounding water vapor partial pressure [PH2O (pt)] and carbon dioxide [PCO2 (pt)] were indirectly estimated. Results Of the 6,559.79 h of biovital recordings, 5051.03 h (77%) were valid for data interpretation. Sleep and wake hours were 9.0 ± 1.1 h and 14.9 ± 1.1 h, respectively. HRmax % [median: 71.86% (interquartile range 61.03-82%)] and HR/LF [median: 3.75 (interquartile range 3.19-5.05)] were elevated, independent from the wake-sleep cycle. The majority of HRV time- and frequency-domain parameters were significantly higher in the pediatric patients (p ≤ 0.031). The HRV HR/LF ratio was associated with phenotype severity, disease progression, clinical sleep disorder, subclinical hypoxia, and electroencephalographic observations of multifocal epileptic activity and general background slowing. Conclusion Our findings indicate the feasibility of a continuous 24-h non-invasive home monitoring of biovital parameters in RTT. Moreover, for the first time, HRmax% and the HR/LF ratio were identified as potential objective markers of fatigue, illness severity, and disease progression.
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Affiliation(s)
- Silvia Leoncini
- Rett Syndrome Trial Center, University Hospital Azienda Ospedaliera Universitaria Senese, Siena, Italy
- Neonatal Intensive Care Unit, University Hospital Azienda Ospedaliera Universitaria Senese, Siena, Italy
- U.O.S.A. Programmazione e Ricerca Clinica, University Hospital Azienda Ospedaliera Universitaria Senese, Siena, Italy
| | - Lidia Boasiako
- Rett Syndrome Trial Center, University Hospital Azienda Ospedaliera Universitaria Senese, Siena, Italy
- Neonatal Intensive Care Unit, University Hospital Azienda Ospedaliera Universitaria Senese, Siena, Italy
| | - Sofia Di Lucia
- Neonatal Intensive Care Unit, University Hospital Azienda Ospedaliera Universitaria Senese, Siena, Italy
| | | | - Valeria Scandurra
- Child Neuropsychiatry Unit, University Hospital Azienda Ospedaliera Universitaria Senese, Siena, Italy
| | - Aglaia Vignoli
- Childhood and Adolescence Neurology and Psychiatry Unit, ASST GOM Niguarda, Milan, Italy
| | - Maria Paola Canevini
- Epilepsy Center – Sleep Medicine Center, Childhood and Adolescence Neuropsychiatry Unit, ASST Santi Paolo e Carlo, San Paolo Hospital, Milan, Italy
| | - Giulia Prato
- Child Neuropsychiatry Unit, IRCCS Istituto Giannina Gaslini, Genova, Italy
| | - Lino Nobili
- Child Neuropsychiatry Unit, IRCCS Istituto Giannina Gaslini, Genova, Italy
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Health (DINOGMI), University of Genova, Genova, Italy
| | | | - Gabriella Di Rosa
- Child Neuropsychiatry Unit, University Hospital “G. Martino”, Messina, Italy
- Department of Biomedical and Dental Sciences and of Morphological and Functional Imaging (BIOMORF), University of Messina, Messina, Italy
| | - Maria Beatrice Testa Chiarini
- Pneumology and Cystic Fibrosis Unit, Academic Department of Pediatrics, Bambino Gesù Children’s Hospital, Rome, Italy
| | - Renato Cutrera
- Pneumology and Cystic Fibrosis Unit, Academic Department of Pediatrics, Bambino Gesù Children’s Hospital, Rome, Italy
| | - Salvatore Grosso
- Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
- Pediatrics Unit, University Hospital Azienda Ospedaliera Universitaria Senese, Siena, Italy
| | - Giacomo Lazzeri
- U.O.S.A. Programmazione e Ricerca Clinica, University Hospital Azienda Ospedaliera Universitaria Senese, Siena, Italy
- Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
| | - Enrico Tongiorgi
- Department of Life Sciences, University of Trieste, Trieste, Italy
| | | | - Matteo Botteghi
- Department of Clinical and Molecular Sciences – Experimental Pathology Research Group, Università Politecnica delle Marche, Ancona, Italy
- Medical Physics Activities Coordination Centre – Alma Mater Studiorum – University of Bologna, Bologna, Italy
| | | | - Claudio De Felice
- Rett Syndrome Trial Center, University Hospital Azienda Ospedaliera Universitaria Senese, Siena, Italy
- Neonatal Intensive Care Unit, University Hospital Azienda Ospedaliera Universitaria Senese, Siena, Italy
- Pediatrics Unit, University Hospital Azienda Ospedaliera Universitaria Senese, Siena, Italy
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Viswanathan LG, Nagaraj BC, Mundlamuri R, Thennarasu K, Kenchaiah R, Asranna A, Nagappa M, Seshagiri D, Saini J, Sinha S. Cardiac Rhythm Aberrations in Subacute Sclerosing Panencephalitis: Insights From Heart Rate Variability Analysis. J Clin Neurophysiol 2024:00004691-990000000-00129. [PMID: 38587485 DOI: 10.1097/wnp.0000000000001079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/09/2024] Open
Abstract
PURPOSE Subacute sclerosing panencephalitis (SSPE) is a fatal neurological disorder resulting from persistent measles virus infection within the brain. Although neurological manifestations have been well-documented, the impact of SSPE on cardiac autonomic function, assessed through heart rate variability (HRV), remains understudied. METHODS In this prospective single-center study conducted from January 2022 to March 2023 in Southern India, 30 consecutive SSPE patients and age- and sex-matched controls underwent electrocardiogram recordings for HRV analysis. Various HRV parameters were assessed, including time-domain metrics (SD of normal-to-normal intervals, root mean square of successive differences between normal heartbeats, percentage of successive normal interbeat intervals greater than 50 msec), SD1 and SD2 for Poincaré plot analysis, and frequency-domain metrics (low frequency %, high frequency %, low frequency:high frequency ratio). RESULTS In the study, SSPE patients exhibited markedly reduced HRV. Specifically, SD of normal-to-normal intervals (P = 0.003), percentage of successive normal interbeat intervals greater than 50 msec (P = 0.03), and SD2 (P = 0.0016) were significantly lower compared with controls. Frequency-domain analysis did not reveal significant distinctions. Correlation analysis demonstrated a negative relationship between percentage of successive normal interbeat intervals greater than 50 msec and SSPE severity (r = -0.37, P = 0.042). Heart rate variability did not significantly differ between SSPE stages or with clinical variables. The interbeat interval range showed a narrower distribution in SSPE subjects. CONCLUSIONS Our study highlights the clinical relevance of HRV analysis in SSPE and autonomic dysfunction throughout the disease course underscoring its importance in SSPE. This investigation provides valuable insights into cardiac autonomic dysfunction probably because of affliction of the central autonomic networks caused by the disease process and may be a contributing factor to mortality in SSPE.
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Affiliation(s)
| | | | | | | | | | - Ajay Asranna
- Department of Neurology, NIMHANS, Bangalore, India
| | | | | | | | - Sanjib Sinha
- Department of Neurology, NIMHANS, Bangalore, India
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Giunta S, Giordani C, De Luca M, Olivieri F. Long-COVID-19 autonomic dysfunction: An integrated view in the framework of inflammaging. Mech Ageing Dev 2024; 218:111915. [PMID: 38354789 DOI: 10.1016/j.mad.2024.111915] [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: 12/31/2023] [Revised: 02/05/2024] [Accepted: 02/09/2024] [Indexed: 02/16/2024]
Abstract
The recently identified syndrome known as Long COVID (LC) is characterized by a constellation of debilitating conditions that impair both physical and cognitive functions, thus reducing the quality of life and increasing the risk of developing the most common age-related diseases. These conditions are linked to the presence of symptoms of autonomic dysfunction, in association with low cortisol levels, suggestive of reduced hypothalamic-pituitary-adrenal (HPA) axis activity, and with increased pro-inflammatory condition. Alterations of dopamine and serotonin neurotransmitter levels were also recently observed in LC. Interestingly, at least some of the proposed mechanisms of LC development overlap with mechanisms of Autonomic Nervous System (ANS) imbalance, previously detailed in the framework of the aging process. ANS imbalance is characterized by a proinflammatory sympathetic overdrive, and a concomitant decreased anti-inflammatory vagal parasympathetic activity, associated with reduced anti-inflammatory effects of the HPA axis and cholinergic anti-inflammatory pathway (CAP). These neuro-immune-endocrine system imbalanced activities fuel the vicious circle of chronic inflammation, i.e. inflammaging. Here, we refine our original hypothesis that ANS dysfunction fuels inflammaging and propose that biomarkers of ANS imbalance could also be considered biomarkers of inflammaging, recognized as the main risk factor for developing age-related diseases and the sequelae of viral infections, i.e. LC.
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Affiliation(s)
- Sergio Giunta
- Casa di Cura Prof. Nobili (Gruppo Garofalo (GHC) Castiglione dei Pepoli -Bologna), Italy
| | - Chiara Giordani
- Clinic of Laboratory and Precision Medicine, IRCCS INRCA, Ancona, Italy.
| | - Maria De Luca
- Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, AL 35294, USA
| | - Fabiola Olivieri
- Clinic of Laboratory and Precision Medicine, IRCCS INRCA, Ancona, Italy; Department of Clinical and Molecular Sciences, DISCLIMO, Università Politecnica delle Marche, Ancona, Italy
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Wang W, Zhou L, Hu Q, Gao Y, Wei Y, Tang X, Hu Y, Xu L, Liu H, Wang Z, Chen T, Li C, Wu H, Wang J, Zhang T. Correlative relationship between body mass index and heart rate variability in psychiatric disorders. Eur Arch Psychiatry Clin Neurosci 2024:10.1007/s00406-024-01768-1. [PMID: 38470538 DOI: 10.1007/s00406-024-01768-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 01/19/2024] [Indexed: 03/14/2024]
Abstract
OBJECTIVE Indicators of heart rate variability (HRV) have been used to assess the autonomic activity. However, the influence of obesity on HRV in these patients remains to be determined. This study aimed to examine how obesity (measured with the body mass index [BMI]) affects HRV and determine whether the effect varies among different psychiatric disorders. We recruited 3159 consecutive patients, including 1744 with schizophrenia, 966 with mood disorders, and 449 with anxiety disorders. Patients were divided into four groups based on BMI: underweight (< 18.5), normal weight (18.5-23.9), overweight (24-27.9), and obese (≥ 28). The cardiovascular status was assessed using several time- and frequency-based HRV indicators, measured via electrocardiogram signals recorded for 5 min. The mean BMI of the participants was 23.6 ± 4.0. The patients in the overweight and obese groups were 29.4% and 13.6% of the total, respectively. The HRV indicators were higher in underweight and normal-weight patients than in the overweight and obese ones. After stratification based on the psychiatric diagnosis, the patients with mood disorders showed lower HRV than those with schizophrenia or anxiety disorder in the normal-weight group. In contrast, in the overweight and obese groups the patients with mood disorders showed higher HRV than those with the other disorders. The HRV variables were significantly associated with BMI, and higher BMI was associated with higher heart rates and lower HRV. These results indicate that weight gain in psychiatric disorders is associated with an imbalance in autonomic nerve activity. However, the relationship between autonomic activity, weight gain, and psychiatric disorders warrants further investigation.
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Affiliation(s)
- WenZheng Wang
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai Engineering Research Center of Intelligent Psychological Evaluation and Intervention, Shanghai Key Laboratory of Psychotic Disorders, Shanghai, 200030, China
| | - LinLin Zhou
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai Engineering Research Center of Intelligent Psychological Evaluation and Intervention, Shanghai Key Laboratory of Psychotic Disorders, Shanghai, 200030, China
| | - Qiang Hu
- Department of Psychiatry, Zhen Jiang Mental Health Center, Zhenjiang, People's Republic of China
| | - YuQing Gao
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai Engineering Research Center of Intelligent Psychological Evaluation and Intervention, Shanghai Key Laboratory of Psychotic Disorders, Shanghai, 200030, China
| | - YanYan Wei
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai Engineering Research Center of Intelligent Psychological Evaluation and Intervention, Shanghai Key Laboratory of Psychotic Disorders, Shanghai, 200030, China
| | - XiaoChen Tang
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai Engineering Research Center of Intelligent Psychological Evaluation and Intervention, Shanghai Key Laboratory of Psychotic Disorders, Shanghai, 200030, China
| | - YeGang Hu
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai Engineering Research Center of Intelligent Psychological Evaluation and Intervention, Shanghai Key Laboratory of Psychotic Disorders, Shanghai, 200030, China
| | - LiHua Xu
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai Engineering Research Center of Intelligent Psychological Evaluation and Intervention, Shanghai Key Laboratory of Psychotic Disorders, Shanghai, 200030, China
| | - HaiChun Liu
- Department of Automation, Shanghai Jiao Tong University, Shanghai, 200240, China
| | - ZiXuan Wang
- Shanghai Xinlianxin Psychological Counseling Center, Shanghai, China
| | - Tao Chen
- Big Data Research Lab, University of Waterloo, Waterloo, ON, Canada
- Labor and Worklife Program, Harvard University, Massachusetts, USA
| | - ChunBo Li
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai Engineering Research Center of Intelligent Psychological Evaluation and Intervention, Shanghai Key Laboratory of Psychotic Disorders, Shanghai, 200030, China
| | - HaiSu Wu
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai Engineering Research Center of Intelligent Psychological Evaluation and Intervention, Shanghai Key Laboratory of Psychotic Disorders, Shanghai, 200030, China.
| | - JiJun Wang
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai Engineering Research Center of Intelligent Psychological Evaluation and Intervention, Shanghai Key Laboratory of Psychotic Disorders, Shanghai, 200030, China.
- Center for Excellence in Brain Science and Intelligence Technology (CEBSIT), Chinese Academy of Science, Beijing, People's Republic of China.
- Institute of Psychology and Behavioral Science, Shanghai Jiao Tong University, Shanghai, People's Republic of China.
| | - TianHong Zhang
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai Engineering Research Center of Intelligent Psychological Evaluation and Intervention, Shanghai Key Laboratory of Psychotic Disorders, Shanghai, 200030, China.
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Ammar A, Boujelbane MA, Simak ML, Fraile-Fuente I, Rizzi N, Washif JA, Zmijewski P, Jahrami H, Schöllhorn WI. Unveiling the acute neurophysiological responses to strength training: An exploratory study on novices performing weightlifting bouts with different motor learning models. Biol Sport 2024; 41:249-274. [PMID: 38524821 PMCID: PMC10955729 DOI: 10.5114/biolsport.2024.133481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Revised: 11/21/2023] [Accepted: 12/03/2023] [Indexed: 03/26/2024] Open
Abstract
Currently, there is limited evidence regarding various neurophysiological responses to strength exercise and the influence of the adopted practice schedule. This study aimed to assess the acute systemic effects of snatch training bouts, employing different motor learning models, on skill efficiency, electric brain activity (EEG), heart rate variability (HRV), and perceived exertion as well as mental demand in novices. In a within-subject design, sixteen highly active males (mean age: 23.13 ± 2.09 years) randomly performed snatch learning bouts consisting of 36 trials using repetitive learning (RL), contextual interference (blocked, CIb; and serial, CIs), and differential learning (DL) models. Spontaneous resting EEG and HRV activities were recorded at PRE and POST training bouts while measuring heart rate. Perceived exertion and mental demand were assessed immediately after, and barbell kinematics were recorded during three power snatch trials performed following the POST measurement. The results showed increases in alpha, beta, and gamma frequencies from pre- to post-training bouts in the majority of the tested brain regions (p values ranging from < 0.0001 to 0.02). The CIb model exhibited increased frequencies in more regions. Resting time domain HRV parameters were altered following the snatch bouts, with increased HR (p < 0.001) and decreased RR interval (p < 0.001), SDNN, and RMSSD (p values ranging from < 0.0001 to 0.02). DL showed more pronounced pulse-related changes (p = 0.01). Significant changes in HRV frequency domain parameters were observed, with a significant increase in LFn (p = 0.03) and a decrease in HFn (p = 0.001) registered only in the DL model. Elevated HR zones (> HR zone 3) were more dominant in the DL model during the snatch bouts (effect size = 0.5). Similarly, the DL model tended to exhibit higher perceived physical (effect size = 0.5) and mental exertions (effect size = 0.6). Despite the highest psycho-physiological response, the DL group showed one of the fewest significant EEG changes. There was no significant advantage of one learning model over the other in terms of technical efficiency. These findings offer preliminary support for the acute neurophysiological benefits of coordination-strength-based exercise in novices, particularly when employing a DL model. The advantages of combining EEG and HRV measurements for comprehensive monitoring and understanding of potential adaptations are also highlighted. However, further studies encompassing a broader range of coordination-strength-based exercises are warranted to corroborate these observations.
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Affiliation(s)
- Achraf Ammar
- Department of Training and Movement Science, Institute of Sport Science, Johannes Gutenberg-University Mainz, Mainz, Germany
- Interdisciplinary Laboratory in Neurosciences, Physiology and Psychology: Physical Activity, Health and Learning (LINP2), UFR STAPS (Faculty of Sport Sciences), UPL, Paris Nanterre University, Nanterre, France
- Research Laboratory, Molecular Bases of Human Pathology, LR19ES13, Faculty of Medicine of Sfax,University of Sfax, Sfax 3029, Tunisia
- High Institute of Sport and Physical Education, University of Sfax, Tunisia
| | - Mohamed Ali Boujelbane
- Department of Training and Movement Science, Institute of Sport Science, Johannes Gutenberg-University Mainz, Mainz, Germany
- High Institute of Sport and Physical Education, University of Sfax, Tunisia
- Research Unit: “Physical Activity, Sport, and Health”, UR18JS01, National Observatory of Sport, Tunis 1003, Tunisia
| | - Marvin Leonard Simak
- Department of Training and Movement Science, Institute of Sport Science, Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Irene Fraile-Fuente
- Department of Training and Movement Science, Institute of Sport Science, Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Nikolas Rizzi
- Department of Training and Movement Science, Institute of Sport Science, Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Jad Adrian Washif
- Sports Performance Division, National Sports Institute of Malaysia, Kuala Lumpur, Malaysia
| | - Piotr Zmijewski
- Jozef Pilsudski University of Physical Education in Warsaw, Warsaw, Poland
| | - Haitham Jahrami
- College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Kingdom of Bahrain
- Government Hospitals, Manama, Kingdom of Bahrain
| | - Wolfgang I. Schöllhorn
- Department of Training and Movement Science, Institute of Sport Science, Johannes Gutenberg-University Mainz, Mainz, Germany
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Rapöhn M, Cyganek L, Voigt N, Hasenfuß G, Lehnart SE, Wegener JW. Noninvasive analysis of contractility during identical maturations revealed two phenotypes in ventricular but not in atrial iPSC-CM. Am J Physiol Heart Circ Physiol 2024; 326:H599-H611. [PMID: 38180453 PMCID: PMC11221812 DOI: 10.1152/ajpheart.00527.2023] [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: 08/28/2023] [Revised: 12/06/2023] [Accepted: 01/02/2024] [Indexed: 01/06/2024]
Abstract
Patient-derived induced pluripotent stem cells (iPSCs) can be differentiated into atrial and ventricular cardiomyocytes to allow for personalized drug screening. A hallmark of differentiation is the manifestation of spontaneous beating in a two-dimensional (2-D) cell culture. However, an outstanding observation is the high variability in this maturation process. We valued that contractile parameters change during differentiation serving as an indicator of maturation. Consequently, we recorded noninvasively spontaneous motion activity during the differentiation of male iPSC toward iPSC cardiomyocytes (iPSC-CMs) to further analyze similar maturated iPSC-CMs. Surprisingly, our results show that identical differentiations into ventricular iPSC-CMs are variable with respect to contractile parameters resulting in two distinct subpopulations of ventricular-like cells. In contrast, differentiation into atrial iPSC-CMs resulted in only one phenotype. We propose that the noninvasive and cost-effective recording of contractile activity during maturation using a smartphone device may help to reduce the variability in results frequently reported in studies on ventricular iPSC-CMs.NEW & NOTEWORTHY Differentiation of induced pluripotent stem cells (iPSCs) into iPSC-derived cardiomyocytes (iPSC-CMs) exhibits a high variability in mature parameters. Here, we monitored noninvasively contractile parameters of iPSC-CM during full-time differentiation using a smartphone device. Our results show that parallel maturations of iPSCs into ventricular iPSC-CMs, but not into atrial iPSC-CMs, resulted in two distinct subpopulations of iPSC-CMs. These findings suggest that our cost-effective method may help to compare iPSC-CMs at the same maturation level.
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Affiliation(s)
- Marcel Rapöhn
- Department of Cardiology and Pulmonology, University Medical Center of Göttingen, Göttingen, Germany
| | - Lukas Cyganek
- Department of Cardiology and Pulmonology, University Medical Center of Göttingen, Göttingen, Germany
- German Centre for Cardiovascular Research (Deutsches Zentrum für Herz-Kreislaufforschung), Göttingen, Germany
- Cluster of Excellence "Multiscale Bioimaging: From Molecular Machines to Networks of Excitable Cells," University of Göttingen, Göttingen, Germany
| | - Niels Voigt
- German Centre for Cardiovascular Research (Deutsches Zentrum für Herz-Kreislaufforschung), Göttingen, Germany
- Department of Pharmacology and Toxicology, University Medical Center of Göttingen, Göttingen, Germany
- Cluster of Excellence "Multiscale Bioimaging: From Molecular Machines to Networks of Excitable Cells," University of Göttingen, Göttingen, Germany
| | - Gerd Hasenfuß
- Department of Cardiology and Pulmonology, University Medical Center of Göttingen, Göttingen, Germany
- German Centre for Cardiovascular Research (Deutsches Zentrum für Herz-Kreislaufforschung), Göttingen, Germany
| | - Stephan E Lehnart
- Department of Cardiology and Pulmonology, University Medical Center of Göttingen, Göttingen, Germany
- German Centre for Cardiovascular Research (Deutsches Zentrum für Herz-Kreislaufforschung), Göttingen, Germany
- Cluster of Excellence "Multiscale Bioimaging: From Molecular Machines to Networks of Excitable Cells," University of Göttingen, Göttingen, Germany
| | - Jörg W Wegener
- Department of Cardiology and Pulmonology, University Medical Center of Göttingen, Göttingen, Germany
- German Centre for Cardiovascular Research (Deutsches Zentrum für Herz-Kreislaufforschung), Göttingen, Germany
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Mograss M, Frimpong E, Vilcourt F, Chouchou F, Zvionow T, Dang-Vu TT. The effects of acute exercise and a nap on heart rate variability and memory in young sedentary adults. Psychophysiology 2024; 61:e14454. [PMID: 37855092 DOI: 10.1111/psyp.14454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 08/29/2023] [Accepted: 09/20/2023] [Indexed: 10/20/2023]
Abstract
Recent evidence suggests that the autonomic nervous system can contribute to memory consolidation during sleep. Whether fluctuations in cardiac autonomic activity during sleep following physical exercise contribute to the process of memory consolidation has not been studied. We assessed the effects of a non-rapid eye movement (NREM) nap following acute exercise on cardiac autonomic regulation assessed with heart rate variability (HRV) to examine if HRV influences memory processes. Fifty-six (59% female) healthy young adults (23.14 ± 3.74 years) were randomly allocated to either the exercise plus nap (ExNap, n = 27) or nap alone (NoExNap, n = 29) groups. The ExNap group performed a 40-minute moderate-intensity cycling, while the NoExNap group was sedentary prior to learning 45 neutral pictures for a later test. Subsequently, participants underwent a 60-minute NREM nap while measuring EKG, followed by a visual recognition test. Our results indicated that heart rate did not significantly differ between the groups (p = .243), whereas vagally mediated HRV indices were lower in the ExNap group compared to the NoExNap group (p < .05). There were no significant differences in sleep variables between the groups (p > .05). Recognition accuracy was significantly higher in the ExNap group than in the NoExNap group (p = .027). In addition, the recognition accuracy of the ExNap group was negatively associated with vagally mediated HRV (p < .05). Pre-nap acute exercise appears to attenuate parasympathetic activity and to alter the relationship between memory and cardiac autonomic activity.
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Affiliation(s)
- Melodee Mograss
- Sleep, Cognition and Neuroimaging Laboratory, Concordia University, Montreal, Quebec, Canada
- Department of Health, Kinesiology & Applied Physiology, Concordia University, Montreal, Quebec, Canada
- Department of Psychology, Concordia University, Montreal, Quebec, Canada
- PERFORM Centre, Concordia University, Montreal, Quebec, Canada
| | - Emmanuel Frimpong
- Sleep, Cognition and Neuroimaging Laboratory, Concordia University, Montreal, Quebec, Canada
- Department of Health, Kinesiology & Applied Physiology, Concordia University, Montreal, Quebec, Canada
- PERFORM Centre, Concordia University, Montreal, Quebec, Canada
- Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, Montreal, Quebec, Canada
| | - Franck Vilcourt
- IRISSE Laboratory (EA4075), UFR SHE, University of La Réunion, Le Tampon, France
| | - Florian Chouchou
- IRISSE Laboratory (EA4075), UFR SHE, University of La Réunion, Le Tampon, France
| | - Tehila Zvionow
- Sleep, Cognition and Neuroimaging Laboratory, Concordia University, Montreal, Quebec, Canada
- Department of Health, Kinesiology & Applied Physiology, Concordia University, Montreal, Quebec, Canada
| | - Thien Thanh Dang-Vu
- Sleep, Cognition and Neuroimaging Laboratory, Concordia University, Montreal, Quebec, Canada
- Department of Health, Kinesiology & Applied Physiology, Concordia University, Montreal, Quebec, Canada
- PERFORM Centre, Concordia University, Montreal, Quebec, Canada
- Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, Montreal, Quebec, Canada
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Wesolowski E, Ahmed Z, Di Pietro V. History of concussion and lowered heart rate variability at rest beyond symptom recovery: a systematic review and meta-analysis. Front Neurol 2024; 14:1285937. [PMID: 38318235 PMCID: PMC10838961 DOI: 10.3389/fneur.2023.1285937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 12/26/2023] [Indexed: 02/07/2024] Open
Abstract
Introduction Concussion is a growing concern in worldwide sporting culture. Heart rate variability (HRV) is closely tied with autonomic nervous system (ANS) deficits that arise from a concussion. The objective of this review was to determine if a history of concussion (HOC) can impact HRV values in the time-domain in individuals at rest. This review works to add to the literature surrounding HRV testing and if it can be used to check for brain vulnerabilities beyond the recovery of concussion symptoms. Materials and methods The systematic review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) method. A computer based systematic review scanned articles dating from 1996 to June 2023 through PubMed, Cochrane Library, Google Scholar, and EMBASE databases. A risk of bias assessment was conducted using the ROBINS-E tool. The average difference in time between heartbeats (MeanNN), the standard deviation of the differences (SDNN), and the root mean squared of the successive intervals (RMSSD) were measured. Results Six total studies were found that fit the inclusion criteria including a total of 242 participants (133 without HOC, 109 with HOC). The average age of the control group was 23.3 ± 8.2, while the average age of the history of TBI group was 25.4 ± 9.7, with no significant difference between the groups (p = 0.202). Four of the studies reported no significant difference in any of the three measures, while two of the studies reported significant difference for all three measures. The meta-analysis was conducted and found that MeanNN (p = 0.03) and RMSSD (p = 0.04) reached statistical significance, while SDNN did not (p = 0.11). Conclusion The results of this meta-analysis showed significant difference in two of the three HRV time-domain parameters evaluated. It demonstrates that there can be lowered HRV values that expand beyond the recovery of symptoms, reflecting an extensive period of ANS susceptibility after a concussion. This may be an important variable in determining an athlete's return to play (RTP). Lack of homogenous study populations and testing methods introduces potential for bias and confounding factors, such as gender or age. Future studies should focus on baseline tests to compare individuals to themselves rather than matched controls.
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Affiliation(s)
- Eric Wesolowski
- Institute of Inflammation and Ageing, University of Birmingham, Birmingham, United Kingdom
| | - Zubair Ahmed
- Institute of Inflammation and Ageing, University of Birmingham, Birmingham, United Kingdom
- Centre for Trauma Sciences Research, University of Birmingham, Birmingham, United Kingdom
| | - Valentina Di Pietro
- Institute of Inflammation and Ageing, University of Birmingham, Birmingham, United Kingdom
- Centre for Trauma Sciences Research, University of Birmingham, Birmingham, United Kingdom
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Nicolini P, Malfatto G, Lucchi T. Heart Rate Variability and Cognition: A Narrative Systematic Review of Longitudinal Studies. J Clin Med 2024; 13:280. [PMID: 38202287 PMCID: PMC10780278 DOI: 10.3390/jcm13010280] [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: 11/05/2023] [Revised: 12/23/2023] [Accepted: 12/27/2023] [Indexed: 01/12/2024] Open
Abstract
BACKGROUND Heart rate variability (HRV) is a reliable and convenient method to assess autonomic function. Cross-sectional studies have established a link between HRV and cognition. Longitudinal studies are an emerging area of research with important clinical implications in terms of the predictive value of HRV for future cognition and in terms of the potential causal relationship between HRV and cognition. However, they have not yet been the objective of a systematic review. Therefore, the aim of this systematic review was to investigate the association between HRV and cognition in longitudinal studies. METHODS The review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The Embase, PsycINFO and PubMed databases were searched from the earliest available date to 26 June 2023. Studies were included if they involved adult human subjects and evaluated the longitudinal association between HRV and cognition. The risk of bias was assessed with the Newcastle-Ottawa Scale for Cohort Studies. The results were presented narratively. RESULTS Of 14,359 records screened, 12 studies were included in this systematic review, with a total of 24,390 participants. Two thirds of the studies were published from 2020 onwards. All studies found a longitudinal relationship between HRV and cognition. There was a consistent association between higher parasympathetic nervous system (PNS) activity and better cognition, and some association between higher sympathetic nervous system activity and worse cognition. Also, higher PNS activity persistently predicted better executive functioning, while data on episodic memory and language were more scant and/or controversial. CONCLUSIONS Our results support the role of HRV as a biomarker of future cognition and, potentially, as a therapeutic target to improve cognition. They will need confirmation by further, more comprehensive studies also including unequivocal non-HRV sympathetic measures and meta-analyses.
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Affiliation(s)
- Paola Nicolini
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Geriatric Unit, Internal Medicine Department, 20122 Milan, Italy;
| | - Gabriella Malfatto
- Istituto Auxologico Italiano IRCCS, Department of Cardiovascular, Neural and Metabolic Sciences, Ospedale San Luca, 20149 Milan, Italy;
| | - Tiziano Lucchi
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Geriatric Unit, Internal Medicine Department, 20122 Milan, Italy;
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Witczyńska A, Alaburda A, Grześk G, Nowaczyk J, Nowaczyk A. Unveiling the Multifaceted Problems Associated with Dysrhythmia. Int J Mol Sci 2023; 25:263. [PMID: 38203440 PMCID: PMC10778936 DOI: 10.3390/ijms25010263] [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: 11/27/2023] [Revised: 12/15/2023] [Accepted: 12/21/2023] [Indexed: 01/12/2024] Open
Abstract
Dysrhythmia is a term referring to the occurrence of spontaneous and repetitive changes in potentials with parameters deviating from those considered normal. The term refers to heart anomalies but has a broader meaning. Dysrhythmias may concern the heart, neurological system, digestive system, and sensory organs. Ion currents conducted through ion channels are a universal phenomenon. The occurrence of channel abnormalities will therefore result in disorders with clinical manifestations depending on the affected tissue, but phenomena from other tissues and organs may also manifest themselves. A similar problem concerns the implementation of pharmacotherapy, the mechanism of which is related to the impact on various ion currents. Treatment in this case may cause unfavorable effects on other tissues and organs. Drugs acting through the modulation of ion currents are characterized by relatively low tissue specificity. To assess a therapy's efficacy and safety, the risk of occurrences in other tissues with similar mechanisms of action must be considered. In the present review, the focus is shifted prominently onto a comparison of abnormal electrical activity within different tissues and organs. This review includes an overview of the types of dysrhythmias and the basic techniques of clinical examination of electrophysiological disorders. It also presents a concise overview of the available pharmacotherapy in particular diseases. In addition, the authors review the relevant ion channels and their research technique based on patch clumping.
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Affiliation(s)
- Adrianna Witczyńska
- Department of Organic Chemistry, Faculty of Pharmacy, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, 87-100 Toruń, Poland;
| | - Aidas Alaburda
- Department of Neurobiology and Biophysics, Institute of Bioscience, Vilnius University Saulėtekio Ave. 7, LT-10257 Vilnius, Lithuania;
| | - Grzegorz Grześk
- Department of Cardiology and Clinical Pharmacology, Faculty of Health Sciences, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, 87-100 Toruń, Poland;
| | - Jacek Nowaczyk
- Department of Physical Chemistry and Physicochemistry of Polymers, Faculty of Chemistry, Nicolaus Copernicus University, 7 Gagarina St., 87-100 Toruń, Poland;
| | - Alicja Nowaczyk
- Department of Organic Chemistry, Faculty of Pharmacy, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, 87-100 Toruń, Poland;
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Srichawla BS, Kipkorir V, Hayward L. Heart rate variability analysis in toxic leukoencephalopathy-induced malignant catatonia: A case report. Medicine (Baltimore) 2023; 102:e35371. [PMID: 37932984 PMCID: PMC10627692 DOI: 10.1097/md.0000000000035371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 08/31/2023] [Indexed: 11/08/2023] Open
Abstract
RATIONALE Toxic leukoencephalopathy, a condition resulting from exposure to toxic substances, can lead to malignant catatonia, a severe motor dysfunction with symptoms such as muscle rigidity and high-spiking fever, hypertensive urgency, and tachycardia. This case study investigates the relationship between toxic leukoencephalopathy-induced malignant catatonia and heart rate variability (HRV), a marker of autonomic nervous system function. PATIENT CONCERNS A 51-year-old male presented to the emergency department with acute onset of progressively worsening mental status. DIAGNOSES The patient was diagnosed with cocaine-induced toxic leukoencephalopathy causing malignant catatonia. INTERVENTIONS A 5-day escalating treatment regimen was instituted for the management of malignant catatonia until resolution. Daily HRV parameters in the temporal and frequency domain, geometric data, and cardiac entropy were recorded using HRVAnalysis v.1.2 (ANS Lab Tools). The HRV analysis was correlated with pharmacologic management, the Bush-Francis catatonia rating scale, and hemodynamic parameters, including blood pressure, heart rate, and temperature. OUTCOMES The results showed a correlation between the severity and frequency of malignant catatonic episodes and the patient autonomic dysfunction. Improvement in malignant catatonia with pharmacological management was associated with an improved HRV, including elevated rMSSD, SDNN, cardiac entropy, and pNN50%. LESSONS Malignant catatonia is associated with decreased HRV, and its management is associated with an increase. This suggests a link between malignant catatonia and autonomic dysfunction, highlighting the potential benefits of treating malignant catatonia to improve autonomic function and reduce cardiovascular risk.
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Affiliation(s)
- Bahadar S. Srichawla
- Department of Neurology, University of Massachusetts Chan Medical School, MA, USA
| | - Vincent Kipkorir
- Department of Medicine, University of Nairobi, University Way, Nairobi, Kenya
| | - Lawrence Hayward
- Department of Neurology, University of Massachusetts Chan Medical School, MA, USA
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Tharion E, Kachroo U, Noel J, Samuel P. Cardiac Autonomic Activity, Personality Traits, and Academic Performance in First-Year Medical Students: A Gender-Specific Relation. Cureus 2023; 15:e49087. [PMID: 38024029 PMCID: PMC10660775 DOI: 10.7759/cureus.49087] [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: 11/20/2023] [Indexed: 12/01/2023] Open
Abstract
Background It is not always the sincere or hardworking or intelligent student that gets the highest grades. Exploring unknown dimensions that may distinguish academic performance in adolescents/youth migrating from a high school study environment to that of a professional school and in a learning environment without parental supervision for the first time remains important. We hypothesized that cardiac autonomic activity influenced by cognitive domain factors and emotions would predict academic success in them. Further, we investigated which of their personality traits related to academic performance. Exploratory gender-based analysis was included. Methods A prospective cohort study measured first-year medical students' resting heart rate, heart rate variability (HRV), and personality traits (from the self-reported NEO Five-Factor Inventory-3). Spearman's correlation coefficient tested the correlation between the year-end final aggregate marks and assessed parameters, including subgroup analysis based on gender. Regression analyses of variables with academic marks were performed in the entire cohort. Results The aggregate marks of 81 volunteering students (Mage = 18.7, SD = 0.8 years; 42 females, 39 males) as a cohort did not correlate with their resting heart rate or HRV indices. Subgroup analysis revealed a positive correlation between marks and high-frequency power (r = 0.33, p= 0.03) and total power (r = 0.37, p= 0.02) of HRV in females. The marks positively correlated with the personality conscientiousness score (r = 0.32, p= 0.04) and extraversion score (r = 0.34, p= 0.03) in females. Multivariable regression analysis in the entire cohort revealed no significant interactions. Conclusion Academic performance was significantly related to cardiac autonomic modulation and personality traits of conscientiousness and extraversion in female but not male first-year medical students. These results indicate a gender-specific difference in the relation between scholastic performance and HRV in adolescents/youth transiting from high school to professional schools and entering a study environment without parental supervision for the first time. Further our data expands the knowledge base of educational psychology among them.
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Affiliation(s)
- Elizabeth Tharion
- Department of Physiology, Christian Medical College, Vellore, Vellore, IND
| | - Upasana Kachroo
- Department of Physiology, All India Institute of Medical Sciences, Raipur, Raipur, IND
| | - Joseph Noel
- Department of Psychiatry, Christian Medical College, Vellore, Vellore, IND
| | - Prasanna Samuel
- Department of Biostatistics, Christian Medical College, Vellore, Vellore, IND
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Nicolini P, Lucchi T, Vicenzi M. Heart rate variability: a predictor of cognitive decline. Aging (Albany NY) 2023; 15:9233-9234. [PMID: 37733678 PMCID: PMC10564411 DOI: 10.18632/aging.204715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 05/05/2023] [Indexed: 09/23/2023]
Affiliation(s)
- Paola Nicolini
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Geriatric Unit, Internal Medicine Department, Milan, Italy
| | - Tiziano Lucchi
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Geriatric Unit, Internal Medicine Department, Milan, Italy
| | - Marco Vicenzi
- Dyspnea Lab, Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Department of Cardio-Thoracic-Vascular Diseases, Milan, Italy
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