1
|
Hu J, Ju M, Shi Y, Liu X, Zhu Y. Efficacy and safety of trigeminal parasympathetic pathway stimulation for dry eye: A systematic review and meta-analysis. Indian J Ophthalmol 2024; 72:S381-S392. [PMID: 38454841 DOI: 10.4103/ijo.ijo_2147_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 11/28/2023] [Indexed: 03/09/2024] Open
Abstract
This study aimed to investigate the efficacy and safety of trigeminal parasympathetic pathway (TPP) stimulation in the treatment of dry eye. A comprehensive search for randomized clinical trials was performed in seven databases (MEDLINE, Embase, CENTRAL, etc.) up to 28 February 2023. After screening the suitable studies, the data were extracted and transformed as necessary. Data synthesis and analysis were performed using Review Manager 5.4, and the risk of bias and quality of evidence were evaluated with the recommended tools. Fourteen studies enrolling 1714 patients with two methods (electrical and chemical) of TPP stimulation were included. Overall findings indicate that TPP stimulation was effective in reducing subjective symptom score (standardized mean difference [SMD], -0.45; 95% confidence interval [CI], -0.63 to -0.28), corneal fluorescence staining (mean difference [MD], -0.78; 95% CI, -1.39 to -0.18), goblet cell area (MD, -32.10; 95% CI, -54.58 to -9.62) and perimeter (MD, -5.90; 95% CI, -10.27 to -1.53), and increasing Schirmer's test score (SMD, 0.98; 95% CI, 0.65 to 1.31) and tear film break-up time (SMD, 0.57; 95% CI, 0.19 to 0.95). Compared to inactive or low-activity stimulation controls, it has a higher incidence of adverse events. Therefore, TPP stimulation may be an effective treatment for dry eye, whether electrical or chemical. Adverse events are relatively mild and tolerable. Due to the high heterogeneity and low level of evidence, the current conclusions require to be further verified.
Collapse
Affiliation(s)
- Jindong Hu
- Department of Integrative Medicine, Huashan Hospital, Fudan University, Shanghai, China
- Department of Integrative Medicine, Baoshan Campus of Huashan Hospital, Fudan University, Shanghai, China
| | - Mohan Ju
- Institute of Antibiotics, Huashan Hospital, Fudan University, Shanghai, China
| | - Yongjun Shi
- Department of Anesthesiology, Yichun Hospital of Traditional Chinese Medicine, Yichun, Jiangxi, China
| | - Xinquan Liu
- Department of Ophthalmology, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yongbao Zhu
- Department of Oncology, Shanghai Baoshan Luodian Hospital, Shanghai University, Shanghai, China
| |
Collapse
|
2
|
Letson HL, Biros E, Morris JL, Dobson GP. ALM Fluid Therapy Shifts Sympathetic Hyperactivity to Parasympathetic Dominance in the Rat Model of Non-Compressible Hemorrhagic Shock. Shock 2022; 57:264-273. [PMID: 34798632 DOI: 10.1097/shk.0000000000001886] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
ABSTRACT Excessive sympathetic outflow following trauma can lead to cardiac dysfunction, inflammation, coagulopathy, and poor outcomes. We previously reported that buprenorphine analgesia decreased survival after hemorrhagic trauma. Our aim is to examine the underlying mechanisms of mortality in a non-compressible hemorrhage rat model resuscitated with saline or adenosine, lidocaine, magnesium (ALM). Anesthetized adult male Sprague-Dawley rats were randomly assigned to Saline control group or ALM therapy group (both n = 10). Hemorrhage was induced by 50% liver resection. After 15 min, 0.7 mL/kg 3% NaCl ± ALM intravenous bolus was administered, and after 60 min, 0.9% NaCl ± ALM was infused for 4 h (0.5 mL/kg/h) with 72 h monitoring. Animals received 6-12-hourly buprenorphine for analgesia. Hemodynamics, heart rate variability, echocardiography, and adiponectin were measured. Cardiac tissue was analyzed for adrenergic/cholinergic receptor expression, inflammation, and histopathology. Four ALM animals and one Saline control survived to 72 h. Mortality was associated with up to 97% decreases in adrenergic (β-1, α-1A) and cholinergic (M2) receptor expression, cardiac inflammation, myocyte Ca2+ loading, and histopathology, indicating heart ischemia/failure. ALM survivors had higher cardiac output and stroke volume, a 30-fold increase in parasympathetic/sympathetic receptor expression ratio, and higher circulating adiponectin compared to Saline controls. Paradoxically, Saline cardiac adiponectin hormone levels were higher than ALM, with no change in receptor expression, indicating intra-cardiac synthesis. Mortality appears to be a "systems failure" associated with CNS dysregulation of cardiac function. Survival involves an increased parasympathetic dominance to support cardiac pump function with reduced myocardial inflammation. Increased cardiac α-1A adrenergic receptor in ALM survivors may be significant, as this receptor is highly protective during heart dysfunction/failure.
Collapse
Affiliation(s)
- Hayley L Letson
- Heart and Trauma Research Laboratory, College of Medicine and Dentistry, James Cook University, Queensland, Australia
| | | | | | | |
Collapse
|
3
|
Cuenca-Bermejo L, Almela P, Navarro-Zaragoza J, Fernández Villalba E, González-Cuello AM, Laorden ML, Herrero MT. Cardiac Changes in Parkinson's Disease: Lessons from Clinical and Experimental Evidence. Int J Mol Sci 2021; 22:13488. [PMID: 34948285 PMCID: PMC8705692 DOI: 10.3390/ijms222413488] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 12/10/2021] [Accepted: 12/11/2021] [Indexed: 01/18/2023] Open
Abstract
Dysautonomia is a common non-motor symptom in Parkinson's disease (PD). Most dysautonomic symptoms appear due to alterations in the peripheral nerves of the autonomic nervous system, including both the sympathetic and parasympathetic nervous systems. The degeneration of sympathetic nerve fibers and neurons leads to cardiovascular dysfunction, which is highly prevalent in PD patients. Cardiac alterations such as orthostatic hypotension, heart rate variability, modifications in cardiogram parameters and baroreflex dysfunction can appear in both the early and late stages of PD, worsening as the disease progresses. In PD patients it is generally found that parasympathetic activity is decreased, while sympathetic activity is increased. This situation gives rise to an imbalance of both tonicities which might, in turn, promote a higher risk of cardiac damage through tachycardia and vasoconstriction. Cardiovascular abnormalities can also appear as a side effect of PD treatment: L-DOPA can decrease blood pressure and aggravate orthostatic hypotension as a result of a negative inotropic effect on the heart. This unwanted side effect limits the therapeutic use of L-DOPA in geriatric patients with PD and can contribute to the number of hospital admissions. Therefore, it is essential to define the cardiac features related to PD for the monitorization of the heart condition in parkinsonian individuals. This information can allow the application of intervention strategies to improve the course of the disease and the proposition of new alternatives for its treatment to eliminate or reverse the motor and non-motor symptoms, especially in geriatric patients.
Collapse
Affiliation(s)
- Lorena Cuenca-Bermejo
- Clinical and Experimental Neuroscience Group/Biomedical Research Institute of Murcia (NiCE-IMIB)/Institute for Aging Research, School of Medicine, University of Murcia, 30100 Murcia, Spain; (L.C.-B.); (A.-M.G.-C.)
| | - Pilar Almela
- Department of Pharmacology, School of Medicine, Biomedical Research Institute of Murcia (IMIB), University of Murcia, 30100 Murcia, Spain; (P.A.); (J.N.-Z.); (M.-L.L.)
| | - Javier Navarro-Zaragoza
- Department of Pharmacology, School of Medicine, Biomedical Research Institute of Murcia (IMIB), University of Murcia, 30100 Murcia, Spain; (P.A.); (J.N.-Z.); (M.-L.L.)
| | - Emiliano Fernández Villalba
- Clinical and Experimental Neuroscience Group/Biomedical Research Institute of Murcia (NiCE-IMIB)/Institute for Aging Research, School of Medicine, University of Murcia, 30100 Murcia, Spain; (L.C.-B.); (A.-M.G.-C.)
| | - Ana-María González-Cuello
- Clinical and Experimental Neuroscience Group/Biomedical Research Institute of Murcia (NiCE-IMIB)/Institute for Aging Research, School of Medicine, University of Murcia, 30100 Murcia, Spain; (L.C.-B.); (A.-M.G.-C.)
| | - María-Luisa Laorden
- Department of Pharmacology, School of Medicine, Biomedical Research Institute of Murcia (IMIB), University of Murcia, 30100 Murcia, Spain; (P.A.); (J.N.-Z.); (M.-L.L.)
| | - María-Trinidad Herrero
- Clinical and Experimental Neuroscience Group/Biomedical Research Institute of Murcia (NiCE-IMIB)/Institute for Aging Research, School of Medicine, University of Murcia, 30100 Murcia, Spain; (L.C.-B.); (A.-M.G.-C.)
| |
Collapse
|
4
|
Guvenc-Bayram G, Yalcin M. The involvement of the central cholinergic system in the hyperventilation effect of centrally injected nesfatin-1 in rats. Neuropeptides 2021; 90:102186. [PMID: 34425506 DOI: 10.1016/j.npep.2021.102186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 08/11/2021] [Accepted: 08/15/2021] [Indexed: 11/17/2022]
Abstract
We recently demonstrated that peripheral and central administration of nesfatin-1 in fasting and satiety states generate hyperventilation activity by increasing tidal volume (TV), respiratory rate (RR), and respiratory minute ventilation (RVM). The present study aimed to investigate the mediation of central cholinergic receptors effective in respiratory control in the hyperventilation activity of nesfatin-1. Besides this, we intended to determine possible changes in blood gases due to hyperventilation activity caused by nesfatin-1 and investigate the mediation of central cholinergic receptors in these changes. Intracerebroventricular (ICV) administration of nesfatin-1 revealed a hyperventilation response with an increase in TV, RR, RMV, and pO2 and a decrease in pCO2 in saturated Sprague Dawley rats. ICV pretreatment with the muscarinic receptor antagonist atropine partially blocked the RR, RMV, pO2, and pCO2 responses produced by nesfatin-1 while completely blocking the TV response. However, central pretreatment with nicotinic receptor antagonist mecamylamine blocked the respiratory and blood gas responses induced by nesfatin-1. The study's conclusion demonstrated that nesfatin-1 had active hyperventilation effects resulting in an increase in pO2 and a decrease in pCO2. The critical finding of the study was that activation of central cholinergic receptors was involved in nesfatin-1-evoked hyperventilation and blood gas responses.
Collapse
Affiliation(s)
- Gokcen Guvenc-Bayram
- Department of Physiology, Faculty of Veterinary Medicine, Uludag University, Bursa 16059, Turkey; Department of Physiology, Faculty of Veterinary Medicine, Dokuz Eylul University, Kiraz, Izmir 35890, Turkey
| | - Murat Yalcin
- Department of Physiology, Faculty of Veterinary Medicine, Uludag University, Bursa 16059, Turkey.
| |
Collapse
|
5
|
Takeshita Y, Tanaka T, Wakakuri H, Kita Y, Kanamori T, Takamura T. Metabolic and sympathovagal effects of bolus insulin glulisine versus basal insulin glargine therapy in people with type 2 diabetes: A randomized controlled study. J Diabetes Investig 2021; 12:1193-1201. [PMID: 33251697 PMCID: PMC8264393 DOI: 10.1111/jdi.13471] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 11/12/2020] [Accepted: 11/22/2020] [Indexed: 11/28/2022] Open
Abstract
AIMS/INTRODUCTION This study compares the effects of two different insulin regimens - basal versus bolus insulin - on metabolic and cardiovascular autonomic function in Japanese participants with type 2 diabetes. MATERIALS AND METHODS Participants were randomly assigned to groups for therapy with insulin glulisine (IGlu) or insulin glargine (IGla). The primary efficacy end-point was glycemic variability, including M-values, mean of glucose levels, and a blood glucose profile of seven time points before and after the intervention. The secondary end-points included pleiotropic effects, including endothelial and cardiac autonomic nerve functions. RESULTS Blood glucose levels at all time points significantly decreased in both groups. Post-lunch, post-dinner, and bedtime blood glucose levels were significantly lower in the IGlu group than in the IGla group. Nadir fasting blood glucose levels at the end-point were significantly lower in the IGla group than in the IGlu group. The M-value and mean blood glucose levels were significantly decreased from baseline in both groups, although the former was significantly lower in the IGlu group than in the IGla group. IGla, but not IGlu, was found to elevate 24-h parasympathetic tone, especially during night-time, and it decreased 24-h sympathetic nerve activity, especially at dawn. CONCLUSIONS Both IGlu and IGla regimens reduced glucose variability, with IGlu bringing a greater reduction in M-value. IGla, but not IGlu, increased parasympathetic tone during night-time and decreased sympathetic nerve activity at dawn. These findings shed light on the previously unrecognized role of night-time basal insulin supplementation on sympathovagal activity in type 2 diabetes patients.
Collapse
Affiliation(s)
- Yumie Takeshita
- Department of Endocrinology and MetabolismKanazawa University Graduate School of Medical SciencesKanazawaIshikawaJapan
| | - Takeo Tanaka
- Department of Endocrinology and MetabolismKanazawa University Graduate School of Medical SciencesKanazawaIshikawaJapan
| | - Hitomi Wakakuri
- Department of Endocrinology and MetabolismKanazawa University Graduate School of Medical SciencesKanazawaIshikawaJapan
| | - Yuki Kita
- Department of Endocrinology and MetabolismKanazawa University Graduate School of Medical SciencesKanazawaIshikawaJapan
| | - Takehiro Kanamori
- Department of Endocrinology and MetabolismKanazawa University Graduate School of Medical SciencesKanazawaIshikawaJapan
| | - Toshinari Takamura
- Department of Endocrinology and MetabolismKanazawa University Graduate School of Medical SciencesKanazawaIshikawaJapan
| |
Collapse
|
6
|
Abstract
Choline is essential for maintaining the structure and function of cells in humans. Choline plays an important role in eye health and disease. It is a precursor of acetylcholine, a neurotransmitter of the parasympathetic nervous system, and it is involved in the production and secretion of tears by the lacrimal glands. It also contributes to the stability of the cells and tears on the ocular surface and is involved in retinal development and differentiation. Choline deficiency is associated with retinal hemorrhage, glaucoma, and dry eye syndrome. Choline supplementation may be effective for treating these diseases.
Collapse
|
7
|
Abstract
Despite a rapidly growing literature, the role played by the brain in both normal glucose homeostasis and in type 2 diabetes pathogenesis remains poorly understood. In this review, we introduce a framework for understanding the brain's essential role in these processes based on evidence that the brain, like the pancreas, is equipped to sense and respond to changes in the circulating glucose level. Further, we review evidence that glucose sensing by the brain plays a fundamental role in establishing the defended level of blood glucose, and that defects in this control system contribute to type 2 diabetes pathogenesis. We also consider the possibility that the close association between obesity and type 2 diabetes arises from a shared defect in the highly integrated neurocircuitry governing energy homeostasis and glucose homeostasis. Thus, whereas obesity is characterised by an increase in the defended level of the body's fuel stores (e.g. adipose mass), type 2 diabetes is characterised by an increase in the defended level of the body's available fuel (e.g. circulating glucose), with the underlying pathogenesis in each case involving impaired sensing of (or responsiveness to) relevant humoral negative feedback signals. This perspective is strengthened by growing preclinical evidence that in type 2 diabetes the defended level of blood glucose can be restored to normal by therapies that restore the brain's ability to properly sense the circulating glucose level. Graphical abstract.
Collapse
Affiliation(s)
- Kimberly M Alonge
- UW Medicine Diabetes Institute, University of Washington, Seattle, WA, USA
| | - David A D'Alessio
- Duke Division of Endocrinology, Department of Medicine, Duke University Medical Center, Durham, NC, USA
| | - Michael W Schwartz
- UW Medicine Diabetes Institute, University of Washington, Seattle, WA, USA.
| |
Collapse
|
8
|
Jung I, Lee DY, Lee MY, Kwon H, Rhee EJ, Park CY, Oh KW, Lee WY, Park SW, Park SE. Autonomic Imbalance Increases the Risk for Non-alcoholic Fatty Liver Disease. Front Endocrinol (Lausanne) 2021; 12:752944. [PMID: 34819920 PMCID: PMC8606663 DOI: 10.3389/fendo.2021.752944] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 10/21/2021] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Although autonomic imbalance is associated with an increased risk for metabolic disease, its effects on nonalcoholic fatty liver disease (NAFLD) remains unclear. We aimed to evaluate whether autonomic dysfunction predicts the risk for nonalcoholic fatty liver disease (NAFLD). METHODS A total of 33,899 participants without NAFLD who underwent health screening programs between 2011 and 2018 were enrolled. NAFLD was identified by ultrasonography. Autonomic activity was estimated using heart rate variability (HRV). Time domain [standard deviation of the normal-to-normal interval (SDNN) and root mean square difference (RMSSD)]; frequency domain [total power (TP), low frequency (LF), and high frequency (HF), and LF/HF ratio were analyzed. FINDINGS A total 6,466 participants developed NAFLD within a median of 5.7 years. Subjects with incident NAFLD showed decreased overall autonomic modulation and vagal activity with lowered SDNN, RMSSD, HF, normalized HF, compared to those without NAFLD. As the SDNN, RMSSD, TP, LF, and HF tertiles increased, the risk of NAFLD decreased with tertile 1 being the reference group [the hazard ratios (95% confidence intervals) of tertile 3 were 0.90 (0.85-0.96), 0.83 (0.78-0.88), 0.91 (0.86-0.97), 0.93 (0.87-0.99) and 0.89 (0.83-0.94), respectively] after adjusting for potential confounders. The risk for NAFLD was significantly higher in subjects in whom sustained elevated heart rate, normalized LF, and LF/HF ratio values than in those with sustained decrease in these parameters during follow-up. CONCLUSIONS Overall autonomic imbalance, decreased parasympathetic activity, and recently increased sympathetic activity might increase the risk of NAFLD.
Collapse
Affiliation(s)
- Inha Jung
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Da Young Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, South Korea
| | - Mi Yeon Lee
- Division of Biostatistics, Department of R&D Management, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Hyemi Kwon
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Eun-Jung Rhee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Cheol-Young Park
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Ki-Won Oh
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Won-Young Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Sung-Woo Park
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Se Eun Park
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea
- *Correspondence: Se Eun Park,
| |
Collapse
|
9
|
Cornell DJ, Noel SE, Zhang X, Ebersole KT. Influence of a Training Academy on the Parasympathetic Nervous System Reactivation of Firefighter Recruits-An Observational Cohort Study. Int J Environ Res Public Health 2020; 18:E109. [PMID: 33375223 PMCID: PMC7795559 DOI: 10.3390/ijerph18010109] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Revised: 12/17/2020] [Accepted: 12/22/2020] [Indexed: 11/16/2022]
Abstract
Sudden cardiac death (SCD) is the leading type of line-of-duty death among firefighters. An inability to restore parasympathetic nervous system (PSNS) control after activity is associated with SCD. Post-exercise heart rate recovery (HRR) provides unique insight into reactivation of the PSNS. Thus, the purpose of this study was to examine longitudinal changes in HRR responses of 25 male firefighter recruits. HR data were collected after submaximal exercise at week 1 (W1), week 6 (W6), and week 15 (W15) of their training at an academy. Percent maximal heart rate (%MHR) measures were computed at each HRR time point (%MHR0, %MHR15, %MHR30, %MHR45, %MHR60, %MHR120, %MHR180) and absolute HRR values were calculated at 30 s (ΔHRR30), 60 s (ΔHRR60), 120 s (ΔHRR120), and 180 s (ΔHRR180). After controlling for age and percent body fat, there was no statistically significant interaction between Week × HRR (p = 0.730), and there were no changes in ΔHRR30, ΔHRR60, and ΔHRR120, and ΔHRR180 indices across time. However, %MHR at W6 and W15 was significantly lower than %MHR at W1 at every HRR time point (ps < 0.001). Therefore, although the firefighter recruit training academy elicited positive training adaptations, changes in PSNS reactivation after submaximal activity were not identified.
Collapse
Affiliation(s)
- David J. Cornell
- Health Assessment Laboratory, University of Massachusetts Lowell, Lowell, MA 01854, USA;
- Center for Population Health, University of Massachusetts Lowell, Lowell, MA 01854, USA;
- Department of Physical Therapy and Kinesiology, University of Massachusetts Lowell, Lowell, MA 01854, USA
| | - Sabrina E. Noel
- Health Assessment Laboratory, University of Massachusetts Lowell, Lowell, MA 01854, USA;
- Center for Population Health, University of Massachusetts Lowell, Lowell, MA 01854, USA;
- Department of Biomedical and Nutritional Sciences, University of Massachusetts Lowell, Lowell, MA 01854, USA
| | - Xiyuan Zhang
- Center for Population Health, University of Massachusetts Lowell, Lowell, MA 01854, USA;
| | - Kyle T. Ebersole
- Human Performance and Sport Physiology Laboratory, University of Wisconsin-Milwaukee, Milwaukee, WI 53211, USA;
- Department of Occupational Sciences and Technology, University of Wisconsin-Milwaukee, Milwaukee, WI 53211, USA
| |
Collapse
|
10
|
Casement MD, Goldstein TR, Merranko J, Gratzmiller SM, Franzen PL. Sleep and Parasympathetic Activity During Rest and Stress in Healthy Adolescents and Adolescents With Bipolar Disorder. Psychosom Med 2020; 81:782-790. [PMID: 31369483 PMCID: PMC6832846 DOI: 10.1097/psy.0000000000000737] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVE Sleep disruption contributes to the pathophysiology of mental disorders, particularly bipolar illness, but the biobehavioral mechanisms of this relationship are insufficiently understood. This study evaluated sleep duration, timing, and variability as prospective predictors of parasympathetic nervous system activity during rest and social stress in adolescents with bipolar disorder, reflecting sleep-related interference in stress regulatory systems that may confer vulnerability to mood episodes. METHOD Participants were adolescents with bipolar disorder (n = 22) and healthy adolescents (n = 27). Sleep duration and timing were measured by actigraphy for 1 week before a laboratory social stress task, during which high-frequency heart rate variability (HF-HRV) was indexed using electrocardiography. Multilevel models were used to evaluate group, sleep characteristics, and their interactions as predictors of initial HF-HRV and change in HF-HRV during rest and stress. RESULTS Associations between group and changes in HF-HRV during stress were moderated by sleep duration mean (z = 2.24, p = .025) and variability (z = -2.78, p = .006). There were also main effects of mean sleep duration on initial HF-HRV during rest (z = -5.37, p < .001) and stress (z = -2.69, p = .007). Follow-up analyses indicated that, in bipolar adolescents during stress, shorter and longer sleep durations were associated with lower initial HF-HRV (z = -5.44, p < .001), and greater variability in sleep duration was associated with less change in HF-HRV (z = -2.18, p = .029). CONCLUSIONS Sleep durations that are relatively short or long, which are characteristic of mood episodes, are associated with parasympathetic vulnerability to social stress in adolescents with bipolar disorder. Obtaining regular sleep of moderate duration may favorably affect responses to stress in bipolar youth.
Collapse
Affiliation(s)
- Melynda D Casement
- From the Department of Psychology (Casement), University of Oregon, Eugene, Oregon; and Department of Psychiatry, University of Pittsburgh (Goldstein, Merranko, Gratzmiller, Franzen), Pittsburgh, Pennsylvania
| | | | | | | | | |
Collapse
|
11
|
Abstract
In COVID-19, lung manifestations present as a slowly evolving pneumonia with insidious early onset interstitial pulmonary edema that undergoes acute exacerbation in the late stages and microvascular thrombosis. Currently, these manifestations are considered to be only consequences of pulmonary SARS-CoV-2 virus infection. We are proposing a new hypothesis that neurogenic insult may also play a major role in the pathogenesis of these manifestations. SARS-CoV-2 mediated inflammation of the nucleus tractus solitarius (NTS) may play a role in the acute exacerbation of pulmonary edema and microvascular clotting in COVID-19 patients.
Collapse
Affiliation(s)
- Anoop U.R.
- UR Anoop Research
Group, Pondicherry, India
605008
| | - Kavita Verma
- UR Anoop Research
Group, Pondicherry, India
605008
| |
Collapse
|
12
|
Zhao DQ, Xue H, Sun HJ. Nervous mechanisms of restraint water-immersion stress-induced gastric mucosal lesion. World J Gastroenterol 2020; 26:2533-2549. [PMID: 32523309 PMCID: PMC7265141 DOI: 10.3748/wjg.v26.i20.2533] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Revised: 04/07/2020] [Accepted: 04/28/2020] [Indexed: 02/06/2023] Open
Abstract
Stress-induced gastric mucosal lesion (SGML) is one of the most common visceral complications after trauma. Exploring the nervous mechanisms of SGML has become a research hotspot. Restraint water-immersion stress (RWIS) can induce GML and has been widely used to elucidate the nervous mechanisms of SGML. It is believed that RWIS-induced GML is mainly caused by the enhanced activity of vagal parasympathetic nerves. Many central nuclei, such as the dorsal motor nucleus of the vagus, nucleus of the solitary tract, supraoptic nucleus and paraventricular nucleus of the hypothalamus, mediodorsal nucleus of the thalamus, central nucleus of the amygdala and medial prefrontal cortex, are involved in the formation of SGML in varying degrees. Neurotransmitters/neuromodulators, such as nitric oxide, hydrogen sulfide, vasoactive intestinal peptide, calcitonin gene-related peptide, substance P, enkephalin, 5-hydroxytryptamine, acetylcholine, catecholamine, glutamate, γ-aminobutyric acid, oxytocin and arginine vasopressin, can participate in the regulation of stress. However, inconsistent and even contradictory results have been obtained regarding the actual roles of each nucleus in the nervous mechanism of RWIS-induced GML, such as the involvement of different nuclei with the time of RWIS, the different levels of involvement of the sub-regions of the same nucleus, and the diverse signalling molecules, remain to be further elucidated.
Collapse
Affiliation(s)
- Dong-Qin Zhao
- Key Laboratory of Animal Resistance of Shandong Province, College of Life Sciences, Shandong Normal University, Jinan 250014, Shandong Province, China
| | - Hua Xue
- Key Laboratory of Animal Resistance of Shandong Province, College of Life Sciences, Shandong Normal University, Jinan 250014, Shandong Province, China
| | - Hai-Ji Sun
- Key Laboratory of Animal Resistance of Shandong Province, College of Life Sciences, Shandong Normal University, Jinan 250014, Shandong Province, China
| |
Collapse
|
13
|
Abstract
The control mechanisms and implications of heart rate variability (HRV) under the sympathetic (SNS) and parasympathetic nervous system (PNS) modulation remain poorly understood. Here, we establish the HR model/HRV responder using a nonlinear process derived from Newton's second law in stochastic self-restoring systems through dynamic analysis of physiological properties. We conduct model validation by testing, predictions, simulations, and sensitivity and time-scale analysis. We confirm that the outputs of the HRV responder can be accepted as the real data-generating process. Empirical studies show that the dynamic control mechanism of heart rate is a stable fixed point, rather than a strange attractor or transitions between a fixed point and a limit cycle; HR slope (amplitude) may depend on the ratio of cardiac disturbance or metabolic demand mean (standard deviation) to myocardial electrical resistance (PNS-SNS activity). For example, when metabolic demands remain unchanged, HR amplitude depends on PNS to SNS activity; when autonomic activity remains unchanged, HR amplitude during resting reflects basal metabolism. HR parameter alterations suggest that age-related decreased HRV, ultrareduced HRV in heart failure, and ultraelevated HRV in ST segment alterations refer to age-related decreased basal metabolism, impaired myocardial metabolism, and SNS hyperactivity triggered by myocardial ischemia, respectively.
Collapse
Affiliation(s)
- Zonglu He
- Faculty of Management and Economics, Kaetsu University, 2-8-4 Minami-cho, Hanakoganei, Kodaira-shi, Tokyo, 187-8578, Japan.
| |
Collapse
|
14
|
Osailan AM, Alqahtani B, Elnaggar R. Obesity and parasympathetic reactivation of the heart following exercise testing in young male adults: a pilot study. Ann Saudi Med 2020; 40:113-119. [PMID: 32241165 PMCID: PMC7118237 DOI: 10.5144/0256-4947.2020.113] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Accepted: 12/27/2019] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND In elderly people, obesity may induce changes in the autonomic nervous system via alteration of the balance between the sympathetic and parasympathetic nervous systems. Little is known about obesity and parasympathetic reactivation following exercise testing, particularly in young people in Saudi Arabia, and its relationship with body composition parameters. OBJECTIVES Compare parasympathetic reactivation using heart rate recovery (HRR) following the exercise test between young obese and nonobese people and explore the association between body composition parameters with HRR. DESIGNS Cross-sectional study. SETTING University research lab. PATIENTS AND METHODS Twenty-seven young male college students underwent anthropometric measurements and treadmill exercise testing, during which the heart rate was monitored via 12-lead electro-cardiography. Participants were divided into a group (n=15) with high body fat percentage (>30%), and a group (n=12) with a normal body fat percentage (<30%) to compare multiple parameters including HRR, which was defined as the absolute change from heart rate (HR) peak during exercise to 1-minute post-HR peak. MAIN OUTCOME MEASURES HRR, body mass index, waist-to-hip ratio, fat percentage, and trunk fat. SAMPLE SIZE AND CHARACTERISTICS: n=27, mean (SD) age=22.4 (0.98) years, range 21-25 years. RESULTS There was no significant difference in HRR between the groups (32.20 [13.42] bpm for high body fat percentage vs 35.42 [13.35] bpm for normal body fat percentage) ( P=.54). We found a non-significant inverse correlations of HRR with BMI (r=-0.18, P=.37), WHR (r=-0.04, P=.86), fat percentage (r=-0.18, P=.38) and trunk fat (r=-0.23, P=.25). CONCLUSION HRR was preserved in our young obese people and was not different from nonobese people. Furthermore, it seems that obese people with higher body composition parameters may have slower HRR, or slower recovery indicating poorer parasympathetic reactivation. LIMITATIONS Need a larger sample to confirm the findings of this pilot study. CONFLICT OF INTEREST None.
Collapse
Affiliation(s)
- Ahmed M. Osailan
- From the Department of Physical Therapy and Rehabilitation Sciences, College of Applied Medical Sciences, Prince Sattam bin Abdulaziz University, Alkharj, Central, Saudi Arabia
| | - Badr Alqahtani
- From the Department of Physical Therapy and Rehabilitation Sciences, College of Applied Medical Sciences, Prince Sattam bin Abdulaziz University, Alkharj, Central, Saudi Arabia
| | - Ragab Elnaggar
- From the Department of Physical Therapy and Rehabilitation Sciences, College of Applied Medical Sciences, Prince Sattam bin Abdulaziz University, Alkharj, Central, Saudi Arabia
| |
Collapse
|
15
|
Rampichini S, Gervasoni E, Cattaneo D, Rovaris M, Grosso C, Maggioni MA, Merati G. Impaired heart rate recovery after sub-maximal physical exercise in people with multiple sclerosis. Mult Scler Relat Disord 2020; 40:101960. [PMID: 32032843 DOI: 10.1016/j.msard.2020.101960] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 01/07/2020] [Accepted: 01/18/2020] [Indexed: 11/18/2022]
Abstract
BACKGROUND Heart Rate Recovery (HRR) after a physical exercise has been poorly investigated in people with multiple sclerosis (PwMS). OBJECTIVE To evaluate the kinetics of HRR and its autonomic modulation in PwMS and to elucidate the interplay between HRR and subjective fatigue. METHODS ECG was digitally acquired during rest (5 min), submaximal exercise (4 min at 10 W of upper limb cycling) and recovery (3 min) in 17 PwMS (EDSS: 5.9 ± 1.2, mean±standard deviation) and 17 healthy control (HC) subjects. Short-term (first 30 s) and long-term (up to180 s) validated indices of HRR were calculated. The time course of the parasympathetic index of heart rate variability RMSSD (Root Mean Square of Successive Differences) was computed every 30 s of recovery. Subjective fatigue was evaluated by the Borg scale applied to breathing and upper limbs. RESULTS In comparison with HC, the short-term HRR indices were significantly slower (P < 0.05) in PwMS, whereas the long-term ones did not. The time course of RMSSD was significantly different in PwMS (P < 0.05). HRR and HRV indexes did not correlate with fatigue perception and baseline HRV values. CONCLUSION The cardiac parasympathetic reactivation from a submaximal exercise was blunted in PwMS, thereby slowing the short-term phase of HRR. This may contribute to the higher cardiovascular risk in PwMS, but the mechanism needs further investigation. The parasympathetic impairment during post-exercise HR reactivation cannot be predicted by baseline HRV values and may therefore be revealed only by an appropriate provocative low-intensity physical test.
Collapse
Affiliation(s)
- Susanna Rampichini
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy
| | | | | | | | | | - Martina Anna Maggioni
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy; Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Physiology, Center for Space Medicine and Extreme Environments, Charitéplatz 1, 10117 Berlin, Germany
| | - Giampiero Merati
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy; IRCCS Fondazione Don Carlo Gnocchi, Milano, Italy
| |
Collapse
|
16
|
Baek A, Shin JC, Lee MY, Kim SH, Kim J, Cho SR. Parasympathetic Effect Induces Cell Cycle Activation in Upper Limbs of Paraplegic Patients with Spinal Cord Injury. Int J Mol Sci 2019; 20:ijms20235982. [PMID: 31783707 PMCID: PMC6929129 DOI: 10.3390/ijms20235982] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Revised: 11/21/2019] [Accepted: 11/23/2019] [Indexed: 01/04/2023] Open
Abstract
The present study aimed to investigate gene expression changes related to cell cycle activation in patients with spinal cord injury (SCI) and to further evaluate the difference between the upper and lower limbs of SCI patients. Fibroblasts were obtained from the upper and lower limbs of SCI patients and healthy subjects. To investigate gene expression profiling in the fibroblasts from SCI patients compared to the healthy subjects, RNA-Seq transcriptome analysis was performed. To validate the parasympathetic effects on cell cycle activation, fibroblasts from upper or lower limbs of SCI patients were treated with the anticholinergic agents tiotropium or acetylcholine, and quantitative RT-PCR and Western blot were conducted. Cell proliferation was significantly increased in the upper limbs of SCI patients compared with the lower limbs of SCI patients and healthy subjects. The pathway and genes involved in cell cycle were identified by RNA-Seq transcriptome analysis. Expression of cell-cycle-related genes CCNB1, CCNB2, PLK1, BUB1, and CDC20 were significantly higher in the upper limbs of SCI patients compared with the lower limbs of SCI patients and healthy subjects. When the fibroblasts were treated with tiotropium the upper limbs and acetylcholine in the lower limbs, the expression of cell-cycle-related genes and cell proliferation were significantly modulated. This study provided the insight that cell proliferation and cell cycle activation were observed to be significantly increased in the upper limbs of SCI patients via the parasympathetic effect.
Collapse
Affiliation(s)
- Ahreum Baek
- Department and Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul 03722, Korea; (A.B.); (J.C.S.); (M.-Y.L.)
- Department of Rehabilitation Medicine, Yonsei University Wonju College of Medicine, Wonju 26426, Korea;
| | - Ji Cheol Shin
- Department and Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul 03722, Korea; (A.B.); (J.C.S.); (M.-Y.L.)
| | - Min-Young Lee
- Department and Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul 03722, Korea; (A.B.); (J.C.S.); (M.-Y.L.)
| | - Sung Hoon Kim
- Department of Rehabilitation Medicine, Yonsei University Wonju College of Medicine, Wonju 26426, Korea;
| | - Jiyong Kim
- Department of Physical Medicine and Rehabilitation, Inje University Ilsanpaik Hospital, 170 Juhwa-ro, Ilsanseo-gu, Goyang 10380, Korea
- Correspondence: (J.K.); (S.-R.C.); Tel.: +82-31-910-7885 (J.K.); +82-2-2228-3715 (S.-R.C.); Fax: +82-31-910-7786 (J.K.); +82-2-363-2795 (S.-R.C.)
| | - Sung-Rae Cho
- Department and Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul 03722, Korea; (A.B.); (J.C.S.); (M.-Y.L.)
- Brain Korea 21 PLUS Project for Medical Science, Yonsei University College of Medicine, Seoul 03722, Korea
- Yonsei Stem Cell Center, Avison Biomedical Research Center, Yonsei University College of Medicine, Seoul 03722, Korea
- Rehabilitation Institute of Neuromuscular Disease, Yonsei University College of Medicine, Seoul 03722, Korea
- Correspondence: (J.K.); (S.-R.C.); Tel.: +82-31-910-7885 (J.K.); +82-2-2228-3715 (S.-R.C.); Fax: +82-31-910-7786 (J.K.); +82-2-363-2795 (S.-R.C.)
| |
Collapse
|
17
|
Levin CJ, Wai JM, Jones JD, Comer SD. Changes in cardiac vagal tone as measured by heart rate variability during naloxone-induced opioid withdrawal. Drug Alcohol Depend 2019; 204:107538. [PMID: 31513980 PMCID: PMC7017784 DOI: 10.1016/j.drugalcdep.2019.06.040] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Revised: 06/03/2019] [Accepted: 06/26/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND Heart rate variability (HRV) is of interest to researchers due to its potential utility as a marker for both physiological and psychological stress. Sympatholytics are used to treat opioid withdrawal, but little information about the parasympathetic system's role in mediating withdrawal symptoms exists. The goal of the current study was to evaluate changes in HRV during opioid withdrawal to provide a better understanding of the autonomic effects of opioid withdrawal. METHODS Ten male participants (mean age = 46.4 years) received intramuscular naloxone (mean dose =0.26 mg) to confirm opioid dependence. The presence and severity of withdrawal symptoms were assessed using subjective and objective measures (Wang et al., 1974). Electrocardiography (ECG) was measured continuously, and HRV was analyzed in 2-minute segments before naloxone injection (at baseline) and after participants were in moderate withdrawal (Wang Test score ≥10). Heart rate, blood pressure, pupil diameter, and respiratory rate were also examined. RESULTS Pupil diameter significantly increased after naloxone administration relative to baseline (t(9) = 5.562, p = 0.000). Both high frequency (HF) HRV (Z = -2.803, p = 0.005) and root mean square of successive differences (RMSSD) HRV (Z = -2.090, p = 0.037) were significantly lower during withdrawal relative to baseline. Increases in heart rate (Z = -2.090, p = 0.032) and systolic pressure (t(9) = 8.099, p = 0.0000) from baseline to withdrawal also were significant. CONCLUSIONS These preliminary data indicate that a large reduction in cardiac vagal tone occurs during naloxone-induced withdrawal. This finding underscores the need for further research into the role of the parasympathetic nervous system in opioid withdrawal.
Collapse
Affiliation(s)
- Charles J Levin
- Division on Substance Use Disorders, New York State Psychiatric Institute and Columbia University Vagelos College of Physicians and Surgeons, 1051 Riverside Drive, New York, NY, 10032, USA.
| | - Jonathan M Wai
- Division on Substance Use Disorders, New York State Psychiatric Institute and Columbia University Vagelos College of Physicians and Surgeons, 1051 Riverside Drive, New York, NY, 10032, USA
| | - Jermaine D Jones
- Division on Substance Use Disorders, New York State Psychiatric Institute and Columbia University Vagelos College of Physicians and Surgeons, 1051 Riverside Drive, New York, NY, 10032, USA
| | - Sandra D Comer
- Division on Substance Use Disorders, New York State Psychiatric Institute and Columbia University Vagelos College of Physicians and Surgeons, 1051 Riverside Drive, New York, NY, 10032, USA
| |
Collapse
|
18
|
Reno CM, Bayles J, Huang Y, Oxspring M, Hirahara AM, Dosdall DJ, Fisher SJ. Severe Hypoglycemia-Induced Fatal Cardiac Arrhythmias Are Mediated by the Parasympathetic Nervous System in Rats. Diabetes 2019; 68:2107-2119. [PMID: 31439645 PMCID: PMC7118248 DOI: 10.2337/db19-0306] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Accepted: 08/09/2019] [Indexed: 12/17/2022]
Abstract
The contribution of the sympathetic nervous system (SNS) versus the parasympathetic nervous system (PSNS) in mediating fatal cardiac arrhythmias during insulin-induced severe hypoglycemia is not well understood. Therefore, experimental protocols were performed in nondiabetic Sprague-Dawley rats to test the SNS with 1) adrenal demedullation and 2) chemical sympathectomy, and to test the PSNS with 3) surgical vagotomy, 4) nicotinic receptor (mecamylamine) and muscarinic receptor (AQ-RA 741) blockade, and 5) ex vivo heart perfusions with normal or low glucose, acetylcholine (ACh), and/or mecamylamine. In protocols 1-4, 3-h hyperinsulinemic (0.2 units/kg/min) and hypoglycemic (10-15 mg/dL) clamps were performed. Adrenal demedullation and chemical sympathectomy had no effect on mortality or arrhythmias during severe hypoglycemia compared with controls. Vagotomy led to a 6.9-fold decrease in mortality; reduced first- and second-degree heart block 4.6- and 4-fold, respectively; and prevented third-degree heart block compared with controls. Pharmacological blockade of nicotinic receptors, but not muscarinic receptors, prevented heart block and mortality versus controls. Ex vivo heart perfusions demonstrated that neither low glucose nor ACh alone caused arrhythmias, but their combination induced heart block that could be abrogated by nicotinic receptor blockade. Taken together, ACh activation of nicotinic receptors via the vagus nerve is the primary mediator of severe hypoglycemia-induced fatal cardiac arrhythmias.
Collapse
Affiliation(s)
- Candace M Reno
- Division of Endocrinology, Metabolism, and Diabetes, Department of Internal Medicine, University of Utah, Salt Lake City, UT
| | - Justin Bayles
- Division of Endocrinology, Metabolism, and Diabetes, Department of Internal Medicine, University of Utah, Salt Lake City, UT
| | - Yiqing Huang
- Division of Endocrinology, Metabolism, and Diabetes, Department of Internal Medicine, University of Utah, Salt Lake City, UT
| | - Milan Oxspring
- Division of Endocrinology, Metabolism, and Diabetes, Department of Internal Medicine, University of Utah, Salt Lake City, UT
| | - Annie M Hirahara
- Nora Eccles Harrison Cardiovascular Research & Training Institute, University of Utah, Salt Lake City, UT
| | - Derek J Dosdall
- Nora Eccles Harrison Cardiovascular Research & Training Institute, University of Utah, Salt Lake City, UT
| | - Simon J Fisher
- Division of Endocrinology, Metabolism, and Diabetes, Department of Internal Medicine, University of Utah, Salt Lake City, UT
- Department of Biochemistry, University of Utah, Salt Lake City, UT
| |
Collapse
|
19
|
Lunkenheimer E, Busuito A, Brown KM, Panlilio C, Skowron EA. The Interpersonal Neurobiology of Child Maltreatment: Parasympathetic Substrates of Interactive Repair in Maltreating and Nonmaltreating Mother-Child Dyads. Child Maltreat 2019; 24:353-363. [PMID: 30674207 PMCID: PMC7556358 DOI: 10.1177/1077559518824058] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Children's repair of conflict with parents may be particularly challenging in maltreating families, and early, stressful parent-child interactions may contribute to children's altered neurobiological regulatory systems. To explore neurobiological signatures of repair processes, we examined whether mother and child individual and dyadic respiratory sinus arrhythmia (RSA) covaried with interactive repair differently in maltreating versus nonmaltreating mother-preschooler dyads (N = 101), accounting for whether repair was mother or child initiated. Mother-initiated repair was equally frequent and protective across groups, associated with no change in mother or child RSA at higher levels of repair. But lower levels of mother repair were associated with child RSA withdrawal in nonmaltreating dyads versus child RSA augmentation in maltreating dyads. In maltreating dyads only, higher child-initiated repair was associated with higher mean mother RSA, whereas lower child repair was associated with mother RSA withdrawal. Findings suggest that interactive repair may have a buffering effect on neurobiological regulation but also that maltreating mothers and children show atypical neurobiological response to interpersonal challenges including differences related to children conducting the work of interactive repair that maltreating parents are less able to provide. We conclude by considering the role of maladaptive parent-child relationship processes in the biological embedding of early adversity.
Collapse
Affiliation(s)
| | - Alex Busuito
- Pennsylvania State University, University Park, PA, USA
| | | | | | | |
Collapse
|
20
|
França da Silva AK, Destro Christofaro DG, Manata Vanzella L, Marques Vanderlei F, Lopez Laurino MJ, Marques Vanderlei LC. Relationship of the Aggregation of Cardiovascular Risk Factors in the Parasympathetic Modulation of Young People with Type 1 Diabetes. ACTA ACUST UNITED AC 2019; 55:medicina55090534. [PMID: 31454959 PMCID: PMC6780872 DOI: 10.3390/medicina55090534] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Revised: 08/20/2019] [Accepted: 08/21/2019] [Indexed: 11/20/2022]
Abstract
Background and objectives: In healthy individuals, autonomic alterations are associated with the aggregation of cardiovascular risk factors. However, in individuals with type 1 diabetes, who are known to present autonomic alterations, mainly characterized by a reduction in parasympathetic modulation, these associations have not yet been investigated. We assess whether the aggregation of cardiovascular risk factors influences parasympathetic indices of heart rate variability in young people with type 1 diabetes. Materials and methods: This cross-sectional study included 39 individuals with type 1 diabetes (22.54 ± 4.31), evaluated in relation to the risk factors: blood pressure, fat percentage, and resting heart rate. For heart rate variability analysis, heart rate was recorded beat-to-beat using a cardio frequency meter (PolarS810i) for 30 min with the volunteers in dorsal decubitus. The parasympathetic heart rate variability indices were calculated: rMSSD, pNN50, high frequency (HF) n.u (normalized units), SD1, 2LV, and 2ULV. Data collection was carried out in 2014 and analyzed in 2017. Results: Individuals with two aggregate risk factors present a reduction in the values of the indices that reflect parasympathetic autonomic modulation compared to individuals without the risk factors analyzed, regardless of sex and age. Conclusion: In young people with type 1 diabetes, the aggregation of cardiovascular risk factors is associated with parasympathetic autonomic impairment.
Collapse
Affiliation(s)
- Anne Kastelianne França da Silva
- Department of Physical Therapy, Faculty of Science and Technology, São Paulo State University (UNESP), Roberto Simonsen Street, 305, Presidente Prudente, São Paulo 19060-900, Brazil.
| | - Diego Giulliano Destro Christofaro
- Department of Physical Education, Faculty of Science and Technology, São Paulo State University (UNESP), Roberto Simonsen Street, 305, Presidente Prudente, São Paulo 19060-900, Brazil
| | - Laís Manata Vanzella
- Department of Physical Therapy, Faculty of Science and Technology, São Paulo State University (UNESP), Roberto Simonsen Street, 305, Presidente Prudente, São Paulo 19060-900, Brazil
| | - Franciele Marques Vanderlei
- Department of Physical Therapy, Faculty of Science and Technology, São Paulo State University (UNESP), Roberto Simonsen Street, 305, Presidente Prudente, São Paulo 19060-900, Brazil
| | - Maria Júlia Lopez Laurino
- Department of Physical Therapy, Faculty of Science and Technology, São Paulo State University (UNESP), Roberto Simonsen Street, 305, Presidente Prudente, São Paulo 19060-900, Brazil
| | - Luiz Carlos Marques Vanderlei
- Department of Physical Therapy, Faculty of Science and Technology, São Paulo State University (UNESP), Roberto Simonsen Street, 305, Presidente Prudente, São Paulo 19060-900, Brazil
| |
Collapse
|
21
|
Lin B, Kaliush PR, Conradt E, Terrell S, Neff D, Allen AK, Smid MC, Monk C, Crowell SE. Intergenerational transmission of emotion dysregulation: Part I. Psychopathology, self-injury, and parasympathetic responsivity among pregnant women. Dev Psychopathol 2019; 31:817-831. [PMID: 31064587 PMCID: PMC6790982 DOI: 10.1017/s0954579419000336] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The World Health Organization recently reported that maternal mental health is a major public health concern. As many as one in four women suffer from psychiatric disorders at some point during pregnancy or the first postpartum year. Furthermore, self-injurious thoughts and behaviors (SITBs) represent one of the leading causes of death among women during this time. Thus, efforts to identify women at risk for serious forms of psychopathology and especially for SITBs are of utmost importance. Despite this urgency, current single-diagnostic approaches fail to recognize a significant subset of women who are vulnerable to perinatal stress and distress. The current study was among the first to investigate emotion dysregulation-a multilevel, transdiagnostic risk factor for psychopathology-and its associations with stress, distress, and SITBs in a sample of pregnant women (26-40 weeks gestation) recruited to reflect a range of emotion dysregulation. Both self-reported emotion dysregulation and respiratory sinus arrhythmia, a biomarker of emotion dysregulation, demonstrated expected associations with measures of mental health, including depression, anxiety, borderline personality pathology, and SITBs. In addition, self-reported emotion dysregulation was associated with blunted respiratory sinus arrhythmia responsivity to an ecologically valid infant cry task. Findings add to the literature considering transdiagnostic risk during pregnancy using a multiple-levels-of-analysis approach.
Collapse
Affiliation(s)
- Betty Lin
- Department of Psychology, University at Albany, State University of New York, Albany, NY, USA
| | - Parisa R. Kaliush
- Department of Psychology, University of Utah, Salt Lake City, UT, USA
| | - Elisabeth Conradt
- Department of Psychology, University of Utah, Salt Lake City, UT, USA
- Department of Pediatrics, University of Utah, Salt Lake City, UT, USA
| | - Sarah Terrell
- Department of Psychology, University of Utah, Salt Lake City, UT, USA
| | - Dylan Neff
- Department of Psychology, University of Utah, Salt Lake City, UT, USA
| | - Ashley K. Allen
- Department of Psychology, University of Utah, Salt Lake City, UT, USA
| | - Marcela C. Smid
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of Utah, Salt Lake City, UT, USA
- Program for Addiction Research, Clinical Care, Knowledge and Advocacy (PARCKA), Division of Epidemiology, Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA
| | - Catherine Monk
- Department of Psychiatry, Columbia University, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | - Sheila E. Crowell
- Department of Psychology, University of Utah, Salt Lake City, UT, USA
- Department of Psychiatry, University of Utah, Salt Lake City, UT, USA
| |
Collapse
|
22
|
Goudman L, Brouns R, Linderoth B, Moens M. Effects of spinal cord stimulation on heart rate variability in patients with Failed Back Surgery Syndrome. PLoS One 2019; 14:e0219076. [PMID: 31260496 PMCID: PMC6602188 DOI: 10.1371/journal.pone.0219076] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Accepted: 06/12/2019] [Indexed: 02/07/2023] Open
Abstract
Background Building on the recent finding that chronic pain patients with impaired functioning of the descending nociceptive inhibitory system (DNIS) present lower resting heart rate variability (HRV), this study aims to investigate the impact of Spinal Cord Stimulation (SCS) on HRV in patients with Failed Back Surgery Syndrome (FBSS). More precisely, we hypothesize that SCS influences the DNIS, with increased parasympathetic tone as a consequence, as measurable by HRV analysis. Methods Twenty-two patients diagnosed with FBSS and treated with SCS participated in this study. HRV was measured with a 2-lead ECG registration tool during on and off states of SCS. HRV analysis for time, frequency, time-frequency and nonlinear domain parameters was based on a 5-minute recording segment. Results The mean heart rate and low frequency power were significantly lower when SCS was activated. HRV, absolute and normalized high frequency power significantly increased during SCS compared to without SCS. The ratio of low frequency/high frequency ratios, as parameter for global sympathetic-parasympathetic equilibrium, significantly decreased when SCS was activated. Conclusions When SCS is switched off, patients with FBSS present relatively stronger sympathetic tone and weaker parasympathetic activity. Activation of the SCS, possibly via stimulation of the DNIS, restores this disbalance of autonomic activity.
Collapse
Affiliation(s)
- Lisa Goudman
- Department of Neurosurgery, Universitair Ziekenhuis Brussel, Brussels, Belgium
- Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Raf Brouns
- Department of Neurology, ZorgSaam Hospital, Terneuzen, Netherlands
- Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Bengt Linderoth
- Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
| | - Maarten Moens
- Department of Neurosurgery, Universitair Ziekenhuis Brussel, Brussels, Belgium
- Department of Radiology, Universitair Ziekenhuis Brussel, Brussels, Belgium
- Center for Neurosciences (C4N), Vrije Universiteit Brussel, Brussels, Belgium
- * E-mail:
| |
Collapse
|
23
|
Li C, Chiluwal A, Afridi A, Chaung W, Powell K, Yang WL, Wang P, Narayan RK. Trigeminal Nerve Stimulation: A Novel Method of Resuscitation for Hemorrhagic Shock. Crit Care Med 2019; 47:e478-e484. [PMID: 30889027 DOI: 10.1097/ccm.0000000000003735] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To determine if trigeminal nerve stimulation can ameliorate the consequences of acute blood loss and improve survival after severe hemorrhagic shock. DESIGN Animal study. SETTING University research laboratory. SUBJECTS Male Sprague-Dawley rats. INTERVENTIONS Severe hemorrhagic shock was induced in rats by withdrawing blood until the mean arterial blood pressure reached 27 ± 1 mm Hg for the first 5 minutes and then maintained at 27 ± 2 mm Hg for 30 minutes. The rats were randomly assigned to either control, vehicle, or trigeminal nerve stimulation treatment groups. The effects of trigeminal nerve stimulation on survival rate, autonomic nervous system activity, hemodynamics, brain perfusion, catecholamine release, and systemic inflammation after severe hemorrhagic shock in the absence of fluid resuscitation were analyzed. MEASUREMENTS AND MAIN RESULTS Trigeminal nerve stimulation significantly increased the short-term survival of rats following severe hemorrhagic shock in the absence of fluid resuscitation. The survival rate at 60 minutes was 90% in trigeminal nerve stimulation treatment group whereas 0% in control group (p < 0.001). Trigeminal nerve stimulation elicited strong synergistic coactivation of the sympathetic and parasympathetic nervous system as measured by heart rate variability. Without volume expansion with fluid resuscitation, trigeminal nerve stimulation significantly attenuated sympathetic hyperactivity paralleled by increase in parasympathetic tone, delayed hemodynamic decompensation, and improved brain perfusion following severe hemorrhagic shock. Furthermore, trigeminal nerve stimulation generated sympathetically mediated low-frequency oscillatory patterns of systemic blood pressure associated with an increased tolerance to central hypovolemia and increased levels of circulating norepinephrine levels. Trigeminal nerve stimulation also decreased systemic inflammation compared with the vehicle. CONCLUSIONS Trigeminal nerve stimulation was explored as a novel resuscitation strategy in an animal model of hemorrhagic shock. The results of this study showed that the stimulation of trigeminal nerve modulates both sympathetic and parasympathetic nervous system activity to activate an endogenous pressor response, improve cerebral perfusion, and decrease inflammation, thereby improving survival.
Collapse
Affiliation(s)
- Chunyan Li
- Department of Neurosurgery, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY
- Center for Bioelectronic Medicine, Feinstein Institute for Medical Research, Northwell Health, Manhasset, NY
| | - Amrit Chiluwal
- Department of Neurosurgery, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY
| | - Adil Afridi
- Center for Bioelectronic Medicine, Feinstein Institute for Medical Research, Northwell Health, Manhasset, NY
| | - Wayne Chaung
- Center for Immunology and Inflammation, Feinstein Institute for Medical Research, Northwell Health, Manhasset, NY
| | - Keren Powell
- Center for Bioelectronic Medicine, Feinstein Institute for Medical Research, Northwell Health, Manhasset, NY
| | - Weng-Lang Yang
- Center for Immunology and Inflammation, Feinstein Institute for Medical Research, Northwell Health, Manhasset, NY
| | - Ping Wang
- Center for Immunology and Inflammation, Feinstein Institute for Medical Research, Northwell Health, Manhasset, NY
| | - Raj K Narayan
- Department of Neurosurgery, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY
- Center for Bioelectronic Medicine, Feinstein Institute for Medical Research, Northwell Health, Manhasset, NY
| |
Collapse
|
24
|
Zhang Y, Welzig CM, Haburcak M, Wang B, Aronovitz M, Blanton RM, Park HJ, Force T, Noujaim S, Galper JB. Targeted disruption of glycogen synthase kinase-3β in cardiomyocytes attenuates cardiac parasympathetic dysfunction in type 1 diabetic Akita mice. PLoS One 2019; 14:e0215213. [PMID: 30978208 PMCID: PMC6461277 DOI: 10.1371/journal.pone.0215213] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Accepted: 03/25/2019] [Indexed: 11/18/2022] Open
Abstract
Type 1 diabetic Akita mice develop severe cardiac parasympathetic dysfunction that we have previously demonstrated is due at least in part to an abnormality in the response of the end organ to parasympathetic stimulation. Specifically, we had shown that hypoinsulinemia in the diabetic heart results in attenuation of the G-protein coupled inward rectifying K channel (GIRK) which mediates the negative chronotropic response to parasympathetic stimulation due at least in part to decreased expression of the GIRK1 and GIRK4 subunits of the channel. We further demonstrated that the expression of GIRK1 and GIRK4 is under the control of the Sterol Regulatory element Binding Protein (SREBP-1), which is also decreased in response to hypoinsulinemia. Finally, given that hyperactivity of Glycogen Synthase Kinase (GSK)3β, had been demonstrated in the diabetic heart, we demonstrated that treatment of Akita mice with Li+, an inhibitor of GSK3β, increased parasympathetic responsiveness and SREBP-1 levels consistent with the conclusion that GSK3β might regulate IKACh via an effect on SREBP-1. However, inhibitor studies were complicated by lack of specificity for GSK3β. Here we generated an Akita mouse with cardiac specific inducible knockout of GSK3β. Using this mouse, we demonstrate that attenuation of GSK3β expression is associated with an increase in parasympathetic responsiveness measured as an increase in the heart rate response to atropine from 17.3 ± 3.5% (n = 8) prior to 41.2 ± 5.4% (n = 8, P = 0.017), an increase in the duration of carbamylcholine mediated bradycardia from 8.43 ± 1.60 min (n = 7) to 12.71 ± 2.26 min (n = 7, P = 0.028) and an increase in HRV as measured by an increase in the high frequency fraction from 40.78 ± 3.86% to 65.04 ± 5.64 (n = 10, P = 0.005). Furthermore, patch clamp measurements demonstrated a 3-fold increase in acetylcholine stimulated peak IKACh in atrial myocytes from GSK3β deficiency mice compared with control. Finally, western blot analysis of atrial extracts from knockout mice demonstrated increased levels of SREBP-1, GIRK1 and GIRK4 compared with control. Taken together with our prior observations, these data establish a role of increased GSK3β activity in the pathogenesis of parasympathetic dysfunction in type 1 diabetes via the regulation of IKACh and GIRK1/4 expression.
Collapse
Affiliation(s)
- Yali Zhang
- Molecular Cardiology Research Institute, Tufts Medical Center, Boston, Massachusetts, United States of America
- * E-mail: (YZ); (JBG)
| | - Charles M. Welzig
- Molecular Cardiology Research Institute, Tufts Medical Center, Boston, Massachusetts, United States of America
- Departments of Neurology and Physiology, Medical College of Wisconsin, Milwaukee, Wisconsin, United States of America
| | - Marian Haburcak
- Molecular Cardiology Research Institute, Tufts Medical Center, Boston, Massachusetts, United States of America
| | - Bo Wang
- Molecular Cardiology Research Institute, Tufts Medical Center, Boston, Massachusetts, United States of America
| | - Mark Aronovitz
- Molecular Cardiology Research Institute, Tufts Medical Center, Boston, Massachusetts, United States of America
| | - Robert M. Blanton
- Molecular Cardiology Research Institute, Tufts Medical Center, Boston, Massachusetts, United States of America
- Department of Medicine, Tufts University School of Medicine, Boston, Massachusetts, United States of America
| | - Ho-Jin Park
- Molecular Cardiology Research Institute, Tufts Medical Center, Boston, Massachusetts, United States of America
| | - Thomas Force
- Division of Cardiovascular Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, United States of America
| | - Sami Noujaim
- Molecular Pharmacology and Physiology, University of South Florida, Tampa, Florida, United States of America
| | - Jonas B. Galper
- Molecular Cardiology Research Institute, Tufts Medical Center, Boston, Massachusetts, United States of America
- Department of Medicine, Tufts University School of Medicine, Boston, Massachusetts, United States of America
- * E-mail: (YZ); (JBG)
| |
Collapse
|
25
|
Tessa C, Toschi N, Orsolini S, Valenza G, Lucetti C, Barbieri R, Diciotti S. Central modulation of parasympathetic outflow is impaired in de novo Parkinson's disease patients. PLoS One 2019; 14:e0210324. [PMID: 30653564 PMCID: PMC6336270 DOI: 10.1371/journal.pone.0210324] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Accepted: 12/20/2018] [Indexed: 01/09/2023] Open
Abstract
Task- and stimulus-based neuroimaging studies have begun to unveil the central autonomic network which modulates autonomic nervous system activity. In the present study, we aimed to evaluate the central autonomic network without the bias constituted by the use of a task. Additionally, we assessed whether this circuitry presents signs of dysregulation in the early stages of Parkinson’s disease (PD), a condition which may be associated with dysautonomia. We combined heart-rate-variability based methods for time-varying assessments of the autonomic nervous system outflow with resting-state fMRI in 14 healthy controls and 14 de novo PD patients, evaluating the correlations between fMRI time-series and the instantaneous high-frequency component of the heart-rate-variability power spectrum, a marker of parasympathetic outflow. In control subjects, the high-frequency component of the heart-rate-variability power spectrum was significantly anti-correlated with fMRI time-series in several cortical, subcortical and brainstem regions. This complex central network was not detectable in PD patients. In between-group analysis, we found that in healthy controls the brain activation related to the high-frequency component of the heart-rate-variability power spectrum was significantly less than in PD patients in the mid and anterior cingulum, sensorimotor cortex and supplementary motor area, insula and temporal lobe, prefrontal cortex, hippocampus and in a region encompassing posterior cingulum, precuneus and parieto-occipital cortex. Our results indicate that the complex central network which modulates parasympathetic outflow in the resting state is impaired in the early clinical stages of PD.
Collapse
Affiliation(s)
- Carlo Tessa
- Department of Radiology and Nuclear Medicine, Versilia Hospital, Azienda USL Toscana Nord Ovest, Lido di Camaiore (Lu), Italy
- * E-mail:
| | - Nicola Toschi
- Medical Physics Section, Department of Biomedicine and Prevention, University of Rome “Tor Vergata”, Rome, Italy
- Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging and Harvard Medical School, Massachusetts General Hospital, Boston, MA, United States of America
| | - Stefano Orsolini
- Department of Electrical, Electronic, and Information Engineering “Guglielmo Marconi”, University of Bologna, Cesena, Italy
| | - Gaetano Valenza
- Department of Anesthesia, Massachusetts General Hospital, Boston, MA, United States of America
- Research Center E. Piaggio and Department of Information Engineering, School of Engineering, University of Pisa, Pisa, Italy
| | - Claudio Lucetti
- Division of Neurology, Versilia Hospital, Azienda USL Toscana Nord Ovest, Lido di Camaiore (Lu), Italy
| | - Riccardo Barbieri
- Department of Anesthesia, Massachusetts General Hospital, Boston, MA, United States of America
- Department of Electronics, Informatics and Bioengineering, Politecnico di Milano, Milano, Italy
| | - Stefano Diciotti
- Department of Electrical, Electronic, and Information Engineering “Guglielmo Marconi”, University of Bologna, Cesena, Italy
| |
Collapse
|
26
|
Sturm VE, Sible IJ, Datta S, Hua AY, Perry DC, Kramer JH, Miller BL, Seeley WW, Rosen HJ. Resting parasympathetic dysfunction predicts prosocial helping deficits in behavioral variant frontotemporal dementia. Cortex 2018; 109:141-155. [PMID: 30317048 PMCID: PMC6261789 DOI: 10.1016/j.cortex.2018.09.006] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Revised: 08/07/2018] [Accepted: 09/06/2018] [Indexed: 01/10/2023]
Abstract
In the behavioral variant of frontotemporal dementia (bvFTD), left-lateralized salience network dysfunction reduces basal activity in the parasympathetic nervous system, a branch of the autonomic nervous system that reduces arousal and fosters empathy and prosociality. Here we examined whether resting parasympathetic deficits in bvFTD related to diminished prosocial behavior. Eighty participants [30 with bvFTD, 25 with Alzheimer's disease (AD), and 25 healthy controls] completed a "helping task" in which we quantified participants' spontaneous reactions to an experimenter who struggled to find a lost key. Participants also underwent an assessment of baseline autonomic nervous system activity and structural magnetic resonance imaging. An exploratory factor analysis of participants' behaviors during the helping task revealed four factors: empathic concern, consolation, disengagement, and impatience. Patients with bvFTD had lower empathic concern and greater disengagement and impatience than the AD and healthy control groups. Patients with bvFTD had lower resting respiratory sinus arrhythmia and faster respiration and heart rates than patients with AD and healthy controls, a pattern consistent with parasympathetic dysfunction. Skin conductance level was also lower in bvFTD than in the other groups. Lower baseline respiratory sinus arrhythmia and faster baseline respiration rates, but not skin conductance level, predicted lower prosocial helping behaviors. Voxel-based morphometry analyses revealed that atrophy in the bilateral medial pulvinar nucleus of the thalamus, midcingulate cortex, and caudate was associated with lower empathic concern and consolation, and atrophy in the bilateral medial pulvinar nucleus of the thalamus, left frontoinsula, and left ventral striatum was associated with greater disengagement and impatience. Left-lateralized frontoinsula atrophy was associated with not only lower respiratory sinus arrhythmia but also with lower consolation and greater disengagement. This study offers evidence for prosocial behavior deficits in bvFTD and suggests that left-lateralized salience network atrophy reduces patients' resting parasympathetic activity and motivation to help others in need.
Collapse
Affiliation(s)
- Virginia E Sturm
- Department of Neurology, University of California, San Francisco, CA, USA.
| | - Isabel J Sible
- Department of Neurology, University of California, San Francisco, CA, USA
| | - Samir Datta
- Department of Neurology, University of California, San Francisco, CA, USA
| | - Alice Y Hua
- Department of Neurology, University of California, San Francisco, CA, USA
| | - David C Perry
- Department of Neurology, University of California, San Francisco, CA, USA
| | - Joel H Kramer
- Department of Neurology, University of California, San Francisco, CA, USA
| | - Bruce L Miller
- Department of Neurology, University of California, San Francisco, CA, USA
| | - William W Seeley
- Department of Neurology, University of California, San Francisco, CA, USA; Department of Pathology, University of California, San Francisco, CA, USA
| | - Howard J Rosen
- Department of Neurology, University of California, San Francisco, CA, USA
| |
Collapse
|
27
|
Andersen EH, Lewis GF, Belger A. Aberrant parasympathetic reactivity to acute psychosocial stress in male patients with schizophrenia spectrum disorders. Psychiatry Res 2018; 265:39-47. [PMID: 29684768 PMCID: PMC5984181 DOI: 10.1016/j.psychres.2018.04.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Revised: 04/02/2018] [Accepted: 04/02/2018] [Indexed: 12/31/2022]
Abstract
Autonomic dysfunction represents a core domain of the pathophysiology of schizophrenia spectrum disorders (SCZ), with aberrant physiologic arousal underlying maladaptive social and cognitive behaviors. Antagonistic parasympathetic and sympathetic systems support autonomic flexibility to appropriately regulate arousal and respond to environmental challenges, which can be modeled using physiologic measures. SCZ patients consistently show heightened basal stress, however, their parasympathetic reactivity to an acute psychosocial stressor is poorly understood. Heart period (HP-arousal), respiratory sinus arrhythmia (RSA-parasympathetic vagal activity), and their relationship were measured in SCZ patients (n = 19) and healthy controls (n = 20) at baseline and during psychosocial stress exposure. Parasympathetic vagal control of arousal, reflected in RSA-HP coupling, was assessed for the first time in SCZ. Patients demonstrated blunted physiologic reactivity (less change in heart period and respiratory sinus arrhythmia), a unique increase in respiratory sinus arrhythmia relative to baseline during recovery, and elevated arousal was associated with poor cognitive performance and greater positive symptoms. Arousal regulation was tightly controlled by parasympathetic activity in controls only, indicated by a strong association between changes in heart period and respiratory sinus arrhythmia. Results are the first to demonstrate maladaptive, inefficient parasympathetic arousal regulation (RSA-HP decoupling) in reaction to psychosocial stress in SCZ, representing an autonomic profile incompatible with appropriate social and emotional functioning.
Collapse
Affiliation(s)
- Elizabeth H Andersen
- Neuroscience Curriculum, University of North Carolina, Chapel Hill, NC, USA; Department of Psychiatry, University of North Carolina, Chapel Hill, NC, USA.
| | - Gregory F Lewis
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC, USA
| | - Aysenil Belger
- Neuroscience Curriculum, University of North Carolina, Chapel Hill, NC, USA; Department of Psychiatry, University of North Carolina, Chapel Hill, NC, USA; Brain Imaging and Analysis Center, Duke University & University of North Carolina, Durham, NC, USA
| |
Collapse
|
28
|
Gigante A, Margiotta D, Navarini L, Liberatori M, Barbano B, Tubani L, Afeltra A, Rosato E. Parasympathetic activity increases with digital microvascular damage and vascular endothelial growth factor in systemic sclerosis. Clin Exp Rheumatol 2018; 36 Suppl 113:24-27. [PMID: 29787366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Accepted: 11/27/2017] [Indexed: 06/08/2023]
Abstract
OBJECTIVES The imbalance between angiogenic and angiostatic factors with derangement of the microvasculature are hallmarks of systemic sclerosis (SSc). Raynaud's phenomenon in SSc probably is due to the impaired neuroendothelial control mechanisms between vasoconstriction and vasodilatation. The aim of this study is to evaluate autonomic nervous system function using heart rate variability (HRV) analysis and to correlate with vascular endothelial growth factor (VEGF). METHODS Twenty-seven SSc patients were enrolled. HRV was measured and markers of global sympathetic and parasympathetic system, respectively standard deviation of normal-to-normal RR intervals (SDNN) and square root of the mean of the sum of the squares of differences between adjacent NN intervals (RMSSD) were evaluated. Serum VEGF levels and nailfold videocapillaroscopy (NVC) were performed. RESULTS A linear positive correlation was observed between RMSSD and VEGF (p<0.01, r=0.55), and RMSSD and disease duration (p< 0.01, r=0.54). The RMSSD median value was significantly increased (p< 0.05) with NVC damage progression. The RMSSD median value was significantly (p<0.05) higher in SSc patients with digital ulcers (DUs) than in SSc patients without DUs [44 (39.4-60.2) vs 24.6 (23-37.1)]. CONCLUSIONS In our study parasympathetic modulation increases in relation to VEGF. When microcirculation is modified with capillaroscopic pattern progression and DUs, autonomic system seems to stimulate vasodilatation trough parasympathetic system. We can conclude that parasympathetic activity increases with digital microvascular damage and promotes VEGF release.
Collapse
Affiliation(s)
- Antonietta Gigante
- Department of Clinical Medicine, Scleroderma Unit, Sapienza University of Rome, Italy.
| | - Domenico Margiotta
- Department of Immuno-Rheumatology Unit, Campus Bio-Medico, University of Rome, Italy
| | - Luca Navarini
- Department of Immuno-Rheumatology Unit, Campus Bio-Medico, University of Rome, Italy
| | - Marta Liberatori
- Department of Clinical Medicine, Scleroderma Unit, Sapienza University of Rome, Italy
| | - Biagio Barbano
- Department of Clinical Medicine, Scleroderma Unit, Sapienza University of Rome, Italy
| | - Luigi Tubani
- Department of Clinical Medicine, Scleroderma Unit, Sapienza University of Rome, Italy
| | - Antonella Afeltra
- Department of Immuno-Rheumatology Unit, Campus Bio-Medico, University of Rome, Italy
| | - Edoardo Rosato
- Department of Clinical Medicine, Scleroderma Unit, Sapienza University of Rome, Italy
| |
Collapse
|
29
|
Tenenbaum RB, Musser ED, Raiker JS, Coles EK, Gnagy EM, Pelham WE. Specificity of Reward Sensitivity and Parasympathetic-Based Regulation among Children with Attention-Deficit/Hyperactivity and Disruptive Behavior Disorders. J Abnorm Child Psychol 2018; 46:965-977. [PMID: 28875352 PMCID: PMC5839917 DOI: 10.1007/s10802-017-0343-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is associated with disruptionsin reward sensitivity and regulatory processes. However, it is unclear whether thesedisruptions are better explained by comorbid disruptive behavior disorder (DBD)symptomology. This study sought to examine this question using multiple levels ofanalysis (i.e., behavior, autonomic reactivity). One hundred seventeen children (aged 6 to 12 years; 72.6% male; 69 with ADHD) completed theBalloon-Analogue Risk Task (BART) to assess external reward sensitivity behaviorally.Sympathetic-based internal reward sensitivity and parasympathetic-based regulationwere indexed via cardiac pre-ejection period (PEP) and respiratory sinus arrhythmia(RSA), respectively. Children with ADHD exhibited reduced internal reward sensitivity (i.e.,lengthened PEP; F(1,112)=4.01, p=0.047) compared to healthy controls and werecharacterized by greater parasympathetic-based dysregulation (i.e., reduced RSAaugmentation F(1,112)=10.12, p=0.002). However, follow-up analyses indicated theADHD effect was better accounted for by comorbid DBD diagnoses; that is, childrenwith ADHD and comorbid ODD were characterized by reduced internal rewardsensitivity (i.e., lengthened PEP; t=2.47, p=0.046) and by parasympathetic-baseddysregulation (i.e., reduced RSA augmentation; t=3.51, p=0.002) in response to rewardwhen compared to typically developing youth. Furthermore, children with ADHD and comorbid CD exhibited greater behaviorally-based external reward sensitivity (i.e.,more total pops; F(3,110)= 5.96, p=0.001) compared to children with ADHD only (t=3.87, p=0.001) and children with ADHD and ODD (t=3.56, p=0.003). Results suggest that disruptions in sensitivity to reward may be betteraccounted for, in part, by comorbid DBD.Key Words: attention-deficit/hyperactivity disorder, autonomic nervous system,disruptive behavior disorders, reward sensitivityPowered.
Collapse
Affiliation(s)
- Rachel B Tenenbaum
- Department of Psychology, Center for Children and Families, Florida International University, 11200 SW 8th St., AHC 4 455, Miami, FL, 33100, USA
| | - Erica D Musser
- Department of Psychology, Center for Children and Families, Florida International University, 11200 SW 8th St., AHC 4 455, Miami, FL, 33100, USA.
| | - Joseph S Raiker
- Department of Psychology, Center for Children and Families, Florida International University, 11200 SW 8th St., AHC 4 455, Miami, FL, 33100, USA
| | - Erika K Coles
- Department of Psychology, Center for Children and Families, Florida International University, 11200 SW 8th St., AHC 4 455, Miami, FL, 33100, USA
| | - Elizabeth M Gnagy
- Department of Psychology, Center for Children and Families, Florida International University, 11200 SW 8th St., AHC 4 455, Miami, FL, 33100, USA
| | - William E Pelham
- Department of Psychology, Center for Children and Families, Florida International University, 11200 SW 8th St., AHC 4 455, Miami, FL, 33100, USA
| |
Collapse
|
30
|
Salsone M, Vescio B, Quattrone A, Roccia F, Sturniolo M, Bono F, Aguglia U, Gambardella A, Quattrone A. Cardiac parasympathetic index identifies subjects with adult obstructive sleep apnea: A simultaneous polysomnographic-heart rate variability study. PLoS One 2018; 13:e0193879. [PMID: 29518111 PMCID: PMC5843243 DOI: 10.1371/journal.pone.0193879] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2017] [Accepted: 02/19/2018] [Indexed: 01/07/2023] Open
Abstract
OBJECTIVE To evaluate circadian fluctuations and night/day ratio of Heart Rate Variability (HRV) spectral components in patients with obstructive sleep apnea (OSA) in comparison with controls. PARTICIPANTS AND METHODS This is a simultaneous HRV-polysomnographic (PSG) study including 29 patients with OSA and 18 age-sex-matched controls. Four patients with OSA dropped out. All participants underwent PSG and HRV analysis. We measured the 24-hour fluctuations and the night/day ratio of low frequency (LF) and high frequency (HF) spectral components of HRV in all subjects and controls. The LF night/day ratio was termed the cardiac sympathetic index while the HF night/day ratio was termed the cardiac parasympathetic index. RESULTS All twenty-five OSA patients were PSG positive (presence of OSA) while 18 controls were PSG negative (absence of OSA). There was no significant difference in LF and HF 24-hour fluctuation values between OSA patients and controls. In OSA patients, LF and HF values were significantly higher during night-time than day time recordings (p<0.001). HF night/day ratio (cardiac parasympathetic index) accurately (100%) differentiated OSA patients from controls without an overlap of individual values. The LF night/day ratio (cardiac sympathetic index) had sensitivity of 84%, specificity of 72.2% and accuracy of 79.1% in distinguishing between groups. CONCLUSIONS The cardiac parasympathetic index accurately differentiated patients with OSA from controls, on an individual basis.
Collapse
Affiliation(s)
- Maria Salsone
- Institute of Bioimaging and Molecular Physiology, National Research Council, Germaneto, Catanzaro, Italy
| | | | - Andrea Quattrone
- Institute of Neurology, Department of Medical Sciences, University Magna Graecia, Catanzaro, Italy
| | - Ferdinando Roccia
- Institute of Rehabilitative Cardiology, Department of Medical Sciences, University Magna Graecia, Catanzaro, Italy
| | - Miriam Sturniolo
- Institute of Neurology, Department of Medical Sciences, University Magna Graecia, Catanzaro, Italy
| | - Francesco Bono
- Institute of Neurology, Department of Medical Sciences, University Magna Graecia, Catanzaro, Italy
| | - Umberto Aguglia
- Institute of Neurology, Department of Medical Sciences, University Magna Graecia, Catanzaro, Italy
| | - Antonio Gambardella
- Institute of Neurology, Department of Medical Sciences, University Magna Graecia, Catanzaro, Italy
| | - Aldo Quattrone
- Institute of Bioimaging and Molecular Physiology, National Research Council, Germaneto, Catanzaro, Italy
- Neuroscience Center, University Magna Graecia, Germaneto, Catanzaro, Italy
- * E-mail:
| |
Collapse
|
31
|
Chi L, Du K, Liu D, Bo Y, Li W. Electroacupuncture brain protection during ischemic stroke: A role for the parasympathetic nervous system. J Cereb Blood Flow Metab 2018; 38:479-491. [PMID: 28281385 PMCID: PMC5851138 DOI: 10.1177/0271678x17697988] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Revised: 01/09/2017] [Accepted: 02/07/2017] [Indexed: 12/19/2022]
Abstract
The demand for using parasympathetic activation for stroke therapy is unmet. In the current study, we investigated whether the neuroprotection provided by electroacupuncture (EA) in an experimental stroke model was associated with activation of the parasympathetic nervous system (PNS). The results showed that parasympathetic dysfunction (PD), performed as unilateral vagotomy combined with peripheral atropine, attenuated both the functional benefits of EA and its effects in improving cerebral perfusion, reducing infarct volume, and hindering apoptosis, neuronal and peripheral inflammation, and oxidative stress. Most importantly, EA rats showed a dramatically less reduction in the mRNA level of choline acetyltransferase, five subtypes of muscarinic receptors and α7nAChR, suggesting the inhibition of the impairment of the central cholinergic system; EA also activated dorsal motor nucleus of the vagus, the largest source of parasympathetic pre-ganglionic neurons in the lower brainstem (detected by c-fos immunohistochemistry), and PD suppressed these changes. These findings indicated EA may serve as an alternative modality of PNS activation for stroke therapy.
Collapse
Affiliation(s)
- Laiting Chi
- Department of Anesthesiology, Second Affiliated Hospital of Harbin Medical University, Harbin, China
- Heilongjiang Province Key Lab of Research on Anesthesiology and Critical Care Medicine, Harbin, China
| | - Kairong Du
- Department of Anesthesiology, Second Affiliated Hospital of Harbin Medical University, Harbin, China
- Heilongjiang Province Key Lab of Research on Anesthesiology and Critical Care Medicine, Harbin, China
| | - Dongdong Liu
- Department of Anesthesiology, Second Affiliated Hospital of Harbin Medical University, Harbin, China
- Heilongjiang Province Key Lab of Research on Anesthesiology and Critical Care Medicine, Harbin, China
| | - Yulong Bo
- Department of Anesthesiology, Second Affiliated Hospital of Harbin Medical University, Harbin, China
- Heilongjiang Province Key Lab of Research on Anesthesiology and Critical Care Medicine, Harbin, China
| | - Wenzhi Li
- Department of Anesthesiology, Second Affiliated Hospital of Harbin Medical University, Harbin, China
- Heilongjiang Province Key Lab of Research on Anesthesiology and Critical Care Medicine, Harbin, China
| |
Collapse
|
32
|
Han L, Limjunyawong N, Ru F, Li Z, Hall OJ, Steele H, Zhu Y, Wilson J, Mitzner W, Kollarik M, Undem BJ, Canning BJ, Dong X. Mrgprs on vagal sensory neurons contribute to bronchoconstriction and airway hyper-responsiveness. Nat Neurosci 2018; 21:324-328. [PMID: 29403029 PMCID: PMC5857222 DOI: 10.1038/s41593-018-0074-8] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2017] [Accepted: 12/04/2017] [Indexed: 01/28/2023]
Abstract
Asthma, accompanied by lung inflammation, bronchoconstriction and airway hyper-responsiveness, is a significant public health burden. Here we report that Mas-related G protein-coupled receptors (Mrgprs) are expressed in a subset of vagal sensory neurons innervating the airway and mediates cholinergic bronchoconstriction and airway hyper-responsiveness. These findings provide insights into the neural mechanisms underlying the pathogenesis of asthma.
Collapse
Affiliation(s)
- Liang Han
- The Solomon H. Snyder Department of Neuroscience, Center for Sensory Biology, School of Medicine, Johns Hopkins University, Baltimore, MD, USA.
- School of Biological Sciences, Georgia Institute of Technology, Atlanta, GA, USA.
| | - Nathachit Limjunyawong
- The Solomon H. Snyder Department of Neuroscience, Center for Sensory Biology, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Fei Ru
- Department of Medicine, Division of Allergy and Clinical Immunology, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Zhe Li
- The Solomon H. Snyder Department of Neuroscience, Center for Sensory Biology, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Olivia J Hall
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Haley Steele
- School of Biological Sciences, Georgia Institute of Technology, Atlanta, GA, USA
| | - Yuyan Zhu
- School of Biological Sciences, Georgia Institute of Technology, Atlanta, GA, USA
| | - Julie Wilson
- School of Biological Sciences, Georgia Institute of Technology, Atlanta, GA, USA
| | - Wayne Mitzner
- Department of Environmental Health Sciences, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Marian Kollarik
- Department of Medicine, Division of Allergy and Clinical Immunology, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Bradley J Undem
- Department of Medicine, Division of Allergy and Clinical Immunology, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Brendan J Canning
- Department of Medicine, Division of Allergy and Clinical Immunology, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Xinzhong Dong
- The Solomon H. Snyder Department of Neuroscience, Center for Sensory Biology, School of Medicine, Johns Hopkins University, Baltimore, MD, USA.
- Howard Hughes Medical Institute, Johns Hopkins University, Baltimore, MD, USA.
| |
Collapse
|
33
|
Garabedian C, Clermont-Hama Y, Sharma D, Aubry E, Butruille L, Deruelle P, Storme L, De Jonckheere J, Houfflin-Debarge V. Correlation of a new index reflecting the fluctuation of parasympathetic tone and fetal acidosis in an experimental study in a sheep model. PLoS One 2018; 13:e0190463. [PMID: 29320537 PMCID: PMC5761865 DOI: 10.1371/journal.pone.0190463] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2017] [Accepted: 11/20/2017] [Indexed: 12/21/2022] Open
Abstract
The autonomic nervous system plays a leading role in the control of fetal homeostasis. Fetal heart rate variability (HRV) analysis is a reflection of its activity. We developed a new index (the Fetal Stress Index, FSI) reflecting parasympathetic tone. The objective of this study was to evaluate this index as a predictor of fetal acid-base status. This was an experimental study on chronically instrumented fetal lambs (n = 11, surgery at 128 +/- 2 days gestational age, term = 145 days). The model was based on 75% occlusion of the umbilical cord for a maximum of 120 minutes or until an arterial pH ≤ 7.20 was reached. Hemodynamic, gasometric and FSI parameters were recorded throughout the experimentation. We studied the FSI during the 10 minutes prior to pH samplings and compared values for pH>7.20 and pH≤ 7.20. In order to analyze the FSI evolution during the 10 minutes periods, we analyzed the minimum, maximum and mean values of the FSI (respectively FSImin, FSImax and FSImean) over the periods. 11 experimentations were performed. During occlusion, the heart rate dropped with an increase in blood pressure (respectively 160(155-182) vs 106(101-120) bpm and 42(41-45) vs 58(55-62) mmHg after occlusion). The FSImin was 38.6 (35.2-43.3) in the group pH>7.20 and was higher in the group pH less than 7.20 (46.5 (43.3-52.0), p = 0.012). The correlation of FSImin was significant for arterial pH (coefficient of -0.671; p = 0.004) and for base excess (coefficient of -0.632; p = 0.009). The correlations were not significant for the other parameters. In conclusion, our new index seems well correlated with the fetal acid-base status. Other studies must be carried out in a situation close to the physiology of labor by sequential occlusion of the cord.
Collapse
Affiliation(s)
- C. Garabedian
- Univ. Lille, EA 4489 –Perinatal Environment and Health, Lille, France
- CHU Lille, Department of Obstetrics, Lille, France
- * E-mail:
| | - Y. Clermont-Hama
- Univ. Lille, EA 4489 –Perinatal Environment and Health, Lille, France
- CHU Lille, Department of Obstetrics, Lille, France
| | - D. Sharma
- Univ. Lille, EA 4489 –Perinatal Environment and Health, Lille, France
- CHU Lille, Department of Pediatric Surgery, Lille, France
| | - E. Aubry
- Univ. Lille, EA 4489 –Perinatal Environment and Health, Lille, France
- CHU Lille, Department of Pediatric Surgery, Lille, France
| | - L. Butruille
- Univ. Lille, EA 4489 –Perinatal Environment and Health, Lille, France
| | - P. Deruelle
- Univ. Lille, EA 4489 –Perinatal Environment and Health, Lille, France
- CHU Lille, Department of Obstetrics, Lille, France
| | - L. Storme
- Univ. Lille, EA 4489 –Perinatal Environment and Health, Lille, France
- CHU Lille, Department of Neonatology, Lille, France
| | - J. De Jonckheere
- Univ. Lille, EA 4489 –Perinatal Environment and Health, Lille, France
- CHU Lille, CIC-IT 1403, Lille, France
| | - V. Houfflin-Debarge
- Univ. Lille, EA 4489 –Perinatal Environment and Health, Lille, France
- CHU Lille, Department of Obstetrics, Lille, France
| |
Collapse
|
34
|
Provan SA, Olstad DS, Solberg EE, Smedslund G, Dagfinrud H. Evidence of reduced parasympathetic autonomic regulation in inflammatory joint disease: A meta-analyses study. Semin Arthritis Rheum 2017; 48:134-140. [PMID: 29291895 DOI: 10.1016/j.semarthrit.2017.11.010] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Revised: 11/28/2017] [Accepted: 11/30/2017] [Indexed: 02/02/2023]
Abstract
BACKGROUND Rheumatoid arthritis (RA) and spondyloarthritis (SpA) are inflammatory joint disorders (IJD) with increased risk of cardiovascular disease (CVD). Autonomic dysfunction (AD) is a risk factor for CVD, and parasympathetic AD is linked to key features of IJD such as inflammation, physical inactivity and pain. Heart-rate variability (HRV) is a marker of cardiac AD. The study objective was to compare parasympathetic cardiac AD, measured by HRV, between patients with IJD and healthy controls, using meta-analysis methodology, and to examine the impact of inflammation, physical inactivity and pain on HRV in IJD. METHODS Medline, Embase and Amed were searched. Inclusion criteria were adult case-control studies published in English or a Scandinavian language, presenting HRV data in IJD. Two measures of HRV and 3 from the Ewing protocol were selected: square root of mean squared difference of successive R-R intervals (RMSSD), high frequency (HF), Ewing protocol; standing (E-S), breathing (E-B) and Valsalva (E-V). Patients with RA, SpA and healthy controls were compared separately using random-effects meta-analyses of standardized mean differences (SMD). RESULTS In all, 35 papers were eligible for inclusion. For RMSSD the pooled SMD (95% CI) RA vs. controls was -0.90 (-1.35 to -0.44), for SpA vs. controls; -0.34 (-0.73 to 0.06). For HF pooled SMD RA vs. controls was -0.78 (-0.99 to -0.57), for SpA vs. controls; -0.04 (-0.22 to 0.13). All Ewing parameters were significantly lower in cases, except for E-V which was comparable between cases and controls in patients with RA. CONCLUSION Patients with IJD have cardiac parasympathetic AD which is related to inflammation.
Collapse
Affiliation(s)
- Sella A Provan
- Department of Rheumatology, Diakonhjemmet Hospital, PB 23 Vindern, 0319 Oslo, Norway.
| | - Daniela Schäfer Olstad
- Department of Rheumatology, National Resource Centre for Rehabilitation in Rheumatology, Diakonhjemmet Hospital, Oslo, Norway
| | - Erik E Solberg
- Department of Medicine, Diakonhjemmet Hospital, Oslo, Norway
| | - Geir Smedslund
- Department of Rheumatology, National Resource Centre for Rehabilitation in Rheumatology, Diakonhjemmet Hospital, Oslo, Norway
| | - Hanne Dagfinrud
- Department of Rheumatology, National Resource Centre for Rehabilitation in Rheumatology, Diakonhjemmet Hospital, Oslo, Norway
| |
Collapse
|
35
|
Abrahamovych O, Abrahamovych M, Farmaha M, Tolopko S. THE PECULIARITIES OF THE STATE OF THE AUTONOMIC NERVOUS SYSTEM ESTIMATED BY THE METHOD OF HEART RATE VARIABILITY IN PATIENTS WITH CIRRHOSIS AND SYNTROPIC DAMAGES OF CARDIOVASCULAR SYSTEM. Georgian Med News 2017:23-30. [PMID: 29328025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
In the article the features of the autonomic nervous system state were estimated by the method of heart rate variability in patients with cirrhosis with syntropic damages of cardiovascular system - cardiomyopathy and arterial hypotension. As a result of an examination of 50 patients with liver cirrhosis and cardiomyopathy (investigational group A), 54 patients with liver cirrhosis and arterial hypotension (investigational group B), and 45 patients with liver cirrhosis also those who don't have the damages of cardiovascular system (group of comparison) it was established that: 1) they have the peculiarities of vegetative imbalance the characteristics of which are the low summarized activity of vegetative influence on heart rhythm and special dynamics of indexes of percentage structure of general spectral power; 2) they depend on the clinical variant of this damage - in patients with cirrhosis and syntropic cardiomyopathy the regulating of internal processes involve the humoral-metabolic influence, i.e. local vasoactive conjunctions, catecholamines, renin-angiotensin-aldosterone system, with a simultaneous influence of sympathetic system and activity reduction of parasympathetic vegetative nervous system, and in patients with cirrhosis and syntropic arterial hypotension - the internal regulation involves the local humoral-metabolic factors with the lack of both sympathetic and parasympathetic parts of vegetative nervous system.
Collapse
Affiliation(s)
- O Abrahamovych
- Danylo Halytsky Lviv National Medical University, Ukraine
| | - M Abrahamovych
- Danylo Halytsky Lviv National Medical University, Ukraine
| | - M Farmaha
- Danylo Halytsky Lviv National Medical University, Ukraine
| | - S Tolopko
- Danylo Halytsky Lviv National Medical University, Ukraine
| |
Collapse
|
36
|
Kamboj SK, Irez D, Serfaty S, Thomas E, Das RK, Freeman TP. Ultra-Brief Mindfulness Training Reduces Alcohol Consumption in At-Risk Drinkers: A Randomized Double-Blind Active-Controlled Experiment. Int J Neuropsychopharmacol 2017; 20:936-947. [PMID: 29016995 PMCID: PMC5737497 DOI: 10.1093/ijnp/pyx064] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2017] [Revised: 07/18/2017] [Accepted: 07/28/2017] [Indexed: 02/04/2023] Open
Abstract
Background Like other complex psychosocial interventions, mindfulness-based treatments comprise various modality-specific components as well as nonspecific therapeutic ingredients that collectively contribute to efficacy. Consequently, the isolated effects of mindfulness strategies per se remain unclear. Methods Using a randomized double-blind design, we compared the isolated effects of 11-minutes of "supervised" mindfulness instruction against a closely matched active control (relaxation) on subjective, physiological, and behavioral indices of maladaptive alcohol responding in drinkers at risk of harm from alcohol use (n = 68). Simple follow-up instructions on strategy use were provided, but practice was unsupervised and not formally monitored. Results Both groups showed acute reductions in craving after training, although a trend group x time interaction (P = .056) suggested that this reduction was greater in the relaxation group (d = 0.722 P < .001) compared with the mindfulness group (d = 0.317, P = .004). Furthermore, upregulation of parasympathetic activity was found after relaxation (d = 0.562; P < .001) but not mindfulness instructions (d = 0.08; P > .1; group x time interaction: P = .009). By contrast, only the mindfulness group showed a reduction in past-week alcohol consumption at 7-day follow-up (-9.31 units, d = 0.593, P < .001), whereas no significant reduction was seen in the relaxation group (-3.00 units, d = 0.268, P > .1; group x time interaction: P = .026). Conclusion Very brief mindfulness practice can significantly reduce alcohol consumption among at-risk drinkers, even with minimal encouragement to use this strategy outside of the experimental context. The effects on consumption may therefore represent a lower bound of efficacy of "ultra-brief" mindfulness instructions in hazardous drinkers, at least at short follow-up intervals.
Collapse
Affiliation(s)
- Sunjeev K Kamboj
- Clinical Psychopharmacology Unit (Dr Kamboj, Ms Thomas, and Drs Das and Freeman); Research Department of Clinical, Educational and Health Psychology (Drs Kamboj, Irez, and Serfaty, Ms Thomas, and Drs Das and Freeman), University College London, United Kingdom
| | - Damla Irez
- Clinical Psychopharmacology Unit (Dr Kamboj, Ms Thomas, and Drs Das and Freeman); Research Department of Clinical, Educational and Health Psychology (Drs Kamboj, Irez, and Serfaty, Ms Thomas, and Drs Das and Freeman), University College London, United Kingdom
| | - Shirley Serfaty
- Clinical Psychopharmacology Unit (Dr Kamboj, Ms Thomas, and Drs Das and Freeman); Research Department of Clinical, Educational and Health Psychology (Drs Kamboj, Irez, and Serfaty, Ms Thomas, and Drs Das and Freeman), University College London, United Kingdom
| | - Emily Thomas
- Clinical Psychopharmacology Unit (Dr Kamboj, Ms Thomas, and Drs Das and Freeman); Research Department of Clinical, Educational and Health Psychology (Drs Kamboj, Irez, and Serfaty, Ms Thomas, and Drs Das and Freeman), University College London, United Kingdom
| | - Ravi K Das
- Clinical Psychopharmacology Unit (Dr Kamboj, Ms Thomas, and Drs Das and Freeman); Research Department of Clinical, Educational and Health Psychology (Drs Kamboj, Irez, and Serfaty, Ms Thomas, and Drs Das and Freeman), University College London, United Kingdom
| | - Tom P Freeman
- Clinical Psychopharmacology Unit (Dr Kamboj, Ms Thomas, and Drs Das and Freeman); Research Department of Clinical, Educational and Health Psychology (Drs Kamboj, Irez, and Serfaty, Ms Thomas, and Drs Das and Freeman), University College London, United Kingdom
| |
Collapse
|
37
|
Rosato E, Gigante A, Liberatori M, Gasperini ML, Barbano B, Amoroso A, Tubani L, Laviano A. Altered diurnal cardiac sympathovagal balance correlates with nutritional status indexes in systemic sclerosis patients. J BIOL REG HOMEOS AG 2017; 31:1133-1138. [PMID: 29254326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Autonomic nervous system is involved in body weight regulation. Gastrointestinal manifestations of systemic sclerosis (SSc) can influence patients nutritional status and facilitate the development of proteinenergy malnutrition. The aim of the study is to assess the nutritional status of SSc patients and to explore its possible correlation with autonomic dysfunction using heart rate variability (HRV). We enrolled 19 SSc subjects and 19 healthy subjects as controls. Body mass index (BMI) and body surface area (BSA) were collected and recorded in all patients. HRV was measured and the domains of low frequencies (LF, index of the sympathetic modulation) and high frequencies (HF, index of the parasympathetic modulation) were recorded. As assessed by the LF/HF RATIO, sympathovagal balance is altered in SSc patients because of increased sympathetic modulation and reduced parasympathetic activity. BMI positively correlates with LF (r=0.57; p less than 0.01) and LF/HF RATIO during daytime (r= 0.46; p less than 0.05). Similarly, BSA positively correlates with LF (r= 0.51; p less than 0.05), LF day time (r= 0.53; p less than 0.05) and LF/HF RATIO night time (r=-0.51; p less than 0.05). In SSc patients the autonomic dysfunction is characterized by increased sympathetic modulation. We observed a correlation between autonomic dysfunction and nutritional status in SSc patients.
Collapse
Affiliation(s)
- E Rosato
- Department of Clinical Medicine, Scleroderma Unit, Sapienza University of Rome, Italy
| | - A Gigante
- Department of Clinical Medicine, Scleroderma Unit, Sapienza University of Rome, Italy
| | - M Liberatori
- Department of Clinical Medicine, Sapienza University of Rome, Rome, Italy
| | - M L Gasperini
- Department of Clinical Medicine, Scleroderma Unit, Sapienza University of Rome, Italy
| | - B Barbano
- Department of Clinical Medicine, Scleroderma Unit, Sapienza University of Rome, Italy
| | - A Amoroso
- Department of Clinical Medicine, Scleroderma Unit, Sapienza University of Rome, Italy
| | - L Tubani
- Department of Clinical Medicine, Sapienza University of Rome, Rome, Italy
| | - A Laviano
- Department of Clinical Medicine, Sapienza University of Rome, Rome, Italy
| |
Collapse
|
38
|
Brock C, Jessen N, Brock B, Jakobsen PE, Hansen TK, Rantanen JM, Riahi S, Dimitrova YK, Dons-Jensen A, Aziz Q, Drewes AM, Farmer AD. Cardiac vagal tone, a non-invasive measure of parasympathetic tone, is a clinically relevant tool in Type 1 diabetes mellitus. Diabet Med 2017; 34:1428-1434. [PMID: 28703868 DOI: 10.1111/dme.13421] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/10/2017] [Indexed: 12/19/2022]
Abstract
AIMS To compare a novel index of parasympathetic tone, cardiac vagal tone, with established autonomic variables and to test the hypotheses that (1) cardiac vagal tone would be associated with established time and frequency domain measures of heart rate and (2) cardiac vagal tone would be lower in people with Type 1 diabetes than in a matched healthy cohort and lower still in people with established neuropathy. METHODS Cardiac vagal tone is a validated cardiometrically derived index of parasympathetic tone. It is measured using a standard three-lead electrocardiogram which connects, via Bluetooth, to a smartphone application. A 5-min resting recording of cardiac vagal tone was undertaken and observational comparisons were made between 42 people with Type 1 diabetes and peripheral neuropathy and 23 without peripheral neuropathy and 65 healthy people. In those with neuropathy, 24-h heart rate variability values were compared with cardiac vagal tone. Correlations between cardiac vagal tone and clinical variables were also made. RESULTS Cardiac vagal tone was lower in people with established neuropathy and Type 1 diabetes in comparison with healthy participants [median (interquartile range) linear vagal scale 3.4 (1.6-5.5 vs 7.0 (5.5-9.6); P < 0.0001]. Cardiac vagal tone was positively associated with time (r = 0.8, P < 0.0001) and frequency domain markers of heart rate variability (r = 0.75, P < 0.0001), representing established measures of parasympathetic function. Cardiac vagal tone was negatively associated with age (r=-0.32, P = 0.003), disease duration (r=-0.43, P < 0.0001) and cardiovascular risk score (r=-0.32, P = 0.006). CONCLUSIONS Cardiac vagal tone represents a convenient, clinically relevant method of assessing parasympathetic nervous system tone, potentially facilitating the earlier identification of people with Type 1 diabetes who should undergo formal autonomic function testing.
Collapse
Affiliation(s)
- C Brock
- Department of Mech-Sense, Department of Gastroenterology and Hepatology and Clinical Institute, Aalborg University Hospital, Aalborg, Denmark
- Department of Pharmacotherapy and Development, University of Copenhagen, Copenhagen
- Department of Rheumatology, Aarhus University Hospital, Aarhus
| | - N Jessen
- Department of Clinical Medicine, Aarhus University Hospital, Aarhus
- Department of Clinical Pharmacology, Aarhus University Hospital, Aarhus
- Department of Biomedicine, Aarhus University Hospital, Aarhus
| | - B Brock
- Department of Clinical Medicine, Aarhus University Hospital, Aarhus
- Department of Biochemistry, Aarhus University Hospital, Aarhus
| | - P E Jakobsen
- Department of Endocrinology, Aalborg University Hospital, Aalborg, Denmark
| | - T K Hansen
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus
| | - J M Rantanen
- Department of Nephrology, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University Hospital, Aalborg, Denmark
| | - S Riahi
- Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark
| | - Y K Dimitrova
- Department of Mech-Sense, Department of Gastroenterology and Hepatology and Clinical Institute, Aalborg University Hospital, Aalborg, Denmark
| | - A Dons-Jensen
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus
| | - Q Aziz
- Centre for Neuroscience and Trauma, Wingate Institute of Neurogastroenterology, Blizard Institute, London School of Medicine and Dentistry, Queen Mary University of London, London
| | - A M Drewes
- Department of Mech-Sense, Department of Gastroenterology and Hepatology and Clinical Institute, Aalborg University Hospital, Aalborg, Denmark
| | - A D Farmer
- Department of Mech-Sense, Department of Gastroenterology and Hepatology and Clinical Institute, Aalborg University Hospital, Aalborg, Denmark
- Centre for Neuroscience and Trauma, Wingate Institute of Neurogastroenterology, Blizard Institute, London School of Medicine and Dentistry, Queen Mary University of London, London
- Department of Gastroenterology, University Hospitals of North Midlands, Stoke on Trent, Staffordshire, UK
| |
Collapse
|
39
|
Abstract
OBJECTIVE Epilepsy is a neurological disorder that causes seizures of many different types. Recent research has shown that epileptic seizures can be predicted by using the electrocardiogrami instead of the electroencephalogram. In this study, we used the heart rate variability that is generated by the fluctuating balance of sympathetic and parasympathetic nervous systems to predict epileptic seizures. METHODS We studied 11 epilepsy patients to predict the seizure interval. With regar tos the fact that HRV signals are nonstationary, our analysis focused on linear features in the time and frequency domain of HRV signal such as RR Interval (RRI), mean heart rate (HR), high-frequency (HF) (0.15-0.40 Hz) and low-frequency (LF) (0.04-0.15 Hz), as well as LF/HF. Also, quantitative analyses of Poincaré plot features (SD1, SD2, and SD1/SD2 ratio) were performed. HRV signal was divided into intervals of 5 minutes. In each segment linear and nonlinear features were extracted and then the amount of each segment compared to the previous segment using a threshold. Finally, we evaluated the performance of our method using specificity and sensitivity. RESULTS During seizures, mean HR, LF/HF, and SD2/SD1 ratio significantly increased while RRI significantly decreased. Significant differences between two groups were identified for several HRV features. Therefore, these parameters can be used as a useful feature to discriminate a seizure from a non-seizure The seizure prediction algorithm proposed based on HRV achieved 88.3% sensitivity and 86.2 % specificity. CONCLUSION These results indicate that the HRV signal contains valuable information and can be a predictor for epilepsy seizure. Although our results in comparison with EEG ares a little bit weaker, the recording of ECG is much easier and faster than EEG. Also, our finding showed the results of this study are considerably better than recent research based on ECG (Tab. 1, Fig. 10, Ref. 17).
Collapse
|
40
|
Hu X, Yuan M, Yin Y, Wang Y, Li Y, Zhang N, Sun X, Yu Z, Xu B. Electroacupuncture at LI11 promotes jejunal motility via the parasympathetic pathway. BMC Complement Altern Med 2017; 17:329. [PMID: 28637453 PMCID: PMC5480127 DOI: 10.1186/s12906-017-1826-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/21/2016] [Accepted: 06/06/2017] [Indexed: 12/14/2022]
Abstract
BACKGROUND Gastrointestinal motility disorder has been demonstrated to be regulated by acupuncture treatment. The mechanisms underlying the effects of acupuncture stimulation of abdominal and lower limb acupoints on gastrointestinal motility have been thoroughly studied; however, the physiology underlying the effects of acupuncture on the forelimbs to mediate gastrointestinal motility requires further exploration. The aim of this study was to determine whether electroacupuncture (EA) at LI11 promotes jejunal motility, whether the parasympathetic pathway participates in this effect, and if so, which somatic afferent nerve fibres are involved. METHODS A manometric balloon was used to observe jejunal motility. The effects and mechanisms of EA at LI11 were explored in male Sprague-Dawley rats with or without drug administration (propranolol, clenbuterol, acetylcholine, and atropine) and with or without vagotomy. Three types of male mice (β1β2 receptor-knockout [β1β2-/-] mice, M2M3 receptor-knockout [M2M3-/-] mice and wild-type [WT] mice) were also studied by using different EA intensities (1, 2, 4, 6, and 8 mA). A total of 72 rats and 56 mice were included in the study. RESULTS EA at LI11 increased the contractile amplitude of jejunal motility in the majority of both rats and mice. However, EA at LI11 did not enhance jejunal motility in rats administered atropine, rats that underwent vagotomy, and M2M3-/- mice (at all intensities). In WT mice, EA at LI11 significantly increased jejunal motility at all intensities except 1 mA, and a plateau was reached at intensities greater than 4 mA. CONCLUSION Our results suggest that EA at LI11 promotes jejunal motility primarily by exciting the parasympathetic pathway, and that Aδ-fibres and C-fibres may play important roles in the process.
Collapse
Affiliation(s)
- Xuanming Hu
- Key Laboratory of Integrated Acupuncture and Drugs Constructed, Nanjing University of Chinese Medicine, Ministry of Education, Nanjing, 210023 China
| | - Mengqian Yuan
- Key Laboratory of Integrated Acupuncture and Drugs Constructed, Nanjing University of Chinese Medicine, Ministry of Education, Nanjing, 210023 China
| | - Yin Yin
- Key Laboratory of Integrated Acupuncture and Drugs Constructed, Nanjing University of Chinese Medicine, Ministry of Education, Nanjing, 210023 China
| | - Yidan Wang
- Key Laboratory of Integrated Acupuncture and Drugs Constructed, Nanjing University of Chinese Medicine, Ministry of Education, Nanjing, 210023 China
| | - Yuqin Li
- Key Laboratory of Integrated Acupuncture and Drugs Constructed, Nanjing University of Chinese Medicine, Ministry of Education, Nanjing, 210023 China
| | - Na Zhang
- Key Laboratory of Integrated Acupuncture and Drugs Constructed, Nanjing University of Chinese Medicine, Ministry of Education, Nanjing, 210023 China
| | - Xueyi Sun
- Key Laboratory of Integrated Acupuncture and Drugs Constructed, Nanjing University of Chinese Medicine, Ministry of Education, Nanjing, 210023 China
| | - Zhi Yu
- Key Laboratory of Integrated Acupuncture and Drugs Constructed, Nanjing University of Chinese Medicine, Ministry of Education, Nanjing, 210023 China
| | - Bin Xu
- Key Laboratory of Integrated Acupuncture and Drugs Constructed, Nanjing University of Chinese Medicine, Ministry of Education, Nanjing, 210023 China
| |
Collapse
|
41
|
Kuleshov A. [HEART RATE VARIABILITY IN CHILDREN WITH FALSE CHORDS IN THE LEFT CARDIAC VENTRICULAR]. Georgian Med News 2017:84-88. [PMID: 28726661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
We examined 64 children with false tendons in the left cardiac ventricular. The research included evaluation of time and frequency domain parameters of the heart rhythm with cardiointervalography. The parameter changes were noted. Thus, sympathetic vegetative system (VS) part prevalence was present in boys and characterized by decreasing of SDNN when compared with control data (85,4±5,8 и 158,2 ±25,6, р<0,05). rMSSD and PNN50%, which are responsible for parasympathetic VS part have the tendency to increasing in girls. Nevertheless, frequency domain analysis showed an increasing of the total spectrum power (TP) in both subgroups with statistically significant result (4734,2±319,4 and 3520±381 - boys, р<0,05 when compared with control; 4961,7±413,7 and 3520±381, р<0,05 - girls, respectively). That was proved by other parameters. VLF were also increased when compared with control group (4188,4±413,1 and 1717±154, р<0,05 - boys; 3050,5±468,1 and 1433±811 - girls, р<0,05, respectively), which characterizes sympathetic VS part prevalence in both subgroups. Other frequency domain parameters statistically were not changed but they had tendency as to increasing as to decreasing. All previously noted shows the sympathicotonia in children with FT. These children should be under observation of pediatricians and child cardiologists.
Collapse
Affiliation(s)
- A Kuleshov
- National Pirogov Memorial Medical University, Ukraine
| |
Collapse
|
42
|
Xiong L, Tian G, Wang L, Lin W, Chen X, Leung TWH, Soo YOY, Wong LKS. External Counterpulsation Increases Beat-to-Beat Heart Rate Variability in Patients with Ischemic Stroke. J Stroke Cerebrovasc Dis 2017; 26:1487-1492. [PMID: 28396189 DOI: 10.1016/j.jstrokecerebrovasdis.2017.03.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2016] [Revised: 01/29/2017] [Accepted: 03/03/2017] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND AND PURPOSE External counterpulsation (ECP) is a noninvasive method used to augment cerebral perfusion in ischemic stroke. However, the response of beat-to-beat heart rate variability (HRV) in patients with ischemic stroke during ECP remains unknown. METHODS Forty-eight patients with unilateral ischemic stroke at the subacute stage and 14 healthy controls were recruited. Beat-to-beat heart rate before, during, and after ECP was monitored. The frequency components of HRV were calculated using power spectral analysis. Very low frequency (VLF; <.04 Hz), low frequency (LF; .04-.15 Hz), high frequency (HF; .15-.40 Hz), total power spectral density (TP; <.40 Hz), and LF/HF ratio were calculated. RESULTS In stroke patients, although there were no statistical differences in all of the HRV components, the HRV at VLF showed a trend of increase during ECP compared with baseline in the left-sided stroke patients (P = .083). After ECP, the HRV at LF and TP remained higher than baseline in the right-sided stroke patients (LF, 209.4 versus 117.9, P = .050; TP, 1275.6 versus 390.2, P = .017, respectively). Besides, the HRV at TP also increased after ECP compared with baseline in the left-sided stroke patients (563.0 versus 298.3, P = .029). CONCLUSIONS Irrespective of the side of the ischemia, patients showed an increased beat-to-beat HRV after ECP. Additionally, sympathetic and parasympathetic cardiac modulations were increased after ECP in patients after right-sided subacute stroke.
Collapse
Affiliation(s)
- Li Xiong
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China
| | - Ge Tian
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China
| | - Li Wang
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China
| | - Wenhua Lin
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China
| | - Xiangyan Chen
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China
| | - Thomas Wai Hong Leung
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China
| | - Yannie Oi Yan Soo
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China
| | - Lawrence Ka Sing Wong
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China.
| |
Collapse
|
43
|
Dimova R, Tankova T, Guergueltcheva V, Tournev I, Chakarova N, Grozeva G, Dakovska L. Risk factors for autonomic and somatic nerve dysfunction in different stages of glucose tolerance. J Diabetes Complications 2017; 31:537-543. [PMID: 27894750 DOI: 10.1016/j.jdiacomp.2016.11.002] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Revised: 10/26/2016] [Accepted: 11/02/2016] [Indexed: 12/30/2022]
Abstract
AIM The present study evaluates autonomic and somatic nerve function in different stages of glucose tolerance and its correlation with different cardio-metabolic parameters. MATERIAL AND METHODS Four hundred seventy-eight subjects, mean age 49.3±13.7years and mean BMI 31.0±6.2kg/m2, divided according to glucose tolerance: 130 with normal glucose tolerance (NGT), 227 with prediabetes (125 with impaired fasting glucose (IFG) and 102 with isolated impaired glucose tolerance (iIGT)), and 121 with newly-diagnosed T2D (NDT2D), were enrolled. Glucose tolerance was studied during OGTT. Antropometric indices, blood pressure, HbA1c, serum lipids, hsCRP and albumin-to-creatinine ratio were assessed. Body composition was estimated by a bioimpedance method (InBody 720, BioSpace). Tissue AGEs accumulation was assessed by skin autofluorescence (AGE-Reader-DiagnOpticsTM). Electroneurography was performed by electromyograph Dantec Keypoint. Cardiovascular autonomic neuropathy (CAN) was assessed by ANX-3.0 method applying standard clinical tests. RESULTS CAN was found in 12.3% of NGT, 19.8% of prediabetes (13.2% of IFG and 20.6% of iIGT), and 32.2% of NDT2D. The prevalence of diabetic sensory polyneuropathy (DSPN) was 5.7% in prediabetes and 28.6% in NDT2D. The panel of age, QTc interval, waist circumference, diastolic blood pressure, and 120-min plasma glucose was related to sympathetic activity (F [5451]=78.50, p<0.001). The panel of age, waist circumference, and QTc interval was related to parasympathetic power (F [3453]=132.26, p<0.001). HbA1c and age were related to sural SNAP (F [2454]=15.12, p<0.001). HbA1c and AGEs were related to sural SNCV (F [2454]=12.18, p<0.001). CONCLUSIONS Our results demonstrate a high prevalence of autonomic and sensory nerve dysfunction in early stages of glucose intolerance. Age, postprandial glycemia, central obesity, diastolic blood pressure and QTc interval outline as predictive markers of CAN; hyperglycemia, glycation and age of DSPN.
Collapse
Affiliation(s)
- Rumyana Dimova
- Department of Diabetology, Clinical Center of Endocrinology, Medical University Sofia, Sofia, 1431, Bulgaria.
| | - Tsvetalina Tankova
- Department of Diabetology, Clinical Center of Endocrinology, Medical University Sofia, Sofia, 1431, Bulgaria
| | | | - Ivailo Tournev
- Department of Neurology, Medical University Sofia, Sofia, 1431, Bulgaria
| | - Nevena Chakarova
- Department of Diabetology, Clinical Center of Endocrinology, Medical University Sofia, Sofia, 1431, Bulgaria
| | - Greta Grozeva
- Department of Diabetology, Clinical Center of Endocrinology, Medical University Sofia, Sofia, 1431, Bulgaria
| | - Lilia Dakovska
- Department of Diabetology, Clinical Center of Endocrinology, Medical University Sofia, Sofia, 1431, Bulgaria
| |
Collapse
|
44
|
TAN CHIEKO, SAITO NAO, MIYAWAKI IKUKO. Changes in Heart Rate and Autonomic Nervous Activity after Orthopedic Surgery in Elderly Japanese Patients. Kobe J Med Sci 2017; 62:E129-E135. [PMID: 28289270 PMCID: PMC5436533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Accepted: 12/14/2016] [Indexed: 06/06/2023]
Abstract
Evidence regarding nursing support for delirium prevention is currently insufficient. An evaluation of changes in autonomic nervous activity over time after surgery would elucidate the features of autonomic nervous activity in patients with delirium. These results could provide a basis for effective nursing intervention and timing for preventing the onset of delirium. Here, we aimed to obtain basic data on effective nursing interventions for preventing the onset of postoperative delirium. Heart rate variability was recorded during the morning and nighttime on the day before surgery until 3 days postoperatively in elderly patients who underwent orthopedic surgery to investigate the manner in which heart rate and autonomic nervous activity changed over time. Data were collected over 11 months from July 2013 to November 2014. Surgical stress led to the maintenance of heart rate at a significantly higher value from the day of the surgery until postoperative day 3 compared to that before surgery. Moreover, the autonomic nervous activity remained unchanged during the morning, and it was significantly lower during the night from postoperative day 1 until postoperative day 3 than before the surgery. These results suggest that there is a decrease in parasympathetic nervous activity during the nighttime postoperatively.
Collapse
Affiliation(s)
- CHIEKO TAN
- Department of Nursing Graduate School of Health Sciences Doctor’s course, Kobe University, Hyogo, Japan
| | - NAO SAITO
- Department of Nursing Graduate School of Health Sciences Kobe University, Hyogo, Japan
| | - IKUKO MIYAWAKI
- Department of Nursing Graduate School of Health Sciences Kobe University, Hyogo, Japan
| |
Collapse
|
45
|
Chang CC, Fang WH, Chang HA, Chang TC, Shyu JF, Huang SY. Serotonin 2A receptor (5-HT2A) gene promoter variant interacts with chronic perceived stress to modulate resting parasympathetic activity in humans. Psychoneuroendocrinology 2017; 76:119-126. [PMID: 27912162 DOI: 10.1016/j.psyneuen.2016.11.015] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2016] [Revised: 10/09/2016] [Accepted: 11/14/2016] [Indexed: 11/18/2022]
Abstract
Decreased resting vagal (parasympathetic) tone is implicated in the development of stress-related disorders, including anxiety and depression. Chronic stress elevates the expression of serotonin 2A receptors (5-HT2A), while activation of 5-HT2A leads to inhibition of parasympathetic synaptic transmission. The T allele of the promoter variant, rs6311 (C>T), of the 5-HT2A gene has been shown to increase the 5-HT2A expression in vitro and to be associated with anxiety and depressive disorders. We thus hypothesized that the 5-HT2A functional polymorphism may influence resting vagal activity among persons with chronically high levels of perceived stress. A total of 1138 well-defined healthy, medication-free Han Chinese were included for 5-HT2A genotyping. The Perceived Stress Scale (PSS) was used to measure the level of perceived stress during the last month and participants were divided into low and high PSS groups. Resting-state heart rate variability (HRV) was used to assess autonomic function. No significant between-genotype difference was found in any HRV variable in the low PSS group (n=610). However, in the high PSS group (n=528), high frequency power and root mean square of successive heartbeat interval differences (both HRV indices of parasympathetic activity) were significantly reduced in T/T genotype carriers compared to C/C homozygotes. Our findings are the first to show that individuals homozygous for the high-expressing 5-HT2A (T) allele exhibit diminished resting vagal tone-an index of stress vulnerability-when experiencing chronically elevated levels of perceived stress. The present results may advance our understanding of the genetic mechanism underlying individual differences in susceptibility to stress.
Collapse
Affiliation(s)
- Chuan-Chia Chang
- Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan; Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan.
| | - Wen-Hui Fang
- Department of Family and Community Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Hsin-An Chang
- Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Tieh-Ching Chang
- Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Jia-Fwa Shyu
- Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan; Department of Biology and Anatomy, National Defense Medical Center, Taipei, Taiwan
| | - San-Yuan Huang
- Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan; Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan
| |
Collapse
|
46
|
Avetisyan EA, Petrosyan AA, Khachiyan MS, Saakyan NA, Simonyan LY, Shogheryan SA. [THE ROLE OF TAURINE THE PROCESS OF ADAPTATION OF VISCERAL SYSTEMS UNDER PSYCHO-EMOTIONAL STRESS IN RAT]. Zh Evol Biokhim Fiziol 2017; 53:33-40. [PMID: 30695440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
In recent years the identification of regulatory mechanisms of the general adaptation syndrome, manifesting itself as the response of an organism to drastic changes in the environment and leading to emotional stress, acquires a special significance. The control over visceral functions plays a particular role in stress reactions because of emerging threat of violation of neurodynamic balance of sympathetic-para- sympathetic relationships with their most sensitive element - the heart. Quick adaptation to stress helps to restore not only the sympathetic-parasympathetic homeostasis but also the energy metabolism. One of the essential components, activating metabolic processes, is taurine. This paper considers the descending influence of the paraventricular nucleus (PVN) on neuronal reactions of the solitary tract nucleus (NTS), the first linking pathways of visceral sensitivity, the mechanisms of central control over visceral reactions by mathematical model analysis of heart rate variability (MMA HRV) as well as morpho-histochemical changes in brain structures integrating and regulating the visceral sphere (PVN of the hypothalamus and the amygdala) under psycho-emotional stress without and with intraperitoneal injection of taurine (50 mg/kg). Acute and semichronic experiments were conducted on white nonlinear rats under 5-hour- long immobilization psycho-emotional stress. A highly defined centralization of vegetative HRV parame- ters (HR, IVR, INRS) was revealed, these parameters being normalized on days 7 and 14 at the background of taurine injections. The interaction and interdependence of the central regulatory mechanisms of cardiovascular reactions are shown as well as a considerable protective effect of taurine on promoting early restoration of adaptive properties of the central and peripheral segments of visceral sensitivity under development of long-term psycho-emotional stress.
Collapse
|
47
|
Setko NP, Bulycheva EV, Beilina EB. [Hygienic estimation of functional reserves and adaptive capabilities of students]. Gig Sanit 2017; 96:166-170. [PMID: 29446605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
In the article there are presented data on characteristics ofpeculiarities of the functional state of medical 1-6 years students of higher educational institutions. The results were obtained with the aid of variation pulsometry. Students were shown to have typical elevated tone of the sympathetic nervous system, especially for students of the 1, 3, 5 and 6 courses, that is confirmed by the amplitude mode (AMo), characterizing the sympathetic activity of autonomous nervous system (ANS), which is an average of the students 1 year accounted for 38.6 ± 1.89%, for students of the 3 course - 38.5 ± 1.72%, for students of the 5 year (40.9 ± 3.25 %) and the students of 6 course (46.7 ± 2.59%). There was determined the trend to the centralization of the heart rate control, as evidenced by a reduced proportion of high-frequency waves (HF) by 29.2% to 35.2%, exceeding by 3.6 to 14.4 times in waves of the very low frequency (VLF) relative to the average standard values; the high proportion of students from 41% to 52%, with a mismatch of the sympathetic and parasympathetic compartments of the autonomic nervous system in the regulation of biological processes of adaptation. For medical students of higher education institutions there are typical functional reserves reduced from 20.5 % to 97.6% and a decrease in the proportion of students with a satisfactory adaptation by 40.4% from the 1 to the 6th year.
Collapse
|
48
|
Kuo TBJ, Lai CT, Chen CY, Yang YC, Yang CCH. The high-frequency component of heart rate variability during extended wakefulness is closely associated with the depth of the ensuing sleep in C57BL6 mice. Neuroscience 2016; 330:257-66. [PMID: 27267244 DOI: 10.1016/j.neuroscience.2016.05.060] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2016] [Revised: 05/28/2016] [Accepted: 05/31/2016] [Indexed: 11/29/2022]
Abstract
This study aimed to test the hypothesis that, during extended wakefulness, parasympathetic activity is associated with the depth of the subsequent recovery sleep in mice. Fourteen male C57BL/6 mice were implanted with electrodes for sleep recording. Continuous spectral analysis was performed on the electroencephalogram (EEG) to obtain theta power (6-9Hz) and delta power (0-4Hz), as well as the R-R interval signals in order to quantify the high-frequency power (HF) and normalized low-frequency power (LF%) that are used to assess parasympathetic and sympathetic activity, respectively. All animals underwent a sleep deprivation experiment and a control experiment (6-h intervention and 1-h recovery period) on two separate days. During sleep deprivation, HF and theta power during wakefulness were significantly higher than during the control wakefulness after the second hour and first hour, respectively. During recovery non-rapid eye movement sleep, there was a rebound in sleep time and delta power as well as an elevation in HF relative to control post-intervention sleep. Both the rise in HF and theta power during extended wakefulness were found to be positively correlated with the delta power rebound. Furthermore, the HF change during extended wakefulness was also correlated with the amount of sleep loss and the enhancement of waking theta power. Our finding suggests that waking parasympathetic activity intimately reflects the cumulative sleep pressure, suggesting a potential role to be an autonomic marker for sleep propensity.
Collapse
Affiliation(s)
- T B J Kuo
- Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan; Sleep Research Center, National Yang-Ming University, Taipei, Taiwan; Department of Education and Research, Taipei City Hospital, Taipei, Taiwan; Research Center for Adaptive Data Analysis, National Central University, Taoyuan, Taiwan
| | - C T Lai
- Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan; Sleep Research Center, National Yang-Ming University, Taipei, Taiwan
| | - C Y Chen
- Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan; Sleep Research Center, National Yang-Ming University, Taipei, Taiwan; Neurological institute, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Y C Yang
- Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan; Sleep Research Center, National Yang-Ming University, Taipei, Taiwan
| | - C C H Yang
- Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan; Sleep Research Center, National Yang-Ming University, Taipei, Taiwan; Department of Education and Research, Taipei City Hospital, Taipei, Taiwan.
| |
Collapse
|
49
|
Osailan A, Metsios GS, Rouse PC, Ntoumanis N, Duda JL, Kitas GD, Veldhuijzen van Zanten JJCS. Factors associated with parasympathetic activation following exercise in patients with rheumatoid arthritis: a cross-sectional study. BMC Cardiovasc Disord 2016; 16:86. [PMID: 27165730 PMCID: PMC4862092 DOI: 10.1186/s12872-016-0264-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2015] [Accepted: 04/29/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Patients with rheumatoid arthritis (RA) have an increased risk for cardiovascular disease (CVD) with poor parasympathetic function being implicated as an underlying factor. Factors related to parasympathetic function, commonly assessed by heart rate recovery (HRR) following maximal exercise, are currently not known in RA. We aimed to explore the association between HRR with CVD risk factors, inflammatory markers, and wellbeing in patients with RA. METHODS Ninety-six RA patients (54.4 ± 12.6 years, 68 % women) completed a treadmill exercise test, during which heart rate (HR) was monitored. HRR1 and HRR2 were defined as the absolute change from HR peak to HRR 1 min post HR peak and 2 min post HR peak, respectively. Cardiorespiratory fitness, CVD risk factors, and serological markers of inflammation were measured in all patients. The Framingham Risk Score (FRS) was used as an assessment of global risk for CVD events, and wellbeing was assessed by questionnaires. RESULTS Mean HRR1 and HRR2 were 29.1 ± 13.2 bpm and 46.4 ± 15.3 bpm, respectively. CVD risk factors as well as most inflammatory markers and measures of wellbeing were inversely correlated with HRR1 and HRR2. Multivariate regression analyses revealed that 27.9 % of the variance in HRR1 and 37.9 % of the variance in HRR2 was explained collectively by CVD risk factors, measures of inflammation, and wellbeing (p = 0.009, p = 0.001 respectively), however no individual measure was independently associated with HRR1 or HRR2. CONCLUSION Parasympathetic activation was associated with overall CVD risk, arthritis-related burden and wellbeing in patients with RA. TRIAL REGISTRATION [Exercise, cardiovascular disease and rheumatoid arthritis, ISRCTN04121489 ].
Collapse
Affiliation(s)
- Ahmad Osailan
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, B15 2TT, UK.
- Department of Rheumatology, Dudley Group NHS Foundation Trust, Dudley, UK.
| | - George S Metsios
- Department of Rheumatology, Dudley Group NHS Foundation Trust, Dudley, UK
- Department of Physical Activity Exercise and Health, University of Wolverhampton, Walsall, West Midlands, UK
| | - Peter C Rouse
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, B15 2TT, UK
- Department of Rheumatology, Dudley Group NHS Foundation Trust, Dudley, UK
- Department for Health, University of Bath, Bath, UK
| | - Nikos Ntoumanis
- School of Psychology & Speech Pathology, Curtin University, Perth, Australia
| | - Joan L Duda
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, B15 2TT, UK
| | - George D Kitas
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, B15 2TT, UK
- Department of Rheumatology, Dudley Group NHS Foundation Trust, Dudley, UK
- Department of Physical Activity Exercise and Health, University of Wolverhampton, Walsall, West Midlands, UK
| | - Jet J C S Veldhuijzen van Zanten
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, B15 2TT, UK
- Department of Rheumatology, Dudley Group NHS Foundation Trust, Dudley, UK
| |
Collapse
|
50
|
Hong CH, Kuo TBJ, Huang BC, Lin YC, Kuo KL, Chern CM, Yang CCH. Cold Exposure Can Induce an Exaggerated Early-Morning Blood Pressure Surge in Young Prehypertensives. PLoS One 2016; 11:e0150136. [PMID: 26919177 PMCID: PMC4769082 DOI: 10.1371/journal.pone.0150136] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2015] [Accepted: 02/09/2016] [Indexed: 11/19/2022] Open
Abstract
Prehypertension is related to a higher risk of cardiovascular events than normotension. Our previous study reported that cold exposure elevates the amplitude of the morning blood pressure surge (MBPS) and is associated with a sympathetic increase during the final sleep transition, which might be critical for sleep-related cardiovascular events in normotensives. However, few studies have explored the effects of cold exposure on autonomic function during sleep transitions and changes of autonomic function among prehypertensives. Therefore, we conducted an experiment for testing the effects of cold exposure on changes of autonomic function during sleep and the MBPS among young prehypertensives are more exaggerate than among young normotensives. The study groups consisted of 12 normotensive and 12 prehypertensive male adults with mean ages of 23.67 ± 0.70 and 25.25 ± 0.76 years, respectively. The subjects underwent cold (16°C) and warm (23°C) conditions randomly. The room temperature was maintained at either 23°C or 16°C by central air conditioning and recorded by a heat-sensitive sensor placed on the forehead and extended into the air. BP was measured every 30 minutes by using an autonomic BP monitor. Electroencephalograms, electrooculograms, electromyograms, electrocardiograms, and near body temperature were recorded by miniature polysomnography. Under cold exposure, a significantly higher amplitude of MBPS than under the warm condition among normotensives; however, this change was more exaggerated in prehypertensives. Furthermore, there was a significant decrease in parasympathetic-related RR and HF during the final sleep transition and a higher early-morning surge in BP and in LF% among prehypertensives, but no such change was found in normotensives. Our study supports that cold exposure might increase the risk of sleep-related cardiovascular events in prehypertensives.
Collapse
Affiliation(s)
- Cian-Hui Hong
- Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan
- Sleep Research Center, National Yang-Ming University, Taipei, Taiwan
| | - Terry B. J. Kuo
- Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan
- Sleep Research Center, National Yang-Ming University, Taipei, Taiwan
- Brain Research Center, National Yang-Ming University, Taipei, Taiwan
- Department of Education and Research, Taipei City Hospital, Taipei, Taiwan
- Institute of Translational and Interdisciplinary Medicine, National Central University, Taoyuan, Taiwan
| | - Bo-Chi Huang
- Institute of Biophotonics, National Yang-Ming University, Taipei, Taiwan
| | - Yu-Cheng Lin
- Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan
- Sleep Research Center, National Yang-Ming University, Taipei, Taiwan
| | - Kuan-Liang Kuo
- Department of Family Medicine, Taipei City Hospital, Taipei, Taiwan
| | - Chang-Ming Chern
- Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan
- Department of Neurology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Cheryl C. H. Yang
- Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan
- Sleep Research Center, National Yang-Ming University, Taipei, Taiwan
- Brain Research Center, National Yang-Ming University, Taipei, Taiwan
- Department of Education and Research, Taipei City Hospital, Taipei, Taiwan
- * E-mail:
| |
Collapse
|