Autonomic Nervous System Dysfunction In Patients Research Articles

Physiological and Behavioral Function of a Female Survivor of Partner Violence with Repetitive Head Impacts

<h3>Research Objectives</h3> To identify the autonomic nervous system (ANS), cognitive, and psychological function of a survivor of intimate partner violence (IPV) with a history of subconcussive head impacts (SHI). <h3>Design</h3> Case report. <h3>Setting</h3> Telehealth. <h3>Participants</h3> A 24-year old female with a six-year history of IPV and complaints of strangulation, dizziness, fatigue, headaches, and poor appetite was screened for anxiety, depression, post-traumatic stress disorder (PTSD), cognitive and ANS function. One virtual study visit, lasting about 1.5 hours, was completed. <h3>Interventions</h3> Not applicable. <h3>Main Outcome Measures</h3> Structured interview, the Generalized Anxiety Disorder Questionnaire (GAD-7), PHQ-9 Depression Scale, Primary Care PTSD Screen for DSM-5 (PC-PTSD-5), Montreal Cognitive Assessment (MOCA), and COMPASS-31 were used to identify SHI, anxiety, depression, PTSD, cognitive and ANS function. <h3>Results</h3> The female survivor demonstrated a positive history of IPV-related SHI and reported being hit in the head, neck, or face at least once a week for more than 2 years. She scored a total of 19 on GAD-7, indicating moderate anxiety. Her PHQ-9 score was 24, suggesting major depression. The PC-PTSD total score was 5 (a score of 3 indicates probable PTSD). The MOCA's total score was 21 which indicated mild cognitive impairment. She scored a cumulative of 15 on COMPASS 31. A score of 13 had implied ANS dysfunction in patients with neurological disorders. <h3>Conclusions</h3> Previously, repetitive head impacts have led to impaired regulation of homeostasis via ANS in athletes. Alteration in heart rate mediated by ANS may influence cognitive and motor function. ANS disruption could be more pronounced in IPV survivors due to psychological distress. This case report suggests that ANS function should be objectively evaluated in survivors presenting with IPV-related SHI and psychological disturbance. <h3>Author(s) Disclosures</h3> The authors declare no conflict of interest.

The Function of the Autonomic Nervous System in Asian Patients With Chronic Migraine.

BackgroundThe pathogenic mechanisms underlying the autonomic nervous system (ANS) dysfunction in patients with chronic migraine (CM) remain unclear. This study investigated the pathogenesis of ANS dysfunction in this population.MethodsA total of 60 patients diagnosed with CM and 60 healthy subjects were recruited to participate in this study. The pupil diameter, pupil contraction velocity, latency, amplitude, and the maximum gradient recovery time were examined before, at 2 min and at 5 min after the cold pressor test, which was combined with the pupillary light reflex method. A brain 3D T1-weighted structural imaging scan, resting-state functional magnetic resonance imaging scan, and diffusion tensor imaging (DTI) scan were also acquired.ResultsPatients with CM exhibited a longer recovery time to the maximum gradient at 2 min and at 5 min after cold pressing compared with the control group (P < 0.01 and P < 0.05, respectively). There was no significant difference in the pupil diameter, pupillary contraction velocity, latency, amplitude, blood pressure, or heart rate between the two groups (all P > 0.05). In the CM group, the regional homogeneity (ReHo) values of the left amygdala and left lateral hypothalamic area were significantly higher than those of other brain areas (P < 0.001, Alphasim corrected). The DTI scan of the whole brain area showed a lack of significant difference in DTI indices, including FA, MD, AD, and RD values between the two groups (P > 0.05, Alphasim corrected).ConclusionThe dysfunction of the left amygdala and left lateral hypothalamic area may be related to ANS dysfunction in patients with CM.

Heart rate variability and inflammatory bowel disease in humans

The autonomic nervous system (ANS) maintains homeostasis in the gastrointestinal tract, including immunity, inflammation and motility, through the brain-gut axis. To date, the associations between ANS function and inflammatory bowel disease (IBD) have been controversial and inconclusive in human studies. PubMed, Cochrane Library, and Embase were searched through February 2020 for articles reporting these association between heart rate variability (HRV), an indirect measure of ANS activity, and IBD. The standardized mean differences and 95% confidence intervals (CIs) were calculated. Ten eligible studies involving 273 ulcerative colitis patients, 167 Crohn's disease patients and 208 healthy controls were included. The values of the total power (SMD = −0.83, 95% CI = −1.44, −0.21), high frequency (SMD = −0.79, 95% CI = −1.20, −0.38), RR interval (SMD = −0.66, 95% CI = −1.04, −0.27), standard deviation of the RR intervals (SMD = −1.00, 95% CI = −1.73, −0.27), percentage of RR intervals with a greater than 50-millisecond variation (SMD = −0.82, 95% CI = −1.33, −0.30) and the square root of the mean squared differences in successive RR intervals (SMD = −0.71, 95% CI = −1.15, −0.26) of the IBD patients were lower than those of the healthy controls, and moderate to large effect sizes were observed in all HRV indices, except for low frequency (SMD = −0.41, 95% CI = 0.95, 0.13). IBD was strongly associated with an overall decrease in HRV, indicating substantially decreased ANS activity. Furthermore, the parasympathetic nerve displayed a stronger inverse association with ANS activity than the sympathetic nerve, indicating ANS dysfunction in patients with IBD.

Recurrence plot of heart rate variability signal in patients with vasovagal syncopes

Abstract Currently, heart rate variability (HRV) is commonly evaluated using time and frequency domain analysis in the clinical practice. Due to the fact that cardiovascular system is regulated by the autonomic nervous system (ANS) that also influences HRV, however exhibits rather nonlinear behaviour, it appears more appropriate to apply nonlinear methods to evaluate functioning of ANS. This study presents recurrence analysis as a tool to test the presence of ANS dysfunction that is responsible i.e. for orthostatic (vasovagal) syncope by which abnormal HRV has been demonstrated in the past. Study included 18 patients that experienced vasovagal syncope (mean age 23.7 ± 5.2 years) and 18 healthy subjects (mean age 24.5 ± 3.2, p = 0.85). In all tested subjects, ECG recording was performed during active orthostatic test that comprised two phases (5 min of resting in a supine position and 5 min of active standing). Sequence of R-R intervals (time intervals between two consecutive heart beats derived from ECG) was analysed using standard time (mean RR, mean HR, SDNN, SDHR, RMSSD, NN50 and pNN50) and frequency domain (LF, HF and LF/HF ratio) analysis. Moreover, recurrence analysis was performed (RATIO, DIV, AVDL, MAXV, DET, ENTR, LMAX, TT and LAM). Frequency domain analysis did not demonstrate significant difference between the two groups in any of the parameters during both phases of the test. On the contrary, both time domain analysis and recurrence analysis showed comparable findings in both groups during resting phase of the orthostatic test with a significant change of most tested parameters after stand-up. As the use of time domain HRV may be perceived as problematic regarding their interpretation in short ECG recordings, recurrence analysis appears to be a sensitive tool for detecting ANS dysfunction in patients with vasovagal syncope.

Patterns of autonomic nervous system impairment following concussion

Background: The presence of significant autonomic nervous system (ANS) impairment following concussion has only recently been recognized. We sought to describe the pattern of ANS dysfunction in patients with persistent symptoms following concussion.

Exploring autonomic nervous system dysfunction in patients with cancer cachexia: A pilot study

IntroductionAbnormalities of the autonomic nervous system (ANS) have been associated with cachexia. MethodsIn nine cancer patients who had lost weight and nine age-matched healthy volunteers heart rate variability (HRV) components were determined, together with serum cortisol and urinary catecholamines/metanephrines. ResultsCompared to volunteers, patients exhibited a global reduction in HRV parameters, significantly so for high frequency, low frequency and total power (median values ms2 103 vs. 313, 62 vs. 148 and 316 vs. 736 respectively, P<0.05). Biochemical values did not differ. ConclusionOur results suggest the presence of ANS dysfunction in patients with cancer cachexia, with reduction in both sympathetic and parasympathetic components.