Autonomic Nervous System Function Research Articles

Arterial hypertension in the Arctic: the role of stress and autonomic dysfunction, gender differences

Introduction. Psychological stress and autonomic dysfunction are recognized as risk factors for cardiovascular diseases, but they affect cardiovascular risk differently in men and women.Aim: To study gender differences in factors influencing the probability of detecting arterial hypertension (AH) from the perspective of the role of stress, autonomic dysfunction and nonspecific inflammation in rotational shift workers in the Arctic region.Material and Methods. In the medical unit of the gas production company “Gazprom dobycha Yamburg” (polar settlement of Yamburg, 68°21’40”N) we simultaneously examined 99 men and 81 women with AH 1,2 degree of AH and normotensive persons comparable in age (p = 0.450), work experience in the Arctic (p = 0.956), number of years of rotational shift work (p = 0.824), level of office systolic (SBP) (p = 0.251) and diastolic blood pressure (DBP) (p = 0.579). Questionnaires were used to determine the level of general stress (PSM25 scale), occupational stress (Vaisman questionnaire); assessment of autonomic nervous system (ANS) function (Wayne A.M. questionnaire); 24-hour blood pressure monitoring was performed; biochemical blood test for biomarkers of inflammation, cortisol, brain natriuretic peptide precursor, homocysteine, folliclestimulating hormone was carrued out.Results. Vegetative manifestations (asthenization, increased fatigue, meteorological dependence, headaches) were significantly more often observed in women. Among men with AH, individuals with high levels of neuropsychological tension predominated, every fifth M had a high level of occupational stress. The median scores on the Wayne A.M. questionnaire were significantly higher in women, regardless of BP, and moderate ANS disorders were significantly more prevalent. According to logistic regression data, a significant effect on the probability of AH in men was the number of stress scores (OR = 1.050; 1.029–1.171, p = 0.001), indicators of nocturnal DBP variability (OR = 1.295; 1.109–1.511, p = 0.001) and nonspecific inflammation: rise in high-sensitivity C-reactive protein (hs-CRP) increased the probability of AH by 1.5 times (OR = 1.532; 1.212–1.937, p = 0.001), IL-1β – by 7 times (OR = 7.275; 3.235–16.361, p = 0.001). The probability of AH in women increased by the values of the daily variability of SBP (OR = 1.154; 1.019–1.306, p = 0.024), hs-CRP by 1.5 times (OR = 1.479; 1.226–1.783, p = 0.001), tumor necrosis factor-alpha (TNF-α) (OR = 1.111; 1.001–1.244, p = 0.044), level of IL-6 increased the probability of AH by 1.7 times (OR = 1.676; 1.149–2.958, p = 0.035), the number of scores on ANS questionnaire had a significant effect (OR = 1.055; 1.006–1.107, p = 0.026).Conclusion. In the conditions of the rotational shift work in the Arctic, gender differences were revealed in the stress perception and the severity of ANS dysfunction with a clear relationship between stress, inflammation and AH in men. ANS dysfunction in women was a trigger of nonspecific inflammation and AH. The identified gender differences will help to reveal vulnerable groups among men and women and develop targeted interventions for individuals in the Arctic region.

Perceived Stress, Mindfulness, and Clinical Concussion Outcomes in Adults with a Concussion History

ABSTRACT Introduction Higher perceived stress negatively impacts concussion recovery, but there are limited data examining connections between perceived stress and concussion. Additionally, higher mindfulness is associated with lower perceived stress, but there is limited research on how mindfulness impacts concussion outcomes. Therefore, this study aimed to estimate the associations among perceived stress, mindfulness, and clinical concussion outcomes. Methods This was a cross-sectional, observational study in 80 young adults with a concussion history. Participants completed a single study visit measuring the following: 1) demographics, concussion history, and current mindfulness practice; 2) perceived stress (Perceived Stress Scale); 3) mindfulness (Five Facet Mindfulness Questionnaire); and 4) clinical concussion outcomes/symptoms (Rivermead Post-Concussion Symptoms Questionnaire), balance performance (Balance Error Scoring System (BESS) and center of mass), autonomic nervous system function (heart rate variability), vestibular/ocular function (vestibular ocular motor screening), and exertion tolerance (step test). Separate multivariable linear regression models were used to determine the associations among 1) perceived stress and clinical concussion outcomes and 2) mindfulness and clinical concussion outcomes. Next, a perceived stress and mindfulness interaction term was included to test the potential moderation effect of mindfulness on clinical concussion outcomes. Results Higher perceived stress was significantly associated with higher concussion symptom severity (P < 0.001) and higher number of concussion symptoms reported as worse than before injury (P < 0.001). Higher mindfulness was associated with lower concussion symptom severity (P < 0.001), and fewer concussion symptoms reported as worse than before injury (P = 0.002). There were no clinically significant models where the interaction effect was also significant, but the BESS parameter estimate did show statistical significance in the interaction model. Conclusions Our results provide a novel understanding of the association among perceived stress, mindfulness, and clinical concussion outcomes. These data are necessary to inform mechanistic concussion rehabilitation interventions.

Design of a Remote Multiparametric Tool to Assess Mental Well-Being and Distress in Young People (mHealth Methods in Mental Health Research Project): Protocol for an Observational Study.

Mental health conditions have become a substantial cause of disability worldwide, resulting in economic burden and strain on the public health system. Incorporating cognitive and physiological biomarkers using noninvasive sensors combined with self-reported questionnaires can provide a more accurate characterization of the individual's well-being. Biomarkers such as heart rate variability or those extracted from the electrodermal activity signal are commonly considered as indices of autonomic nervous system functioning, providing objective indicators of stress response. A model combining a set of these biomarkers can constitute a comprehensive tool to remotely assess mental well-being and distress. This study aims to design and validate a remote multiparametric tool, including physiological and cognitive variables, to objectively assess mental well-being and distress. This ongoing observational study pursues to enroll 60 young participants (aged 18-34 years) in 3 groups, including participants with high mental well-being, participants with mild to moderate psychological distress, and participants diagnosed with depression or anxiety disorder. The inclusion and exclusion criteria are being evaluated through a web-based questionnaire, and for those with a mental health condition, the criteria are identified by psychologists. The assessment consists of collecting mental health self-reported measures and physiological data during a baseline state, the Stroop Color and Word Test as a stress-inducing stage, and a final recovery period. Several variables related to heart rate variability, pulse arrival time, breathing, electrodermal activity, and peripheral temperature are collected using medical and wearable devices. A second assessment is carried out after 1 month. The assessment tool will be developed using self-reported questionnaires assessing well-being (short version of Warwick-Edinburgh Mental Well-being Scale), anxiety (Generalized Anxiety Disorder-7), and depression (Patient Health Questionnaire-9) as the reference. We will perform correlation and principal component analysis to reduce the number of variables, followed by the calculation of multiple regression models. Test-retest reliability, known-group validity, and predictive validity will be assessed. Participant recruitment is being carried out on a university campus and in mental health services. Recruitment commenced in October 2022 and is expected to be completed by June 2024. As of July 2023, we have recruited 41 participants. Most participants correspond to the group with mild to moderate psychological distress (n=20, 49%), followed by the high mental well-being group (n=13, 32%) and those diagnosed with a mental health condition (n=8, 20%). Data preprocessing is currently ongoing, and publication of the first results is expected by September 2024. This study will establish an initial framework for a comprehensive mental health assessment tool, taking measurements from sophisticated devices, with the goal of progressing toward a remotely accessible and objectively measured approach that maintains an acceptable level of accuracy in clinical practice and epidemiological studies. OSF Registries N3GCH; https://doi.org/10.17605/OSF.IO/N3GCH. DERR1-10.2196/51298.

Effect of transcutaneous electrical acupoint stimulation based on the theory of "qi ascending and descending movement" on autonomic nervous system and gastrointestinal function in patients after general anesthesia laparoscopic cholecystectomy.

To observe the therapeutic effect of transcutaneous electrical acupoint stimulation (TEAS) based on the theory of "qi ascending and descending movement" in patients after general anesthesia laparoscopic cholecystectomy, so as to explore the impact of TEAS on the autonomic nervous system and gastrointestinal function of patients. A total of 204 patients scheduled to undergo general anesthesia laparoscopic cholecystectomy were selected and randomly divided into control, double acupoints and multiple acupoints groups, with 68 cases in each group. For patients in the multiple acupoints group, TEAS was applied at Zusanli (ST36), Tiantu (CV22), Danzhong (CV17), Zhongwan (CV12), Taichong (LR3), and Neiguan (PC6) 30 min before anesthesia induction until the end of the surgery. In the double acupoints group, TEAS was applied only at ST36 and PC6. No electrical stimulation was applied in the control group. The postoperative bloating, bowel sound recovery time, first farting time, first defecation time, length of hospital stay, nausea and vomiting were compared among the three groups. Heart rate variability was monitored by twelve-lead electrocardiogram to evaluate the autonomic nervous function of the patients, including the low frequency power/high frequency power ratio (LF/HF), the standard deviation of all sinus RR intervals (SDNN), and the root mean square of difference between successive normal RR intervals (RMSSD). At 6 h and 24 h after surgery, the symptoms of bloating, nausea and vomiting in the multiple acupoints group and double acupoints group were significantly improved compared to the control group (P<0.05), and the multiple acupoints group was superior to the double acupoints group (P<0.05). Compared with the control group, the bowel sound recovery time, first farting time, first defecation time, and length of hospital stay were significantly shorter (P<0.05) in the multiple acupoints group and double acupoints group, and the multiple acupoints group was superior to the double acupoints group (P<0.05). At 1 d and 2 d after surgery, compared with the control group, LF/HF was decreased (P<0.05) while SDNN and RMSSD were increased (P<0.05) in the multiple acupoints group and double acupoints group, and there was a significant difference between the two groups (P<0.05). TEAS treatment based on the theory of "qi ascending and descending movement" can relieve gastrointestinal dysfunction, reduce early postoperative sympathetic nerve excitement and maintain parasympathetic nerve tension in patients after general anesthesia laparoscopic cholecystectomy, thereby promoting gastrointestinal function recovery.

Prevalence and predictors of preoperative cardiac autonomic dysfunction among elective neurosurgical patients: A prospective observational study.

The autonomic nervous system (ANS) is cardinal for systemic homeostasis. Autonomic dysfunction is prevalent in as high as 65% of patients presenting for cardiac surgery in the Indian scenario. Pre-existing cardiac autonomic dysfunction (CAD) in surgical patients can accentuate perioperative haemodynamic fluctuations during stressful intraoperative events, predispose to adverse cardiac events, and contribute to morbidity and mortality. The prevalence and predictors of CAD in the elective neurosurgical population are unknown in the Indian scenario. The current study was conducted to bridge this knowledge gap. In this single-centre prospective observational study conducted at a tertiary care neurosciences centre, among 400 consenting adult patients of either gender, between 18 and 80 years of age, undergoing elective neurosurgery, the preoperative ANS function at the bedside was assessed as the primary outcome measure. The ANS status was evaluated using ANSiscope™-derived indices of heart rate variability. The diagnosis of CAD was made when the ANS index exceeded a threshold of 13.5. Data regarding predictors of CAD were collected from patient records as the secondary outcome measure. Statistical analysis was done using the R software. A P-value of <0.05 was considered statistically significant. The prevalence of preoperative CAD in our study population was 79.7% (319/400 patients). None of the demographic and baseline clinical characteristics we studied predicted CAD in our study. We observed a significant prevalence of preoperative CAD among elective neurosurgical patients. None of the parameters we evaluated predicted CAD in our study.

Acquired hypothalamic obesity: A clinical overview and update.

Hypothalamic obesity (HO) is a rare and complex disorder that confers substantial morbidity and excess mortality. HO is a unique subtype of obesity characterized by impairment in the key brain pathways that regulate energy intake and expenditure, autonomic nervous system function, and peripheral hormonal signalling. HO often occurs in the context of hypothalamic syndrome, a constellation of symptoms that follow from disruption of hypothalamic functions, for example, temperature regulation, sleep-wake circadian control, and energy balance. Genetic forms of HO, including the monogenic obesity syndromes, often impact central leptin-melanocortin pathways. Acquired forms of HO occur as a result of tumours impacting the hypothalamus, such as craniopharyngioma, surgery or radiation to treat those tumours, or other forms of hypothalamic damage, such as brain injury impacting the region. Risk for severe obesity following hypothalamic injury is increased with larger extent of hypothalamic damage or lesions that contain the medial and posterior hypothalamic nuclei that support melanocortin signalling pathways. Structural damage in these hypothalamic nuclei often leads to hyperphagia, central insulin and leptin resistance, decreased sympathetic activity, low energy expenditure, and increased energy storage in adipose tissue, the collective effect of which is rapid weight gain. Individuals with hyperphagia are perpetually hungry. They do not experience fullness at the end of a meal, nor do they feel satiated after meals, leading them to consume larger and more frequent meals. To date, most efforts to treat HO have been disappointing and met with limited, if any, long-term success. However, new treatments based on the distinct pathophysiology of disturbed energy homeostasis in acquired HO may hold promise for the future.

Hypnotic Modulation of Autonomic Nervous System (ANS) Activity.

Hypnosis, a time-honored therapeutic approach, has gained widespread recognition for its effectiveness in addressing a range of psychological and somatic disorders. While its primary effects are mediated by central top-down mechanisms, hypnosis also exerts peripheral influence by modulating the autonomic nervous system (ANS). Psychophysiological measures, such as heart rate (HR) and its variability (HRV), electrodermal activity (EDA), respiratory rate (RR), and the analgesia nociceptive index (ANI), serve as reliable indicators of ANS activity. Studies have consistently demonstrated hypnosis' ability to significantly impact ANS functions, lowering sympathetic activity and enhancing parasympathetic tone. This effect is particularly pronounced during relaxation procedures and is influenced by mediating factors like hypnotizability and task conditions. Despite methodological limitations, this review highlights the potential of enhanced ANS modulation through hypnosis, including its connections to the central nervous system (CNS), to optimize therapeutic outcomes in patients with psychosomatic disorders associated with ANS dysfunction.

Evaluating the indicators ofaheart rate variability analysis indogs using Poincaré plots.

Heart rate variability analyses using Poincaré plots can beuseful for evaluating the autonomic nervous system function. However, the interpretation ofthe quantitative indicators ofPoincaré plots remains controversial. Thus, few studies have verified the effectiveness ofthe quantitative indicators inveterinary medicine. This study aimed toverify the reliability ofPoincaré plot indicators using pharmacological models indogs. Four healthy beagles were used inthis study. Each dog was treated with propranolol, atropine, and propranolol-atropine toblock the sympathetic, parasympathetic, and sympathetic-parasympathetic functions, respectively. The quantitative indicators ofthe Poincaré plots were calculated based ondata from 300electrocardiogram beats collected before and after the administration ofeach drug and statistically analysed. The quantitative indicators ofthe Poincaré plots, such asthe standard deviation perpendicular tothe major axis (SD1), standard deviation along the major axis (SD2), and SD1×SD2, significantly decreased after the drug administration inboth the parasympathetic and sympathetic-parasympathetic blockade models. However, nosignificant differences were observed inSD1/SD2 between the groups. The Poincaré plots reflected the changes inthe autonomic nervous system ofdogs. Indogs, SD1, SD2, and SD1×SD2 can detect astate inwhich parasympathetic nerve activity issuppressed.

Household food insecurity is associated with greater autonomic dysfunction testing score in Latinos with type 2 diabetes.

We examined household food insecurity (HFI) and autonomic nervous system (ANS) function in a subset of low-income Latinos with type 2 diabetes with data from a stress management trial. InclusionLatino or Hispanic, Spanish speaking, age less than 18 years, ambulatory status, type 2 diabetes more than 6 months, A1c less than 7.0%. ExclusionPain or dysfunction in hands (e.g., arthritis) precluding handgrip testing; medical or psychiatric instability. HFI was assessed with the 6-item U.S. household food security survey module; with responses to > = 1 question considered HFI. An ANS dysfunction index was calculated from xix autonomic function tests which were scored 0 = normal or 1 = abnormal based on normative cutoffs and then summed. Autonomic function tests were: 1) 24-hour heart rate variability as reflected in standard deviation of the normal-to-normal (SDNN) heart rate acquired with 3-channel, 7-lead ambulatory electrocardiogram (Holter) monitors; 2) difference between the highest diastolic blood pressure (DBP) during sustained handgrip and the average DBP at rest; 3) difference between baseline supine and the minimal BP after standing up; and, from 24-hour urine specimens 4) cortisol, 5) normetanephrine, and, 6) metanephrine. Thirty-five individuals participated, 23 (65.7%) of them were women, age mean = 61.6 (standard deviation = 11.2) years, HbA1c mean = 8.5% (standard deviation = 1.6) and 20 participants (57.1%) used insulin. Twenty-two participants (62.9%) reported HFI and 25 (71.4%) had one or more abnormal ANS measure. Independent t-tests showed that participants with HFI had a higher ANS dysfunction index (mean = 1.5, standard deviation = 0.9) than patients who were food secure (mean = 0.7, standard deviation = 0.8), p = 0.02. Controlling for financial strain did not change significance. Total ANS index was not related to glycemia, insulin use or other socioeconomic indicators. In this sample, HFI was associated with ANS dysfunction. Policies to improve food access and affordability may benefit health outcomes for Latinos with diabetes.

Assessing autonomic activity and prognostic risk factors comparing multisystem inflammatory syndrome and isolated viral myocarditis/myopericarditis.

In pediatric multisystem inflammatory syndrome and isolated viral myocarditis/myopericarditis, autonomic nervous system function can be evaluated by a non-invasive method called heart rate variability. This study aims to evaluate heart rate variability in these two groups by comparing them with each other. This is the first study assessing these values in these two groups of patients. Patients who are diagnosed with multisystem inflammatory syndrome in children and isolated viral myocarditis/myopericarditis at a university hospital from September 2021 to February 2023 are screened by electrocardiography, echocardiography, and 24-hour Holter monitoring. A healthy control group, compatible in age and gender with the patient groups, was selected from healthy subjects that applied to the hospital for palpitation, murmur, and/or chest pain. Heart rate variability parameters and related laboratory markers were analyzed and compared among the three groups. There were 30 patients with multisystem inflammatory syndrome in children, 43 patients with isolated viral myocarditis/myopericarditis, and 109 participants in the healthy control group. Statistically significant differences were found in most of the heart rate variability parameters: standard deviation of normal to normal intervals (SDNN), the mean of the 5- minute RR interval standard deviations (SDNNİ), the standard deviation of 5-minute R wave to R wave(RR) interval means (SDANN), the root mean square of successive RR interval differences (RMSSD), and the percentage of the beats with a consecutive RR interval difference of more than 50 ms (pNN50%), very low frequency, high frequency, low frequency, triangular index, and low frequency/high-frequency ratio. Multisystem inflammatory syndrome in children patients had impaired and declined heart rate variability values compared to the other two groups. In patients with myocarditis/myopericarditis, we couldn't find a significant difference in these parameters with the control group. Heart rate variability can be used as an important non-invasive autonomic function parameter in determining prognosis and treatment plans, especially in patients diagnosed with multisystem inflammatory syndrome in children. This impairment of autonomic activity could be more prominent in patients with decreased left ventricular systolic functions.

Acute fasting modulates autonomic nervous system function and ambulatory cardiac interoception

Intermittent fasting has been associated with diverse physical and psychological health benefits. According to previous research, fasting-induced alterations in psychophysiological functioning should facilitate the accurate detection of an internal bodily signal (like the heart), which is referred to as interoceptive accuracy. In two within-subjects studies we aimed to examine whether an intermittent fasting protocol (i) evokes distinct autonomic nervous system changes in the laboratory and (ii) improves (objectifiable) interoceptive accuracy and sensibility (i.e., the subjective belief in perceiving bodily signals) in everyday life. Study 1 (N = 36) found increasing heart rate variability (precisely, the root mean square of successive differences; RMSSD) accompanied by a more vascular than myocardial response following a 16 h fast. Study 2 (N = 40) applied an ecological momentary assessment design including intermittent fasting (8 h normal eating followed by 16 h fasting) and normal eating (24 h normal eating) for three consecutive days each. Findings suggested a tendency toward higher interoceptive accuracy and sensibility during the fasting regimen, which was particularly pronounced in individuals exhibiting lower RMSSD. Together, findings suggest that (short-term) fasting seems to facilitate momentary attention to organismic cues due to alterations in autonomic nervous system function.

Mechanisms underlying exercise intolerance in long COVID: An accumulation of multisystem dysfunction.

The pathogenesis of exercise intolerance and persistent fatigue which can follow an infection with the SARS-CoV-2 virus ("long COVID") is not fully understood. Cases were recruited from a long COVID clinic (N = 32; 44 ± 12 years; 10 (31%) men), and age-/sex-matched healthy controls (HC) (N = 19; 40 ± 13 years; 6 (32%) men) from University College London staff and students. We assessed exercise performance, lung and cardiac function, vascular health, skeletal muscle oxidative capacity, and autonomic nervous system (ANS) function. Key outcome measures for each physiological system were compared between groups using potential outcome means (95% confidence intervals) adjusted for potential confounders. Long COVID participant outcomes were compared to normative values. When compared to HC, cases exhibited reduced oxygen uptake efficiency slope (1847 (1679, 2016) vs. 2176 (1978, 2373) mL/min, p = 0.002) and anaerobic threshold (13.2 (12.2, 14.3) vs. 15.6 (14.4, 17.2) mL/kg/min, p < 0.001), and lower oxidative capacity, measured using near infrared spectroscopy (τ: 38.7 (31.9, 45.6) vs. 24.6 (19.1, 30.1) s, p = 0.001). In cases, ANS measures fell below normal limits in 39%. Long COVID is associated with reduced measures of exercise performance and skeletal muscle oxidative capacity in the absence of evidence of microvascular dysfunction, suggesting mitochondrial pathology. There was evidence of attendant ANS dysregulation in a significant proportion. These multisystem factors might contribute to impaired exercise tolerance in long COVID sufferers.

Autonomic activity and cardiovascular system risk assessment in pediatric patients with hemolytic uremic syndrome.

In pediatric patients with hemolytic uremic syndrome (HUS), cardiac involvement and autonomic nervous system function can be evaluated by a non-invasive method called heart rate variability (HRV). This study aims to evaluate heart rate variability and electrocardiography findings in patients with HUS by comparing a healthy group. Patients who are diagnosed with HUS at a university hospital from December 2020 to June 2022 are screened by electrocardiography (ECG), echocardiography, and 24-h Holter ECG. A healthy control group, compatible in age and gender with the patient group, was selected from healthy subjects. HRV parameters, laboratory values, and ECG findings were analyzed and compared with the healthy group and each other. There were 25 patients with HUS and 51 participants in the healthy control group. Statistically significant differences were found in some HRV parameters: standard deviation of normal to normal intervals, the mean of the 5-min RR interval standard deviations, the standard deviation of 5-min RR interval means, the triangular interpolation of normal to normal interval, and very-low-frequency power. HUS patients had impaired and declined HRV values compared to the healthy group. There was a significant decrease in the PR distance, while a significant increase in the corrected QT and QT dispersion values was detected in the electrocardiographic findings of the patient group. HRV values impaired as renal failure parameters increased. Conclusion: Patients with HUS may have autonomic nervous system dysfunction. HRV measurement is a non-invasive method that can evaluate this. It can be thought that there may be an increased risk of cardiovascular events and arrhythmias in some patients with HUS. ECG should be also considered to detect arrhythmia. What is Known: • Hemolytic uremic syndrome (HUS) primarily effects the hematologic parameters and kidney. • Secondary cardiomyopathy with hypertension and renal failure could be observed in these patients. • Rhythm problems are not expected primarily in these patients. • There is very limited data in evaluating autonomic function and arrhythmia risk for these patients. What is New: • Patients with HUS may have autonomic nervous system dysfunction. • HRV measurement is a non-invasive method that can evaluate this. • Cardiovascular events and arrhythmias due to the deterioration of the balance between the sympathetic and parasympathetic systems could manifest in patients with HUS. • An ECG and screening patients for cardiac events, and monitoring them closely should be considered.

The role of the autonomic nervous system in polycystic ovary syndrome.

This article reviewed the relationship between the autonomic nervous system and the development of polycystic ovary syndrome (PCOS). PCOS is the most common reproductive endocrine disorder among women of reproductive age. Its primary characteristics include persistent anovulation, hyperandrogenism, and polycystic ovarian morphology, often accompanied by disturbances in glucose and lipid metabolism. The body's functions are regulated by the autonomic nervous system, which consists mainly of the sympathetic and parasympathetic nervous systems. The autonomic nervous system helps maintain homeostasis in the body. Research indicates that ovarian function in mammals is under autonomic neural control. The ovaries receive central nervous system information through the ovarian plexus nerves and the superior ovarian nerves. Neurotransmitters mediate neural function, with acetylcholine and norepinephrine being the predominant autonomic neurotransmitters. They influence the secretion of ovarian steroids and follicular development. In animal experiments, estrogen, androgens, and stress-induced rat models have been used to explore the relationship between PCOS and the autonomic nervous system. Results have shown that the activation of the autonomic nervous system contributes to the development of PCOS in rat. In clinical practice, assessments of autonomic nervous system function in PCOS patients have been gradually employed. These assessments include heart rate variability testing, measurement of muscle sympathetic nerve activity, skin sympathetic response testing, and post-exercise heart rate recovery evaluation. PCOS patients exhibit autonomic nervous system dysfunction, characterized by increased sympathetic nervous system activity and decreased vagal nerve activity. Abnormal metabolic indicators in PCOS women can also impact autonomic nervous system activity. Clinical studies have shown that various effective methods for managing PCOS regulate patients' autonomic nervous system activity during the treatment process. This suggests that improving autonomic nervous system activity may be an effective approach in treating PCOS.

Assessment of the state of autonomic dysfunction in patients with tuberculosis of the respiratory system and in combination with HIV infection in modern conditions

The autonomic nervous system (ANS) is an important part of the human nervous system responsible for regulating internal organs and maintaining the internal environment of the body. Adequate functioning of the ANS supports homeostasis is the internal stability of the body and regulates many functions in it, such as cardiac activity, breathing, etc. TB-related stress and inflammation affect have influence at the balance of sympathetic and parasympathetic activity. Affecting the work of the peripheral nervous system, it becomes possible to influence at the system of homeostasis of the body through its regulatory systems. Improving the diagnostics of autonomic dysfunction and identifying its dysfunction will provide an integrated individualized approach to treatment and will make a significant contribution to increasing the effectiveness of therapy for patients with tuberculosis.Aim. Diagnosis of the state of the autonomic nervous system by its main indicators using available informative methods for assessing its functional state in patients with respiratory tuberculosis, including in combination with HIV infection at the beginning of treatment and detecting the level of its damage for further correction with the prescription of pathogenetic therapy.Materials and methods. The functional state of the autonomic nervous system has been investigated in 260 people. In the study, 2 groups were formed: a control group (CG) of 70 healthy persons and a monitoring group (MG) of 190 newly diagnosed patients with tuberculosis. There are 3 subgroups in MG. The 1 subgroup included 65 patients with pulmonary tuberculosis, in whom the function of ANS was studied by conventional examination methods, and in 64 patients with tuberculosis 2 subgroups and 61 patients with tuberculosis in combination with HIV infection 3 subgroups using Varikard 2.51. Calculations were carried out in the program SPSS Statistics v. 23.Results and discussion. Comparison of the frequency of autonomic dysfunction in patients with MG, subgroup 1 with that in the CG according to questionnaires No. 1 (χ2=36.346; p&lt;0.001) and No. 2 (χ2=50.885; p&lt;0.001), HR per minute (χ2=31.989; p&lt;0.001), Kerdo index (χ2=30.008; p&lt;0.001), cold sample (χ2=36.549; p&lt;0.001) revealed high reliability of differences and indicated the predominance of sympathicotension, which was determined 7 times more often in patients. At the beginning of treatment, in patients with concomitant HIV infection was detected a more pronounced dysfunction of ANS with a predominance of its sympathetic link, which was found 9.3 times more often than in healthy persons and 2.3 times more often than in patients without HIV infection. Comparing the frequency of PARS in the «normal zone» in the CG and in the 2 subgroup of MG (t1=5.01; p1&lt;0,001; t2=3,69; p2&gt;0.001), in CG and in MG subgroup 3 (t1=3.61; p1&lt;0.001; t2=3.61; p2&lt;0.001) high significant differences were identified, indicating a significant predominance of regulatory process disorders in patients with tuberculosis and especially when combined with HIV infection.Conclusion. The revealed disorders in the work of ANS patients with tuberculosis and in combination with HIV infection are associated with intoxication and asthenovegetative syndrome. Monitoring of heart rate variability can be used in medical research, as well as in clinical practice to assess the state of the autonomic nervous system in patients with tuberculosis and when combined with HIV infection, determine the application point for the effects of pathogenetic therapy in order to improve the results and effectiveness of the treatment.

Correlation between pupillary size and heart rate variability parameters among medical students

Autonomic nervous system controls and balances sympathetic and parasympathetic system to maintain homeostasis without conscious control. The sympathetic nervous system controls the dilation of the pupil or mydriasis. HR variation (HRV) analysis is a popular non-invasive tool for assessing functions of autonomic nervous system. Medical students are under constant cognitive load, it is required to follow-up on status on their autonomic control during their education phase. The objective of this study was to observe any correlation between pupillary size and heart rate.Total of 30 students participated in the study. Anthropometric measurements and vitals like pulse, blood pressure was recorded. Pupillary size of the participants was measured using the pupillometer in the illuminated. HRV recording was done by placing electrodes for standard Lead II ECG. HRV reports were generated using Kubios HRV 3.5 software standard version. The pupillary size Right and Left are negatively correlated with the SDNN, RMSSD, PNN50, HF, SDI and SD2. However, LF, LF/HF and SD2/SD1 ratio are positively correlated. These findings support the notion that pupillary size can serve as a non-invasive indicator of autonomic nervous system activity.

Effect of Nature Space on Enhancing Humans’ Health and Well-Being: An Integrative Narrative Review

With the progress of science and technology, humans’ ability to transform and create has been greatly enhanced, but so have the physical and mental ailments associated with environmental degradation and urbanization. Human survival and health are strongly linked to nature, and there is growing evidence that exposure to nature promotes health and well-being. However, there is currently a lack of synthesis among empirical studies on these aspects for the findings to be sufficient for informing public health strategies and social policy. Here, following basic guidelines for systematic review and meta-analysis, we searched PubMed, Web of Science, ScienceDirect, and Scopus databases in January 2023. The results of our search and analysis show that nature can improve people’s health and well-being from two aspects: physical (reduces CVDs, increases immunity, improves autonomic nervous system function, and improves sleep quality) and psychological (restores attention, improves mood, reduces stress, and improves cognitive development). The ways in which people derive health from nature are varied, and tailored, personalized, symptom-specific exposure can further increase the health benefits. More importantly, it seems that people can gain the health benefits of nature by only being exposed to it for a short time. We incorporate the existing scientific evidence in our review and develop a new heuristic point of view on the necessity of exposure to natural environments for the health of individuals.

Examining Reactivity and Recovery Patterns of Pain-Evoked Cortisol and Alpha-Amylase Trajectories: Relations Between Psychological Markers of Risk and Resilience

Chronic low back pain (cLBP) is one of the leading causes of disability globally and represents an enormous burden to aging adults. While numerous factors contribute to cLBP, dysregulation in the hypothalamic-pituitary-adrenal axis and autonomic nervous system functioning have been implicated in its pathogenesis. It is well documented that negative psychological states can modulate biological stress responsivity in chronic pain; however, little is known regarding the influence of positive psychological factors in this relationship. The aim of this study was to examine the association between psychological risk and resilience factors with patterns of physiological stress reactivity and recovery in 60 older adults with cLBP. Participants completed measures of hope, optimism, pain catastrophizing, and perceived stress, and underwent psychophysical pain testing assessing responses to painful pressure, heat, and cold stimuli. Salivary samples were obtained prior to pain induction and at 7 time points spanning 90 minutes after pain testing terminated. To examine reactivity and recovery profiles in hypothalamic-pituitary-adrenal axis and autonomic nervous system function, samples were assayed for cortisol and alpha-amylase, respectively. Results revealed higher levels of hope and optimism were associated with increased cortisol reactivity (p’s < .003) and more rapid recovery (p’s = .001). Further, pain catastrophizing and perceived stress were associated with cortisol reactivity, with lower levels of these factors predicting larger increases in cortisol from baseline to peak levels (p’s < .04). No significant differences in reactivity or recovery patterns emerged for alpha-amylase. Overall, findings highlight the role of psychological risk and resilience factors in modulating physiological stress reactivity. PerspectiveThis article investigated whether psychosocial risk and resilience factors were associated with stress reactivity and recovery in response to laboratory-based pain testing in older adults with chronic low back pain. Results indicate that high resilience factors may be protective by modulating adrenocortical reactivity and recovery profiles.

Weakened sympathetic response and lower parasympathetic activity in intimate partner violence perpetrators when empathizing: Influence of autonomous activation in affective approach and prosocial behavior.

The autonomic nervous system (ANS) functioning has been proposed as a relevant method to characterize the therapeutic needs of intimate partner violence (IPV) perpetrators. Nevertheless, research has neglected the influence of the ANS on socio-affective functions in this population. The aim of the present study was to analyze the psychophysiological activity of IPV perpetrators (n = 52) compared to controls (n = 46) following an empathic induction task, performed through negative emotion-eliciting videos. We employed two general ANS markers (heart rate [HR] and respiratory rate [RR]), two sympathetic-related indexes (pre-ejection period [PEP] and skin conductance level [SCL]) and a parasympathetic biomarker (respiratory sinus arrhythmia [RSA]). Additionally, we explored the impact of psychophysiological activity on prosocial behavior using Hare's donation procedure. Compared to controls, IPV perpetrators reported lower HR and SCL following the task, as well as longer PEP, suggesting an attenuated sympathetic response to others' distress. No differences in the RSA response pattern were found, however, IPV perpetrators displayed lower overall RSA levels throughout the protocol, indicative of reduced parasympathetic activity. Besides, while no differences in prosocial performance were observed, greater sympathetic responses and overall parasympathetic activity predicted increased donations across the sample. Thus, a high sympathetic and parasympathetic activity might influence the occurrence of prosocial behavior. The present study provides further evidence supporting that IPV perpetrators cope differently with others' negative emotions. In line with this biopsychosocial perspective, insights are gained on the emotional processing of IPV perpetrators which, in turn, could contribute to improve IPV psychotherapeutic programs.

Exposures to Elevated Core Temperatures during Football Training: The Impact on Autonomic Nervous System Recovery and Function.

Exercising with elevated core temperatures may negatively affect autonomic nervous system (ANS) function. Additionally, longer training duration under higher core temperatures may augment these negative effects. This study evaluated the relationship between exercise training duration and 24 h ANS recovery and function at ≥37 °C, ≥38 °C and ≥39 °C core temperature thresholds in a sample of male Division I (D1) collegiate American football athletes. Fifty athletes were followed over their 25-week season. Using armband monitors (Warfighter MonitorTM, Tiger Tech Solutions, Inc., Miami, FL, USA), core temperature (°C) and 24 h post-exercise baseline heart rate (HR), HR recovery and heart rate variability (HRV) were measured. For HRV, two time-domain indices were measured: the root mean square of the standard deviation of the NN interval (rMSSD) and the standard deviation of the NN interval (SDNN). Linear regression models were performed to evaluate the associations between exercise training duration and ANS recovery (baseline HR and HRV) and function (HR recovery) at ≥37 °C, ≥38 °C and ≥39 °C core temperature thresholds. On average, the athletes were 21.3 (± 1.4) years old, weighed 103.0 (±20.2) kg and had a body fat percentage of 15.4% (±7.8%, 3.0% to 36.0%). The duration of training sessions was, on average, 161.1 (±40.6) min and they ranged from 90.1 to 339.6 min. Statistically significant associations between training duration and 24 h ANS recovery and function were observed at both the ≥38.0 °C (baseline HR: β = 0.10 ± 0.02, R2 = 0.26, p < 0.0000; HR recovery: β = -0.06 ± 0.02, R2 = 0.21, p = 0.0002; rMSSD: β = -0.11 ± 0.02, R2 = 0.24, p < 0.0000; and SDNN: β = -0.16 ± 0.04, R2 = 0.22, p < 0.0000) and ≥39.0 °C thresholds (β = 0.39 ± 0.05, R2 = 0.62, p < 0.0000; HR recovery: β = -0.26 ± 0.04, R2 = 0.52, p < 0.0000; rMSSD: β = -0.37 ± 0.05, R2 = 0.58, p < 0.0000; and SDNN: β = -0.67 ± 0.09, R2 = 0.59, p < 0.0000). With increasing core temperatures, increases in slope steepness and strengths of the associations were observed, indicating accelerated ANS deterioration. These findings demonstrate that exercise training under elevated core temperatures (≥38 °C) may negatively influence ANS recovery and function 24 h post exercise and progressively worsen.