Autonomic Nervous System In Patients Research Articles

Nervous system functioning disorders in patients with mandible fractures

Relevance. Fractures of the mandibular fracture are a stressor on the body and lead to changes in the functioning of the autonomic nervous system. At the same time, patients with mandibular fractures often experience local changes in the nervous system associated with the anatomical and physiological features of the location of the third branch of the trigeminal nerve and its damage. These changes affect the course of the post-traumatic period and may increase the likelihood of complications of mandibular fractures.Purpose: to determine the significance of disturbances in the functioning of the nervous system during the post-traumatic period of fractures of the mandibular fracture.Materials and methods. When examining 130 patients with fractures of the mandibular fracture, the state of the autonomic nervous system and local neurological changes were studied.Results. In patients with mandibular fractures, dysfunction of the autonomic (autonomic) nervous system and local neurological changes were revealed.The severity of these changes is reflected in the development of complications of fractures. When studying the autonomic nervous system in patients with mandibular fractures, there was an increase in the activity of the sympathetic nervous system, which increased the likelihood of developing complications of mandibular fractures. A high incidence of injury to the inferior alveolar nerve was also found. The most pronounced deviations in autonomic balance indicators – pathological increased excitability of the autonomic nervous system – were diagnosed in patients with complicated fractures of the mandibular fractures. In most patients with complicated mandibular fractures, damage to the trigeminal nerve was detected, confirming the role of neurotrophic disorders in the development of complications.Conclusion. With fractures of the mandible, there is an increase in the activity of the sympathetic nervous system, which increases the likelihood of complications. The most pronounced deviations in autonomic balance indicators were diagnosed in patients with complicated fractures of the mandible. In addition, in patients with mandibular fractures, a high incidence of damage to the inferior alveolar nerve was revealed; in complicated fractures, neuropathy is severe, which confirms the role of neurotrophic disorders in the development of complications. Thus, methods for preventing purulent-inflammatory complications in jaw fractures should include correction of neurological disorders.

Monitoring differences in the function of the autonomic nervous system in patients with chronic insomnia using a wearable device

Study objectivesto characterize possible differences in the function of the ANS in patients with chronic insomnia compared to a control group, using a wearable device, in order to determine whether those findings allow diagnosing this medical entity. MethodsThirty-two patients with chronic insomnia and nineteen patients without any sleep disorder, as a control group, were recruited prospectively. Both groups of patients underwent an in-patient night with simultaneous polysomnography and wearable device recording Empatica E4 a diverse array of physiological signals, including electrodermal activity, temperature, accelerometry, and photoplethysmography, providing a comprehensive resource for in-depth sleep analysis. ResultsIn polysomnography, patients suffering from insomnia showed a significant decrease in sleep efficiency and total sleep time, prolonged sleep latency, and increased wakefulness after sleep onset. Accelerometry results were statistically significant differences in the three axis (x, y, z) just in stage N3, no differences were observed between both groups in REM sleep. The lowest temperature was reached in REM sleep in both groups. Peripheral temperature did not decrease during the different sleep phases compared to wakefulness in insomnia, unlike in the control group. Heart rate was higher in patients with insomnia than in controls during wakefulness and sleep stage. Heart rate variability was lower in stage N3 and higher in REM sleep compared to wakefulness in both groups. Sweating was significantly higher in patients with insomnia compared to the control group, as indicated by Skin Conductance Variability values and Sudomotor Nerve. ConclusionsOur study suggests that patients with insomnia have increased sympathetic activity during sleep, showing a higher heart rate. Temperature and sweating significantly influence the different sleep phases.

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<0.001) and No. 2 (χ2=50.885; p<0.001), HR per minute (χ2=31.989; p<0.001), Kerdo index (χ2=30.008; p<0.001), cold sample (χ2=36.549; p<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<0,001; t2=3,69; p2>0.001), in CG and in MG subgroup 3 (t1=3.61; p1<0.001; t2=3.61; p2<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.

The Immediate Effects of Immersive Virtual Reality on Autonomic Nervous System Function in Patients with Disorders of Consciousness after Severe Acquired Brain Injury: A Pilot Study.

Disorders of Consciousness (DoCs) after severe acquired brain injury involve substantial impairment of cognition and physical functioning, requiring comprehensive rehabilitation and support. Technological interventions, such as immersive Virtual Reality (VR), have shown promising results in promoting neural activity and enhancing cognitive and motor recovery. VR can induce physical sensations that may activate the Autonomic Nervous System (ANS) and induce ANS-regulated responses. This study aimed to investigate the effects of immersive VR on the ANS in patients with DoCs through the analysis of the electrodermal activity (EDA). EDA was measured with a wearable device during a single immersive VR session consisting of static and dynamic videos depicting naturalistic environments. A pilot case-control study was conducted with 12 healthy participants and 12 individuals with DoCs. Results showed higher EDA values in patients than in healthy participants (p = 0.035), suggesting stronger autonomic activation during immersive VR exposure, while healthy subjects, in turn, showed a decrease in EDA values. Our results revealed a significant interaction between conditions and groups (p = 0.003), with patients showing significantly increased EDA values from the baseline compared to dynamic video observation (p = 0.014) and final rest (p = 0.007). These results suggest that immersive VR can elicit sympathetic arousal in patients with DoCs. This study highlights the potential of immersive VR as a tool to strengthen autonomic responses in patients with impaired consciousness.

Evaluation of the autonomic nervous system in patients with essential tremor

BackgroundEssential tremor (ET) is a prevalent movement disorder that may be linked to neurodegenerative changes. It is marked by a mix of motor and non-motor symptoms, which include disturbances in the autonomic nervous system. Aim of the study: We aimed to assess autonomic dysfunction in individuals with essential tremor. Thirty patients with essential tremor (Group 1) and 30 age and sex-matched healthy subjects as the control group (Group 2) were recruited. Comprehensive medical and neurological examinations were conducted on all participants, followed by electrophysiological assessments of autonomic function, including heart rate variability (HRV) tests (E/I ratio, Valsalva ratio, 30:15 ratio), adrenergic tests (blood pressure responses to active standing and sustained hand grip), and sympathetic skin response (SSR) tests. Finally, the results of these tests were classified according to the Ewing classification of autonomic failure. Results: The study revealed significant differences between ET patients and the control group. Heart rate variability tests showed a marked difference between the groups. Adrenergic tests, measuring sympathetic innervation, also displayed a significant difference. The sudomotor function test exhibited noteworthy differences in onset latencies and amplitudes in the palm and sole, with ET patients showing prolonged onset latencies and decreased amplitudes. Moreover, the study found a significant correlation between disease severity and autonomic function test results and the Ewing score. Conclusion: The study highlights the presence of autonomic dysfunction in essential tremor patients, with disease severity being associated with the level of autonomic affection, as evidenced by various autonomic function tests and the Ewing score.

Dysfunction of peripheral somatic and autonomic nervous system in patients with severe forms of Crohn's disease on biological therapy with TNFα inhibitors-A single center study.

Crohn's disease (CD) can be associated with a wide range of extraintestinal manifestations (EIMs), including neurological ones. Published studies differ in their conclusions about the epidemiology and etiopathogenesis of neurological EIMs. The aims of this study were to demonstrate the presence and find risk factors of peripheral (somatic and autonomic) neuropathy patients with severe CD on anti-TNFα biological therapy. A clinical examination focusing on detection of peripheral sensor-motor nervous dysfunction (including Sudoscan) and examination of autonomic nervous system dysfunction (using Ewing´s battery tests and spectral analysis) together with laboratory tests and collection of demographic data followed by administration of questionnaires were performed on a total of 30 neurologically asymptomatic outpatients with severe CD on anti-TNFα biological therapy. Peripheral sensor-motor nervous function via clinical neurological examination was pathological in 36.7% and Sudoscan in 33.3% of cases. Statistically significant associations between vibration perception test and age, CD and biological therapy duration, body mass index and Crohn's Disease Activity Index were proved while statistically significant associations between temperature perception test and age and BMI were proved as well. Additionally, a decrease of total protein in a patient´s serum below the physiological cut-off in the 6 months prior to measurement was associated with a pathological result of a Sudoscan. Cardiovascular autonomic neuropathy based on Ewing´s battery tests was present in 56.7% of patients, no statistically significant risk factors were found. Our peripheral neuropathy questionnaire correlated with the results of the Sudoscan test and some tests of the clinical examination of peripheral sensor-motor nervous function (discriminatory contact perception test, temperature perception test). This study demonstrated a relatively high prevalence of peripheral (especially autonomic) neuropathy and verified some risk factors for the development of peripheral somatic neuropathy in asymptomatic patients with severe form of CD on anti-TNFα biological therapy.

A History of Suicide Attempt Is Associated with Increased Sympathetic Activation in Bipolar Disorder.

Suicide risk in bipolar disorder (BD) is estimated to be up to 20 times higher than in the general population. While there is a large body of evidence suggesting that increased sympathetic activation is associated with disease and death, there is a paucity of research on the role of autonomic nervous system (ANS) dysfunction in patients with BD who have attempted suicide. Fifty-three participants with BD used a wearable device to assess the association between history of suicide attempt, current suicidal ideation, and ANS dysfunction, including measures of heart rate variability (HRV) and respiratory rate. Data were analyzed in a series of unadjusted and adjusted bivariate models of association controlling for relevant variables. A history of suicide attempts was significantly associated with an increase in respiratory rate (p < 0.01). These results remained significant after adjusting for age, BMI, and current mood state. There was no association between current suicidal ideation and heart rate or respiratory rate. In the frequency domain, HRV parameters suggest reduced parasympathetic (i.e., vagal) activity in participants with a history of suicide attempts and in those with current suicidality, suggesting changes in sympathicovagal balance in BD. Our results suggest that changes in the ANS in patients with BD and a history of suicide attempt are not restricted to pure vagally mediated HRV parameters, but rather signal a general ANS dysregulation. This ANS imbalance may be contributing to illness burden and cardiovascular disease. Further research on the relationship between ANS and suicidality in BD is needed.

Changes in indicators of the autonomic nervous system in acute poisoning with 1,4-butanediol complicated by withdrawal syndrome

Introduction. The article presents an assessment of the functional state of the autonomic nervous system in patients with acute 1,4-butanediol poisoning complicated by withdrawal syndrome using pupillometry. Purpose of the study: to analyze changes in the indicators of the autonomic nervous system in patients with acute 1,4-butanediol poisoning complicated by withdrawal syndrome.&#x0D; Material and methods. In the course of the work, a prospective examination of 30 patients with acute 1,4-butanediol poisoning, complicated by withdrawal syndrome, aged 19 to 39 years (median age was 25.3 [20.1; 24.9] years) was carried out. All patients were treated at the Center for the Treatment of &#x0D; St. Petersburg I.I. Dzhanelidze Research Institute of Emergency Medicine. Pupullometry was performed using the hardware-software complex KSRZRts-01. Statistical processing of the obtained results was carried out in the program Statistica for Windows (version 10).&#x0D; Results. In the course of the study, patients with acute poisoning with 1,4-butanediol develop a neurovegetative variant of AS, manifested by signs of parasympathicotonia, expressed in changes in the bioelectrical activity of the brain in the form of irritation of cortical-subcortical structures with rapid exhaustion and instability of the functional tone of cortical neurons, cognitive impairment, ideation and motor retardation, deviations of pupillometry parameters (decrease in the initial pupil diameter and constriction amplitude, increase in the time of onset of the pupillary reaction).&#x0D; limitations. In the study of the effect of 1,4-butanediol on the indicators of the autonomic nervous system in the course of a prospective examination of 30 male patients of the Center for the Treatment of &#x0D; St. Petersburg I.I. Dzhanelidze Research Institute of Emergency Medicine with acute poisoning by a toxicant, it was found that there were significant changes in the parameters of this system in the withdrawal period.&#x0D; Conclusion. The indicators revealed during the study prove the predominance of the neurovegetative variant of the withdrawal syndrome with a characteristic change in the bioelectrical activity of the brain, cognitive functions and pupillometry parameters.

The effect and mechanisms of music therapy on the autonomic nervous system and brain networks of patients of minimal conscious states: a randomized controlled trial.

Music therapy has been employed as an alternative treatment modality for the arousal therapy of patients with disorders of consciousness (DOC) in clinical settings. However, due to the absence of continuous quantitative measurements and the lack of a non-musical sound control group in most studies, the identification of the specific impact of music on DOC patients remains challenging. In this study, 20 patients diagnosed with minimally consciousness state (MCS) were selected, and a total of 15 patients completed the experiment. All patients were randomly assigned to three groups: an intervention group (music therapy group, n = 5), a control group (familial auditory stimulation group, n = 5), and a standard care group (no sound stimulation group, n = 5). All three groups received 30 min of therapy five times a week for a total of 4 weeks (20 times per group, 60 times in total). Autonomic nervous system (ANS) measurements, Glasgow Coma Scale (GCS), and functional magnetic resonance-diffusion tensor imaging (fMRI-DTI) were used to measure the peripheral nervous system indicators and brain networks, and to evaluate patients' behavior levels. The results reveal that PNN50 (p = 0.0004**), TP (p = 0.0003**), VLF (p = 0.0428**), and LF/HF (p = 0.0001**) in the music group were significantly improved compared with the other two groups. Such findings suggest that the ANS of patients with MCS exhibits higher activity levels during music exposure compared to those exposed to family conversation or no auditory stimulation. In fMRI-DTI detection, due to the relative activity of ANS in the music group, the ascending reticular activation system (ARAS) in the brain network also exhibited significant nerve fiber bundle reconstruction, superior temporal gyrus (STG), transverse temporal gyrus (TTG), inferior temporal gyrus (ITG), limbic system, corpus callosum, subcorticospinal trace, thalamus and brainstem regions. In the music group, the reconstructed network topology was directed rostrally to the diencephalon's dorsal nucleus, with the brainstem's medial region serving as the hub. This network was found to be linked with the caudal corticospinal tract and the ascending lateral branch of the sensory nerve within the medulla. Music therapy, as an emerging treatment for DOC, appears to be integral to the awakening of the peripheral nervous system-central nervous system based on the hypothalamic-brainstem-autonomic nervous system (HBA) axis, and is worthy of clinical promotion. The research was supported by the Beijing Science and Technology Project Foundation of China, No. Z181100001718066, and the National Key R&D Program of China No. 2022YFC3600300, No. 2022YFC3600305.

Effects of music therapy on the autonomic nervous system in patients with COVID-19: a clinical crossover trial

Effects of music therapy on the autonomic nervous system in patients with COVID-19: a clinical crossover trial

Функциональное состояние вегетативной нервной системы как предиктор состоятельности нейрогенных механизмов регуляции сосудистого тонуса при расстройствах кровообращения в вертебробазилярной системе

The article presents the results of assessing the functional state of the autonomic nervous system in patients with circulatory disorders in the vertebrobasilar system. It has been established that the addition of neuro-reflex diagnostic methods (dynamic segmental diagnostics and manual examination) improves the assessment of the functional state of the sympathetic nervous system and allows monitoring the effectiveness of etiopathogenetic therapy. The application of methods of reflexotherapy and biodynamic correction of the spine improves the functional state of the autonomic nervous system and enhances the effectiveness of treatment of patients with circulatory disorders in the vertebrobasilar system.

Functional state of the autonomic nervous system in patients with chronic pancreatitis combined with chronic bronchitis

60 patients with chronic pancreatitis (acute exacerbation) combined with chronic bronchitis (mild exacerbation) were examined. 33 almost healthy patients (the control group) were also examined.&#x0D; The functional state of the autonomic nervous system was assessed using an analysis of heart rate variability.&#x0D; The study was carried out in two stages. The electrocardiogram was recorded in standard lead II at rest and in active orthostasis for 100 cardiocycles. The obtained data were processed using the Korveg computer program. Based on the data obtained, the following indices were calculated: the regulatory system stress index (SI), which reflects the total activity of the central regulatory mechanisms, allows us to assess the degree of shift of the autonomic balance towards sympathetic regulation, characterizes the stress of compensatory mechanisms, and the level of functioning of the central circuit of heart rate regulation; vegetative balance index (VBI), which reflects the ratio of the activity of the sympathetic and parasympathetic divisions of the autonomic nervous system; an indicator of the adequacy of regulation processes (IARP), which reflects the adequacy of the activity of the sympathetic division of the autonomic nervous system; vegetative rhythm index (VRI), which reflects the vegetative balance in terms of assessing the activity of the autonomic regulation circuit; orthoprobe ratio (OR), which is the ratio of the 30th R–R interval to the 15th R–R interval after standing up, this coefficient reflects the state of the parasympathetic division of the autonomic nervous system.&#x0D; SI was statistically significantly higher in the group of chronic pancreatitis combined with bronchitis at rest than in controls, indicating a shift in the autonomic balance towards the sympathetic system.&#x0D; VBI in patients with chronic pancreatitis combined with bronchitis was significantly higher in the lying position, but significantly lower in the standing position than in the control group.&#x0D; IARP was statistically significantly lower in the group of patients in the standing position, which indicates some excessive centralization of heart rate control in comorbidities.&#x0D; VRI did not differ statistically significantly in the control group and in the group of chronic pancreatitis combined with bronchitis, which indicates the normalization of parasympathetics in the group of patients during exercise.&#x0D; OR was significantly lower in chronic pancreatitis combined with bronchitis, which indicates an increase in the effect of the parasympathetic nervous system.&#x0D; Thus, there is an imbalance in the sympathetic and parasympathetic divisions of the autonomic nervous system in patients with chronic pancreatitis combined with chronic bronchitis, which depends on the position of the patient (lying or standing).&#x0D;

Hypothalamic-pituitary-adrenal axis activity and its relationship to the autonomic nervous system in patients with psychogenic erectile dysfunction.

Psychological stress and its two stress response systems, the hypothalamic-pituitary-adrenal (HPA) axis and the autonomic nervous system (ANS), are closely related to psychogenic erectile dysfunction (pED). However, the analyses of perceived stress and stress systems in pED patients need to be more in-depth, especially the interactions between them. Our study included 75 patients with pEDs and 75 healthy men. The International Index of Erectile Function-5 (IIEF-5) and the 10-item Perceived Stress Scale (PSS-10) were used for assessing the severity of ED and perceived stress. All participants collected saliva samples on three consecutive days at eight specific times with strict reference to the time of morning awakening for measuring cortisol parameters and wore electrocardiography for 24h to derive heart rate variability (HRV). The PSS-10 scores of pED patients were significantly higher than the control group (p<0.001). Although PSS-10 and IIEF-5 scores were negatively correlated in pED patients, there was no statistical significance between them (r=-0.049, p=0.677). Compared with the control group, the HRV parameters of pED patients were significantly increased in LF/HF ratio (p=0.014) but significantly decreased in LF, HF, and pNN50 (p<0.001). However, the two groups had no statistically significant differences in cortisol variables (all p>0.05). The interaction between sympathovagal modulation (HF, rMSSD) and cortisol awakening response (CAR AUCi) explained significantly greater variance in perceived stress than either stress system alone. Higher parasympathetic activity combined with a higher cortisol awakening response was associated with greater perceived stress. Our results suggested that the interrelation between ANS and HPA axis activity might enhance our comprehension of how stress affected the physical and mental health of pED patients.

ВЕГЕТАТИВНАЯ ДИСФУНКЦИЯ ПРИ ХРОНИЧЕСКОМ ОПИСТОРХОЗЕ

Introduction. Altai Krai is one of the most significant natural foci of opisthorchiasis not only in Western Siberia, but also on the territory of the Russian Federation as a whole, where the incidence of opisthorchiasis ranges from 44 to 34 per 100,000 people. The primary habitat of opisthorchiasis is the hepatobiliary system; the polymorphism of long-term invasion polymorphism is characterized by a violation of the functions of many organs and systems: liver, immune and cardiovascular systems, digestive organs, etc. The control center responsible for these vital functions of the body is the autonomic nervous system, which regulates them in the body. Analysis of heart rate variability can give an idea of sympathetic-parasympathetic vegetative balance. The purpose of the study. A comprehensive study of the state of autonomic regulation by analyzing heart rate variability in patients with chronic opisthorchiasis. Materials and methods. During the course of the study, 31 patients with chronic opisthorchiasis (CO) were observed, a comparison was made with 30 healthy individuals of similar age and gender. When studying the function of the autonomic nervous system, the method of mathematical analysis of the heart rate according to R.M. Baevsky was used with the help of the original program "CORVEG". The level of critical significance of the null statistical hypothesis was assumed to be 0.05. Results and Discussion. In the study of the nature of vegetative changes, methods of frequency and spectral analysis of heart rate were used. Changes in heart rate regulation indicators were statistically significantly (p&lt;0.05) indicated an increase in sympathetic regulation at rest and orthostasis in patients with SC, their autonomic homeostasis was shifted toward the sympathetic nervous system both at rest and under load, and in some patients (31%) dysregulation of the central type was detected. Conclusions. Dysregulation of autonomic nervous system in patients with chronic opisthorchiasis was revealed at all levels of its regulation and was characterized by increased sympathetic tone and a decrease in parasympathetic and humoral regulation, as well as vasoreflective and baroreflective mechanisms.

Do Psychological Factors Influence the Elastic Properties of Soft Tissue in Subjects with Fibromyalgia? A Cross-Sectional Observational Study.

Nowadays, there is evidence related to the impact that psychological factors have on symptoms, specifically vegetative ones, and on the autonomic nervous system in patients with fibromyalgia (FM). However, there are no studies to correlate the level of association between psychological factors and the elastic properties of tissue in the FM population. Elastic properties of soft tissue reflect age- and disease-related changes in the mechanical functions of soft tissue, and mechanical failure has a profound impact on morbidity and mortality. The study has a cross-sectional observational design with 42 participants recruited from a private clinic and rehabilitation service. The Pain Catastrophizing Scale, Tampa Kinesiophobia Scale and Self-Efficacy Scale were used to assess psychological factors. The elastic properties of the tissue in the characteristic painful points, which patients suffering from FM described, were assessed by strain elastography. A low and significant level of association was found between pain catastrophising scale (PCS) and the non-dominant lateral epicondyle (r = -0.318; p = 0.045). Kinesiophobia was found to be related to the dominant lateral epicondyle (r = 0.403; p = 0.010), the non-dominant knee (r = -0.34; p = 0.027) and the dominant forearm (r = 0.360; p = 0.010). Self-Efficacy showed a low level of association with the non-dominant supraspinatus (r = -0.338; p = 0.033) and the non-dominant medial epicondyle (r = -0.326; p = 0.040). Psychological factors and the elastic properties of tissue seem to be associated in patients suffering from FM. The most profound association between psychological factors and non-dominant parts of the body could be related to neglect and non-use of those parts of the body.

O100 / #804 THE LINK BETWEEN SPINAL CORD STIMULATION FOR PAIN AND THE PARASYMPATHETIC NERVOUS SYSTEM: IS THERE AN INFLUENCE ON THE AUTONOMIC NERVOUS SYSTEM?: TRACK 1: MECHANISMS OF ACTION, MAPPING AND SPINAL CORD STIMULATION

Despite the well-known clinical effects of spinal cord stimulation (SCS), the mechanisms of action have not yet been fully unraveled. It is hypothesized that SCS is able to influence the autonomic nervous system. In patients with chronic pain, a relative lower parasympathetic activity is already suggested based on heart rate variability measurements. The aim of this study is to further explore the influence of SCS on the autonomic nervous system in patients with Persistent Spinal Pain Syndrome Type 2 (PSPS T2) by evaluating whether SCS is able to influence (electrochemical) skin conductance, blood volume pulse, heart rate, and respiration rate.

Pupillary Responses Reveal Autonomic Regulation Impairments in Patients With Central Serous Chorioretinopathy.

PurposeThis study assessed the autonomic nervous system in patients with central serous chorioretinopathy (CSC) by simultaneously measuring pupillary responses and heart rate variability (HRV).MethodsWe recruited 33 patients with CSC and 26 age- and sex-matched healthy controls. Using a pupillometry and acceleration plethysmography system, we measured the participants’ pupillary light reflex and HRV simultaneously, and compared the following parameters between the two groups: the pupil diameters, diameter changes, and time and frequency domain HRV indices (high frequency power: HF; low frequency power: LF; log LF/HF ratio). Additional data from the Profile of Mood States (POMS) and pupillary responses during mental tasks were also analyzed.ResultsThe CSC group had a significantly lower constriction amplitude and a higher re-dilation ratio compared with the control group, indicating parasympathetic inhibition and sympathetic activation. For the HRV measures, the CSC group demonstrated significantly lower HF and higher LF and log LF/HF ratio, indicative of higher sympathetic activity. The CSC group also showed significantly larger pupil dilation during tasks of moderate difficulty, and higher negative/lower positive POMS mood scores. Further analyses also revealed that the baseline pupil diameter was significantly larger in patients with active as opposed to chronic CSC.ConclusionsPupillary responses and HRV measures both revealed sympathetic activation and parasympathetic attenuation in patients with CSC. Larger pupil dilation during mental tasks in CSC could be a potential marker of psychophysiological stress.

Prevalence and heart rate variability characteristics of premature ventricular contractions detected by 24-hour Holter among outpatients with palpitations in China: a cross-sectional study

ObjectiveTo analyse the prevalence and heart rate variability (HRV) characteristics of premature ventricular contraction (PVC) detected by 24-hour Holter among Chinese outpatients with palpitations.DesignA cross-sectional study.SettingThis study was conducted in...

The State of Vegetative Regulation in Patients with Ischemic Stroke in the Acute and Peracute Periods: an Observational Cohort Study

Background. The high number of stroke cases is predetermined by risk factors, pathogenetic heterogeneity, genetic predisposition to the disease. Neurovascular changes can serve as a marker for the severity of the patient’s condition. By means of cardiointervalography, the reactions of the autonomic nervous system in patients with ischemic stroke were studied, depending on the territory of the cerebral infarction and its period. With a favorable outcome of the disease, the detected changes in regulatory mechanisms can be considered adaptive, while with fatal outcome — disadaptive. Objectives. Determination of the state of the autonomic nervous system by means of cardiointervalography in patients with stroke in various pools of blood supply.Methods. 52 patients with a verifi ed diagnosis of ischemic stroke in the acute and peracute periods were examined. All patients were divided into 3 groups. Group 1 — patients with ischemic stroke in the middle cerebral artery territory on the left. Group 2 — with ischemic stroke in the middle cerebral artery territory on the right. Group 3 — with ischemic stroke in the vertebrobasilar territory. Patients with a fatal outcome are separately described. The functional state of the autonomic nervous system was assessed by the method of mathematical analysis of heart rate variability according to R.M. Baevsky (1984). Cardiointervalography was performed in the morning on the 1st day from the onset of the stroke and on the 10th day.Results. The state of autonomic regulation in patients with ischemic stroke depends on the localization and size of the lesion. According to cardiointervalography, parasympathetic effects on the rhythm of the heart prevailed in patients with ischemic stroke in the middle cerebral artery territory on the left and in the vertebrobasilar territory in the peracute period, while the sympathetic one predominated in patients with ischemic stroke in the middle cerebral artery territory on the right. In the acute period, the general tendency for the increase in activity of the opposite part of the autonomic nervous system was observed.Conclusion. Statistically signifi cant changes in the indicators of the total power of the wave oscillation spectrum and the indicator of ultra-low-frequency waves in the peracute and acute periods of stroke in the examined patients indicate the importance of neurohumoral mechanisms of regulation in the dynamics of the pathological state

Low-Intensity Resistance Exercise Combined With Blood Flow Restriction is More Conducive to Regulate Blood Pressure and Autonomic Nervous System in Hypertension Patients-Compared With High-Intensity and Low-Intensity Resistance Exercise.

Background: The effect of resistance exercise on the autonomic nervous system of patients with hypertension has not been identified. Objective: To explore a suitable resistance training method for hypertension patients to regulate blood pressure (BP) and autonomic nervous system function. Method: Forty-five hypertension patients aged between 55 and 70 years were randomly equally divided into three groups: the high-intensity resistance exercise (HE) group, the low-intensity resistance exercise combined with blood flow restriction (LE-BFR) group, and the low-intensity resistance exercise (LE) group. All patients performed quadriceps femoris resistance exercise. The exercise intensity of HE, LE-BFR and LE group was 65, 30 and 30% of one repetition maximum (1RM), respectively. The LE-BFR group used pressure cuffs to provide 130% of systolic pressure to the patient’s thighs during resistance exercise. The training program was 20 times/min/set with a 1-min break after each set, and was conducted five sets/day and 3 days/week, lasting for 12 weeks. The heart rate (HR), BP, root-mean-square of difference-value of adjacent RR intervals (RMSSD), low frequency (LF) and high frequency (HF) were evaluated before and after the first training and the last training. Result: Significant differences in HR were observed in both recovery states after the first and last training (p < 0.01). After 12 weeks of training, the recovery speed of HR in the LE-BFR group increased significantly (p < 0.01). The systolic blood pressures in the HE and LE-BFR group were significantly reduced (p < 0.05 and p < 0.01), and the differences among groups were significant (p < 0.01). In the last recovery state, the RMSSD of the LE group was significantly lower than that in the first recovery state (p < 0.01). The LF/HF ratios of the HE and LE groups in the resting and recovery states were increased significantly (all p < 0.01). LF/HF ratios in the LE-BFR group in the resting and recovery state were decreased significantly (both p < 0.01). Conclusion: Compared to HE and LE, LE-BFR could effectively decrease systolic pressure and regulate the autonomic nervous system function in hypertension patients.