Autonomic Function Research Articles

Association of Continuous Glucose Monitoring-Derived Glycemia Risk Index With Cardiovascular Autonomic Neuropathy in Patients With Type 1 Diabetes Mellitus: A Cross-sectional Study.

The glycemia risk index (GRI) is a new composite continuous glucose monitoring (CGM) metric for weighted hypoglycemia and hyperglycemia. We evaluated the association between the GRI and cardiovascular autonomic neuropathy (CAN) and compared the effects of the GRI and conventional CGM metrics on CAN. For this cross-sectional study, three-month CGM data were retrospectively analyzed before autonomic function tests were performed in 165 patients with type 1 diabetes. CAN was defined as at least two abnormal results of parasympathetic tests according to an age-specific reference. The overall prevalence of CAN was 17.1%. Patients with CAN had significantly higher GRI scores, target above range (TAR), coefficient of variation (CV), and standard deviation (SD) but significantly lower time in range (TIR) than those without CAN. The prevalence of CAN increased across higher GRI zones (P for trend <.001). A multivariate logistic regression analysis, adjusted for covariates such as HbA1c, demonstrated that the odds ratio (OR) of CAN was 9.05 (95% confidence interval [CI]: 2.21-36.96, P = .002) per 1-SD increase in the GRI. TIR and CV were also significantly associated with CAN in the multivariate model. The area under the curve of GRI for the prediction of CAN (0.85, 95% CI: 0.76-0.94) was superior to that of TIR (0.80, 95% CI: 0.71-0.89, P for comparison = .046) or CV (0.71, 95% CI: 0.57-0.84, P for comparison = .049). The GRI is significantly associated with CAN in patients with type 1 diabetes and may be a better CGM metric than TIR for predicting CAN.

Safety in the application of high-velocity low-amplitude technique in upper cervical in elderly: Preliminary study

Background: The literature is still controversial regarding the safety of applying high-velocity, low-amplitude (HVLA) techniques to the upper cervical spine, as well as the effects on heart rate variability (HRV) in the elderly. To date, there are no studies reporting the safety of applying these techniques to elderly. Objective: To verify the safety and immediate effects on HRV after applying an HVLA technique to elderly, for the purpose of conducting a future clinical trial. Materials and Methods: This is a preliminary, randomized, crossover study. Six physically active elderly individuals without cardiovascular disease were recruited. The subjects underwent two interventions, with a seven-day interval between them: intervention one consisted of an HVLA technique to the upper cervical spine, while intervention two was a simulated (sham) technique. Data on self-reported symptoms after applying the techniques were collected, in addition to HRV, to assess autonomic function. Results: There were no records of immediate adverse effects after applying the intervention techniques. However, a significant increase in the root means square difference between adjacent normal RR intervals over a time interval (RMSSD) and in the instantaneous beat-to-beat heart rate recording (SD1) was observed in the HVLA group when compared to the sham group. Conclusion: The application of the HVLA technique in the upper cervical spine did not produce self-reported adverse effects in elderly. The HVLA technique increased the activity of the parasympathetic nervous system, producing adjustments in HRV, thus indicating that there may be a significant parasympathetic stimulation in elderly.

Cardiovascular autonomic function in middle-aged people with long-term cervical and upper thoracic spinal cord injuries

Objectives To examine cardiovascular autonomic function in middle-aged people with long-term cervical and upper thoracic spinal cord injury (SCI) compared with the general population, and explore if the neurological level of injury (NLI) is related to cardiovascular autonomic function. Design Population-based cross-sectional study with matched controls. Setting Outpatient SCI unit in Southern Sweden. Participants Twenty-five individuals (20% women, mean age 58 years and mean time since injury 28 years, NLI C2-T6, American Spinal Injury Association Impairment Scale A-C) from the Swedish SPinal Cord Injury Study on Cardiopulmonary and Autonomic Impairment (SPICA). Matched controls were obtained from the population-based Swedish CArdioPulmonary bioImage Study (SCAPIS) at a ratio of 5:1. Interventions Not applicable. Outcome measures 24 h electrocardiography and deep breathing tests. 24 h ambulatory blood pressure (BP) monitoring and orthostatic BP tests. Results In individuals with SCI compared with controls, heart rate variability (24h mean SD of the normal-to-normal interval 112 ms vs 145 ms, P < 0.001) and diastolic orthostatic BP increase (2.0 and 9.4 mmHg, P < 0.001), were significantly lower, whereas BP variability was significantly higher (24h mean systolic SDBP 17.8 mmHg vs 15.7 mmHg, P = 0.029). Circadian patterns of heart rate variability and BP (lack of nocturnal dip) were significantly different among the individuals with SCI than controls. Higher NLI was significantly (P < 0.05) correlated with impairments to various cardiovascular autonomic function variables. Conclusions This exploratory study indicates that cardiovascular autonomic function is impaired in middle-aged people with long-term cervical and upper thoracic SCI compared with the general non-SCI population, and more pronounced with a higher NLI. Future research is needed to understand the pathophysiological mechanisms underlying these impairments, and the prognostic significance for individuals with SCI. Trial registration ClinicalTrials.gov identifier: NCT03515122.

Internet of Things-Driven Precision in Fish Farming: A Deep Dive into Automated Temperature, Oxygen, and pH Regulation

The research introduces a revolutionary Internet of Things (IoT)-based system for fish farming, designed to significantly enhance efficiency and cost-effectiveness. By integrating the NodeMcu12E ESP8266 microcontroller, this system automates the management of critical water quality parameters such as pH, temperature, and oxygen levels, essential for fostering optimal fish growth conditions and minimizing mortality rates. The core of this innovation lies in its intelligent monitoring and control mechanism, which not only supports accelerated fish development but also ensures the robustness of the farming process through automated adjustments whenever the monitored parameters deviate from desired thresholds. This smart fish farming solution features an Arduino IoT cloud-based framework, offering a user-friendly web interface that enables fish farmers to remotely monitor and manage their operations from any global location. This aspect of the system emphasizes the importance of efficient information management and the transformation of sensor data into actionable insights, thereby reducing the need for constant human oversight and significantly increasing operational reliability. The autonomous functionality of the system is a key highlight, designed to persist in adjusting the environmental conditions within the fish farm until the optimal parameters are restored. This capability greatly diminishes the risks associated with manual monitoring and adjustments, allowing even those with limited expertise in aquaculture to achieve high levels of production efficiency and sustainability. By leveraging data-driven technologies and IoT innovations, this study not only addresses the immediate needs of the fish farming industry but also contributes to solving the broader global challenge of protein production. It presents a scalable and accessible approach to modern aquaculture, empowering stakeholders to maximize output and minimize risks associated with fish farming, thereby paving the way for a more sustainable and efficient future in the global food supply.

Higher skin sympathetic nerve activity as a potential predictor of overactive bladder in females refractory to oral monotherapy.

This study investigates predictors of unsatisfactory outcomes in female overactive bladder (OAB) patients treated with oral monotherapy by analyzing skin sympathetic nerve activity (SKNA) using a novel "neuECG" method. The study included 55 newly diagnosed female patients with idiopathic OAB, autonomic function was evaluated using neuECG before treatment initiation, and validated OAB questionnaires and urodynamic studies were administered. Initial monotherapy was administered for the first 4 weeks, with non-responders defined as patients not achieving satisfactory symptom relief and requiring further treatment. Responders (n = 32) and non-responders (n = 23) had no significant differences in baseline characteristics or urodynamic parameters; however, non-responders exhibited significantly higher baseline average SKNA (aSKNA) (1.36 ± 0.49 vs. 0.97 ± 0.29 μV, p = 0.001), higher recovery aSKNA (1.28 ± 0.46 vs. 0.97 ± 0.35 μV, p = 0.007), and a lower stress/baseline ratio of aSKNA (1.05 ± 0.42 vs. 1.26 ± 0.26, p = 0.029). Baseline aSKNA had the highest predictive value for monotherapy refractoriness in OAB (AUROC = 0.759, p = 0.001), with an optimal cut-off point of >1.032 μV. These findings suggest that elevated pre-treatment aSKNA can predict resistance to oral monotherapy in OAB, warranting close monitoring and proactive treatment strategies for patients with high aSKNA.

Pathogenicity of psychrotolerant strains of Antarctic Pseudogmynoascus fungi reveals potential opportunistic profiles

Recent studies have demonstrated the presence of fungal taxa in the extreme ecosystems of Antarctica that are known to opportunistically infect humans and animals. Among these are members of the genus Pseudogymnoascus, including some that are genetically similar to P. destructans, known to be pathogenic to bats. We evaluated the in vitro and in vivo pathogenic potential of 11 Pseudogymnoascus spp. strains recovered from Antarctica. All strains were able to grow at temperatures up to 28 °C and displayed in vitro pathogenicity through hemolytic activity, growth at different pH levels, production of hydrolytic enzymes, spore diameters, tolerance to oxidative stress, hypoxia, and halotolerance. Among them, Pseudogymnoascus sp. UFMG 8532 exhibited strong in vitro pathogenicity and in preliminary in vivo assay killed 100 % of Tenebrio molitor larvae within one day. The pathogenicity of the same strain was also tested using immunosuppressed BALB/c mouse models. Survival of BALB/c mice was affected, with oscillations between weight gain and loss, and impacts on sensory function, reflexes and autonomic function. Histopathological data from the organs of infected mice showed evidence of inflammatory processes, with numerous neutrophils, a small number of macrophages, fluid accumulation inside the lungs and intense hyperemia. Our results indicate that Antarctic Pseudogymnoascus spp. strains obtained from various substrates/habitats in maritime Antarctica may possess intrinsic virulence factors and pathogenic potential for immunosuppressed animals and humans in the region. Given that the Antarctic environment is an important reservoir for Pseudogymnoascus species, which display growth performance across a range of temperatures, it is possible that increasing temperatures in the maritime Antarctic could activate dormant genes or biochemical pathways, select virulent species and/or strains, and facilitate their spread within and beyond the region. The ability of Pseudogymnoascus species to grow slowly even at 28°C, coupled with their potential in vitro and in vivo virulence factors, suggests that these fungi might be undergoing an opportunistic transition due to the effects of climate change on the Antarctic Peninsula.

Comparative Analysis of Heart Rate Variability and Arterial Stiffness in Elite Male Athletes after COVID-19.

This study investigated the long-term cardiovascular effects of coronavirus disease (COVID-19) in elite male athletes by comparing the heart rate variability (HRV), arterial stiffness, and other cardiovascular parameters between those with and without prior COVID-19 infection. Methods: This cross-sectional study evaluated 120 elite male athletes (60 post COVID-19, 60 controls) using anthropometric measurements, body composition analysis, pulmonary function tests, HRV analysis, arterial stiffness assessments, hemodynamic monitoring, and microcirculatory function tests. Results: Athletes post COVID-19 showed significantly higher lean mass (p = 0.007), forced vital capacity (p = 0.001), and forced expiratory volume in 1 s (p = 0.007) than controls. HRV parameters did not significantly differ between the groups. Post-COVID-19 athletes exhibited peripheral vascular resistance (p = 0.048) and reflection index (p = 0.038). No significant differences were observed in the blood pressure, cardiac output, oxygen saturation, or microcirculatory oxygen absorption. Conclusions: Elite male athletes showed notable cardiovascular resilience after COVID-19, with only minor differences in vascular function. The maintained cardiac autonomic function and improved lung parameters in post-COVID-19 athletes suggests an adaptive response. These findings support the cardiovascular health of elite athletes following COVID-19 but emphasize the importance of continued monitoring.

Gender differences in autonomic and psychological stress responses among educators: a heart rate variability and psychological assessment study.

This study explores the gender differences in psychological stress perception and autonomic modulation among teachers. Utilizing heart rate variability (HRV) as a measure of autonomic function and a suite of validated psychological tests, the study examines the discrepancies in stress, anxiety, burnout, and personality traits between male and female educators. Results indicate that despite higher reported levels of stress and anxiety, women demonstrate a higher HRV, suggesting a stronger parasympathetic response. These findings highlight the complex interplay between psychological stressors and physiological responses, emphasizing the need for gender-specific interventions in stress management within the educational sector. Implications for enhancing educators' well-being and performance through tailored strategies are discussed.

8479 A Challenging Case of Hypercortisolism in an Adult Patient With McCune Albright Syndrome

Abstract Disclosure: P. Kesavan Chary: None. S. Jasim: None. Background: McCune Albright Syndrome (MAS) is a rare genetic disorder that occurs due to a spontaneous post-zygotic missense mutation in the GNAS gene resulting in activating gain of function mutations in G-proteins. MAS classically presents as a triad of café-au-lait skin pigmentation, fibrous dysplasia of bone, and precocious puberty. However, continuous autonomous stimulation of endocrine glands can also result in various other endocrinopathies. We present a rare case of hypercortisolism due to bilateral multinodular adrenal hyperplasia (BMAH) in an adult patient with MAS. Case Report: A 38 year old female had MAS, clinically manifested by precocious puberty, renal phosphate wasting with rickets and osteomalacia, fibrous dysplasia of bone with history of multiple fractures, growth hormone excess, and multinodular thyroid status-post total thyroidectomy. A surveillance CT abdomen showed bilateral (right 3.8 x 1.3 cm and left 1.0 x 0.9 cm) adrenal adenomas with low intrinsic attenuation and washout. On diagnosis, the patient had an AM cortisol of 32.5 ug/dL (6.2-19.4 ug/dL) after a low-dose dexamethasone suppression test (DST), and an AM cortisol of 27.3 ug/dL after a high-dose DST. Late night salivary cortisol was 0.518 ug/dL (&amp;lt;0.010-0.090 ug/dL), 24-hour urine cortisol was 78 ug/24hrs (6-42 ug/24hrs), and ACTH was &amp;lt;1.5 pg/mL (7.2-63.3 pg/mL). The patient was initially asymptomatic and monitored for a few months, but subsequently developed easy bruising, recurrent skin infections, and irritability. The patient declined surgical intervention and was initiated on Osilodrostat. Shortly after medication initiation, she was hospitalized for perforated diverticulitis, hypokalemia, and hypomagnesemia. During hospitalization, AM Cortisol was 49 mcg/dL (4.8-19.5 mcg/dL) and 24-hour urine cortisol was 1023 mcg/24hrs (normal range 3.5-45 mcg/24hrs; the patient’s level prior to admission was 170-190 mcg/24hrs). Osilodrostat was held and the patient was initiated on Etomidate infusion. Once plasma cortisol levels normalized, she resumed Osilodrostat prior to discharge. The patient subsequently tried multiple medical therapy options before undergoing a bilateral adrenalectomy as a definitive treatment choice. Conclusion: The gain of function mutations in MAS result in autonomous endocrine gland function that can manifest clinically as various endocrinopathies. While the most common endocrinopathies in MAS are precocious puberty, hyperthyroidism, and pituitary dysfunction, active surveillance is critical to monitor for less common presentations such as hypercortisolism. This is the first report of adrenal Cushing’s in an adult patient with MAS. Presentation: 6/3/2024

Sexual Abuse, Post-Traumatic Stress Disorder and Psychopathological Characteristics in Women with Functional/Dissociative Seizures.

Functional/dissociative seizures (FDS), also known as psychogenic non-epileptic seizures (PNES), are sudden, transient, and involuntary events that include motor, sensory, cognitive or autonomic function alterations. In this work we analyzed the psychopathological characteristics of a subgroup of women who suffer from FDS with the aim to analyze the role of psychological trauma, with special emphasis on trauma due to sexual abuse (SA). Forty-five women diagnosed with FDS were included in the study (age range 18 to 64 years, mean = 34.7, standard deviation (SD) = 13.1). Clinical and psychopathological characteristics were reviewed. All patients have completed the clinical interviews, the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I), the Structured Clinical Interview for DSM-IV Axis II Personality Disorders (SCID II) and the Global Assessment of Functioning (GAF) according to a special protocol for mental health assessment. Also, the history of sexual abuse trauma, the history of other non-sexual traumas and absence of history of trauma were reviewed. Eighty percent of the cases reported a history of trauma, and 40% reported a history of SA. Patients with a history of SA presented a significantly lower average age of seizure onset than patients with a history of other non-sexual traumas (p = 0.021). Significant associations were found between SA and post-traumatic stress disorder (PTSD) (p = 0.031), and SA and history of suicide attempts (p = 0.037). SA carries serious implications for the mental health of women suffering from FDS. Mental health professionals must consider the history of this type of trauma to provide the necessary care for this patient population.

5165 Cushing’s Disease And Primary Aldosteronism Confounded By A Non-functioning Solitary Adrenal Incidentaloma

Abstract Disclosure: J.G. Friedman: None. W. Huang: None. Background: Adrenal incidentalomas are common, affecting ∼2% of the general population. The presence of adrenal incidentaloma necessitates biochemical testing for hypersecretion, however hypercortisolism and/or hyperaldosteronism may not necessarily originate from the nodule that prompted the initial workup. Clinical Case: A 53-year-old man with a history of obesity and hypertension was referred for workup of a 2.4 x 1.4 cm R adrenal nodule that was incidentally discovered on an abdominal CT to rule out pancreatitis. He was noted on examination to have some Cushingoid features. He was on three antihypertensives (amlodipine 10 mg, carvedilol 50 mg, and spironolactone 50 mg) with adequate blood pressure control and no hypokalemia. He denied spells nor exogenous steroid exposure. Initial testing for hypersecretion showed an elevated cortisol 8.7 ug/dL (&amp;lt;1.8) after 1 mg dexamethasone with adequate dexamethasone level, aldosterone concentration (PAC) 9 ng/dL (3-16), plasma renin activity (PRA) 0.7 ng/mL/h (0.25-5.82), potassium of 3.8 mmol/L (3.5-5.1), and normal plasma metanephrines. Further testing revealed elevated 24-hour urinary free cortisol 81.3 mcg/24h (4-50) and elevated late night salivary cortisol 0.10 and 0.13 mg/dL (&amp;lt;0.09). Baseline 8 AM ACTH was not suppressed 16.3 pg/mL (7.2-63.6). DDAVP stimulation resulted in an increase in cortisol and ACTH suggestive of Cushing’s disease, which was confirmed by inferior petrosal sinus sampling (IPSS). Pituitary MRI showed a 3.6 mm L-sided microadenoma. He underwent transsphenoidal resection with pathology consistent with an ACTH-staining pituitary adenoma. Immediate post-op cortisol nadir was 4.9 ug/dL. A few weeks after surgery, he underwent retesting for primary aldosteronism notable for PAC 14 ng/dL, PRA 0.58 ng/mL/h, and K 4.0 mmol/L. After oral salt loading, 24-hour urine aldosterone was 14.4 mcg/24h (&amp;lt;12) with urine sodium 247 mmol/L/24h (&amp;gt;200). He completed AVS which lateralized to the L adrenal gland despite a R adrenal nodule. He underwent L adrenalectomy with significant improvement in blood pressure which is now well-controlled on carvedilol monotherapy with normalization of PRA to 1.94 ng/ml/h. The R adrenal nodule remains stable in size and appearance on follow up imaging. Conclusion: The presence of an adrenal adenoma with concomitant biochemical evidence of hormonal excess cannot inherently be attributed to nodular autonomous function without further workup. Other hormonal assessment including ACTH level and localization studies are necessary prior to any surgical procedure to avoid missed diagnoses of Cushing’s disease and contralateral primary aldosteronism in the presence of a non-functioning adrenal nodule. Presentation: 6/1/2024

Pulmonary Hypertension: Pharmacological and Non-Pharmacological Therapies.

Pulmonary hypertension (PH) is a severe and chronic disease characterized by increased pulmonary vascular resistance and remodeling, often precipitating right-sided heart dysfunction and death. Although the condition is progressive and incurable, current therapies for the disease focus on multiple different drugs and general supportive therapies to manage symptoms and prolong survival, ranging from medications more specific to pulmonary arterial hypertension (PAH) to exercise training. Moreover, there are multiple studies exploring novel experimental drugs and therapies including unique neurostimulation, to help better manage the disease. Here, we provide a narrative review focusing on current PH treatments that target multiple underlying biochemical mechanisms, including imbalances in vasoconstrictor-vasodilator and autonomic nervous system function, inflammation, and bone morphogenic protein (BMP) signaling. We also focus on the potential of novel therapies for managing PH, focusing on multiple types of neurostimulation including acupuncture. Lastly, we also touch upon the disease's different subgroups, clinical presentations and prognosis, diagnostics, demographics, and cost.

Relationship between autonomic nervous function and brain functions such as memory and attention

This study aimed to evaluate the relationship between autonomic nervous function (ANF) and cognitive abilities, such as memory and attention, using the Kana pick-out test (KPT). The participants were 11 female college students aged 21 years old. Each participant completed the KPT ten times, during which their ANF was assessed via heart rate variability analysis. During the KPT, participants circled Japanese vowels in a 400-character story written in hiragana. We measured attention using the KPT score and assessed memory using a memory score based on ten descriptive questions about the story. Statistical analysis revealed a significant positive correlation between higher KPT and memory scores, indicating a link between memory and attention. The parasympathetic sinus modulation marker, high-frequency component power (HF), decreased during the kana-picking task (Interval B) and recovered during the subsequent content verification task (Interval C). In Interval A (before the kana-picking task), the HF showed a positive correlation with both the KPT and memory scores. Additionally, a positive correlation was observed between HF and memory scores during interval B. Other autonomic nervous indices, including low-frequency component power (LF), total power (TP), and LF/HF ratio, also showed significant correlations with KPT and memory scores. Our findings strongly suggest that ANF is intricately connected to cognitive functions, such as memory and attention. This indicates that monitoring ANF could provide a novel methodology for assessing learning and occupational efficiency.

Sodium channels Nav1.7, Nav1.8 and pain; two distinct mechanisms for Nav1.7 null analgesia

Genetic deletion and pharmacological inhibition are distinct approaches to unravelling pain mechanisms, identifying targets and developing new analgesics. Both approaches have been applied to the voltage-gated sodium channels Nav1.7 and Nav1.8. Genetic deletion of Nav1.8 in mice leads to a loss of pain and antagonists are effective analgesics. The situation with Nav1.7 is more complex. Complete embryonic loss of Nav1.7 in humans or in mouse sensory neurons leads to anosmia as well as profound analgesia as a result of diminished neurotransmitter release. This is mediated by enhanced endogenous opioid signaling in humans and mice. In contrast, anosmia is opioid-independent. Sensory neuron excitability and autonomic function appear to be normal.Adult deletion of Nav1.7 in sensory neurons also leads to analgesia, but through diminished sensory and autonomic neuron excitability. There is no opioid component of analgesia or anosmia as shown by a lack of effect of naloxone. Pharmacological inhibition of Nav1.7 in mice and humans leads both to analgesia and dramatic side-effects on the autonomic nervous system with no therapeutic window. These data demonstrate that specific Nav1.7 channel blockers will fail as analgesic drugs. The viability of embryonic null mutants suggests that there are compensatory changes to replace the lost Nav1.7 channel. Here we show that sensory neuron sodium channels Nav1.1, Nav1.2 and β4 subunits detected by Mass Spectrometry are upregulated in Nav1.7 embryonic null neurons and, together with other proteome changes, potentially compensate for the loss of Nav1.7. Interestingly, many of the upregulated proteins are known to interact with Nav1.7.

Bone Strength, Autonomic Function, and Glycation: Key Determinants of Red Blood Cell Aggregation

Bone Strength, Autonomic Function, and Glycation: Key Determinants of Red Blood Cell Aggregation

Impact of neonatal hyperoxia on adult cardiac autonomic function in rats: Role of angiotensin II type 1 receptor activation

Individuals born preterm present altered cardiac autonomic function, a risk factor to heart diseases. Neonatal renin-angiotensin-system activation contributes to adult cardiomyopathy in rats exposed to neonatal hyperoxia, a well-established model of preterm birth-related conditions. Central angiotensin II receptor activation is a key modulator of the autonomic drive to the heart. Whether neonatal hyperoxia leads to alteration of the cardiac autonomic function through activation of the angiotensin II receptor type 1 (AT1) is unknown and was examined in the present study.Sprague-Dawley pups were exposed to hyperoxia or room air from postnatal days 3–10. AT1 antagonist losartan or water was given orally postnatal days 8–10. Blood pressure, autonomic function, left ventricular sympathetic innervation, β-adrenergic-receptors expression, and AT1 expression in the solitary-tract-nucleus were examined in adult rats.Neonatal hyperoxia led to loss of day-night blood pressure variation, decreased heart rate variability, increased sympathovagal balance, increased AT1 expression in the solitary-tract, decreased left ventricle sympathetic innervation, and increased β1-adrenergic-receptor protein expression. Losartan prevented the autonomic changes and AT1 expression in the solitary-tract but did not impact the loss of circadian blood pressure variation nor the changes in sympathetic innervation and in β1-adrenergic-receptor expression.In conclusion, neonatal hyperoxia leads to both central autonomic and cardiac sympathetic changes, partly programmed by neonatal activation of the renin-angiotensin system.

Acute Effects Of Exercise On Autonomic Function In Parkinson's Disease

Acute Effects Of Exercise On Autonomic Function In Parkinson's Disease

Inspiratory muscle training improves autonomic function in myalgic encephalomyelitis/chronic fatigue syndrome and post-acute sequelae of SARS-CoV-2: A pilot study

Post-acute sequelae of SARS-CoV-2 (PASC), or Long COVID, and myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) are debilitating post-viral conditions with many symptomatic overlaps, including exercise intolerance and autonomic dysfunction. Both conditions are growing in prevalence, and effective safe treatment strategies must be investigated. We hypothesized that inspiratory muscle training (IMT) could be used in PASC and mild to moderate ME/CFS to mitigate symptoms, improve exercise capacity, and improve autonomic function. We recruited healthy controls (n=12; 10 women), people with PASC (n=9; 8 women), and people with mild to moderate ME/CFS (n=12; 10 women) to complete 8 weeks of IMT. This project was registered as a clinical trial (NCT05196529) with clinicaltrials.gov. After completion of IMT, all groups experienced improvements in inspiratory muscle pressure (p<0.001), 6-minute walk distance (p=0.002), resting heart rate (p=0.037), heart rate variability (p<0.05), and symptoms related to sleep (p=0.009). In the ME/CFS group only, after completion of IMT, there were additional improvements with regard to vascular function (p=0.001), secretomotor function (p=0.023), the total weighted score (p=0.005) of the COMPASS 31 autonomic questionnaire, and symptoms related to pain (p=0.016). We found that after 8 weeks of IMT, people with PASC and/or ME/CFS could see some overall improvements in their autonomic function and symptomology.

Impact of slouching on heart rate variability and cardiovascular health among medical students

Background: Medical students frequently adopt poor postures such as slouching potentially impacting health. Heart rate variability (HRV) serves as an indicator of autonomic nervous system function, correlated with cardiovascular health. Aims and Objectives: The objective of the study was to compare HRV parameters among medical students in three postures: Sitting erect, easy pose (cross-legged), and slouching (stooping head and shoulders). Materials and Methods: A comparative cross-sectional study enrolled 26 male medical students. Participants were instructed to maintain each posture for 5 min while HRV was recorded using a Polar V800. Time domain and frequency domain parameters among different postures were analyzed using Friedman’s test and post hoc tests for pairwise comparisons. P&lt;0.05 was considered significant. Data were expressed as median interquartile range. Results: Significant differences were observed in HRV parameters between postures. The easy pose demonstrated a significantly higher median value of root mean square of differences of successive RR intervals (48.28 ms vs. 35.35 ms) and pNN50% (24.40% vs. 13.62%) compared to slouching. Frequency domain analysis revealed a significantly higher median value of high-frequency (HF) power in easy pose (626.56 ms² vs. 378.15 ms²) and HF normalized unit (33.78 vs. 22.55) compared to slouching. A lower low frequency (LF)/HF ratio and (1.96 vs. 3.43) lower LF normalized unit (66.18 vs. 77.30) was also seen in easy pose. Although statistically not significant, the parasympathetic indicators of HRV were higher in erect sitting compared to slouching posture. Conclusion: Among medical students, adopting the easy pose (cross-legged sitting) appeared to enhance HRV and thus increase parasympathetic activity, whereas adopting slouching postures decreased it.

Autonomous Grid Support Functionality in Variable-Speed Drive-Based End-Use Loads

Autonomous Grid Support Functionality in Variable-Speed Drive-Based End-Use Loads