Index Of Sympathetic Activity Research Articles

Effect of remimazolam and propofol anesthesia on autonomic nerve activities during Le Fort I osteotomy under general anesthesia: blinded randomized clinical trial.

This study evaluated the effect of remimazolam and propofol on changes in autonomic nerve activity caused by surgical stimulation during orthognathic surgery, using power spectrum analysis of blood pressure variability (BPV) and heart rate variability (HRV), and their respective associations with cardiovascular fluctuations. A total of 34 patients undergoing Le Fort I osteotomy were randomized to the remimazolam (Group R, 17 cases) or propofol (Group P, 17 cases) groups. Observables included the low-frequency component of BPV (BPV LF; index of vasomotor sympathetic nerve activity), high-frequency component of HRV (HRV HF; index of parasympathetic nerve activity), balance index of the low- and high-frequency components of HRV (HRV LF/HF; index of sympathetic nerve activity), heart rate (HR), and systolic blood pressure (SBP). Four observations were made: (1) baseline, (2) immediately before down-fracture, (3) down-fracture, and (4) 5 min after down-fracture. Data from each observation period were compared using a two-way analysis of variance with a mixed model. A Bonferroni multiple comparison test was performed in the absence of any interaction. One-way analysis of variance followed by Tukey's multiple comparisons test was performed when a significant interaction was observed between time and group, with P < 0.05 indicating statistical significance. Evaluation of autonomic nerve activity in comparison with baseline during down-fracture showed a significant increase in BPV LF (P < 0.001), an increasing trend in HRV LF/HF in Group P, and an increasing trend in HRV HF in Group R. There were no significant differences in HR or SBP between the two groups. During down-fracture of Le Fort I osteotomy, sympathetic nerve activity was predominant with propofol anesthesia, and parasympathetic nerve activity was predominant with remimazolam anesthesia.

Activation of cardiac parasympathetic and sympathetic activity occurs at different skin temperatures during face cooling.

Sufficiently cold-water temperatures (<7°C) are needed to elicit the sympathetic response to the cold pressor test using the hand. However, it is not known if stimulating the trigeminal nerve via face cooling, which increases both sympathetic and cardiac parasympathetic activity, also has a threshold temperature. We tested the hypothesis that peak autonomic activation during a progressive face cooling challenge would be achieved when the stimulus temperature is ≤7°C. Twelve healthy participants (age: 25 ± 3 yr, four women) completed our study. Six pliable bags, each containing water or an ice slurry (34°C, 28°C, 21°C, 14°C, 7°C, and 0°C) were applied sequentially to participants' forehead, eyes, and cheeks for 5 min each. Mean arterial pressure (photoplethysmography; index of sympathetic activity) and heart rhythm (3-lead ECG) were averaged in 1-min increments at the end of baseline and throughout each temperature condition. Heart rate variability in the time [(root mean square of successive differences (RMSSD)] and frequency [high-frequency (HF) power] domains was used to estimate cardiac parasympathetic activity. Data are presented as the increase from baseline ± SD. Mean arterial pressure only increased from baseline in the 7°C (13.1 ± 10.3 mmHg; P = 0.018) and 0°C (25.2 ± 7.8 mmHg; P < 0.001) conditions. Only the 0°C condition increased RMSSD (160.6 ± 208.9 ms; P = 0.009) and HF power (11,450 ± 14,555 ms2; P = 0.014) from baseline. Our data indicate that peak increases in sympathetic activity during face cooling are initiated at a higher forehead skin temperature than peak increases in cardiac parasympathetic activity.

Local alternating heat and cold stimulation affects hemodynamics and oxygenation in fatigued muscle tissue and autonomic nervous activity: a single-arm interventional study

BackgroundLocal alternating heat and cold stimulation as an alternative to contrast bath may cause intermittent vasoconstriction and vasodilation, inducing a vascular pumping effect and consequently promoting increased tissue blood flow and oxygenation. This study aimed to examine the effects of local alternating heat and cold stimulation, using a wearable thermal device, on the hemodynamics of fatigued muscle tissue and autonomic nervous activity.MethodsTwenty healthy individuals experienced fatigue in the periarticular muscles of the shoulder joint due to a typing task. Local alternating heat and cold stimulations were then applied to the upper trapezius muscle. Muscle hardness was measured using a muscle hardness meter, and muscle tissue hemodynamics and oxygenation were evaluated using near-infrared spectroscopy before and after the stimulation. Autonomic nervous activity was also evaluated using heart rate variability.ResultsAlternating heat and cold stimulation decreased muscle hardness of the fatigued trapezius muscle from 1.38 ± 0.15 to 1.31 ± 0.14 N (P < 0.01). The concentration of total hemoglobin in the trapezius muscle tissue increased from − 0.21 ± 1.36 to 2.29 ± 3.42 µmol/l (P < 0.01), and the tissue hemoglobin oxygen saturation also increased from 70.1 ± 5.4 to 71.1 ± 6.0% (P < 0.05). Additionally, the heart rate variability parameter, which is an index of sympathetic nervous activity, increased from 3.82 ± 2.96 to 6.86 ± 3.49 (P < 0.01). A correlation was found between increased tissue hemoglobin oxygen saturation and increased parameters of sympathetic nervous activity (r = 0.50, P < 0.05).ConclusionsLocal alternating heat and cold stimulation affected the hemodynamic response in fatigued muscle tissue and autonomic nervous activity. This stimulation is more efficient than conventional contrast baths in terms of mobility and temperature control and has potential as a new versatile therapeutic intervention for muscle fatigue.Trial registrationUMIN-CTR (UMIN000040087: registered on April 7, 2020, https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000045710. UMIN000040620: registered on June 1, 2020, https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000046359).

Sympathetic and parasympathetic central autonomic networks

Abstract The central-autonomic network (CAN) comprises brain regions that are functionally linked to the activity of peripheral autonomic nerves. While parasympathetic CAN (i.e., the CAN projecting onto parasympathetic branches) has recently been investigated and is known to be involved in neurological and neuropsychiatric disorders, sympathetic CAN (i.e., the CAN projecting onto sympathetic nerves) has not been fully characterized. Using functional magnetic resonance imaging (fMRI) data from the Human Connectome Project in conjunction with heartbeat dynamics and its orthonormal autoregressive descriptors as a proxy for sympathetic activity estimation, namely, the sympathetic activity index (SAI), we uncover brain regions belonging to the sympathetic CAN at rest. We uncover a widespread CAN comprising both cortical (in all lobes) and subcortical areas, including the cerebellum and brainstem, which is functionally linked to sympathetic activity and overlaps with brain regions driving parasympathetic activity. These findings may constitute fundamental knowledge linking brain and bodily dynamics, including the link between neurological and psychiatric disorders and autonomic dysfunctions.

P300/CBP Regulates HIF-1-Dependent Sympathetic Activation and Hypertension by Intermittent Hypoxia.

Obstructive sleep apnea (OSA), a widespread breathing disorder, leads to intermittent hypoxia (IH). Patients with OSA and IH-treated rodents exhibit heightened sympathetic nerve activity and hypertension. Previous studies reported transcriptional activation of nicotinamide adenine dinucleotide phosphate (NADPH) oxidases (Nox) by HIF-1 (hypoxia-inducible factor-1) contribute to autonomic dysfunction in IH-treated rodents. Lysine acetylation, regulated by KATs (lysine acetyltransferases) and KDACs (lysine deacetylases), activates gene transcription and plays an important role in several physiological and pathological processes. This study tested the hypothesis that acetylation of HIF-1α by p300/CBP (CREB-binding protein) (KAT) activates Nox transcription, leading to sympathetic activation and hypertension. Experiments were performed on pheochromocytoma-12 cells and rats treated with IH. IH increased KAT activity, p300/CBP protein, HIF-1α lysine acetylation, HIF-1 transcription, and HIF-1 binding to the Nox4 gene promoter in pheochromocytoma-12 cells, and these responses were blocked by CTK7A, a selective p300/CBP inhibitor. Plasma norepinephrine (index of sympathetic activation) and blood pressures were elevated in IH-treated rats. These responses were associated with elevated p300/CBP protein, HIF-1α stabilization, transcriptional activation of Nox2 and Nox4 genes, and reactive oxygen species, and all these responses were absent in CTK7A-treated IH rats. These findings suggest lysine acetylation of HIF-1α by p300/CBP is an important contributor to sympathetic excitation and hypertension by IH.

Physiological adjustment effect of visual stimulation by fresh rose flowers on sympathetic nervous activity.

As modern societies are often stressful due to urbanization and artificialization, the physiological relaxing effects of natural environments or nature-derived stimuli on humans have attracted attention and scientific data are being accumulated. It is known that there is inter-individual variation in these effects. The study aim was to apply the law of initial values to investigate the physiological adjustment effect of viewing fresh roses on sympathetic nervous activity. In this crossover study, a total of 214 high school students, office workers, healthcare workers, and elderly people were analyzed. The participants viewed fresh roses in a vase for 4 min. In the control condition, participants did not view any fresh roses during the period. To offset any order effect, participants received visual stimuli in the order of fresh roses then the control (no fresh roses) or the control and then fresh roses. ln (LF/HF) of heart rate variability (HRV) obtained from a-a interval measurements using an acceleration plethysmograph and used as an index of sympathetic nervous activity. The initial value was ln (LF/HF) of HRV during the control viewing (no fresh roses), and the change value was ln(LF/HF) of HRV during visual stimulation by fresh roses minus the control viewing. The correlation between the two was assessed by determining Pearson's correlation coefficient r, which was significantly negative. A physiological adjustment effect was observed such that participants with high initial sympathetic nervous activity showed a decrease in activity after visual stimulation with fresh roses, whereas participants with low initial activity showed an increase.

Efficiency of hyperbaric oxygenation in complex rehabilitation of soldiers with traumatic brain injury: prospective study

OBJECTIVE: Evaluate the effect of hyperbaric oxygenation course on indicators of central hemodynamics, heart-rate variability and ability to concentrate and switch attention in soldiers with traumatic brain injury. MATERIALS AND METHODS: The main group contained 50 patients with combat traumatic brain injury, aged 25-45, whose comprehensive treatment course included hyperbaric oxygenation. The control group consisted of 20 patients, treated with medical therapy under the clinical protocol. Hyperbaric oxygenation treatment was carried out in BLKS-303 MK pressure apparatuses in the 0.3–0.7 ati mode with an isopression exposure of 40 min. The course of hyperbaric oxygenation included 10±2 sessions per day. The indicators of heart-rate variability and central hemodynamics were measured. Bourdon proofreading sample was used to assess alertness and ability to switch attention. Statistics. Statistical analysis of data was performed using “Statistica for Windows 6.5” program. Comparisons are shown as median values (Me) and quartile range (LQ÷UQ) (25% and 75% percentile). Criteria of significance was considered p&lt;0,05. the Mann-Whitney test was used to compare quantitative indicators in the main and control groups, the Wilcoxon T test was applied when studying the dynamics of change in indicators in the study groups. RESULTS: Including hyperbaric oxygenation in the complex therapy of patients with combat traumatic brain injury led to significant reduction in indicators of sympathetic activity - mode amplitude - up to 35,7 % (29,5÷48,0), decrease of tension index up to 116,5 %/с2 (99,0÷122,0) and recovery of vegetative equilibrium indicator LF/HF up to 2,8 (2,5÷4,3). Patients with hyperkinetic type of blood circulation in the main group, compared to the control group experienced significant reduction in stroke volume index to 41,8 (40,7÷54,8) ml/m2 cardiac index up to 4,6 (4,4÷5,2) kg*m/min/m2 , decreased energy expenditure for blood moving to 12,3 (12,3÷12,7) Wh/l. improve coordination is observed in 54 % of the main group in comparison with 34 % of the control group, reduced pathological reflexes - in 50 % of the main group, compared to 22 % of the control group, decrease in the severity of deep reflection disorders - in 55 % of the main group versus 28 % of the control group. Conducting Bourdon proofreading sample test after HBO course in the main group, compared to the control group showed significant error reduction from 12,7 (10,2÷14,6) to 4,2 (3,7÷5,2) (р&lt;0,001); reliable error reduction from 11,8 (9,6÷12,8) to 8,4 (6,5÷10,2) (р&lt;0,05) was noted in the control group. DISCUSSION: Early application of hyperbaric oxygenation in the complex therapy of patients with combat traumatic brain injury contributes to rapid normalization of central hemodynamics, decrease in the severity of impact on the sympathetic part of the autonomic nervous system, reduction in the degree of cardiac rhythm management centralization. Reliable regression of focal symptoms in the main group was accompanied by significant improvement in concentration and stability of attention, ability to switch it, compared to the control group. CONCLUTION: Including hyperbaric oxygenation in the complex treatment of traumatic brain injury can significantly increase therapy efficiency, resulting in faster restoration of impaired brain functions, memory and attention activation, normalizing the indicators of heart-rate variability and central hemodynamics, and promotes transition to a more economical operating mode according to the new level of oxygenation.

Abnormal Systemic and Ocular Responses to the Valsalva Manoeuvre in Primary Open-Angle Glaucoma: A Case for Autonomic Failure?

This study aimed to examine the association of primary open-angle glaucoma (POAG) with autonomic dysfunction by assessing the differences in systemic and ocular responses to an autonomic provocation test, the Valsalva manoeuvre (VM), between POAG patients and normal subjects. Forty POAG and forty control subjects were subjected to the VM. Systemic and ocular parameters were measured at baseline, phase 2, and phase 4 of the VM (VM2 and VM4), where VM2 and VM4 are sympathetic and parasympathetic nervous activation states, respectively. Heart rate variability was used to assess the autonomic nervous activity, among which the high-frequency component (HF) and the low-frequency (LF)/HF ratio were used as indices of parasympathetic and sympathetic activation, respectively. POAG patients demonstrated higher sympathetic activation (LF/HF ratio median: 2.17 vs. 1.53, P=0.000) than controls at baseline and exhibited attenuated sympathetic and parasympathetic responses (a smaller change in LF/HF and HF values) during the VM than controls. During VM, the intraocular pressure (IOP), mean blood pressure (MAP), mean ocular perfusion pressure (MOPP), and the Schlemm's canal area (SCAR) increased from baseline to VM2 and then decreased from VM2 to VM4 in both the POAG and control groups (all P<0.05). However, when we compared the changes above, the fluctuations in IOP, MAP, and MOPP were more pronounced in POAG than in controls (all P<0.05), while the changes in amplitudes of SCAR were smaller in POAG (P<0.05). Furthermore, from VM2 to VM4, the choroid thickness (ChT) in the POAG group was significantly decreased, while it was unchanged in normal subjects (P=0.258). A regression analysis showed a significant correlation of the baseline LF/HF with IOP change values (ΔIOP) from baseline to VM2 in POAG (R2=0.147, P=0.014). Patients with POAG showed more pronounced fluctuations in IOP, MAP, MOPP and ChT during the VM than controls. These reactions could be associated with autonomic dysfunction in POAG.

Characterization of autonomic states by complex sympathetic and parasympathetic dynamics* *Work partially supported by the Italian Ministry of Education and Research (MIUR) in the framework of the FoReLab project (Departments of Excellence).

Assessment of heartbeat dynamics provides a promising framework for non-invasive monitoring of cardiovascular and autonomic states. Nevertheless, the non-specificity of such measurements among clinical populations and healthy conditions associated with different autonomic states severely limits their applicability and exploitation in naturalistic conditions. This limitation arises especially when pathological or postural change-related sympathetic hyperactivity is compared to autonomic changes across age and experimental conditions. In this frame, we investigate the intrinsic irregularity and complexity of cardiac sympathetic and vagal activity series in different populations, which are associated with different cardiac autonomic dynamics. Sample entropy, fuzzy entropy, and distribution entropy are calculated on the recently proposed sympathetic and parasympathetic activity indices (SAI and PAI) series, which are derived from publicly available heartbeat series of congestive heart failure patients, elderly and young subjects watching a movie in the supine position, and healthy subjects undergoing slow postural changes. Results show statistically significant differences between pathological/old subjects and young subjects in the resting state and during slow tilt, with interesting trends in SAI- and PAI-related entropy values. Moreover, while CHF patients and healthy subjects in upright position show the higher cardiac sympathetic activity, elderly and young subjects in resting state showed higher vagal activity. We conclude that quantification of intrinsic cardiac complexity from sympathetic and vagal dynamics may provide new physiology insights and improve on the non-specificity of heartbeat-derived biomarkers.

Using sleep heart rate variability to investigate the sleep quality in children with obstructive sleep apnea.

Obstructive sleep apnea (OSA) is associated with impaired sleep quality and autonomic dysfunction. Adenotonsillectomy significantly improves subjective and objective sleep quality in children with OSA. However, the postoperative changes in heart rate variability (HRV) indices (indicators of cardiac autonomic function) and their importance remain inconclusive in childhood OSA. This retrospective case series aimed to investigate the association of sleep HRV indices, total OSA-18 questionnaire score (a subjective indicator of sleep quality) and polysomnographic parameters (objective indicators of sleep quality), and effects of adenotonsillectomy on HRV indices, total OSA-18 questionnaire score and polysomnographic parameters in children with OSA. Seventy-six children with OSA were included in baseline analysis, of whom 64 (84%) completed at least 3 months follow-up examinations after adenotonsillectomy and were included in outcome analysis. Associations between baseline variables, and relationships with treatment-related changes were examined. Multivariable linear regression models in the baseline analysis revealed independent relationships between tonsil size and obstructive apnea-hypopnea index (OAHI), adenoidal-nasopharyngeal ratio and very low frequency (VLF) power of HRV (an indicator of sympathetic activity), and normalized low frequency power (an indicator of sympathetic activity) and OAHI. The outcome analysis showed that adenotonsillectomy significantly improved standard deviation of all normal-to-normal intervals, and high frequency power, QoL (in terms of reduced total OSA-18 questionnaire score), OAHI and hypoxemia. Using a conceptual serial multiple mediation model, % change in OSA-18 questionnaire score and % change in VLF power serially mediated the relationships between change in tonsil size and % change in OAHI. The improvement in OAHI after adenotonsillectomy was serially mediated by reductions in total OSA-18 questionnaire score and VLF power. These preliminary findings are novel and provide a direction for future research to investigate the effects of VLF power-guided interventions on childhood OSA.

Relaxing effects of music and odors on physiological recovery after cognitive stress and unexpected absence of multisensory benefit.

Several studies have described, often separately, the relaxing effects of music or odor on the autonomic nervous system (ANS) activity. Only a few studies compared the presentation of these stimuli and their interaction within a same experimental protocol. Here, we examined whether relaxing music (slow-paced classical pieces) and odor (lavender essential oil) either presented in isolation or in combination would facilitate physiological recovery after cognitive stress. We continuously recorded the electrocardiogram to assess the high-frequency component of heart rate variability (HF-HRV), an index of parasympathetic activity, and electrodermal activity (EDA), an index of sympathetic activity, 10min before, during and 30 min after a cognitive stress (i.e., completing timely constrained cognitively demanding tasks) in 99 participants allocated to four recovery conditions (control N=26, music N=23, odor N=24, music+odor N=26). The stressing event triggered both a significant increase in EDA and decrease in HF-HRV (compared to baseline). During the recovery period, the odor elicited a greater decrease in EDA compared to an odorless silent control, whereas no difference in HRV was observed. Conversely, during this period, music elicited a greater increase in HF-HRV compared to control whereas no difference in EDA was observed. Strikingly, in the multimodal music+odor condition, no beneficial effect was observed on ANS indexes 30 min after stress. Overall, our study confirms that both olfactory and musical stimuli have relaxing effects after stress on ANS when presented separately only, which might rely on distinct neural mechanisms and autonomic pathways.

코그니사이즈(Cognicise)와 매트 필라테스 복합 운동이 여성 노인의 신체조성과 정신건강 지수에 미치는 영향

In this study, elderly women were subjected to a combination of Cognicise and Pilates exercise 3 times a week for 12 weeks to determine their body composition (weight, muscle mass, body fat percentage, waist circumference, hip circumference) and mental health index (pulse wave, brain wave). It was carried out to analyze what kind of effect it has, and the following conclusions were obtained through the results.BR First, in body composition, the exercise group significantly (p.01) decreased in body weight, significantly increased (p.01) muscle mass, and significantly (p.05) decreased waist and hip circumferences. Second, in the exercise group, the HRV-index and sympathetic nerve activity index among the pulse wave items increased significantly (p.001), and the autonomic nerve health index also increased significantly (p.01). Body (autonomic nerve) age decreased significantly (p.001). The control group significantly (p.01) decreased in the parasympathetic activity index. EEG significantly (p.001) increased in the exercise group in the brain health score. The control group showed a significant (p.05) increase in body weight and body fat percentage. As described above, 12 weeks of Cognicise and Pilates combined exercise is effective for positive changes in body composition and improvement of mental health index in elderly women, and it is thought to be helpful in maintaining a healthy life.

The use of electrodermal activity in pulpal diagnosis and dental pain assessment.

To explore whether electrodermal activity (EDA) can serve as a complementary tool for pulpal diagnosis (Aim 1) and an objective metric to assess dental pain before and after local anaesthesia (Aim 2). A total of 53 subjects (189 teeth) and 14 subjects (14 teeth) were recruited for Aim 1 and Aim 2, respectively. We recorded EDA using commercially available devices, PowerLab and Galvanic Skin Response (GSR) Amplifier, in conjunction with cold and electric pulp testing (EPT). Participants rated their level of sensation on a 0-10 visual analogue scale (VAS) after each test. We recorded EPT-stimulated EDA activity before and after the administration of local anaesthesia for participants who required root canal treatment (RCT) due to painful pulpitis. The raw data were converted to the time-varying index of sympathetic activity (TVSymp), a sensitive and specific parameter of EDA. Statistical analysis was performed using Python 3.6 and its Scikit-post hoc library. Electrodermal activity was upregulated by the stimuli of cold and EPT testing in the normal pulp. TVSymp signals were significantly increased in vital pulp compared to necrotic pulp by both cold test and EPT. Teeth that exhibited intensive sensitivity to cold with or without lingering pain had increased peak numbers of TVSymp than teeth with mild sensation to cold. Pre- and post-anaesthesia EDA activity and VAS scores were recorded in patients with painful pulpitis. Post-anaesthesia EDA signals were significantly lower compared to pre-anaesthesia levels. Approximately 71% of patients (10 of 14 patients) experienced no pain during treatment and reported VAS score of 0 or 1. The majority of patients (10 of 14) showed a reduction of TVSymp after the administration of anaesthesia. Two of three patients who experienced increased pain during RCT (post-treatment VAS > pre-treatment VAS) exhibited increased post-anaesthesia TVSymp. Our data show promising results for using EDA in pulpal diagnosis and for assessing dental pain. Whilst our testing was limited to subjects who had adequate communication skills, our future goal is to be able to use this technology to aid in the endodontic diagnosis of patients who have limited communication ability.

Lifestyle intervention in obese pregnancy and cardiac remodelling in 3-year olds: children of the UPBEAT RCT

Background/ObjectivesObesity in pregnancy has been associated with increased childhood cardiometabolic risk and reduced life expectancy. The UK UPBEAT multicentre randomised control trial was a lifestyle intervention of diet and physical activity in pregnant women with obesity. We hypothesised that the 3-year-old children of women with obesity would have heightened cardiovascular risk compared to children of normal BMI women, and that the UPBEAT intervention would mitigate this risk.Subjects/MethodsChildren were recruited from one UPBEAT trial centre. Cardiovascular measures included blood pressure, echocardiographic assessment of cardiac function and dimensions, carotid intima-media thickness and heart rate variability (HRV) by electrocardiogram.ResultsCompared to offspring of normal BMI women (n = 51), children of women with obesity from the trial standard care arm (n = 39) had evidence of cardiac remodelling including increased interventricular septum (IVS; mean difference 0.04 cm; 95% CI: 0.018 to 0.067), posterior wall (PW; 0.03 cm; 0.006 to 0.062) and relative wall thicknesses (RWT; 0.03 cm; 0.01 to 0.05) following adjustment. Randomisation of women with obesity to the intervention arm (n = 31) prevented this cardiac remodelling (intervention effect; mean difference IVS −0.03 cm (−0.05 to −0.008); PW −0.03 cm (−0.05 to −0.01); RWT −0.02 cm (−0.04 to −0.005)). Children of women with obesity (standard care arm) compared to women of normal BMI also had elevated minimum heart rate (7 bpm; 1.41 to 13.34) evidence of early diastolic dysfunction (e prime) and increased sympathetic nerve activity index by HRV analysis.ConclusionsMaternal obesity was associated with left ventricular concentric remodelling in 3-year-old offspring. Absence of remodelling following the maternal intervention infers in utero origins of cardiac remodelling.Clinical trial registry name and registration numberThe UPBEAT trial is registered with Current Controlled Trials, ISRCTN89971375.

Impact of Sodium-Glucose Cotransporter-2 Inhibitors on Sympathetic Nervous System Activity Detected by Sympathetic Activity Index and LF/HF Ratio in Patients with Type 2 Diabetes Mellitus.

Cardiac autonomic neuropathy is a serious microvascular complication of type 2 diabetes mellitus that affects a significant portion of patients. Due to decreased parasympathetic activity, the sympathetic nervous system becomes dominant, causing several problems that lead to increased cardiovascular morbidity and mortality. Sodium-glucose cotransporter-2 inhibitors have been shown to reduce sympathetic nervous system activity previously. This is a promising finding for restoring the impaired sympathovagal balance in cardiac autonomic neuropathy. The aim of this study is to evaluate the effect of at least 6 months of sodium-glucose cotransporter-2 inhibitor treatment on sympathetic nervous system activity with sympathetic activity index and heart rate variability parameters in patients with type 2 diabetes mellitus. Holter-electrocardiogram recordings of 50 patients who were using an sodiumglucose cotransporter-2 inhibitor (empagliflozin or dapagliflozin) for at least 6 months and 50 patients who did not were analyzed retrospectively. The sympathetic activity index and heart rate variability parameters of these 2 groups, which were similar in terms of age, gender, hemoglobin A1c, and duration of diabetes, were compared. The ratio of low-frequency to high-frequency power reflecting the sympathovagal balance [-1.495 (-2.165/-1.196) vs. -1.224 (-1.619/-0.863), P=.008] and sympathetic activity index [1.44 (1.06/2.76) vs. 2.47 (1.42/3.68), P=.009] was lower in the sodiumglucose cotransporter-2 inhibitor group than in the control group. In addition, the sympathetic activity index was correlated with the ratio of low-frequency to high-frequency power (r=0.418, P < .001). Sodium-glucose cotransporter-2 inhibitor treatment for at least 6 months was found to result in lower values of sympathetic activity index and the ratio of low-frequency to high-frequency power in patients with type 2 diabetes mellitus. These findings indicate lower sympathetic nervous system activity, which supports the sympathoinhibitor effects of sodiumglucose cotransporter-2 inhibitors.

How are learning experiences and task properties associated with adolescents’ emotions and psychophysiological states?

We examined whether learning experiences (value of success, mastery experience) and task properties (challenge) are related to early adolescents’ (n = 190, median age = 12) emotional responses and psychophysiological states (autonomic nervous system, ANS) in achievement situations in an ambulatory laboratory. They completed four achievement tasks (two math and two reading) at different challenge levels in randomized order, and reported their learning and task perceptions for each task. The proportion of errors indicated the objective demandingness of each task. As indices of sympathetic nervous system activity, we recorded skin conductance response (SCR) and heart rate (HR), and, as parasympathetic nervous system activity, their heart rate variability (HRV). Following control-value and flow theories, we proposed hypotheses for main and interaction effects and specified multilevel models (tasks nested in persons). Novel findings emerged. Aside from the anticipated main effects, Challenge × Mastery interaction also was related to adolescents’ emotions and SCR at the within-person (task) level. Furthermore, Value × Mastery Experience interaction was related to SCR and HRV at the task level, whereas Value × Errors interaction contributed to experienced anger and anxiety at the between-person (individual) level. The findings provide novel understanding of situational interplay between the value of success, challenge, and mastery experience in adolescents’ experienced emotions and psychophysiological states.

EFFECT OF ARTIFICIAL INTELLIGENCE ON ONE-TO-ONE EMOTIONAL REGULATION AND PSYCHOLOGICAL INTERVENTION SYSTEM OF MIDDLE SCHOOL STUDENTS

BackgroundThis study discusses the effectiveness of artificial intelligence in one-to-one psychological intervention system for middle school students. The purpose of this study is to determine whether middle school students have enough trust in AI machines, to explore their internal psychology, and to evaluate the intervention effect of AI in middle school students' one-to-one psychological intervention system.Subjects and Methods76 eighth grade students from two parallel classes in the same grade were randomly assigned to the same teacher. The research tools used include two sets of autonomic nerve detectors produced by South Korean medicore company and two sets of self-developed artificial intelligence one-to-one psychological intervention systems, including two artificial intelligence robots Xiaoxin and two emotional bracelets. 36 students in the intervention group received one-on-one intervention of artificial intelligence robot Xiaoxin, and t-test was conducted on physical stress, psychological stress, stress index, sympathetic nerve activity, stress resistance and average heart rate. Test participants can effectively alleviate psychological stress and prevent depression. The data showed that the DASS-21 comprehensive score of subjects participating in the test was 1.7 times that of subjects not participating in the test. In contrast, without participation, they are more likely to show depression, anxiety and stress, and tend to be passive in simple coping styles. The improved method can effectively alleviate the psychological pressure of employees and improve the ability to actively deal with pressure.ResultsExcept for the four indexes of nerve stress and sympathetic nerve activity, P < 0.001. After the intervention, the average heart rate, physical stress and stress index decreased significantly, while the anti stress ability increased significantly. Statistical analysis shows that the one-to-one intervention of artificial intelligence robot Xiaoxin can effectively alleviate students' physical stress and stress index, and improve students' stress resistance. The intermediary effect analysis of emotional arousal found that the direct effect of anger on MCT fluency was significant, B = 3.80, P < 0.001, CI = [1.99, 5.62], and the indirect effect of arousal on MCT fluency was significant, B = 0.58, CI = [0.08, 1.66]; The direct effect of anger on MCT anger was significant, B = 6.08, P < 0.001, CI = [3.26, 8.89], and the indirect effect of arousal on MCT anger was significant, B = 0.80, CI = [0.08, 2.41]; The direct effect of anger on MCT harmfulness was significant, B = 0.42, P = 0.004, CI = [0.14, 0.69], and the indirect effect of arousal on MCT harmfulness was not significant, B = 0.03, CI = [− 0.03, 0.18]. The direct effect of anger on aut fluency was significant, B = 2.58, P = 0.032, CI = [0.23, 4.92], and the indirect effect of arousal on aut fluency was significant, B = 1.22, CI = [0.27, 2.62]); The direct effect of anger on aut novelty was significant, B = 4.60, P = 0.008, CI = [1.23, 7.96], and the indirect effect of arousal on aut novelty was significant, B = 1.79, CI = [0.42, 3.91] (see Figure 4D). The above results show that emotional arousal plays a partial mediating role in the influence of anger on the fluency and novelty of malicious creativity and general creativity, but it has no mediating role in the influence of anger on the harmfulness of malicious creativity.ConclusionArtificial intelligence one-to-one psychological intervention system is effective. Among the 38 students in the intervention group, this shows that most students have a high sense of trust in the artificial intelligence robot Xiaoxin. This sense of trust is enough to make the artificial intelligence one-to-one psychological intervention system play the role of psychological intervention. We should fully understand the important position of artificial intelligence robot in emotional factors, actively improve its role psychological ability, pay special attention to its impact on life attitude and healthy behavior, and be a healthy self-manager, coordinator and collaborator. According to the psychological characteristics of these groups, we should actively and flexibly organize colorful activities, strive to create a relaxed and harmonious living atmosphere, create a friendly and mutually beneficial emotional artificial intelligence relationship, encourage and guide these groups, adjust their psychology to the best state, and promote the healthy development of their good cognition and life.

Simultaneous beat-to-beat heart rate and systolic blood pressure variability in patients with and without neurally mediated syncope.

Introduction: Autonomic changes play an essential role in the genesis of neurally mediated syncope (NMS). The aim of this study was to compare the changes of the autonomic nervous system (ANS) by measuring spectral indices of beat-to-beat systolic blood pressure and heart rate variability (SBPV and HRV) in ranges of low frequency (LF), high frequency (HF), and the LF/HF ratio during head-up tilt test (HUTT) in patients with and without a syncope response. Methods: In this case-control study of 46 patients with a suspected history of unexplained syncope, data were recorded separately during the typical three phases of HUTT. Patients who developed syncope were designated as the case group and the rest as the control group. Results: Thirty one patients experienced syncope during HUTT. Resting HRV and SBPV indices were significantly lower in cases than controls. After tilting in the syncope group, both HF and LF powers of SBPV showed a significant and gradual decrease. LF/HF in HRV increased in both groups similarly during the test but in SBPV, mainly driven by oscilations in its LF power, it increased significantly more during the first two phases of the test in syncope patients only to paradoxically decrease during active tilt (P< 0.001). Conclusion: Our findings show an abnormal autonomic function in patients with syncope, both at rest and tilting. Fluctuations of spectral indices of beat-to-beat SBPV, a potential noval index of pure sympathetic activity, show an exaggerated response during tilt and its withdrawal before syncope.

Classification of Dichotomous Emotional States Using Electrodermal Activity Signals and Multispectral Analysis.

In this work, an analysis based on complex demodulation is proposed to classify dichotomous emotional states using Electrodermal activity (EDA) signals. For this, annotated happy and sad EDA is obtained from an online public database. The sympathetic activity indices, namely Time-varying (TVSymp) and Modified TVSymp, are computed from the reconstructed EDA signal. Further, the derivative of phasic EDA is calculated from the phasic component obtained using the convex optimization (cvxEDA) based EDA decomposition method. Five statistical features are computed from each index and used for the classification. The results of the classification indicate that these features are capable of differentiating happy and sad emotional states with 75% accuracy. This technique could be effective in the identification of clinical disorders associated with happy and sad emotional states.

Reliability of Heart Rate Variability during Polysomnographic Sleep

Spectral analysis of heart rate variability (HRV) is often used as a noninvasive index of cardiac sympathetic and/or parasympathetic activity during sleep. During controlled wake recordings, the low frequency (LF) component of HRV can be unreliable within experimental sessions and against other direct sympathetic measurements. In contrast, the high frequency (HF) component of HRV has higher reported reproducibility within controlled wake sessions. It remains unknown if the frequency component of HRV is reliable across sleep cycles within individuals during stable sleep. The purpose of the present study was to determine HRV reliability during stable stage II (N2) sleep, slow wave sleep (SWS) and rapid eye movement (REM) sleep. We hypothesized that both LF and HF components of HRV would be less reliable during REM sleep than during SWS and N2 sleep. Twenty‐seven participants (11 male, 16 female, 26±1 years, 27±1 kg/m2) were enrolled in the present study. Overnight polysomnography (PSG; NATUS, Middleton, WI) and continuous two‐lead electrocardiography (ECG) were recorded during an 8‐hour sleep opportunity. The nocturnal ECG recordings were imported into a custom software (WinCPRS, Absolute Aliens, Finland) for analysis of HRV via fast‐Fourier transformation function. Autonomic cardiac activity was quantified as LF (0.04‐0.15 Hz) and HF (0.15‐0.4 Hz) HRV. Two separate stable periods of sleep (range, 5‐10 min) absent of cortical arousal were selected from each sleep stage for comparison. Raw LF and HF HRV underwent logarithmic transformation due to non‐normal distribution. Statistical analysis included bivariate correlation of HRV across differing sleep stage cycles (α = 0.05). LF HRV was significantly correlated across two independent sleep cycles in N2 (r=0.694, p&lt;0.001, n=26), SWS (r=0.765, p&lt;0.001, n=25), and REM sleep (r=0.699, p&lt;0.001, n=20). Similarly, HF HRV was reliable across two independent sleep cycles in N2 sleep (r=0.839, p&lt;0.001, n=26), SWS (r=0.765, p&lt;0.001, n=25), and REM sleep (r=0.881 p&lt;0.001, n=21). Taken together, both LF and HF HRV measures were reliable across stable N2, SWS, and REM sleep. Our results support the reliability of frequency domain analysis of HRV during key PSG sleep stages within a single night, but further research across nights is warranted.