Parasympathetic Function Research Articles

Relationship between cardiac parasympathetic dysfunction and the anteroposterior diameter of the medulla oblongata in multiple system atrophy.

Neurodegeneration of the nucleus ambiguus and the dorsal vagal motor nucleus has been implicated in cardiac parasympathetic dysfunction in multiple system atrophy (MSA). The nucleus ambiguus and the dorsal vagal motor nucleus, which are located in the medulla oblongata (MO), control the autonomic-specifically, the parasympathetic-functions of the body. The aim of our study was to investigate the relationship between cardiac parasympathetic dysfunction and the anteroposterior diameter of the MO in MSA by quantitatively analyzing magnetic resonance imaging (MRI) outcome measures. We retrospectively assessed 40 consecutive patients with probable MSA and 25 age- and sex-matched controls. The anteroposterior diameter of the MO at two locations (MO diameter-A and -B) and the diameters of the midbrain and pons were measured by conventional MRI. A cardiac parasympathetic function score (CP-score) and cardiac sympathetic function score (CS-score) were generated by calculating the z-scores of multiple autonomic function tests. The relationship between the scores and the measured diameters of the brainstem was also investigated. The CP-score and CS-score were significantly lower in the patients with MSA than in the controls (CP-score: 0.61 ± 0.75 vs. - 0.38 ± 0.52, p < 0.001; CS-score: 0.91 ± 1.06 vs. - 0.57 ± 1.07, p < 0.001). Also, in the patients with MSA, the CP-score was significantly correlated with MO diameter-A (r = 0.40, p = 0.010), and the CS-score was significantly correlated with the diameter of the midbrain (r = 0.33, p = 0.038). The anteroposterior diameter of the MO is a potential imaging marker of parasympathetic dysfunction in MSA.

Probing age-related changes in cardio-respiratory dynamics by multimodal coupling assessment.

Quantifying respiratory sinus arrhythmia (RSA) can provide an index of parasympathetic function. Fourier spectral analysis, the most widely used approach, estimates the power of the heart rate variability in the frequency band of breathing. However, it neglects the time-varying characteristics of the transitions as well as the nonlinear properties of the cardio-respiratory coupling. Here, we propose a novel approach based on Hilbert-Huang transform, called the multimodal coupling analysis (MMCA) method, to assess cardio-respiratory dynamics by examining the instantaneous nonlinear phase interactions between two interconnected signals (i.e., heart rate and respiration) and compare with the counterparts derived from the wavelet-based method. We used an online database. The corresponding RSA components of the 90-min ECG and respiratory signals of 20 young and 20 elderly healthy subjects were extracted and quantified. A cycle-based analysis and a synchro-squeezed wavelet transform were also introduced to assess the amplitude or phase changes of each respiratory cycle. Our results demonstrated that the diminished mean and standard deviation of the derived dynamical RSA activities can better discriminate between elderly and young subjects. Moreover, the degree of nonlinearity of the cycle-by-cycle RSA waveform derived from the differences between the instantaneous frequency and the mean frequency of each respiratory cycle was significantly decreased in the elderly subjects by the MMCA method. The MMCA method in combination with the cycle-based analysis can potentially be a useful tool to depict the aging changes of the parasympathetic function as well as the waveform nonlinearity of RSA compared to the Fourier-based high-frequency power and the wavelet-based method.

EVALUATION OF CARDIOVASCULAR AUTONOMIC FUNCTIONS IN MIGRAINE INDIVIDUALS IN TERTIARY CARE HOSPITAL

Introduction: Migraine is a chronic neurological disorder characterized by recurrent disabling attacks of a headache with heterogeneous characterized by headache and hypersensitivity to sensory stimuli. Migraine attacks can depend upon from multitude of causative factors like diet, stress, fatigue, environmental changes and hormonal changes among others. It causes painful condition where individuals suffer from recurrent episodes of headache, which could be very severe. Pain sensations are discerned at various levels of the nervous system. Migraine as one of the top 20 leading neurological causes of disability according to WHO. About 12% of world’s population suffers from migraine and in India about of 1200 million populations there are 150-200 million migraineurs under treatment. About 20% in females and 6% in males has prevalence of migraine. Migraine is define as a heterogeneous disorder where there is variation in attacks in duration, frequency, severity, character and associated with physical and emotional disability. There is anxiety and panic disorder with sympathetic over activity with stress being the most important triggering factor. Migraine is also associated with ischemic stroke. Autonomic nervous system (ANS) plays central role in the cascade of events leading to migraine attack. &#x0D; Aim: The main aim of this study is to testing migraine on cardiac autonomic functions and finding the sympathetic or parasympathetic dysfunction in the heart that relates with the pathogenesis of migraine. &#x0D; Material and methods: This study was carried out in the Dept. of Physiology at Chandulal Chandrakar Memorial Medical College Kachandur, Durg.. In this study total 60 individuals were included from ages 20 to 50 years with 30 in each group. Two groups were included in this study. Migraine fulfilling International Headache Society (IHS) criteria for migraine consists of newly diagnosed cases were included in this study. Participant’s individuals were instructed about various manoeuvres that would be employed and allowed to practice these manoeuvres. ECG was acquired by continuous recording for 5 min (320 s) which is needed for short term ECG analysis. Mean respiratory rate (RR), mean HR, total power, low frequency (LF), high frequency (HF), and LF/HF were estimated as proposed by Wang and Mishra(2006). Both the sympathetic and parasympathetic reactivity of ANS test were done with Orthostatic standing test (OST) as well as deep breathing (DB) which tests the intactness of parasympathetic function were performed after giving enough rest in between the tests. Isometric handgrip (IHG) test and cold pressor (CP) test were also performing for evaluating the sympathetic reactivity. &#x0D; Result: Total 30 patients were include in each group with mean age of control group 33.3 ± 5.6 and mean age of case group 30.9 ± 8.6. 24 cases in controls and 26 in cases group there is Female dominant which shown females are more prone to migraine. While compares the resting HR, diastolic blood pressure (DBP) and systolic blood pressure (SBP), between the cases and controls as shown in table no 1. There was not significant between Mean value for HR and mean value of DBP between cases and control. However mean value of SBP showed a P = 0.001 which was highly significant. The mean value of HR, RR interval and total power were also not statistically significant as P &gt; 0.05. &#x0D; Conclusion: Evaluation of cardiovascular functions in migraine reveals sympathetic hypofunction with an intact parasympathetic activity which as indicated by a significant reduction of sympathetic modulation of RR intervals. Better understanding of the role of sympathetic function and its dysfunction may help to prevent or successfully treat migraine and other headaches.&#x0D; Keywords: Migraine, Autonomic function, Sympathetic activity, Headache

Knowledge, Perception and Seroprevalence of HIV/STIS among Young Adults in Brazilian Amazon Region: A Population-Based Study

Background: Neurological complications involving central and peripheral nervous system are well described but there is paucity of literature on involvement of autonomic nervous system. HIV patients on ART have a higher prevalence of symptoms due to dysautonomia in comparison to normal individuals. Aims and objectives: To study the prevalence of cardiac autonomic dysfunction in PLHA (People living with HIV/ AIDS) with and without antiretroviral treatment. Methodology: It is a cross sectional study. The subjects are broadly divided into 3 categories with 25 patients in each group. PLHA on ART, PLHA not on ART and healthy controls. Observation and results: Three patients from ART group two from ART naive group had symptoms of syncope. There was a significant difference between the autonomic parameters in the control population as compared to that of PLHA, but no difference between those on ART and not on ART. The resting heart rate was significantly higher in PLHA compared to controls. On testing for sympathetic response, there was no notable difference between the median values of fall in systolic blood pressure between PLHA patients and control population. Respiratory sinus arrhythmia, expiration to inspiration ratio, in the controls was higher when compared to PLHA There is a significant difference in fall in systolic blood pressure between the HIV on ART and not on ART, however there was no significant difference in other autonomic parameters. Conclusion: This study shows that deterioration of parasympathetic function is more common than sympathetic function decline in HIV infected subjects as compared to normal population.

Abstract WP377: Heart Rate Variability Biofeedback Improves Cardiac Autonomic Function in Patients With Acute Ischaemic Stroke: A Randomized Controlled Study

Introduction: In patients with acute ischaemic stroke (AIS) dysregulation of cardiac function with decreased heart rate variability (HRV) due to impaired integrity of the autonomic nervous system is a frequent complication which is associated with increased mortality and worsening of clinical outcome. HRV biofeedback has previously been suggested to improve cardiac autonomic function by increasing parasympathetic tone. Hypothesis: We hypothesized that HRV biofeedback can be used to complement stroke unit care and alleviate autonomic cardiac dysfunction following AIS. Methods: We randomly allocated patients with AIS to either receive 9 sessions of HRV (n=24) or sham (n=24) biofeedback in addition to standard stroke unit care. These patients underwent detailed assessment of autonomic cardiac function including analysis of HRV via standard deviation of NN intervals (SDNN) and spectral analysis. Furthermore, we assessed vasomotor and sudomotor autonomic function, severity of autonomic symptoms and neurological and functional outcomes. Results: We included 48 patients (19 females, ages 65±14 years, baseline NIHSS 2.2 ± 2.2, mean ± standard deviation). Patients who had undergone HRV biofeedback displayed improved cardiac function compared to baseline (SDNN 72.6 ± 52.4 ms vs. 45.5 ± 34.7 ms, p&lt;0.01) which was not seen in those who received sham biofeedback (p=ns). Similar changes were seen on spectral analysis measures of parasympathetic function (p&lt;0.01). Improvement of autonomic cardiac function following HRV biofeedback was paralleled by decreased severity of autonomic symptoms (p&lt;0.05). Contrasting our observation of an increase in predominantly parasympathetic parameters such as CVNN, sympathetic measures of sudomotor and vasomotor function remained unchanged in both groups (p=ns). Neurological and functional outcomes were unchanged immediately post intervention, however 3-month follow up is yet to be completed. Discussion: HRV biofeedback can modulate autonomic cardiac function post AIS to increase HRV and alleviate autonomic symptoms which might be beneficial in facilitating recovery from functional impairment. This seems to be mediated by a predominantly parasympathetic mechanism of action.

Toward a social psychophysiology of vagally mediated heart rate variability: Concepts and methods in self‐regulation, emotion, and interpersonal processes

AbstractTheory and research on self‐regulation, emotional adjustment, and interpersonal processes focus increasingly on parasympathetic functioning, using measures of vagally mediated heart rate variability (vmHRV) or respiratory sinus arrhythmia (RSA). This review describes models of vmHRV in these areas, and issues in measurement and analysis. We propose a framework organizing theory and research as examining (a) vmHRV as an individual difference or a situational response, and (b) resting, reactive, or recovery levels. Evidence supports interpretation of individual differences in resting vmHRV as a broad biomarker for adaptive functioning, but its specificity and underlying mechanisms require elaboration. Individual differences in vagal reactivity (i.e., trait‐like differences in vmHRV decreases during challenge or stress) are less commonly studied in adults and results are mixed. Many stressors and challenges evoke temporary decreases in vmHRV, and in some research self‐regulatory effort evokes increases. In a smaller literature, positive interpersonal experiences and some restorative processes increase resting vmHRV, whereas depletion of self‐regulatory capacity through related effort decreases it. Greater attention to conceptual distinctions regarding vmHRV constructs and several methodological issues will strengthen future research. Importantly, researchers should exercise caution in equating vmHRV with specific psychosocial constructs, especially in the absence of converging assessments and precise experimental manipulations.

Study of the Distribution of Epicardial Vagal Ganglion and the Relationship Between Delayed Enhancement Magnetic Resonance Imaging and Radiofrequency Ablation in Patients with Atrial Fibrillation

This article presents a retrospective study of patients undergoing radiofrequency ablation of atrial fibrillation (AF); analyzes the characteristics of heart rate variability (HRV) in patients; and explores the role of delayed enhancement magnetic resonance imaging and autonomic nervous system function, changes in autonomic nervous system function, and recurrence of AF after radiofrequency ablation to understand the effect of denervation of the autonomic nervous system on the efficacy of radiofrequency ablation of AF. The study found that there were no significant differences in clinical baseline characteristics, mean heart rate, and HRV indicators between patients without relapse and patients with relapse (P > 0.05). The overall HRV index was significantly reduced after surgery as well as before surgery. In the relapse-free group, the high-frequency power that responded to vagal tone was more significant, the low-frequency/high-frequency power ratio increased, and other HRV indicators were significantly reduced; in the relapse group, mean heart rate increased, sympathetic response to the low-frequency power of nerve tension was significantly reduced, and the low-frequency/high-frequency power ratio was decreased. The difference was statistically significant (P < 0.05). Therefore, sympathetic and parasympathetic nerve function were significantly reduced after radiofrequency ablation of the pulmonary veins in patients with AF. Reducing vagus nerve tension may inhibit early recurrence of paroxysmal AF in patients after left atrial ring pulmonary vein ablation.

Correlation between cotinine urinary levels & cardiovascular autonomic function tests among smokeless tobacco chewers: A cross-sectional study.

Background & objectives:Cardiovascular disease (CVD), the leading cause of death worldwide is responsible for over 17 million deaths globally, of which 10 per cent deaths have been expected due to consumption of tobacco. The association between CVD and chewing of tobacco is limited and remains arguable. The aim of this study was to find out the correlation between urinary cotinine level and cardiovascular autonomic function tests of tobacco chewers.Methods:In the present study, 600 participants, 300 smokeless tobacco chewers (STC) and 300 non-tobacco chewers (NTC), between 18 and 65 yr were selected. Various parameters such as anthropometric, systolic blood pressure (SBP), diastolic blood pressure (DBP), autonomic function tests and urinary cotinine levels were measured.Results:Significant difference (P<0.001) was noted in STC and NTC for anthropometric parameters, SBP, DBP and urinary cotinine levels. Sympathetic and parasympathetic autonomic function test showed significant difference on comparison in STC and NTC groups, except in Valsalva ratio. Correlations with urinary cotinine levels were significant for sympathetic autonomic functions, SBP fall (r=0.138, P=0.016), DBP rise (r=−0.141, P≤0.014); parasympathetic autonomic function, heart rate (HR) response to standing (r=−0.208, P≤0.003), deep breathing (r=−0.473, P≤0.001) and Valsalva ratio (r=−0.396, P≤0.0001).Interpretation & conclusions:Correlation between urinary cotinine levels and autonomic function tests elucidates the linkage involving autonomic nervous system damage which can be considered as an important associated relationship for early diagnosis of CVD health risk factors among smokeless tobacco (ST) users.

Reducing suicidal ideation by biofeedback-guided respiration – heart rate coherence

Background Effectiveness of heart rate variability (HRV) biofeedback is dependent on the relationship between the measured respiratory-heart rate coherence (C HR) and the resonant frequency (RFB) breathing. C HR is driven by the central autonomic network which consists of the interplay between the components of the autonomic nervous system, brainstem modulatory nuclei and cortical function. The extent to which heart rate is in coherence with respiratory frequency and the function of the central autonomic network in major depressive disorder (MDD) and suicidal ideation (SI) has not been investigated. Method: Sixty-one patients provided informed consent to participate and were divided into no MDD (CONT), MDD and an MDD plus SI (MDDSI) group. HRV activity was determined by multi lag tone-entropy (T-E) and respiratory-C HR at rest was characterized by the relationship between respiratory rate and heart rate. Results: CONT had the highest entropy compared to the MDDSI group, which had the lowest entropy and highest tone (p < 0.05). Autonomic parasympathetic function was also significantly lower in the MDDSI compared to the MDD group (p < 0.05). C HR indicated a significant phase desynchronization (decrease in coherence) between MDDSI, MDD and CONT (p < 0.05), with MDDSI having the lowest coherence and CONT the highest. Conclusion: T-E analysis indicated that HRV was significantly different in patients with SI. C HR as measured by our proposed synchronization index provides a novel feature to adapt HRV biofeedback to individual psychiatric profiles and may provide better clinical outcomes for this patient group.

Parasympathetic Dysfunction in Black African Patients with Heart Failure: A Cross-Sectional Study in Sub-Saharan Africa

Background: Heart Failure (HF) is a major public health problem worldwide. Neurohormonal changes associated with HF are current therapeutic targets. The parasympathetic system in HF has not been well studied especially in black Africans. Aim: This study aimed to report on the prevalence and determinants of parasympathetic dysfunction in patients with heart failure in sub-Saharan Africa. Methods: We conducted a cross-sectional study between December 2017 and April 2018 in the outpatient and inpatient departments in two teaching hospitals in Yaounde-Cameroon. Cases were patients with HF matched with controls without HF according to age, sex, and risk factors (hypertension, diabetes, and obesity). We assessed the parasympathetic function via the Deep Breathing Test using an electrocardiograph. Results: We recruited 35 patients in each group. The mean age was 57 ± 11.68 years. Vagal dysfunction was seen in 51.4% of cases and 11.4% of controls (aOR: 10.1 [95% CI: 2.7 - 38.3], p = 0.001). This risk increased with the severity of HF-aOR: 11.8, [95% CI: 1.8 - 77.9], p = 0.01 for dyspnea stage III-IV, and aOR: 9.27, [95% CI: 1.3 - 65.3], p = 0.025) for HF with reduced Ejection fraction. This risk was not associated with the classic cardiovascular risk factors. Conclusion: Parasympathetic dysfunction as assessed with the Deep Breathing Test was seen in over half of the patients with HF and this was associated with the severity and type of HF.

A cross-sectional study on cardiac autonomic functions in psoriasis patients

Background: Psoriasis is a chronic, genetically determined and immune-mediated inflammatory disease of unknown etiology with a prevalence of 0.44–2.8% in India. The literature reports an increased risk of cardiovascular diseases in psoriatic patients. The present study was designed to explore the autonomic nervous system functions in psoriatic patients. Aim and Objective: The objective of the present study was to assess cardiac autonomic functions in psoriasis patients aged 30–40 years as compared to age- and sex-matched healthy controls. Materials and Methods: The present study was conducted in the Department of Physiology, SMS Medical College, Jaipur. Forty psoriatic patients of both genders were recruited from the Dermatology Department and forty, age- and gender-matched healthy subjects were taken as controls subjects from among employees of SMS Medical College, Jaipur. Prior approval and consent were obtained by the institutional ethics committee and institutional research review board. Parasympathetic function tests include E:I ratio, 30:15 ratio (lying to standing ratio), and Valsalva ratio; sympathetic function tests included blood pressure (BP) response to standing and sustained hand grip. Results: Change in diastolic BP during isometric hand grip exercise was significantly lower in psoriasis patients (P < 0.05). Change in systolic BP on immediate standing was higher in psoriasis group (P < 0.05). E:I ratio, Valsalva ratio, and 30:15 ratio were also significantly decreased (P < 0.05) in psoriasis patients as compared to the healthy controls. Conclusion: The deranged autonomic function tests in psoriasis patients suggested definite cardiac autonomic dysfunction. Autonomic dysfunction might put the psoriasis patients at greater cardiovascular disease risk. Therefore, autonomic function assessment of psoriasis patients is necessary for a better prognosis.

Povezanost nivoa adipocitokina sa telesnom kompozicijom i indeksima oporavka srčane frekvencije

Introduction: Adipose tissue as an endocrine organ primarily regulates metabolism of carbohydrates and lipids. Anorexigenic hormone leptin increases sympathetic activity and decreases insulin secretion, thereby reducing energy depots, while adiponectin elevates tissue sensitivity to insulin, which role visfatin imitates. Heart rate recovery index (DHRR), linked with insulin resistance syndrome, reflects parasympathetic function. Our goal was to analyze correlation between adipocytokines with body composition and DHRR in athletes and sedentary controls. Material and methods: Research included 19 volleyball and water polo national team members (mean age 19.26 ± 1.94 years) and 13 physically inactive male students (mean age 20.46 ± 1.13 years). Anthropometric data were measured and blood samples for hormone analysis were taken: at the beginning, the end and 30 minutes after finishing ergospirometry. Statistical evaluation was performed using: Student's t-test, Mann-Whitney, Wilcoxon's and Spearman's rank correlation test. Results: Adiponectin levels between dependent and independent variables didn't show statistical significance. Leptin level, noteworthy lower in athletes, at the beginning and the end of the test (p &lt; 0.001 and p = 0.001, respectively), was declining in students in every before-after study aspect (p &lt; 0.001 in each case). Visfatin was higher in sportsmen at the end of the test and 30 minutes later (p &lt; 0.001 in both cases), but their levels decreased comparing the beginning and 30 minutes after the test (p = 0.02). Body height, VO2 max and DHRR3 were considerably higher in athletes, just as BMI, BF% and HR in the third minute of recovery were in controls (p &lt; 0.05). Sportsmen had moderately strong negative correlation of visfatin with BF% (p = 0.002, RS = -0.674), whilst leptin showed moderately strong positive correlation with BMI and BF% (p = 0.002, RS = -0.657 and p = 0.011, RS = 0.567), respectively. Controls demonstrated strong and moderately strong positive correlation between leptin with DHRR1 (p = 0.008, RS = 0.702) and DHRR3 (p = 0.018, RS = 0.641), respectively. Conclusion: Research showed positive correlation between visfatin with BF% and leptin with BMI and BF% in athletes, considering small number of participants.

Cardiovascular Autonomic Function in Normotensive Men with High Salt and Low Salt Intakes

Background and Aim: The autonomic nervous system may play an important role in saltinduced increases in blood pressure (BP). The aim of this study is to assess and compare the heart rate (HR) responses to Valsalva maneuver, deep breathing and standing and BP responses to standing and sustained handgrip between normotensive men with habitual high salt intake (HSI) and low salt intake (LSI). Methods: Twenty-fourty years old normotensive men (n=34; n=17 for HSI and n=17 for LSI) were recruited by collecting 4 early morning spot urine samples. Average estimated 24-hr sodium (Na+) excretion of 4 urine samples of ≥166 mmol/day was regarded as HSI and &lt;115 mmol/day as LSI. Heart rate responses to Valsalva maneuver, deep breathing and standing (parasympathetic function tests) and BP responses to standing and sustained handgrip (sympathetic function tests) were investigated in both groups. Results: Valsalva ratio (VR) [1.64±0.36 (HSI) vs 1.78±0.49 (LSI)], deep breathing difference (DBD) [24.51±9.56 beats/min (HSI) vs 22.93±6.37 beats/min (LSI)] and 30:15 ratio [1.34 (1.12–1.46) (HSI) vs 1.19 (1.13–1.52) (LSI)] were not significantly different in both groups. Systolic blood pressure (SBP) change from lying to standing [-0.67 (-4.00–9.00) mmHg (HSI) vs 0.00 (-3.34–2.34) mmHg (LSI)] was not significantly different between the two groups whereas diastolic blood pressure (DBP) rise in sustained handgrip [18.20±3.49 mmHg (HSI) vs 14.77±4.71 mmHg (LSI)] was significantly higher in the HSI (p=0.022). Conclusion: Cardiovascular sympathetic activity appears to increase in normotensive men with habitual high salt intake.

Effects of a 12-Minute Smartphone-Based Mindful Breathing Task on Heart Rate Variability for Students With Clinically Relevant Chronic Pain, Depression, and Anxiety: Protocol for a Randomized Controlled Trial.

BackgroundMindfulness meditation (MM) is a commonly used psychological intervention for pain, mood, and anxiety conditions, but can be challenging to practice with severe symptoms without proper training. The Mindfulness Meditation app (MMA) is a supportive training tool specifically developed for this study to aid in the practice of mindful breathing using a smartphone.ObjectiveThis study aims to evaluate the psychophysiological effects of the MMA. Specifically, the study will assess parasympathetic functioning using heart rate variability (HRV; primary outcome), pain and mood symptoms, mind-wandering and present moment awareness, and breath focus in groups of undergraduate participants who self-report clinically-relevant symptoms of chronic pain (CP) and depression or anxiety (DA) and condition-free (CF) participants who do not meet either criteria. We hypothesize that use of the MMA by study groups will lead to improved HRV, pain, and mood symptoms compared with groups who do not use the app.MethodsThis study is a two-arm randomized controlled trial (RCT) recruiting through a Web-based research participation pool at York University in Toronto, Canada. We are aiming for minimum 60 participants in each of CP, DA, and CF groups. Upon arriving to the laboratory, participants will be prescreened for classification into groups of CP, DA, or CF. Groups will be randomly assigned by a 1:1 ratio to an MMA (MMA+) condition or MM condition without the app (MMA−) after a brief stress induction procedure. In MMA+, participants will practice mindful breathing with a smartphone and press breath or other buttons at the sound of audio tones if their awareness was on breathing or another experience, respectively. HRV and respiration data will be obtained during rest (5 min), stress induction (5 min), and meditation conditions (12 min). Participants will complete psychological self-report inventories before and after the stress induction and after the meditation condition. Separate linear mixed models will be used to examine HRV and self-report inventories comparing groups and treatment conditions.ResultsRecruitment for the study began in November 2017 and is expected to be completed in winter of 2019-2020. As of July 2019, 189 participants have been recruited. The study’s main findings are expected to reveal a positive pattern of HRV responses in the CP, DA, and CF groups, such that a significant increase in HRV (P<.05) is detected in those randomized to the MMA+ condition in comparison with those randomized to the MMA− condition.ConclusionsThis RCT will contribute to the burgeoning health psychology literature regarding the clinical relevance of HRV in assessment and treatment of psychological and medical conditions. Furthermore, possible ways to inform designs of MM training tools delivered by apps and Web platforms for CP, depression, and anxiety conditions’ treatment will be discussed.Trial RegistrationClinicaltrials.gov NCT03296007; https://clinicaltrials.gov/ct2/show/NCT03296007.International Registered Report Identifier (IRRID)DERR1-10.2196/14119

TO FIND OUT THE VARIATION OF SYMPATHETIC & PARASYMPATHETIC TESTS BETWEEN MALE & MENSTRUAL PHASE OF MENSTRUAL CYCLE IN FEMALE.

The hormonal fluctuations that occur during normal menstrual cycle has profound influence on autonomic functions. This influence on autonomic nervous system may affect cardiovagal control. The aim of the study is to find out the variation of Parasympathetic function tests during different phases of menstrual cycle in young healthy females.&#x0D; The mean E:I ratio in Menstrual Phase of menstrual cycle in females is 1.34 ± 0.06.&#x0D; The mean E:I ratio in males is 1.41 ± 0.12.&#x0D; The mean Postural SBP in Menstrual Phase of menstrual cycle in females is 97.76 ± 5.13 mmHg. The mean Postural SBP in males is 103.24 ± 6.88 mmHg.&#x0D; The study concludes that there was statistically significant heart rate variability during three phases of the menstrual cycle, as observed by the increased sympathetic discharge in the luteal phase compared to the increased parasympathetic discharge in the follicular phase. The results of our study have emphasized the complexity of the relationship between ovarian steroids and various hemodynamic regulatory systems.&#x0D; Keywords: Sympathetic, Parasympathetic &amp; Menstrual.

Efeitos da massagem terapêutica em recém-nascidos prematuros na unidade de terapia intensiva neonatal: uma revisão sistemática

INTRODUÇÃO: A Unidade de Terapia Intensiva Neonatal (UTIN) é o local para recém-nascidos de risco que necessitam de cuidados contínuos. A massagem terapêutica é um toque sistemático das mãos humanas que contribui para o ganho de peso, diminui as respostas à dor e diminui a permanência no hospital. OBJETIVO: Revisar os efeitos sistêmicos da massagem terapêutica em prematuros Na Unidade de Terapia Intensiva Neonatal. METODOLOGIA: Esta é uma revisão sistemática. Foi realizada uma busca nas bases de dados Pubmed, Scielo e Lilacs, sem restrições relacionadas ao ano de publicação. Apenas ensaios clínicos randomizados foram incluídos neste estudo, com uma amostra de indivíduos de ambos os sexos, com menos de 28 dias de idade e abordando massoterapia relacionada a respostas sistêmicas em prematuros na unidade de terapia intensiva neonatal. Foram excluídos os estudos relacionados ao exercício físico, uso de medicamentos, estimulação oral e efeitos gastrointestinais relacionados à massagem. Foram utilizados os seguintes descritores: “massagem” AND “recém-nascido prematuro” OR “prematuro” OR “prematuro” AND “unidades de terapia intensiva neonatal”. RESULTADOS: Dos seis artigos incluídos nesta revisão, cinco apresentaram resultados satisfatórios sobre os efeitos sistêmicos da massagem terapêutica em recém-nascidos prematuros, como ganho de peso, diminuição da permanência na UTIN, melhora da função do sistema nervoso parassimpático e aumento da citotoxicidade celular de células assassinas naturais. Apenas um estudo relata que a massagem terapêutica não induz o sono. CONCLUSÃO: A massagem terapêutica produz efeitos benéficos sistêmicos em prematuros internados na Unidade de Terapia Intensiva Neonatal.

Cardiovascular autonomic function and MCI in Parkinson's disease

Introductiondysautonomic dysfunction and cognitive impairment represent the most disabling non-motor features of Parkinson's Disease (PD). Recent evidences suggest the association between Orthostatic Hypotension (OH) and PD-Dementia. However, little is known on the interactions between cardiovascular dysautonomia and Mild Cognitive Impairment (MCI). We aimed to evaluate the association between cardiovascular dysautonomia and MCI in patients with PD. Methodsnon-demented PD patients belonging to the PACOS cohort underwent a comprehensive instrumental neurovegetative assessment including the study of both parasympathetic and sympathetic function (30:15 ratio, Expiratory-Inspiratory ratio [E-I] and presence of Orthostatic Hypotension [OH]). Diagnosis of MCI was made according to the MDS criteria level II. Resultswe enrolled 185 PD patients of whom 102 (55.1%) were men, mean age was 64.6 ± 9.7 years, mean disease duration of 5.6 ± 5.5 years with a mean UPDRS-ME score of 31.7 ± 10.9. MCI was diagnosed in 79 (42.7%) patients. OH was recorded in 52 (28.1%) patients, altered 30:15 ratio was recorded in 39 (24.1%) patients and an altered E-I ratio was found in 24 (19.1%) patients. Presence of MCI was associated with an altered 30:15 ratio (adjOR 2.83; 95%CI 1.25–6.40) but not with an altered E-I ratio, while OH was associated only with the amnestic MCI subgroup (OR 2.43; 95% CI 1.05–5.06). Conclusionin our study sample, MCI was mainly associated with parasympathetic dysfunction in PD.

Youth Parasympathetic Functioning Moderates Relations between Cumulative Family Risk and Internalizing Behaviors

Problematic family functioning places young adolescents at risk for internalizing behaviors. However, not all adolescents who experience family risk develop internalizing behaviors during early adolescence. Informed by a cumulative risk perspective, the current study examined whether associations between cumulative family risk, as well as particular family risk domains, and youth internalizing behaviors are moderated by youth parasympathetic reactivity. Participants include 68 young adolescents in 6th grade. Youth were 56% female, 41% African American, and 54% European American. For young adolescents who experienced higher change in respiratory sinus arrhythmia during a challenge/stressor task, greater cumulative family risk, exposure to more family risk domains, and several particular risk factors (maternal psychological well-being, marital/family system risk), were associated with higher levels of internalizing behaviors. The findings from this study demonstrate that the extent to which both particular family risk factors and cumulative family risk place youth at increased risk for internalizing behaviors depends on youth's parasympathetic functioning.

Parasympathetic Function: Relevance and Methodology for Early Education Research

Early childhood education programs, and particularly those designed to reduce gaps in school readiness between children in poverty and their more affluent peers, have increasingly addressed children’s self-regulatory abilities – their ability to manage behaviors, emotions, and cognitive processes. Although self-regulation is typically defined in volitional terms, the activity of multiple, involuntary, neurophysiological systems scaffolds the development of effortful self-regulation. In this article, we argue that the activity of one of these neurophysiological systems, the parasympathetic nervous system (PNS), is directly relevant to the design and evaluation of early childhood education programs, given that the PNS makes moment-to-moment adjustments in children’s metabolic output to support their interaction with the classroom environment. We go on to explain how examining PNS activity while children are in the early education classroom may offer insight into how early education programs achieve their effects and for whom these effects are most-fully realized. We conclude by offering a summary of modern methods of parasympathetic data collection and cleaning drawn from a recent study of young children in an early education environment and discussing the implications of these methods for future research.

Neural tracking of musical rhythm reflected in the autonomic nervous system

Humans start responding to music even before birth, and one particular measure, heart rate variability (HRV), reflecting the parasympathetic nervous system (PNS) function, has been shown to respond to a music stimulus and to music therapy in the NICU. However, whether and how HRV is related to musical rhythm processing has not been examined. A group of adults (N = 15) passively listened to duple and triple rhythmic patterns while we measured their neural tracking of the rhythmic patterns and PNS function simultaneously using MEG and ECG. Results showed that adults’ neural tracking of beat level rhythm is 2.5 times stronger than their tracking of meter level rhythm, regardless of the energy of the beat and meter in the stimulus. Moreover, this ratio is significantly related to HRV across individuals. That is, the stronger an individual’s brain tracks the meter level rhythm, the higher the HRV, indicating a higher level PNS function (i.e., lower stress). This relation is not affected by an individual’s experience with music training. Data collection in infants (7-month and 11-month) is currently ongoing and the results will be discussed in relation to the adult findings.