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Ritz T. How to account for respiration in respiratory sinus arrhythmia: Publication standards for heart rate variability studies in Biological Psychology. Biol Psychol 2024; 190:108806. [PMID: 38718885 DOI: 10.1016/j.biopsycho.2024.108806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2024] [Accepted: 04/24/2024] [Indexed: 05/18/2024]
Affiliation(s)
- Thomas Ritz
- Department of Psychology, Southern Methodist University, 6116 North Central Expressway, Suite 1160, Dallas, TX 75206, USA.
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Sparacino L, Antonacci Y, Barà C, Švec D, Javorka M, Faes L. A method to assess linear self-predictability of physiologic processes in the frequency domain: application to beat-to-beat variability of arterial compliance. FRONTIERS IN NETWORK PHYSIOLOGY 2024; 4:1346424. [PMID: 38638612 PMCID: PMC11024367 DOI: 10.3389/fnetp.2024.1346424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 03/19/2024] [Indexed: 04/20/2024]
Abstract
The concept of self-predictability plays a key role for the analysis of the self-driven dynamics of physiological processes displaying richness of oscillatory rhythms. While time domain measures of self-predictability, as well as time-varying and local extensions, have already been proposed and largely applied in different contexts, they still lack a clear spectral description, which would be significantly useful for the interpretation of the frequency-specific content of the investigated processes. Herein, we propose a novel approach to characterize the linear self-predictability (LSP) of Gaussian processes in the frequency domain. The LSP spectral functions are related to the peaks of the power spectral density (PSD) of the investigated process, which is represented as the sum of different oscillatory components with specific frequency through the method of spectral decomposition. Remarkably, each of the LSP profiles is linked to a specific oscillation of the process, and it returns frequency-specific measures when integrated along spectral bands of physiological interest, as well as a time domain self-predictability measure with a clear meaning in the field of information theory, corresponding to the well-known information storage, when integrated along the whole frequency axis. The proposed measure is first illustrated in a theoretical simulation, showing that it clearly reflects the degree and frequency-specific location of predictability patterns of the analyzed process in both time and frequency domains. Then, it is applied to beat-to-beat time series of arterial compliance obtained in young healthy subjects. The results evidence that the spectral decomposition strategy applied to both the PSD and the spectral LSP of compliance identifies physiological responses to postural stress of low and high frequency oscillations of the process which cannot be traced in the time domain only, highlighting the importance of computing frequency-specific measures of self-predictability in any oscillatory physiologic process.
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Affiliation(s)
- Laura Sparacino
- Department of Engineering, University of Palermo, Palermo, Italy
| | - Yuri Antonacci
- Department of Engineering, University of Palermo, Palermo, Italy
| | - Chiara Barà
- Department of Engineering, University of Palermo, Palermo, Italy
| | - Dávid Švec
- Department of Physiology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovakia
| | - Michal Javorka
- Department of Physiology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovakia
| | - Luca Faes
- Department of Engineering, University of Palermo, Palermo, Italy
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3
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Hermann B, Candia‐Rivera D, Sharshar T, Gavaret M, Diehl J, Cariou A, Benghanem S. Aberrant brain-heart coupling is associated with the severity of post cardiac arrest brain injury. Ann Clin Transl Neurol 2024; 11:866-882. [PMID: 38243640 PMCID: PMC11021613 DOI: 10.1002/acn3.52000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 12/24/2023] [Indexed: 01/21/2024] Open
Abstract
OBJECTIVE To investigate autonomic nervous system activity measured by brain-heart interactions in comatose patients after cardiac arrest in relation to the severity and prognosis of hypoxic-ischemic brain injury. METHODS Strength and complexity of bidirectional interactions between EEG frequency bands (delta, theta, and alpha) and ECG heart rate variability frequency bands (low frequency, LF and high frequency, HF) were computed using a synthetic data generation model. Primary outcome was the severity of brain injury, assessed by (i) standardized qualitative EEG classification, (ii) somatosensory evoked potentials (N20), and (iii) neuron-specific enolase levels. Secondary outcome was the 3-month neurological status, assessed by the Cerebral Performance Category score [good (1-2) vs. poor outcome (3-4-5)]. RESULTS Between January 2007 and July 2021, 181 patients were admitted to ICU for a resuscitated cardiac arrest. Poor neurological outcome was observed in 134 patients (74%). Qualitative EEG patterns suggesting high severity were associated with decreased LF/HF. Severity of EEG changes were proportional to higher absolute values of brain-to-heart coupling strength (p < 0.02 for all brain-to-heart frequencies) and lower values of alpha-to-HF complexity (p = 0.049). Brain-to-heart coupling strength was significantly higher in patients with bilateral absent N20 and correlated with neuron-specific enolase levels at Day 3. This aberrant brain-to-heart coupling (increased strength and decreased complexity) was also associated with 3-month poor neurological outcome. INTERPRETATION Our results suggest that autonomic dysfunctions may well represent hypoxic-ischemic brain injury post cardiac arrest pathophysiology. These results open avenues for integrative monitoring of autonomic functioning in critical care patients.
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Affiliation(s)
- Bertrand Hermann
- Faculté de MédecineUniversité Paris CitéParisFrance
- Medical Intensive Care UnitHEGP Hospital, Assistance Publique ‐ Hôpitaux de Paris‐Centre (APHP.Centre)ParisFrance
- INSERM UMR 1266, Institut de Psychiatrie et Neurosciences de Paris (IPNP)Université Paris CitéParisFrance
| | - Diego Candia‐Rivera
- Sorbonne Université, Paris Brain Institute (ICM), INRIA, CNRS UMR 722, INSERM U1127, AP‐HP Hôpital Pitié‐SalpêtrièreParisFrance
| | - Tarek Sharshar
- Faculté de MédecineUniversité Paris CitéParisFrance
- INSERM UMR 1266, Institut de Psychiatrie et Neurosciences de Paris (IPNP)Université Paris CitéParisFrance
- GHU Paris Psychiatrie Neurosciences, Service hospitalo‐universitaire de Neuro‐anesthésie réanimationParisFrance
| | - Martine Gavaret
- Faculté de MédecineUniversité Paris CitéParisFrance
- INSERM UMR 1266, Institut de Psychiatrie et Neurosciences de Paris (IPNP)Université Paris CitéParisFrance
- Neurophysiology and Epileptology DepartmentGHU Paris Psychiatrie et NeurosciencesParisFrance
| | - Jean‐Luc Diehl
- Faculté de MédecineUniversité Paris CitéParisFrance
- Medical Intensive Care UnitHEGP Hospital, Assistance Publique ‐ Hôpitaux de Paris‐Centre (APHP.Centre)ParisFrance
- Université Paris Cité, INSERM, Innovative Therapies in HaemostasisParisFrance
- Biosurgical Research Lab (Carpentier Foundation)ParisFrance
| | - Alain Cariou
- Faculté de MédecineUniversité Paris CitéParisFrance
- Medical Intensive Care UnitCochin Hospital, Assistance Publique ‐ Hôpitaux de Paris‐Centre (APHP‐Centre)ParisFrance
- Paris‐Cardiovascular‐Research‐CenterINSERM U970ParisFrance
| | - Sarah Benghanem
- Faculté de MédecineUniversité Paris CitéParisFrance
- INSERM UMR 1266, Institut de Psychiatrie et Neurosciences de Paris (IPNP)Université Paris CitéParisFrance
- Medical Intensive Care UnitCochin Hospital, Assistance Publique ‐ Hôpitaux de Paris‐Centre (APHP‐Centre)ParisFrance
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4
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You M, Laborde S, Ackermann S, Borges U, Dosseville F, Mosley E. Influence of Respiratory Frequency of Slow-Paced Breathing on Vagally-Mediated Heart Rate Variability. Appl Psychophysiol Biofeedback 2024; 49:133-143. [PMID: 38063977 DOI: 10.1007/s10484-023-09605-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/23/2023] [Indexed: 02/16/2024]
Abstract
Breathing techniques, particularly slow-paced breathing (SPB), have gained popularity among athletes due to their potential to enhance performance by increasing cardiac vagal activity (CVA), which in turn can help manage stress and regulate emotions. However, it is still unclear whether the frequency of SPB affects its effectiveness in increasing CVA. Therefore, this study aimed to investigate the effects of a brief SPB intervention (i.e., 5 min) on CVA using heart rate variability (HRV) measurement as an index. A total of 75 athletes (22 female; Mage = 22.32; age range = 19-31) participated in the study, attending one lab session where they performed six breathing exercises, including SPB at different frequencies (5 cycles per minute (cpm), 5.5 cpm, 6 cpm, 6.5 cpm, 7 cpm), and a control condition of spontaneous breathing. The study found that CVA was significantly higher in all SPB conditions compared to the control condition, as indexed by both root mean square of the successive differences (RMSSD) and low-frequency HRV (LF-HRVms2). Interestingly, LF-HRVms2 was more sensitive in differentiating the respiratory frequencies than RMSSD. These results suggest that SPB at a range of 5 cpm to 7 cpm can be an effective method to increase CVA and potentially improve stress management and emotion regulation in athletes. This short SPB exercise can be a simple yet useful tool for athletes to use during competitive scenarios and short breaks in competitions. Overall, these findings highlight the potential benefits of incorporating SPB into athletes' training and competition routines.
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Affiliation(s)
- Min You
- School of Teacher Education, University of Weifang, Weifang, China.
- UFR Psychologie, UR 3918 CERREV, Université de Caen Normandie, Caen, 14032, France.
| | - Sylvain Laborde
- Department of Performance Psychology, Institute of Psychology, German Sport University, Cologne, Germany
- UFR STAPS, UR 7480 VERTEX, Université de Caen Normandie, Caen, 14032, France
| | - Stefan Ackermann
- Department of Performance Psychology, Institute of Psychology, German Sport University, Cologne, Germany
| | - Uirassu Borges
- Department of Health & Social Psychology, Institute of Psychology, German Sport University, Cologne, Germany
| | - Fabrice Dosseville
- UFR STAPS, UR 7480 VERTEX, Université de Caen Normandie, Caen, 14032, France
- CNDAPS, Colombelles, F-14460, France
| | - Emma Mosley
- Department of Rehabilitation and Sport Sciences, School of Sport, Bournemouth University, Fern Barrow, Poole, Dorset, BH12 5BB, UK
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Wang YP, Kuo TBJ, Wang GZ, Yang CCH. Different effects of inspiratory duration and expiratory duration on heart rate deceleration capacity and heart rate asymmetry. Eur J Appl Physiol 2024:10.1007/s00421-024-05433-2. [PMID: 38421428 DOI: 10.1007/s00421-024-05433-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 02/04/2024] [Indexed: 03/02/2024]
Abstract
PURPOSE Low values of heart rate deceleration capacity (DC) and heart rate asymmetry (HRA) are associated with cardiovascular risks. Slow respiration has been proven to enhance the magnitudes of these indexes, but individual inspiratory (TI) and expiratory (TE) durations were not controlled in most studies. This study aims to examine whether the effects of TI and TE on these indexes would be the same and, if not, how to adjust TI and TE to maximize the effect of slow respiration. METHODS We evaluated 14 seated healthy young adults who randomly controlled their breathing to nine combinations of TI and TE, each chosen respectively from 2, 4, and 6 s. A 5-min R-R interval time series was obtained from each study period for further analysis. RESULTS The magnitude of DC increased when TI or TE increased, while that of acceleration capacity (AC) remained almost unchanged by TI. We further defined a new index as 100 × DC2/(DC2 + AC2) and found it to be correlated with conventional Guzik's (r = 0.94) and Porta's (r = 0.99) indexes of HRA during different combinations of TI and TE. Increasing TI and increasing TE both enhanced the magnitudes of HRA indexes, with TI taking effect when ≤ 4 s, and TE taking effect when > 4 s. DC and HRA indexes were maximized with a TI of 4 s and a TE of 6 s. CONCLUSION We suggest that a TI of 3-4 s with a TE of 7-6 s is an appropriate standard for slow respiration.
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Affiliation(s)
- Yong-Ping Wang
- Department of Anesthesiology, National Taiwan University Hospital, Taipei, Taiwan
| | - Terry B J Kuo
- Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Sleep Research Center and Institute of Brain Science, National Yang Ming Chiao Tung University, No. 155, Sec. 2, Li-Nong St., Taipei, 11221, Taiwan
- Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Department of Education and Research, Taipei City Hospital, Taipei, Taiwan
- Clinical Research Center, Taoyuan Psychiatric Center, Ministry of Health and Welfare, Taoyuan, Taiwan
| | - Guo-Zhi Wang
- Department of Surgery, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Cheryl C H Yang
- Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei, Taiwan.
- Sleep Research Center and Institute of Brain Science, National Yang Ming Chiao Tung University, No. 155, Sec. 2, Li-Nong St., Taipei, 11221, Taiwan.
- Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan.
- Department of Education and Research, Taipei City Hospital, Taipei, Taiwan.
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Zhou Y, Wang Q, Larkey L, James D, Cui H. Tai Chi Effects on Heart Rate Variability: A Systematic Review and Meta-Analysis. JOURNAL OF INTEGRATIVE AND COMPLEMENTARY MEDICINE 2024; 30:121-132. [PMID: 37695835 DOI: 10.1089/jicm.2022.0682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/13/2023]
Abstract
Background: Tai Chi, originating in China, is a mind-body exercise that integrates mind training, Qi training, and body training. While Tai Chi practice has demonstrated beneficial physical and psychological health benefits, how it achieves effects has been less studied. In recent years, some researchers have begun to explore the potential of heart rate variability (HRV) changes as balancing the autonomic nervous system (ANS) to achieve results, but only a few studies have directly tested how Tai Chi impacts HRV, and results have been mixed. Objective: This study systematically evaluates the effects of Tai Chi on HRV. Methods: Electronic databases including Web of Science, PubMed, Scopus, Cochrane Library, and EBSCOhost direct from inception until December 2020 were searched to obtain eligible studies. The primary outcomes examined were HRV parameters (time domain and frequency domain), and secondary analysis was whether breathing was emphasized during Tai Chi interventions. Results: Based on the 11 randomized controlled trials included comparing Tai Chi with non-active control condition, meta-analyses showed significantly beneficial effects on HRV parameters (low-frequency power [LF], mean difference [MD] = -200.40, 95% confidence interval [CI]: 365.31 to -35.49, p = 0.02; normalized low-frequency power [nLF], MD = -7.39, 95% CI: -12.48 to -2.29, p = 0.004; total power [TP], MD = -649.82, 95% CI: -1180.54 to -119.11, p = 0.02; very low-frequency power [VLF], MD = -200.55, 95% CI: -349.63 to -51.46, p = 0.008; root mean square of the square sum of the difference between adjacent normal heartbeat intervals [RMSSD], MD = 2.59, 95% CI: -7.23 to 12.41, p < 0.0001; standard deviation of the heartbeat interval [SDNN], MD = 8.33, 95% CI: 0.69 to 15.98, p = 0.03). The effect of Tai Chi on certain HRV parameters compared with active control conditions was less favorable (nLF, MD = 6.42, 95% CI: 3.74 to 9.09, p < 0.00001; normalized high-frequency power [nHF], MD: -6.13, 95% CI: -8.76 to -3.50, p < 0.00001; low-frequency/high-frequency power ratio [LF/HF], MD = 1.00, 95% CI: 0.68 to 1.33, p < 0.00001). In addition, studies describing an emphasis on breathing in the Tai Chi intervention showed positive impact on HRV (nLF, MD = -3.22, 95% CI: -5.32 to -1.12, p = 0.003; nHF, MD = 3.80, 95% CI: 0.80 to 6.81, p = 0.01; SDNN, MD = 5.55, 95% CI: 4.85 to 6.25, p < 0.00001). Conclusions: Meta-analysis results showed that Tai Chi compared with non-active control conditions has a positive impact on key HRV parameters associated with the ANS balance. However, active control condition comparisons showed greater HRV improvements than for Tai Chi. Considering the limited number of studies and their heterogeneity, further robust studies are necessary to verify findings and investigate differential effects of Tai Chi on HRV.
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Affiliation(s)
- Yujiao Zhou
- Department of Wushu, Beijing Sport University, Beijing, China
| | - Qiuyu Wang
- Department of Foreign Languages, Beijing Sport University, Beijing, China
| | - Linda Larkey
- Center for Health Promotion and Disease Prevention, Edson College of Nursing & Health Innovation, Arizona State University, Phoenix, AZ, USA
| | - Dara James
- Center for Health Promotion and Disease Prevention, Edson College of Nursing & Health Innovation, Arizona State University, Phoenix, AZ, USA
| | - Hua Cui
- Department of Wushu, Beijing Sport University, Beijing, China
- Sport Information Research and Teaching Center, Beijing Sport University, Beijing, China
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Roche F, Pichot V, Mouhli-Gasmi L, Monier M, Barthélémy JC, Berger M, Celle S, Chouchou F. Anatomy and physiology of the autonomic nervous system: Implication on the choice of diagnostic/monitoring tools in 2023. Rev Neurol (Paris) 2024; 180:42-52. [PMID: 38176987 DOI: 10.1016/j.neurol.2023.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Revised: 12/18/2023] [Accepted: 12/20/2023] [Indexed: 01/06/2024]
Abstract
The autonomic nervous system (ANS) harmoniously regulates all internal organic functions (heart rate, blood pressure, vasomotion, digestive tract motility, endocrinal secretions) and adapts them to the needs. It's the control of so-called vegetative functions, which allows homeostasis but also allostasis of our body. ANS is divided into two systems often understood as antagonistic and complementary: the sympathetic and the parasympathetic systems. However, we currently know of many situations of co-activation of the two systems. Long seen as acting through "reflex" control loops passing through the integration of peripheral information and the efferent response to the peripheral organ, more recent electrophysiological and brain functional imaging knowledge has been able to identify the essential role of the central autonomic network. This element complicates the understanding of the responses of the reflex loops classically used to identify and quantify dysautonomia. Finding the "ANS" tools best suited for the clinician in their daily practice is a challenge that we will attempt to address in this work.
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Affiliation(s)
- F Roche
- Clinical Physiology, Saint-Étienne University Hospital, Saint-Étienne, France; Inserm U1059 Sainbiose, Jean-Monnet University, Saint-Étienne, France.
| | - V Pichot
- Clinical Physiology, Saint-Étienne University Hospital, Saint-Étienne, France; Inserm U1059 Sainbiose, Jean-Monnet University, Saint-Étienne, France
| | - L Mouhli-Gasmi
- Clinical Physiology, Saint-Étienne University Hospital, Saint-Étienne, France
| | - M Monier
- Clinical Physiology, Saint-Étienne University Hospital, Saint-Étienne, France
| | - J-C Barthélémy
- Clinical Physiology, Saint-Étienne University Hospital, Saint-Étienne, France; Inserm U1059 Sainbiose, Jean-Monnet University, Saint-Étienne, France
| | - M Berger
- Clinical Physiology, Saint-Étienne University Hospital, Saint-Étienne, France; Inserm U1059 Sainbiose, Jean-Monnet University, Saint-Étienne, France
| | - S Celle
- Clinical Physiology, Saint-Étienne University Hospital, Saint-Étienne, France; Inserm U1059 Sainbiose, Jean-Monnet University, Saint-Étienne, France
| | - F Chouchou
- IRISSE EA4075, STAPS Department, La Reunion University, Le Tampon, France
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8
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Ritz T. Putting back respiration into respiratory sinus arrhythmia or high-frequency heart rate variability: Implications for interpretation, respiratory rhythmicity, and health. Biol Psychol 2024; 185:108728. [PMID: 38092221 DOI: 10.1016/j.biopsycho.2023.108728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Revised: 12/06/2023] [Accepted: 12/07/2023] [Indexed: 12/23/2023]
Abstract
Research on respiratory sinus arrhythmia, or high-frequency heart rate variability (its frequency-domain equivalent), has been popular in psychology and the behavioral sciences for some time. It is typically interpreted as an indicator of cardiac vagal activity. However, as research has shown for decades, the respiratory pattern can influence the amplitude of these noninvasive measures substantially, without necessarily reflecting changes in tonic cardiac vagal activity. Although changes in respiration are systematically associated with experiential and behavioral states, this potential confound in the interpretation of RSA, or HF-HRV, is rarely considered. Interpretations of within-individual changes in these parameters are therefore only conclusive if undertaken relative to the breathing pattern. The interpretation of absolute levels of these parameters between individuals is additionally burdened with the problem of residual inspiratory cardiac vagal activity in humans. Furthermore, multiple demographic, anthropometric, life-style, health, and medication variables can act as relevant third variables that might explain associations of RSA or HF-HRV with experiential and behavioral variables. Because vagal activity measured by these parameters only represents the portion of cardiac vagal outflow that is modulated by the respiratory rhythm, alternative interpretations beyond cardiac vagal activity should be considered. Accumulating research shows that activity of multiple populations of neurons in the brain and the periphery, and with that organ activity and function, are modulated rhythmically by respiratory activity. Thus, observable health benefits ascribed to the cardiac vagal system through RSA or HF-HRV may actually reflect beneficial effects of respiratory modulation. Respiratory rhythmicity may ultimately provide the mechanism that integrates central, autonomic, and visceral activities.
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Affiliation(s)
- Thomas Ritz
- Department of Psychology, Southern Methodist University, Dallas, TX, USA.
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9
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Watso JC, Cuba JN, Boutwell SL, Moss JE, Bowerfind AK, Fernandez IM, Cassette JM, May AM, Kirk KF. Acute nasal breathing lowers diastolic blood pressure and increases parasympathetic contributions to heart rate variability in young adults. Am J Physiol Regul Integr Comp Physiol 2023; 325:R797-R808. [PMID: 37867476 DOI: 10.1152/ajpregu.00148.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Revised: 10/12/2023] [Accepted: 10/13/2023] [Indexed: 10/24/2023]
Abstract
There is growing interest in how breathing pace, pattern, and training (e.g., device-guided or -resisted breathing) affect cardiovascular health. It is unknown whether the route of breathing (nasal vs. oral) affects prognostic cardiovascular variables. Because nasal breathing can improve other physiological variables (e.g., airway dilation), we hypothesized that nasal compared with oral breathing would acutely lower blood pressure (BP) and improve heart rate variability (HRV) metrics. We tested 20 adults in this study [13 females/7 males; age: 18(1) years, median (IQR); body mass index: 23 ± 2 kg·m-2, means ± SD]. We compared variables between nasal- and oral-only breathing (random order, five min each) using paired, two-tailed t tests or Wilcoxon signed-rank paired tests with significance set to P < 0.05. We report the median (interquartile range) for diastolic BP and means ± SD for all other variables. We found that nasal breathing was associated with a lower mean BP (nasal: 84 ± 7 vs. oral: 86 ± 5 mmHg, P = 0.006, Cohen's d = 0.70) and diastolic BP [nasal: 68(8) vs. oral: 72(5) mmHg, P < 0.001, Rank-biserial correlation = 0.89] but not systolic BP (nasal: 116 ± 11 vs. oral: 117 ± 9 mmHg, P = 0.48, Cohen's d = 0.16) or heart rate (HR; nasal: 74 ± 10 vs. oral: 75 ± 8 beats·min-1, P = 0.90, Cohen's d = 0.03). We also found that nasal breathing was associated with a higher high-frequency (HF) contribution to HRV (nasal: 59 ± 19 vs. oral: 52 ± 21%, P = 0.04, Cohen's d = 0.50) and a lower low frequency-to-HF ratio at rest (nasal: 0.9 ± 0.8 vs. oral: 1.2 ± 0.9, P = 0.04, Cohen's d = 0.49). These data suggest that nasal compared with oral breathing acutely 1) lowers mean and diastolic BP, 2) does not affect systolic BP or heart rate, and 3) increases parasympathetic contributions to HRV.NEW & NOTEWORTHY There is growing interest in how breathing pace, pattern, and training (e.g., device-guided or -resisted breathing) affect prognostic cardiovascular variables. However, the potential effects of the breathing route on prognostic cardiovascular variables are unclear. These data suggest that nasal compared with oral breathing 1) lowers mean and diastolic blood pressure (BP), 2) does not affect systolic BP or heart rate (HR), and 3) increases parasympathetic contributions to heart rate variability (HRV). These data suggest that acute nasal breathing improves several prognostic cardiovascular variables.
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Affiliation(s)
- Joseph C Watso
- Cardiovascular and Applied Physiology Laboratory, Department of Health, Nutrition, & Food Sciences, Florida State University, Tallahassee, Florida, United States
| | - Jens N Cuba
- Cardiovascular and Applied Physiology Laboratory, Department of Health, Nutrition, & Food Sciences, Florida State University, Tallahassee, Florida, United States
| | - Savannah L Boutwell
- Cardiovascular and Applied Physiology Laboratory, Department of Health, Nutrition, & Food Sciences, Florida State University, Tallahassee, Florida, United States
| | - Justine E Moss
- Cardiovascular and Applied Physiology Laboratory, Department of Health, Nutrition, & Food Sciences, Florida State University, Tallahassee, Florida, United States
| | - Allison K Bowerfind
- Cardiovascular and Applied Physiology Laboratory, Department of Health, Nutrition, & Food Sciences, Florida State University, Tallahassee, Florida, United States
| | - Isabela M Fernandez
- Cardiovascular and Applied Physiology Laboratory, Department of Health, Nutrition, & Food Sciences, Florida State University, Tallahassee, Florida, United States
| | - Jessica M Cassette
- Cardiovascular and Applied Physiology Laboratory, Department of Health, Nutrition, & Food Sciences, Florida State University, Tallahassee, Florida, United States
| | - Allyson M May
- Cardiovascular and Applied Physiology Laboratory, Department of Health, Nutrition, & Food Sciences, Florida State University, Tallahassee, Florida, United States
| | - Katherine F Kirk
- Cardiovascular and Applied Physiology Laboratory, Department of Health, Nutrition, & Food Sciences, Florida State University, Tallahassee, Florida, United States
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10
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Evans AJ, Russo CM, Tovar MA, Liu A, Conley SP. Physiologic Fidelity as a Domain in Assessing Mixed Reality Trauma Simulation. Mil Med 2023; 188:3322-3329. [PMID: 35994047 DOI: 10.1093/milmed/usac244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 07/11/2022] [Accepted: 08/02/2022] [Indexed: 11/14/2022] Open
Abstract
INTRODUCTION Mixed reality has been used in trauma and emergency medicine simulation for more than a decade. As mixed reality potential in trauma simulation continues to expand, so too does the need to validate it as a surrogate for real-life emergency scenarios. Validation of these simulations can occur by measuring fidelity, or the degree to which a computing system can reproduce real-world experiences. After performing a literature review, we determined that most fidelity assessments of trauma and emergency simulations focus on how the user subjectively experiences the simulation. Although subjective user assessment is an important component of determining fidelity, we pose an introductory three-part framework that may assess mixed reality trauma simulation more adequately. MATERIALS AND METHODS A literature review was conducted using Google Scholar, PubMed, and the Uniformed Services University PowerER search database. Relevant articles were assessed to identify how studies measured fidelity in trauma simulation. We then designed the three-part framework to aid researchers in assessing the fidelity of mixed reality trauma simulations. RESULTS The domains we determined to best assess mixed reality emergency simulation are as follows:1. Continue assessing fidelity via subjective user assessments. This allows the researcher to know how real the simulation looked and felt to the user based on their individual report.2. Determine whether the trauma simulation changes the medical decision-making capacity of the user. If the user's decision-making capacity changes with a stress-inducing trauma simulation versus a non-stress-inducing simulation, then the stress-inducing trauma environment would be approaching greater fidelity.3. Study the domain of our newly proposed concept: physiologic fidelity. We define physiologic fidelity as the degree to which the simulation elicits a measurable, autonomic response independent of observed emotion or perceived affect. Recreating objective autonomic arousal may be the best way to ensure a trauma simulation reaches fidelity. CONCLUSION We propose a methodology to assess mixed reality trauma simulation fidelity. Once fidelity is more fully known to the researcher and the simulation user, adjustments can be made to approach reality more closely. Improved simulators may enrich the preparedness of both junior and senior learners for real-life emergencies. We believe assessing the three domains using the Wide Area Virtual Experience at the Val G. Hemming simulation center in Bethesda, MD, will validate mixed reality-trauma simulators as invaluable surrogates for real-life emergency scenarios and ultimately contribute to improved clinical outcomes for clinicians and their patients.
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Affiliation(s)
- Andrew J Evans
- School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA
| | - Christopher M Russo
- Department of Anesthesiology, Walter Reed National Military Medical Center, Bethesda, MD 20814, USA
| | - Matthew A Tovar
- School of Medicine and Health Sciences, George Washington University, Washington, DC 20052, USA
| | - Alan Liu
- Virtual Medical Environments Laboratory, Val G. Hemming Simulation Center, Silver Spring, MD 20910, USA
| | - Sean P Conley
- Department of Military & Emergency Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA
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11
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Cairo B, Bari V, Gelpi F, De Maria B, Porta A. Assessing cardiorespiratory interactions via lagged joint symbolic dynamics during spontaneous and controlled breathing. FRONTIERS IN NETWORK PHYSIOLOGY 2023; 3:1211848. [PMID: 37602202 PMCID: PMC10436098 DOI: 10.3389/fnetp.2023.1211848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 07/13/2023] [Indexed: 08/22/2023]
Abstract
Introduction: Joint symbolic analysis (JSA) can be utilized to describe interactions between time series while accounting for time scales and nonlinear features. JSA is based on the computation of the rate of occurrence of joint patterns built after symbolization. Lagged JSA (LJSA) is obtained from the more classical JSA by introducing a delay/lead between patterns built over the two series and combined to form the joint scheme, thus monitoring coordinated patterns at different lags. Methods: In the present study, we applied LJSA for the assessment of cardiorespiratory coupling (CRC) from heart period (HP) variability and respiratory activity (R) in 19 healthy subjects (age: 27-35 years; 8 males, 11 females) during spontaneous breathing (SB) and controlled breathing (CB). The R rate of CB was selected to be indistinguishable from that of SB, namely, 15 breaths·minute-1 (CB15), or slower than SB, namely, 10 breaths·minute-1 (CB10), but in both cases, very rapid interactions between heart rate and R were known to be present. The ability of the LJSA approach to follow variations of the coupling strength was tested over a unidirectionally or bidirectionally coupled stochastic process and using surrogate data to test the null hypothesis of uncoupling. Results: We found that: i) the analysis of surrogate data proved that HP and R were significantly coupled in any experimental condition, and coupling was not more likely to occur at a specific time lag; ii) CB10 reduced CRC strength at the fastest time scales while increasing that at intermediate time scales, thus leaving the overall CRC strength unvaried; iii) despite exhibiting similar R rates and respiratory sinus arrhythmia, SB and CB15 induced different cardiorespiratory interactions; iv) no dominant temporal scheme was observed with relevant contributions of HP patterns either leading or lagging R. Discussion: LJSA is a useful methodology to explore HP-R dynamic interactions while accounting for time shifts and scales.
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Affiliation(s)
- Beatrice Cairo
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Vlasta Bari
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
- Department of Cardiothoracic, Vascular Anesthesia and Intensive Care, IRCCS Policlinico San Donato Milanese, Milan, Italy
| | - Francesca Gelpi
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | | | - Alberto Porta
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
- Department of Cardiothoracic, Vascular Anesthesia and Intensive Care, IRCCS Policlinico San Donato Milanese, Milan, Italy
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12
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Yen CF, Chou WP, Hsu CY, Wu HC, Wang PW. Effects of heart rate variability biofeedback (HRVBFB) on sleep quality and depression among methamphetamine users. J Psychiatr Res 2023; 162:132-139. [PMID: 37149922 DOI: 10.1016/j.jpsychires.2023.05.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 03/29/2023] [Accepted: 05/01/2023] [Indexed: 05/09/2023]
Abstract
Methamphetamine is garnering concern due to its increasing use worldwide. Depression and sleep quality are major mental health issues in substance users. Heart rate variability biofeedback (HRVBFB) has shown promising results in terms of reducing depression and increasing sleep quality. The present study aimed to explore the effects of HRVBFB on these two issues in methamphetamine users. Sixty-one methamphetamine users were enrolled and allocated randomly into a treatment as usual (TAU) group and a HRVBFB plus TAU group. The levels of depressive symptoms and sleep quality were assessed at intake, end of the intervention, and end of follow-up. Compared with baseline, the levels of depressive symptoms and poor sleep quality were decreased at the end of the intervention and follow-up in the HRVBFB group. The HRVBFB group exhibited a greater decrease in depressive symptoms and a better improvement in sleep quality than the TAU group. The associations of HRV indices with levels of depressive symptoms and poor sleep quality were different in the two groups. Our results showed that HRVBFB is a promising intervention for reducing depressive symptoms and improving sleep quality in methamphetamine users. The benefits with respect to depressive symptoms and poor sleep quality can extend beyond the end of HRVBFB intervention.
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Affiliation(s)
- Cheng-Fang Yen
- Department of Psychiatry, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, 80708, Taiwan; Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung, 80708, Taiwan
| | - Wei-Po Chou
- Department of Psychiatry, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, 80708, Taiwan; Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung, 80708, Taiwan
| | - Chih-Yao Hsu
- Department of Addiction Science, Kai-Suan Psychiatric Hospital, Kaohsiung, Taiwan
| | - Hung-Chi Wu
- Department of Addiction Science, Kai-Suan Psychiatric Hospital, Kaohsiung, Taiwan
| | - Peng-Wei Wang
- Department of Psychiatry, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, 80708, Taiwan; Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung, 80708, Taiwan.
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13
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Metelmann M, Baum P, Pelz J. Autonome Diagnostik bei der Amyotrophen
Lateralsklerose. KLIN NEUROPHYSIOL 2023. [DOI: 10.1055/a-2018-3174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2023]
Abstract
ZusammenfassungBei der Amyotrophen Lateralsklerose (ALS) handelt sich um eine neurodegenerative
Multisystemerkrankung. Diese äußert sich neben den motorischen
Defiziten mit nicht-motorischen Symptomen. Hierzu zählen auch autonome
Störungen, die von veränderter Schweißsekretion
über Tachykardie bis zu gastrointestinalen Symptomen reichen. Autonome
Störungen können mit verschiedenen Methoden, wie
Selbsterhebungsfragebögen, Messung der Herzfrequenzvariabilität,
QTc-Intervallmessung, Erhebung der sudomotorischen Funktion und Sonographie des
Nervus vagus erfasst werden, die in diesem Artikel dargestellt werden. Die
bislang bei der ALS eingesetzten Methoden der autonomen Diagnostik ergeben zum
Teil deutlich divergierende Ergebnisse über die Aktivität des
Sympathikus im Krankheitsverlauf. Relevante autonome Störungen scheinen
zumeist erst im fortgeschrittenen Krankheitsstadium aufzutreten, wobei
multizentrische Studien mit longitudinalem Ansatz ausstehen.
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Affiliation(s)
- Moritz Metelmann
- Department of Neurology,Universitätsklinikum Leipzig, Leipzig,
Germany
| | - Petra Baum
- Klinik für Neurologie , Universitätsklinikum Leipzig,
Leipzig, Germany
| | - Johann Pelz
- Department of Neurology,Universitätsklinikum Leipzig, Leipzig,
Germany
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14
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Oliver TE, Sánchez‐Hechavarría ME, Carrazana‐Escalona R, Blaha CA, Sinoway LI, Drew RC. Rapid adjustments to autonomic control of cardiac rhythm at the onset of isometric exercise in healthy young adults. Physiol Rep 2023; 11:e15616. [PMID: 36823959 PMCID: PMC9950538 DOI: 10.14814/phy2.15616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 01/11/2023] [Accepted: 02/01/2023] [Indexed: 02/25/2023] Open
Abstract
Sympathetic nervous system (SNS) and parasympathetic nervous system (PNS) influences on cardiac rhythm at the onset of exercise, a time of rapid autonomic adjustments, are clinically important areas of investigation. Continuous wavelet transform (CWT) involves time-frequency-based heart rate variability (HRV) analysis allowing investigation of autonomic influences on cardiac rhythm during short durations of exercise. Therefore, the purpose of this study was to characterize SNS and PNS influences on cardiac rhythm at the onset of isometric exercise in healthy young adults. CWT analysis was retrospectively applied to R-R interval data (electrocardiogram) previously collected from 14 healthy young adults (26 ± 2 years) who performed 30-s, one-legged, isometric, calf exercise at 70% maximal voluntary contraction (MVC; 70% MVC trial) or rested (0% MVC trial). Absolute and normalized low-frequency (aLF, nLF; 0.04-0.15 Hz) and high-frequency (aHF, nHF; 0.15-0.4 Hz) bands and LF/HF were used to analyze one 30-s baseline period and six 5-s time windows during the 30-s exercise (70% MVC) or rest (0% MVC). Statistical analysis involved two-way analysis of variance with post-hoc analysis. aHF, aLF, LF/HF, nHF, and nLF displayed a trial-time interaction (all p ≤ 0.027). In the 70% compared to the 0% MVC trial, aHF and nHF were lower after 5-30 s (all p ≤ 0.040), aLF was lower after 20-30 s (all p ≤ 0.011) and LF/HF and nLF were higher after 5-20 s (all p ≤ 0.045). These results indicate the reduction of the PNS influence on cardiac rhythm begins sooner than the augmentation of the SNS influence at the onset of isometric exercise in healthy young adults.
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Affiliation(s)
- Tyler E. Oliver
- Department of Exercise and Health SciencesUniversity of Massachusetts BostonBostonMassachusettsUSA
| | - Miguel E. Sánchez‐Hechavarría
- Departamento de Ciencias Básicas, Facultad de MedicinaUniversidad Católica de la Santísima ConcepciónConcepciónChile,Facultad de Ciencias de la SaludUniversidad Adventista de ChileChillánChile
| | - Ramón Carrazana‐Escalona
- Departamento de Ciencias Básicas, Facultad de MedicinaUniversidad Católica de la Santísima ConcepciónConcepciónChile
| | - Cheryl A. Blaha
- Penn State Heart and Vascular Institute, Penn State College of MedicineHersheyPennsylvaniaUSA
| | - Lawrence I. Sinoway
- Penn State Heart and Vascular Institute, Penn State College of MedicineHersheyPennsylvaniaUSA
| | - Rachel C. Drew
- Department of Exercise and Health SciencesUniversity of Massachusetts BostonBostonMassachusettsUSA,Penn State Heart and Vascular Institute, Penn State College of MedicineHersheyPennsylvaniaUSA
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15
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Herawati I, Mat Ludin AF, M M, Ishak I, Farah NMF. Breathing exercise for hypertensive patients: A scoping review. Front Physiol 2023; 14:1048338. [PMID: 36760529 PMCID: PMC9905130 DOI: 10.3389/fphys.2023.1048338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 01/11/2023] [Indexed: 01/26/2023] Open
Abstract
Background: Non-pharmacological management of hypertension includes weight loss, alcohol and sodium restriction, regular exercise, and relaxation. In people with overweight hypertension, systolic blood pressure (SBP) and diastolic blood pressure (DBP) can be decreased via exercise and weight loss together. Breathing exercises are one method of relaxing. Objectives: The aim of this scoping review is to map the information that is currently available about the advantages of breathing exercises in decreasing blood pressure in hypertension patients. Methods: This scoping review adheres to Arksey and O'Malley's framework, which entails identifying review questions, seeking pertinent evidence, choosing pertinent studies, mapping data, and discussing, concluding, and reporting the findings. The PRISMA flowchart is used to show how the evidence search process works. Results: As a result, 339 articles in total were retrieved from the three databases. 20 papers total were included in this review after screening. In 14 of the 20 investigations, participants with stage 1 and stage 2 essential hypertension, two with pre-hypertension, and four with Isolated Systolic Hypertension (ISH) were studied. The respondents' ages ranged from 18 to 75. The systolic blood pressure declined by 4-54.22 mmHg, while the diastolic blood pressure dropped by 3-17 mmHg. Conclusion: Slow breathing can be used as an alternate, non-pharmacological therapy for hypertension individuals to reduce blood pressure. Systematic Review Registration: (https://osf.io/ta9u6/).
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Affiliation(s)
- Isnaini Herawati
- Biomedical Science Programme & Center for Healthy Ageing and Wellness (HCARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur, Malaysia,Faculty of Health Sciences, Universitas Muhammadiyah Surakarta, J. A.Yani Tromol Pos 1 Pabelan Kartasura, Surakarta, Indonesia
| | - Arimi Fitri Mat Ludin
- Biomedical Science Programme & Center for Healthy Ageing and Wellness (HCARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur, Malaysia,*Correspondence: Arimi Fitri Mat Ludin,
| | - Mutalazimah M
- Faculty of Health Sciences, Universitas Muhammadiyah Surakarta, J. A.Yani Tromol Pos 1 Pabelan Kartasura, Surakarta, Indonesia
| | - Ismarulyusda Ishak
- Biomedical Science Programme & Center for Toxicology and Health Risk (CORE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur, Malaysia
| | - Nor M. F. Farah
- Occupational Therapy Programme & Center for Community Health Studies (REACH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur, Malaysia
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16
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Ziadia H, Sassi I, Trudeau F, Fait P. Normative values of resting heart rate variability in young male contact sport athletes: Reference values for the assessment and treatment of concussion. Front Sports Act Living 2023; 4:730401. [PMID: 36699983 PMCID: PMC9869270 DOI: 10.3389/fspor.2022.730401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 12/07/2022] [Indexed: 01/12/2023] Open
Abstract
Objective The objective of this study was to identify the main determinants of heart rate variability (HRV) in male athletes aged 14 to 21 years who practice competitive contact sports and to integrate these determinants with the aim of defining normative values of short-term HRV in the time and frequency domains. Methods Participants (n = 369) were aged 14 to 21 years and included 221 football players and 148 ice hockey players. HRV was measured for 5 min at rest, and standard HRV parameters in the time and frequency domains were calculated. Heart rate (HR), age, body mass index (BMI), number of sports weekly practices (WSP) and concussion history (mTBI) were considered determinants potentially able to influence HRV. Results Multiple regression analysis revealed that HR was the primary determinant of standard HRV parameters. The models accounted for 13% to 55% of the total variance of HRV and the contribution of HR to this model was the strongest (β ranged from -0.34 to -0.75). HR was the only determinant that significantly contributes to all HRV parameters. To counteract this dependence, we calculated HRV corrected by the mean RR interval (RRm). Such corrections do not remove any physiological differences in HRV; they simply remove the mathematical bias. HRV parameters were therefore normalized, and their normative limits were developed relative to the mean heart rate. After correction, the correlation coefficients between HR and all corrected HRV parameters were not statistically significant and ranged from -0.001 to 0.045 (p > 0.40 for all). The automatically corrected HRV calculator, which recalculates standard HRV parameters and converts them into corrected parameters in addition to determining whether a given value is within normal limits, facilitates clinical interpretation. Conclusion This study provides for the first time corrected normative values of short-term and resting state HRV parameters in competitive contact sport athletes aged 14 to 21 years. These values were developed independently of the major determinants of HRV. The baseline values for HRV parameters given here could be used in clinical practice when assessing and monitoring cerebral concussions. They may assist in decision making for a safe return to play.
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Affiliation(s)
- Hatem Ziadia
- Department of Anatomy, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada,Exercise Physiology Laboratory, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada,Correspondence: Hatem Ziadia
| | - Idriss Sassi
- Exercise Physiology Laboratory, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada,Department of Psychology, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
| | - François Trudeau
- Exercise Physiology Laboratory, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada,Department of Human Kinetics, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
| | - Philippe Fait
- Department of Human Kinetics, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada,Research Group on Neuromusculoskeletal Conditions (GRAN), Trois-rivieres, QC, Canada,Centre for Research in Neuropsychology and Cognition (CERNEC), Montreal, QC, Canada,Cortex Concussion Clinic, Quebec City, QC, Canada
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17
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Tovar MA, Zebley JA, Higgins M, Herur-Raman A, Zwemer CH, Pierce AZ, Ranniger C, Sarani B, Phillips JP. Exposure to a Virtual Reality Mass-Casualty Simulation Elicits a Differential Sympathetic Response in Medical Trainees and Attending Physicians. Prehosp Disaster Med 2023; 38:1-9. [PMID: 36606324 PMCID: PMC9885434 DOI: 10.1017/s1049023x22002448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 11/18/2022] [Accepted: 11/29/2022] [Indexed: 01/07/2023]
Abstract
BACKGROUND Previous studies have demonstrated the use of virtual reality (VR) in mass-casualty incident (MCI) simulation; however, it is uncertain if VR simulations can be a substitute for in-person disaster training. Demonstrating that VR MCI scenarios can elicit the same desired stress response achieved in live-action exercises is a first step in showing non-inferiority. The primary objective of this study was to measure changes in sympathetic nervous system (SNS) response via a decrease in heart rate variability (HRV) in subjects participating in a VR MCI scenario. METHODS An MCI simulation was filmed with a 360º camera and shown to participants on a VR headset while simultaneously recording electrocardiography (EKG) and HRV activity. Baseline HRV was measured during a calm VR scenario immediately prior to exposure to the MCI scenarios, and SNS activation was captured as a decrease in HRV compared to baseline. Cognitive stress was measured using a validated questionnaire. Wilcoxon matched pairs signed rank analysis, Welch's t-test, and multivariate logistic regression were performed with statistical significance established at P <.05. RESULTS Thirty-five subjects were enrolled: eight attending physicians (two surgeons, six Emergency Medicine [EM] specialists); 13 residents (five Surgery, eight EM); and 14 medical students (six pre-clinical, eight clinical-year students). Sympathetic nervous system activation was observed in all groups during the MCI compared to baseline (P <.0001) and occurred independent of age, sex, years of experience, or prior MCI response experience. Overall, 23/35 subjects (65.7%) reported increased cognitive stress in the MCI (11/14 medical students, 9/13 residents, and 3/8 attendings). Resident and attending physicians had higher odds of discordance between SNS activation and cognitive stress compared to medical students (OR = 8.297; 95% CI, 1.408-64.60; P = .030). CONCLUSIONS Live-actor VR MCI simulation elicited a strong sympathetic response across all groups. Thus, VR MCI training has the potential to guide acquisition of confidence in disaster response.
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Affiliation(s)
- Matthew A. Tovar
- School of Medicine and Health Sciences, George Washington University, Washington, DCUSA
| | - James A. Zebley
- Department of Surgery, George Washington University, Washington, DCUSA
| | - Mairead Higgins
- School of Medicine and Health Sciences, George Washington University, Washington, DCUSA
| | - Aalap Herur-Raman
- School of Medicine and Health Sciences, George Washington University, Washington, DCUSA
| | - Catherine H. Zwemer
- School of Medicine and Health Sciences, George Washington University, Washington, DCUSA
| | - Ayal Z. Pierce
- Department of Emergency Medicine, George Washington University, Washington, DCUSA
| | - Claudia Ranniger
- School of Medicine and Health Sciences, George Washington University, Washington, DCUSA
- Department of Emergency Medicine, George Washington University, Washington, DCUSA
| | - Babak Sarani
- School of Medicine and Health Sciences, George Washington University, Washington, DCUSA
- Department of Surgery, George Washington University, Washington, DCUSA
- Department of Emergency Medicine, George Washington University, Washington, DCUSA
| | - James P. Phillips
- School of Medicine and Health Sciences, George Washington University, Washington, DCUSA
- Department of Emergency Medicine, George Washington University, Washington, DCUSA
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18
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Gąsior JS, Zamunér AR, Madeyska M, Tomik A, Niszczota C, Williams CA, Werner B. Heart Rate Variability in Individuals with Down Syndrome: A Scoping Review with Methodological Considerations. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:941. [PMID: 36673696 PMCID: PMC9859252 DOI: 10.3390/ijerph20020941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 12/31/2022] [Accepted: 01/01/2023] [Indexed: 06/17/2023]
Abstract
Individuals with Down syndrome (DS) present similar heart rate variability (HRV) parameters at rest but different responses to selected movement maneuvers in comparison to individuals without DS, which indicates reduced vagal regulation. The present study undertakes a scoping review of research on HRV in individuals with DS, with special attention paid to the compliance of the studies with standards and methodological paper guidelines for HRV assessment and interpretation. A review was performed using PubMed, Web of Science and CINAHL databases to search for English language publications from 1996 to 2020 with the MESH terms "heart rate variability" and "down syndrome", with the additional inclusion criteria of including only human participants and empirical investigations. From 74 studies, 15 were included in the review. None of the reviewed studies met the recommendations laid out by the standards and guidelines for providing the acquisition of RR intervals and necessary details on HRV analysis. Since authors publishing papers on this research topic do not adhere to the prescribed standards and guidelines when constructing the methodology, results of the research papers on the topic are not directly comparable. Authors need to design the study methodology more robustly by following the aforementioned standards, guidelines and recommendations.
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Affiliation(s)
- Jakub S. Gąsior
- Department of Pediatric Cardiology and General Pediatrics, Medical University of Warsaw, 02-091 Warsaw, Poland
| | | | - Margaret Madeyska
- Pediatric Cardiology and General Pediatrics Clinic, Jan Polikarp Brudziński Pediatric Hospital, 02-091 Warsaw, Poland
| | - Anna Tomik
- Faculty of Medicine, Medical University of Warsaw, 02-091 Warsaw, Poland
| | - Cezary Niszczota
- Pediatric Cardiology and General Pediatrics Clinic, Jan Polikarp Brudziński Pediatric Hospital, 02-091 Warsaw, Poland
| | - Craig A. Williams
- Children’s Health & Exercise Research Centre, Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, Exeter EX1 2LU, UK
| | - Bożena Werner
- Department of Pediatric Cardiology and General Pediatrics, Medical University of Warsaw, 02-091 Warsaw, Poland
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Morlin MT, da Cruz CJG, Guimarães FER, da Silva RAS, Porto LGG, Molina GE. High-Intensity Interval Training Combined with Different Types of Exercises on Cardiac Autonomic Function. An Analytical Cross-Sectional Study in CrossFit ® Athletes. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:634. [PMID: 36612955 PMCID: PMC9819219 DOI: 10.3390/ijerph20010634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 11/19/2022] [Accepted: 11/21/2022] [Indexed: 06/17/2023]
Abstract
UNLABELLED It is well established that endurance exercise has positive effects on cardiac autonomic function (CAF). However, there is still a dearth of information about the effects of regular high-intensity interval training combined with different types of exercises (HIITCE) on CAF. OBJECTIVE The aim of this study is to compare CAF at rest, its reactivity, and reactivation following maximal exercise testing in HIITCE and endurance athletes. METHODS An observational study was conducted with 34 male athletes of HIITCE (i.e., CrossFit®) [HG: n = 18; 30.6 ± 4.8 years] and endurance athletes (i.e., triathlon) [TG.: n = 16; 32.8 ± 3.6 years]. We analyzed 5 min of frequency-domain indices (TP, LF, HF, LFn, HFn, and LF/HF ratio) of heart rate variability (HRV) in both supine and orthostatic positions and its reactivity after the active orthostatic test. Post-exercise heart rate recovery (HRR) was assessed at 60, 180, and 300 s. Statistical analysis employed a non-parametric test with a p-value set at 5%. RESULTS The HG showed reduced HFn and increased LFn modulations at rest (supine). Overall cardiac autonomic modulation (TP) at supine and all indices of HRV at the orthostatic position were similar between groups. Following the orthostatic test, the HG showed low reactivity for all HRV indices compared to TG. After the exercise, HRR does not show a difference between groups at 60 s. However, at 180 and 300 s, an impairment of HRR was observed in HG than in TG. CONCLUSION At rest (supine), the HG showed reduced parasympathetic and increased sympathetic modulation, low reactivity after postural change, and impaired HRR compared to TG.
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Affiliation(s)
- Michelle Teles Morlin
- Exercise Physiology Laboratory, Faculty of Physical Education, University of Brasilia, Brasilia 70910-900, DF, Brazil
- SARAH Network of Rehabilitation Hospitals, Brasilia 70910-900, DF, Brazil
- GEAFS—Research Group on Physiology and Epidemiology of Exercise and Physical Activity, Brasilia 70910-900, DF, Brazil
| | - Carlos Janssen Gomes da Cruz
- Exercise Physiology Laboratory, Faculty of Physical Education, University of Brasilia, Brasilia 70910-900, DF, Brazil
- GEAFS—Research Group on Physiology and Epidemiology of Exercise and Physical Activity, Brasilia 70910-900, DF, Brazil
- Laboratory of Physical Performance and Healthy, Faculty of Physical Education, Euro American University Center, Brasilia 70200-001, DF, Brazil
| | - Freddy Enrique Ramos Guimarães
- Exercise Physiology Laboratory, Faculty of Physical Education, University of Brasilia, Brasilia 70910-900, DF, Brazil
- GEAFS—Research Group on Physiology and Epidemiology of Exercise and Physical Activity, Brasilia 70910-900, DF, Brazil
- Goiano Federal Institute, Campus Morrinhos, Morrinhos 75650-000, GO, Brazil
| | - Renato André Sousa da Silva
- Laboratory of Physical Performance and Healthy, Faculty of Physical Education, Euro American University Center, Brasilia 70200-001, DF, Brazil
| | - Luiz Guilherme Grossi Porto
- Exercise Physiology Laboratory, Faculty of Physical Education, University of Brasilia, Brasilia 70910-900, DF, Brazil
- GEAFS—Research Group on Physiology and Epidemiology of Exercise and Physical Activity, Brasilia 70910-900, DF, Brazil
| | - Guilherme Eckhardt Molina
- Exercise Physiology Laboratory, Faculty of Physical Education, University of Brasilia, Brasilia 70910-900, DF, Brazil
- GEAFS—Research Group on Physiology and Epidemiology of Exercise and Physical Activity, Brasilia 70910-900, DF, Brazil
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20
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Park C, Youn I, Han S. Single-lead ECG based autonomic nervous system assessment for meditation monitoring. Sci Rep 2022; 12:22513. [PMID: 36581715 PMCID: PMC9800362 DOI: 10.1038/s41598-022-27121-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 12/26/2022] [Indexed: 12/30/2022] Open
Abstract
We propose a single-lead ECG-based heart rate variability (HRV) analysis algorithm to quantify autonomic nervous system activity during meditation. Respiratory sinus arrhythmia (RSA) induced by breathing is a dominant component of HRV, but its frequency depends on an individual's breathing speed. To address this RSA issue, we designed a novel HRV tachogram decomposition algorithm and new HRV indices. The proposed method was validated by using a simulation, and applied to our experimental (mindfulness meditation) data and the WESAD open-source data. During meditation, our proposed HRV indices related to vagal and sympathetic tones were significantly increased (p < 0.000005) and decreased (p < 0.000005), respectively. These results were consistent with self-reports and experimental protocols, and identified parasympathetic activation and sympathetic inhibition during meditation. In conclusion, the proposed method successfully assessed autonomic nervous system activity during meditation when respiration influences disrupted classical HRV. The proposed method can be considered a reliable approach to quantify autonomic nervous system activity.
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Affiliation(s)
- Chanki Park
- grid.36303.350000 0000 9148 4899Future and Basic Technology Research Division, ICT Creative Research Laboratory, Electronics and Telecommunications Research Institute, CybreBrain Research Section, Daejeon, 34129 Republic of Korea
| | - Inchan Youn
- grid.35541.360000000121053345Bionics Research Center, Biomedical Research Division, Korea Institute of Science and Technology, Seoul, 02792 Republic of Korea ,grid.35541.360000000121053345Division of Bio‑Medical Science and Technology, Korea Institute of Science and Technology School, Seoul, 02792 Republic of Korea ,grid.289247.20000 0001 2171 7818KHU-KIST Department of Converging Science and Technology, Kyung Hee University, Seoul, Seongbuk-gu 02447 Republic of Korea
| | - Sungmin Han
- grid.35541.360000000121053345Bionics Research Center, Biomedical Research Division, Korea Institute of Science and Technology, Seoul, 02792 Republic of Korea ,grid.35541.360000000121053345Division of Bio‑Medical Science and Technology, Korea Institute of Science and Technology School, Seoul, 02792 Republic of Korea
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21
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Solinsky R, Schleifer GD, Draghici AE, Hamner JW, Taylor JA. Methodologic implications for rehabilitation research: Differences in heart rate variability introduced by respiration. PM R 2022; 14:1483-1489. [PMID: 35077032 PMCID: PMC9309192 DOI: 10.1002/pmrj.12770] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 12/09/2021] [Accepted: 01/07/2022] [Indexed: 01/01/2023]
Abstract
BACKGROUND Heart rate variability is a measure of autonomic activity that is growing in popularity as a research outcome. However, despite its increased use, the known effects of respiration on heart rate variability measures are rarely accounted for in rehabilitation medicine research, leading to potential misinterpretation. OBJECTIVE To describe the effect that unpaced and paced breathing introduces to heart rate variability measures in a rehabilitation medicine relevant example of individuals with spinal cord injury. DESIGN Cross-sectional comparison of heart rate variability during unpaced and paced breathing (0.25 Hz, 15 breaths per minute) within the same individuals during the same lab session. SETTING Academic autonomic physiology laboratory. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Mean low frequency (LF) and high frequency (HF) heart rate variability power, percentage of total power derived from the LF spectrum, LF:HF ratio. RESULTS Fifty-nine individuals with spinal cord injury completed laboratory assessments using standardized protocols (NCT02139436). In repeated measures within individuals, mean LF power was significantly higher in unpaced breathing compared to paced breathing (1292 vs. 573 ms2 , p < .001). A Bland-Altman plot demonstrated significant positive proportional bias for LF power when comparing unpaced and paced breathing conditions (R2 = 0.39). Mean HF power was similar between unpaced and paced breathing conditions, although there were wide positive and negative differences between measures, leading to notable uncertainty when respiratory confounders were not accounted for. The percentages of total power derived from the LF spectrum and the mean LF:HF ratio were both significantly higher for unpaced breathing compared to paced breathing (64 vs. 42%, p < .001; and 3.2 vs. 1.1, p < .001, respectively). CONCLUSION Respiration has a significant effect on heart rate variability following spinal cord injury, and not accounting for this has serious consequences for accurate interpretation of unpaced data. Future studies of heart rate variability in rehabilitation medicine should accordingly consider paced breathing.
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Affiliation(s)
- Ryan Solinsky
- Spaulding Rehabilitation Hospital, Boston, Massachusetts, USA
- Department of Physical Medicine and Rehabilitation, Harvard Medical School
- Spaulding Research Institute, Boston, Massachusetts, USA
| | | | - Adina E Draghici
- Spaulding Rehabilitation Hospital, Boston, Massachusetts, USA
- Department of Physical Medicine and Rehabilitation, Harvard Medical School
- Spaulding Research Institute, Boston, Massachusetts, USA
| | - Jason W Hamner
- Spaulding Rehabilitation Hospital, Boston, Massachusetts, USA
- Department of Physical Medicine and Rehabilitation, Harvard Medical School
- Spaulding Research Institute, Boston, Massachusetts, USA
| | - J Andrew Taylor
- Spaulding Rehabilitation Hospital, Boston, Massachusetts, USA
- Department of Physical Medicine and Rehabilitation, Harvard Medical School
- Spaulding Research Institute, Boston, Massachusetts, USA
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22
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Stubbe L, Houel N, Cottin F. Accuracy and reliability of the optoelectronic plethysmography and the heart rate systems for measuring breathing rates compared with the spirometer. Sci Rep 2022; 12:19255. [PMID: 36357452 PMCID: PMC9648890 DOI: 10.1038/s41598-022-23915-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 11/07/2022] [Indexed: 11/12/2022] Open
Abstract
Measuring breathing rates without a mouthpiece is of interest in clinical settings. Electrocardiogram devices and, more recently, optoelectronic plethysmography (OEP) methods can estimate breathing rates with only a few electrodes or motion-capture markers placed on the patient. This study estimated and compared the accuracy and reliability of three non-invasive devices: an OEP system with 12 markers, an electrocardiogram device and the conventional spirometer. Using the three devices simultaneously, we recorded 72 six-minute epochs on supine subjects. Our results show that the OEP system has a very low limit of agreement and a bias lower than 0.4% compared with the spirometer, indicating that these devices can be used interchangeably. We observed comparable results for electrocardiogram devices. The OEP system facilitates breathing rate measurements and offers a more complete chest-lung volume analysis that can be easily associated with heart rate analysis without any synchronisation process, for useful features for clinical applications and intensive care.
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Affiliation(s)
- Laurent Stubbe
- grid.460789.40000 0004 4910 6535Université Paris-Saclay, CIAMS EA 4532, 91405 Orsay, France ,grid.112485.b0000 0001 0217 6921Université d’Orléans, CIAMS EA 4532, 45067 Orléans, France ,ESO-Paris Recherche, Ecole Supérieure d’Ostéopathie – Paris, 77420 Champs Sur Marne, France
| | - Nicolas Houel
- grid.11667.370000 0004 1937 0618Université de Reims Champagne-Ardenne, PSMS, Reims, France
| | - François Cottin
- grid.460789.40000 0004 4910 6535Université Paris-Saclay, CIAMS EA 4532, 91405 Orsay, France ,grid.112485.b0000 0001 0217 6921Université d’Orléans, CIAMS EA 4532, 45067 Orléans, France
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23
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The effects of normobaric and hypobaric hypoxia on cognitive performance and physiological responses: A crossover study. PLoS One 2022; 17:e0277364. [DOI: 10.1371/journal.pone.0277364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 10/25/2022] [Indexed: 11/12/2022] Open
Abstract
This partially randomised controlled, crossover study sought to investigate the effects of normobaric hypoxia (NH) and hypobaric hypoxia (HH) on cognitive performance, the physiological response at rest and after a 3-min step-test. Twenty healthy participants (10 females and 10 males, 27.6±6.2yrs, 73.6±13.7kg, 175.3±8.9cm) completed a cognitive performance test, followed by the modified Harvard-step protocol, in four environments: normobaric normoxia (NN; PiO2: 146.0±1.5mmHg), NH (PiO2: 100.9±1.3mmHg), HH at the first day of ascent (HH1: PiO2 = 105.6±0.4mmHg) and HH after an overnight stay (HH2: PiO2 = 106.0±0.5mmHg). At rest and/or exercise, SpO2, NIRS, and cardiovascular and perceptual data were collected. The cerebral tissue oxygenation index and the cognitive performance (throughput, accuracy, and reaction time) were not different between the hypoxic conditions (all p>0.05). In NH, SpO2 was higher compared to HH1 (ΔSpO2 NH vs HH1: 1.7±0.5%, p = 0.003) whilst heart rate (ΔHR NH vs HH2: 5.8±2.6 bpm, p = 0.03) and sympathetic activation (ΔSNSi NH vs HH2: 0.8±0.4, p = 0.03) were lower in NH compared to HH2. Heart rate (ΔHR HH1 vs HH2: 6.9±2.6 bpm, p = 0.01) and sympathetic action (ΔSNSi HH1 vs HH2: 0.9±0.4, p = 0.02) were both lower in HH1 compared to HH2. In conclusion, cognitive performance and cerebral oxygenation didn’t differ between the hypoxic conditions. SpO2 was only higher in NH compared to HH1. In HH2, heart rate and sympathetic activation were higher compared to both NH and HH1. These conclusions account for a PiO2 between 100–106 mmHg.
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24
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Kushwaha P, Moiz JA, Mujaddadi A. Exercise training and cardiac autonomic function following coronary artery bypass grafting: a systematic review and meta-analysis. Egypt Heart J 2022; 74:67. [PMID: 36138168 PMCID: PMC9500144 DOI: 10.1186/s43044-022-00306-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 09/11/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Exercise training improves cardiac autonomic function is still debatable in patients with coronary artery bypass grafting (CABG). The aim of the present review is to assess the effect of exercise on CABG patient's heart rate variability (HRV) and heart rate recovery (HRR) parameters. MAIN BODY Databases (PubMed, Web of Science and PEDro) were accessed for systematic search from inception till May 2022. Eleven potential studies were qualitatively analyzed by using PEDro and eight studies were included in the quantitative synthesis. Meta-analysis was conducted by using a random-effect model, inverse-variance approach through which standardized mean differences (SMDs) were estimated. The analysis of pooled data showed that exercise training improved HRV indices of standard deviation of the R-R intervals (SDNN) [SMD 0.44, 95% CI 0.17, 0.71, p = 0.002], square root of the mean squared differences between adjacent R-R intervals (RMSSD) [SMD 0.68, 95% CI 0.28, 1.08, p = 0.0008], high frequency (HF) [SMD 0.58, 95% CI 0.18, 0.98, p = 0.005] and low frequency-to-high frequency (LF/HF) ratio [SMD - 0.34, 95% CI - 0.65, - 0.02, p = 0.03]. CONCLUSIONS Exercise training enhances cardiac autonomic function in CABG patients. Owing to the methodological inconsistencies in assessing HRV, the precise effect on autonomic function still remains conflicted. Future high-quality trials are needed focusing on precise methodological approach and incorporation of various types of exercise training interventions will give clarity regarding autonomic adaptations post-exercise training in CABG. Trial registration CRD42021230270 , February 19, 2021.
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Affiliation(s)
- Purnima Kushwaha
- Centre for Physiotherapy and Rehabilitation Sciences, Jamia Millia Islamia (A Central University), New Delhi, 110025, India
| | - Jamal Ali Moiz
- Centre for Physiotherapy and Rehabilitation Sciences, Jamia Millia Islamia (A Central University), New Delhi, 110025, India
| | - Aqsa Mujaddadi
- Centre for Physiotherapy and Rehabilitation Sciences, Jamia Millia Islamia (A Central University), New Delhi, 110025, India.
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25
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Barthelemy JC, Pichot V, Hupin D, Berger M, Celle S, Mouhli L, Bäck M, Lacour JR, Roche F. Targeting autonomic nervous system as a biomarker of well-ageing in the prevention of stroke. Front Aging Neurosci 2022; 14:969352. [PMID: 36185479 PMCID: PMC9521604 DOI: 10.3389/fnagi.2022.969352] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 08/25/2022] [Indexed: 11/13/2022] Open
Abstract
Stroke prediction is a key health issue for preventive medicine. Atrial fibrillation (AF) detection is well established and the importance of obstructive sleep apneas (OSA) has emerged in recent years. Although autonomic nervous system (ANS) appears strongly implicated in stroke occurrence, this factor is more rarely considered. However, the consequences of decreased parasympathetic activity explored in large cohort studies through measurement of ANS activity indicate that an ability to improve its activity level and equilibrium may prevent stroke. In support of these observations, a compensatory neurostimulation has already proved beneficial on endothelium function. The available data on stroke predictions from ANS is based on many long-term stroke cohorts. These data underline the need of repeated ANS evaluation for the general population, in a medical environment, and remotely by emerging telemedicine digital tools. This would help uncovering the reasons behind the ANS imbalance that would need to be medically adjusted to decrease the risk of stroke. This ANS unbalance help to draw attention on clinical or non-clinical evidence, disclosing the vascular risk, as ANS activity integrates the cumulated risk from many factors of which most are modifiable, such as metabolic inadaptation in diabetes and obesity, sleep ventilatory disorders, hypertension, inflammation, and lack of physical activity. Treating these factors may determine ANS recovery through the appropriate management of these conditions. Natural aging also decreases ANS activity. ANS recovery will decrease global circulating inflammation, which will reinforce endothelial function and thus protect the vessels and the associated organs. ANS is the whistle-blower of vascular risk and the actor of vascular health. Such as, ANS should be regularly checked to help draw attention on vascular risk and help follow the improvements in response to our interventions. While today prediction of stroke relies on classical cardiovascular risk factors, adding autonomic biomarkers as HRV parameters may significantly increase the prediction of stroke.
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Affiliation(s)
- Jean-Claude Barthelemy
- Physical Exercise and Clinical Physiology Department, CHU Nord, Saint-Étienne, France
- INSERM U1059 Santé Ingénierie Biologie, Université Jean Monnet, Saint-Étienne, France
- *Correspondence: Jean-Claude Barthelemy,
| | - Vincent Pichot
- Physical Exercise and Clinical Physiology Department, CHU Nord, Saint-Étienne, France
- INSERM U1059 Santé Ingénierie Biologie, Université Jean Monnet, Saint-Étienne, France
| | - David Hupin
- Physical Exercise and Clinical Physiology Department, CHU Nord, Saint-Étienne, France
- INSERM U1059 Santé Ingénierie Biologie, Université Jean Monnet, Saint-Étienne, France
- Section of Translational Cardiology, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden
| | - Mathieu Berger
- Physical Exercise and Clinical Physiology Department, CHU Nord, Saint-Étienne, France
- INSERM U1059 Santé Ingénierie Biologie, Université Jean Monnet, Saint-Étienne, France
- Centre d’Investigation et de Recherche sur le Sommeil, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Sébastien Celle
- Physical Exercise and Clinical Physiology Department, CHU Nord, Saint-Étienne, France
- INSERM U1059 Santé Ingénierie Biologie, Université Jean Monnet, Saint-Étienne, France
| | - Lytissia Mouhli
- Physical Exercise and Clinical Physiology Department, CHU Nord, Saint-Étienne, France
- Département de Neurologie, Hôpital Universitaire Nord, Saint-Étienne, France
| | - Magnus Bäck
- Section of Translational Cardiology, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden
- Department of Cardiology, Karolinska University Hospital, Stockholm, Sweden
| | - Jean-René Lacour
- Laboratoire de Physiologie, Faculté de Médecine Lyon-Sud, Oullins, France
| | - Frederic Roche
- Physical Exercise and Clinical Physiology Department, CHU Nord, Saint-Étienne, France
- INSERM U1059 Santé Ingénierie Biologie, Université Jean Monnet, Saint-Étienne, France
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26
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Beyond mindfulness: Arousal-driven modulation of attentional control during arousal-based practices. CURRENT RESEARCH IN NEUROBIOLOGY 2022; 3:100053. [PMID: 36246552 PMCID: PMC9559070 DOI: 10.1016/j.crneur.2022.100053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Accepted: 08/22/2022] [Indexed: 11/20/2022] Open
Abstract
Here we report meditative techniques, which modulate attentional control by arousal-driven influences and not by monitoring continuous thought processes as during mindfulness-related practices. We focus on Vajrayana (Tantric Buddhism) practices, during which a sequence of generation (self-visualization as a deity - Yidam) or completion with sign (inner heat -Tummo) stages necessarily precedes non-dual awareness (NDA) Tantric Mahamudra. We compared the electrocardiographic and electroencephalographic correlates of Mahamudra performed after rest (non-Tantric Mahamudra) with Mahamudra performed after Yidam (Tantric Mahamudra) in 16 highly experienced Vajrayana practitioners, 10 of whom also performed Tummo. Both Yidam and Tummo developed the state of PNS withdrawal (arousal) and phasic alertness, as reflected by HF HRV decreases and Alpha2 power increases, later neurophysiologically employed in Tantric Mahamudra. The latter led to the unique state of high cortical excitability, “non-selective” focused attention, and significantly reduced attentional control, quantified by power reductions in all frequency bands, except Theta. In contrast, similar to mindfulness-related practices, non-Tantric Mahamudra was performed in a state of PNS dominance (relaxation), tonic alertness, and active monitoring, as suggested by Alpha1 power increases and less pronounced decreases in other frequency bands. A neurobiological model of meditation is proposed, differentiating arousal-based and mindfulness-related practices. Arousal-based meditations involve the state of PNS withdrawal and phasic alertness. Top-down control during arousal-based practices is modulated by arousal. Mindfulness-based practices involve the state of PNS dominance and tonic alertness. Top-down control during mindfulness-based practices is regulated by monitoring. NDA practices aim at non-selectivity of attention and reduction of top-down control.
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27
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Respiratory and heart rate dynamics during peripheral chemoreceptor deactivation compared to targeted sympathetic and sympathetic/parasympathetic (co-)activation. Auton Neurosci 2022; 241:103009. [PMID: 35753247 DOI: 10.1016/j.autneu.2022.103009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 05/29/2022] [Accepted: 06/13/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND The importance of peripheral chemoreceptors for cardiorespiratory neural control is known for decades. Pure oxygen inhalation deactivates chemoreceptors and increases parasympathetic outflow. However, the relationship between autonomic nervous system (ANS) activation and resulting respiratory as well as heart rate (HR) dynamics is still not fully understood. METHODS In young adults the impact of (1) 100 % pure oxygen inhalation (hyperoxic cardiac chemoreflex sensitivity (CHRS) testing), (2) the cold face test (CFT) and (3) the cold pressor test (CPT) on heart rate variability (HRV), hemodynamics and respiratory rate was investigated in randomized order. Baseline ANS outflow was determined assessing respiratory sinus arrhythmia via deep breathing, baroreflex sensitivity and HRV. RESULTS Baseline ANS outflow was normal in all participants (23 ± 1 years, 7 females, 3 males). Hyperoxic CHRS testing decreased HR (after 60 ± 3 vs before 63 ± 3 min-1, p = 0.004), while increasing total peripheral resistance (1053 ± 87 vs 988 ± 76 dyne*s + m2/cm5, p = 0.02) and mean arterial blood pressure (93 ± 4 vs 91 ± 4 mm Hg, p = 0.02). HRV indicated increased parasympathetic outflow after hyperoxic CHRS testing accompanied by a decrease in respiratory rate (15 ± 1vs 19 ± 1 min-1, p = 0.001). In contrast, neither CFT nor CPT altered the respiratory rate (18 ± 1 vs 18 ± 2 min-1, p = 0.38 and 18 ± 1 vs 18 ± 1 min-1, p = 0.84, respectively). CONCLUSION Changes in HR characteristics during deactivation of peripheral chemoreceptors but not during the CFT and CPT are related with a decrease in respiratory rate. This highlights the need of respiratory rate assessment when evaluating adaptations of cardiorespiratory chemoreceptor control.
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28
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Kwon PM, Lawrence S, Mueller BR, Thayer JF, Benn EKT, Robinson-Papp J. Interpreting resting heart rate variability in complex populations: the role of autonomic reflexes and comorbidities. Clin Auton Res 2022; 32:175-184. [PMID: 35562548 DOI: 10.1007/s10286-022-00865-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 04/17/2022] [Indexed: 11/25/2022]
Abstract
PURPOSE Resting heart rate variability (HRV) is an important biomarker linking mental health to cardiovascular outcomes. However, resting HRV is also impaired in autonomic neuropathy, a common and underdiagnosed complication of common medical conditions which is detected by testing autonomic reflexes. We sought to describe the relationship between autonomic reflex abnormalities and resting HRV, taking into consideration medical comorbidities and demographic variables. METHODS Participants (n = 209) underwent a standardized autonomic reflex screen which was summarized as the Composite Autonomic Severity Score (CASS) and included measures of reflexive HRV, e.g., heart rate with deep breathing (HRDB). Resting HRV measures were: pNN50 (percentage of NN intervals that differ by > 50 ms) and cvRMSSD (adjusted root mean square of successive differences). RESULTS In univariate analyses, lower resting HRV was associated with: older age, higher CASS, neuropathy on examination, hypertension, diabetes, chronic obstructive pulmonary disease, chronic kidney disease, and psychiatric disease. Adaptive regression spline analysis revealed that HRDB explained 27% of the variability in resting HRV for participants with values of HRDB in the normal range. Outside this range, there was no linear relationship because: (1) when HRDB was low (indicating autonomic neuropathy), resting HRV was also low with low variance; and (2) when HRDB was high, the variance in resting HRV was high. In multivariate models, only HRDB was significantly independently associated with cvRMSSD and pNN50. CONCLUSION Subclinical autonomic neuropathy, as evidenced by low HRDB and other autonomic reflexes, should be considered as a potential confounder of resting HRV in research involving medically and demographically diverse populations.
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Affiliation(s)
- Patrick M Kwon
- Department of Neurology, NYU Grossman School of Medicine, 8714 5th Ave 2nd Floor, Brooklyn, NY, 11209, USA.
| | - Steven Lawrence
- Center for Biostatistics and Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Bridget R Mueller
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Julian F Thayer
- Department of Psychological Science, School of Social Ecology, University of California at Irvine, Irvine, CA, USA
| | - Emma K T Benn
- Center for Biostatistics and Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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29
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Takahashi K, Wang X, Shinohara D, Imai K. Link Between Electroacupuncture Stimulation near the Sympathetic Trunk and Heart Rate Variability. J Acupunct Meridian Stud 2022; 15:114-120. [DOI: 10.51507/j.jams.2022.15.2.114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 09/15/2021] [Accepted: 12/23/2021] [Indexed: 11/03/2022] Open
Affiliation(s)
- Kazufumi Takahashi
- Department of Acupuncture and Moxibustion, Faculty of Health Care, Teikyo Heisei University, Tokyo, Japan
- Research Institute of Oriental Medicine, Teikyo Heisei University, Tokyo, Japan
| | - Xiaoming Wang
- Department of Acupuncture and Moxibustion, Faculty of Health Care, Teikyo Heisei University, Tokyo, Japan
- Research Institute of Oriental Medicine, Teikyo Heisei University, Tokyo, Japan
| | - Daiyu Shinohara
- Department of Acupuncture and Moxibustion, Graduate School of Health Sciences, Teikyo Heisei University, Tokyo, Japan
| | - Kenji Imai
- Department of Acupuncture and Moxibustion, Faculty of Health Care, Teikyo Heisei University, Tokyo, Japan
- Research Institute of Oriental Medicine, Teikyo Heisei University, Tokyo, Japan
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30
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Michela A, van Peer JM, Brammer JC, Nies A, van Rooij MMJW, Oostenveld R, Dorrestijn W, Smit AS, Roelofs K, Klumpers F, Granic I. Deep-Breathing Biofeedback Trainability in a Virtual-Reality Action Game: A Single-Case Design Study With Police Trainers. Front Psychol 2022; 13:806163. [PMID: 35222194 PMCID: PMC8868154 DOI: 10.3389/fpsyg.2022.806163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Accepted: 01/03/2022] [Indexed: 11/15/2022] Open
Abstract
It is widely recognized that police performance may be hindered by psychophysiological state changes during acute stress. To address the need for awareness and control of these physiological changes, police academies in many countries have implemented Heart-Rate Variability (HRV) biofeedback training. Despite these trainings now being widely delivered in classroom setups, they typically lack the arousing action context needed for successful transfer to the operational field, where officers must apply learned skills, particularly when stress levels rise. The study presented here aimed to address this gap by training physiological control skills in an arousing decision-making context. We developed a Virtual-Reality (VR) breathing-based biofeedback training in which police officers perform deep and slow diaphragmatic breathing in an engaging game-like action context. This VR game consisted of a selective shoot/don’t shoot game designed to assess response inhibition, an impaired capacity in high arousal situations. Biofeedback was provided based on adherence to a slow breathing pace: the slower and deeper the breathing, the less constrained peripheral vision became, facilitating accurate responses to the in-game demands. A total of nine male police trainers completed 10 sessions over a 4-week period as part of a single-case experimental ABAB study-design (i.e., alternating sessions with and without biofeedback). Results showed that eight out of nine participants showed improved breathing control in action, with a positive effect on breathing-induced low frequency HRV, while also improving their in-game behavioral performance. Critically, the breathing-based skill learning transferred to subsequent sessions in which biofeedback was not presented. Importantly, all participants remained highly engaged throughout the training. Altogether, our study showed that our VR environment can be used to train breathing regulation in an arousing and active decision-making context.
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Affiliation(s)
- Abele Michela
- Behavioral Science Institute, Radboud University, Nijmegen, Netherlands
| | | | - Jan C Brammer
- Behavioral Science Institute, Radboud University, Nijmegen, Netherlands
| | - Anique Nies
- Behavioral Science Institute, Radboud University, Nijmegen, Netherlands
| | - Marieke M J W van Rooij
- Faculty of Behavioral, Management and Social Sciences, University of Twente, Twente, Netherlands
| | - Robert Oostenveld
- Donders Institute for Brain, Cognition and Behavior, Radboud University, Nijmegen, Netherlands.,NatMEG, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | | | - Annika S Smit
- Police Academy of the Netherlands, Apeldoorn, Netherlands.,Humanism and Social Resilience, University of Humanistic Studies, Utrecht, Netherlands
| | - Karin Roelofs
- Behavioral Science Institute, Radboud University, Nijmegen, Netherlands.,Donders Institute for Brain, Cognition and Behavior, Radboud University, Nijmegen, Netherlands
| | - Floris Klumpers
- Behavioral Science Institute, Radboud University, Nijmegen, Netherlands.,Donders Institute for Brain, Cognition and Behavior, Radboud University, Nijmegen, Netherlands
| | - Isabela Granic
- Behavioral Science Institute, Radboud University, Nijmegen, Netherlands.,Faculty of Social Sciences, McMaster University, Hamilton, ON, Canada
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Gąsior JS, Rosoł M, Młyńczak M, Flatt AA, Hoffmann B, Baranowski R, Werner B. Reliability of Symbolic Analysis of Heart Rate Variability and Its Changes During Sympathetic Stimulation in Elite Modern Pentathlon Athletes: A Pilot Study. Front Physiol 2022; 13:829887. [PMID: 35295583 PMCID: PMC8918944 DOI: 10.3389/fphys.2022.829887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 01/21/2022] [Indexed: 11/24/2022] Open
Abstract
Background and Purpose Most studies on heart rate variability (HRV) in professional athletes concerned linear, time-, and frequency-domain indices, and there is lack of studies on non-linear parameters in this group. The study aimed to determine the inter-day reliability, and group-related and individual changes of short-term symbolic dynamics (SymDyn) measures during sympathetic nervous system activity (SNSa) stimulation among elite modern pentathletes. Methods Short-term electrocardiographic recordings were performed in stable measurement conditions with a 7-day interval between tests. SNSa stimulation via isometric handgrip strength test was conducted on the second day of study. The occurrence rate of patterns without variations (0V), with one variation (1V), two like (2LV), and two unlike variations (2UV) obtained using three approaches (the Max–min, the σ, and the Equal-probability methods) were analyzed. Relative and absolute reliability were evaluated. Results All SymDyn indices obtained using the Max–min method, 0V, and 2UV obtained using the σ method, 2UV obtained using the Equal-probability method presented acceptable inter-day reliability (the intraclass correlation coefficient between .91 and .99, Cohen’s d between −.08 and .10, the within-subject coefficient of variation between 4% and 22%). 2LV, 2UV, and 0V obtained using the Max–min and σ methods significantly decreased and increased, respectively, during SNSa stimulation—such changes were noted for all athletes. There was no significant association between differences in SymDyn parameters and respiratory rate in stable conditions and while comparing stable conditions and SNSa stimulation. Conclusion SymDyn indices may be used as reliable non-respiratory-associated parameters in laboratory settings to detect autonomic nervous system (ANS) activity modulations in elite endurance athletes. These findings provide a potential solution for addressing the confounding influence of respiration frequency on HRV-derived inferences of cardiac autonomic function. For this reason, SymDyn may prove to be preferable for field-based monitoring where measurements are unsupervised.
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Affiliation(s)
- Jakub S. Gąsior
- Department of Pediatric Cardiology and General Pediatrics, Medical University of Warsaw, Warsaw, Poland
- *Correspondence: Jakub S. Gąsior,
| | - Maciej Rosoł
- Faculty of Mechatronics, Institute of Metrology and Biomedical Engineering, Warsaw University of Technology, Warsaw, Poland
| | - Marcel Młyńczak
- Faculty of Mechatronics, Institute of Metrology and Biomedical Engineering, Warsaw University of Technology, Warsaw, Poland
| | - Andrew A. Flatt
- Biodynamics and Human Performance Center, Department of Health Sciences and Kinesiology, Georgia Southern University (Armstrong Campus), Savannah, GA, United States
| | - Bartosz Hoffmann
- Physiotherapy Division, Faculty of Medical Sciences, Medical University of Warsaw, Warsaw, Poland
| | - Rafał Baranowski
- Department of Heart Rhythm Disorders, National Institute of Cardiology, Warsaw, Poland
| | - Bożena Werner
- Department of Pediatric Cardiology and General Pediatrics, Medical University of Warsaw, Warsaw, Poland
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32
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Early heart rate variability evaluation enables to predict ICU patients' outcome. Sci Rep 2022; 12:2498. [PMID: 35169170 PMCID: PMC8847560 DOI: 10.1038/s41598-022-06301-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 01/17/2022] [Indexed: 12/05/2022] Open
Abstract
Heart rate variability (HRV) is a mean to evaluate cardiac effects of autonomic nervous system activity, and a relation between HRV and outcome has been proposed in various types of patients. We attempted to evaluate the best determinants of such variation in survival prediction using a physiological data-warehousing program. Plethysmogram tracings (PPG) were recorded at 75 Hz from the standard monitoring system, for a 2 h period, during the 24 h following ICU admission. Physiological data recording was associated with metadata collection. HRV was derived from PPG in either the temporal and non-linear domains. 540 consecutive patients were recorded. A lower LF/HF, SD2/SD1 ratios and Shannon entropy values on admission were associated with a higher ICU mortality. SpO2/FiO2 ratio and HRV parameters (LF/HF and Shannon entropy) were independent correlated with mortality in the multivariate analysis. Machine-learning using neural network (kNN) enabled to determine a simple decision tree combining the three best determinants (SDNN, Shannon Entropy, SD2/SD1 ratio) of a composite outcome index. HRV measured on admission enables to predict outcome in the ICU or at Day-28, independently of the admission diagnosis, treatment and mechanical ventilation requirement. Trial registration: ClinicalTrials.gov identifier NCT02893462.
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33
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Room to breathe: Using adaptive architecture to examine the relationship between alexithymia and interoception. J Psychosom Res 2022; 153:110708. [PMID: 34954603 DOI: 10.1016/j.jpsychores.2021.110708] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 12/15/2021] [Accepted: 12/16/2021] [Indexed: 12/16/2022]
Abstract
OBJECTIVE Individuals with alexithymia experience difficulties interpreting emotional states in self and others, which has been associated with interoceptive impairment. Current theories are primarily based on subjective and conscious measures of interoceptive sensitivity, such as heartrate detection, but it is unclear whether similar observations would be found for objective or implicit psychophysiological measures. The present exploratory study assesses the potential of a novel assay through the use of adaptive immersive architecture [ExoBuilding]. METHODS N = 88 participants were screened for alexithymic traits and N = 27 individuals, representing the range of scores, were sampled to participate in the behavioural task. In a repeated-measures design, participants were placed within ExoBuilding and asked to match their respiration to its movement. Performance was compared to a two-dimensional pacer condition. Behavioural (accuracy) and psychophysiological (Respiratory Sinus Arrhythmia [RSA] and heartrate) measures were compared across conditions, and also related to individual alexithymic traits. RESULTS Participants with higher levels of alexithymia performed less accurately than participants with lower levels, in both conditions. High-alexithymia participants showed a smaller reduction in heartrate over the course of the ExoBuilding condition than low-alexithymia participants, although there were no differences in RSA between conditions or participants. CONCLUSION Alexithymia extends beyond conscious interoceptive activities and is also observed in immersive contexts that usually exert psychophysiological effects on typical occupants. These initial findings highlight the importance of considering both conscious and implicit measures of interoception, and we suggest ways in which theories of alexithymia might benefit from capturing this distinction.
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Abstract
Much of biology is rhythmical and comprises oscillators that can couple. These have optimized energy efficiency and have been preserved during evolution. The respiratory and cardiovascular systems contain numerous oscillators, and importantly, they couple. This coupling is dynamic but essential for an efficient transmission of neural information critical for the precise linking of breathing and oxygen delivery while permitting adaptive responses to changes in state. The respiratory pattern generator and the neural network responsible for sympathetic and cardiovagal (parasympathetic) tone generation interact at many levels ensuring that cardiac output and regional blood flow match oxygen delivery to the lungs and tissues efficiently. The most classic manifestations of these interactions are respiratory sinus arrhythmia and the respiratory modulation of sympathetic nerve activity. These interactions derive from shared somatic and cardiopulmonary afferent inputs, reciprocal interactions between brainstem networks and inputs from supra-pontine regions. Disrupted respiratory-cardiovascular coupling can result in disease, where it may further the pathophysiological sequelae and be a harbinger of poor outcomes. This has been well documented by diminished respiratory sinus arrhythmia and altered respiratory sympathetic coupling in animal models and/or patients with myocardial infarction, heart failure, diabetes mellitus, and neurological disorders as stroke, brain trauma, Parkinson disease, or epilepsy. Future research needs to assess the therapeutic potential for ameliorating respiratory-cardiovascular coupling in disease.
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Affiliation(s)
- James P Fisher
- Manaaki Manawa-The Centre for Heart Research, Department of Physiology, Faculty of Medical & Health Sciences, University of Auckland, Auckland, New Zealand
| | - Tymoteusz Zera
- Department of Experimental and Clinical Physiology, Laboratory of Centre for Preclinical Research, Medical University of Warsaw, Warsaw, Poland
| | - Julian F R Paton
- Manaaki Manawa-The Centre for Heart Research, Department of Physiology, Faculty of Medical & Health Sciences, University of Auckland, Auckland, New Zealand.
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de Zambotti M, Yuksel D, Kiss O, Barresi G, Arra N, Volpe L, King C, Baker FC. A virtual reality-based mind–body approach to downregulate psychophysiological arousal in adolescent insomnia. Digit Health 2022; 8:20552076221107887. [PMID: 35733879 PMCID: PMC9208061 DOI: 10.1177/20552076221107887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Accepted: 05/30/2022] [Indexed: 11/15/2022] Open
Abstract
Objective In this study, we describe the rationale, supported by preliminary data, for a novel, digital, immersive virtual reality (VR)-based mind–body approach, designed to reduce bedtime arousal in adolescents with insomnia. Methods Fifty-two high-school students (16–20 years; 32 female) with ( N = 18) and without ( N = 34) DSM-5 insomnia symptoms engaged with 20 min of immersive VR-guided meditation and paced breathing (0.1 Hz) ( intervention condition) and 20 min of quiet activity ( control condition), right before bedtime, on two separate evenings. Results The intervention resulted in acute autonomic and cortical modulation ( p < 0.05), leading to reduced physiological arousal (↓heart rate, ↓cortisol) compared with the control condition, with similar effects in adolescents with and without insomnia. No significant changes were detected for cognitive arousal levels. During the intervention, all participants were able to achieve the targeted 0.1 Hz breathing rate, and the majority experienced no discomfort associated with the VR exposure. However, 30–40% of the participants experienced some trouble slowing down their breathing. Conclusions The study provides supporting preliminary evidence for the mechanism behind a novel VR-based digital approach, designed to regulate psychophysiological arousal levels by acting on neurocognitive and autonomic pathways. Further studies (e.g. randomized clinical trials) are needed to evaluate the isolated and synergistic effects of its components (e.g. VR vs. VR + paced breathing), and its efficacy, acceptance, and feasibility in alleviating insomnia symptoms in adolescents.
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Affiliation(s)
| | - Dilara Yuksel
- Center for Health Sciences, SRI International, Menlo Park, CA, USA
| | - Orsolya Kiss
- Center for Health Sciences, SRI International, Menlo Park, CA, USA
| | - Giacinto Barresi
- Rehab Technologies, Istituto Italiano di Tecnologia, Genoa, Italy
| | - Nicole Arra
- Center for Health Sciences, SRI International, Menlo Park, CA, USA
| | - Laila Volpe
- Center for Health Sciences, SRI International, Menlo Park, CA, USA
| | - Christopher King
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
- Pediatric Pain Research Center (PPRC), Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Fiona C Baker
- Center for Health Sciences, SRI International, Menlo Park, CA, USA
- Brain Function Research Group, School of Physiology, University of the Witwatersrand, Johannesburg, South Africa
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Tanner V, Faiss R, Saugy J, Bourdillon N, Schmitt L, Millet GP. Similar Supine Heart Rate Variability Changes During 24-h Exposure to Normobaric vs. Hypobaric Hypoxia. Front Neurosci 2021; 15:777800. [PMID: 34955728 PMCID: PMC8695977 DOI: 10.3389/fnins.2021.777800] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 11/22/2021] [Indexed: 01/22/2023] Open
Abstract
Purpose: This study aimed to investigate the differences between normobaric (NH) and hypobaric hypoxia (HH) on supine heart rate variability (HRV) during a 24-h exposure. We hypothesized a greater decrease in parasympathetic-related parameters in HH than in NH. Methods: A pooling of original data from forty-one healthy lowland trained men was analyzed. They were exposed to altitude either in NH (FIO2 = 15.7 ± 2.0%; PB = 698 ± 25 mmHg) or HH (FIO2 = 20.9%; PB = 534 ± 42 mmHg) in a randomized order. Pulse oximeter oxygen saturation (SpO2), heart rate (HR), and supine HRV were measured during a 7-min rest period three times: before (in normobaric normoxia, NN), after 12 (H12), and 24 h (H24) of either NH or HH exposure. HRV parameters were analyzed for time- and frequency-domains. Results: SpO2 was lower in both hypoxic conditions than in NN and was higher in NH than HH at H24. Subjects showed similarly higher HR during both hypoxic conditions than in NN. No difference in HRV parameters was found between NH and HH at any time. The natural logarithm of root mean square of the successive differences (LnRMSSD) and the high frequency spectral power (HF), which reflect parasympathetic activity, decreased similarly in NH and HH when compared to NN. Conclusion: Despite SpO2 differences, changes in supine HRV parameters during 24-h exposure were similar between NH and HH conditions indicating a similar decrease in parasympathetic activity. Therefore, HRV can be analyzed similarly in NH and HH conditions.
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Affiliation(s)
- Valérian Tanner
- Medicine School, Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - Raphael Faiss
- Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland.,REDs, Research and Expertise in Anti-Doping Sciences, University of Lausanne, Lausanne, Switzerland
| | - Jonas Saugy
- Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland.,REDs, Research and Expertise in Anti-Doping Sciences, University of Lausanne, Lausanne, Switzerland
| | - Nicolas Bourdillon
- Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland
| | - Laurent Schmitt
- National Centre of Nordic-Ski, Research and Performance, Prémanon, France
| | - Grégoire P Millet
- Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland
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Porta A, Gelpi F, Bari V, Cairo B, De Maria B, Tonon D, Rossato G, Ranucci M, Faes L. Categorizing the Role of Respiration in Cardiovascular and Cerebrovascular Variability Interactions. IEEE Trans Biomed Eng 2021; 69:2065-2076. [PMID: 34905489 DOI: 10.1109/tbme.2021.3135313] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Respiration disturbs cardiovascular and cerebrovascular controls but its role is not fully elucidated. METHODS Respiration can be classified as a confounder if its observation reduces the strength of the causal relationship from source to target. Respiration is a suppressor if the opposite situation holds. We prove that a confounding/suppression (C/S) test can be accomplished by evaluating the sign of net redundancy/synergy balance in the predictability framework based on multivariate autoregressive modelling. In addition, we suggest that, under the hypothesis of Gaussian processes, the C/S test can be given in the transfer entropy decomposition framework as well. Experimental protocols: We applied the C/S test to variability series of respiratory movements, heart period, systolic arterial pressure, mean arterial pressure, and mean cerebral blood flow recorded in 17 pathological individuals (age: 648 yrs; 17 males) before and after induction of propofol-based general anesthesia prior to coronary artery bypass grafting, and in 13 healthy subjects (age: 278 yrs; 5 males) at rest in supine position and during head-up tilt with a table inclination of 60. RESULTS Respiration behaved systematically as a confounder for cardiovascular and cerebrovascular controls. In addition, its role was affected by propofol-based general anesthesia but not by a postural stimulus of limited intensity. CONCLUSION The C/S test can be fruitfully exploited to categorize the role of respiration over causal variability interactions. SIGNIFICANCE The application of the C/S test could favor the comprehension of the role of respiration in cardiovascular and cerebrovascular regulations.
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Wang J, Liu J, Gao L, Li G, Sun Y, Shi B. Heart Rate Variability is an Independent Predictor of Lymph Node Metastasis in Patients with Cervical Cancer. Cancer Manag Res 2021; 13:8821-8830. [PMID: 34853536 PMCID: PMC8627856 DOI: 10.2147/cmar.s336268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 11/11/2021] [Indexed: 01/19/2023] Open
Abstract
Purpose Heart rate variability (HRV) has been reported as a useful biomarker for prognostic factors in a variety of cancers. The purpose of this study was to explore the predictive value of preoperative HRV for lymph node metastasis (LNM) in patients with cervical cancer (CC). Patients and Methods A total of 77 patients with CC were included, including 18 LNM and 59 non-LNM patients. A five-minute resting electrocardiogram (ECG) was collected before surgery for the analysis of HRV time domain, frequency domain and Poincaré plot parameters (ie, SDNN, RMSSD, LF, HF, LF/HF, SD1, SD2 and SD2/SD1). Student’s t-tests and logistic regression were performed to determine the relationship between HRV and LNM. Results The LNM group had significantly lower SDNN, LF, and SD2 than the non-LNM group (all p < 0.05; all Cohen’s d > 0.5). Binary logistic regression analysis indicated that SDNN, LF and SD2 were still significantly associated with LNM. Specifically, for each 1 ms decrease in SDNN and SD2 and each 1 logarithmic unit decrease in ln (LF), the odds of LNM increased by 12%, 9%, and 86%, respectively (all p < 0.05). Conclusion These findings suggest an association between HRV and CC LNM, and HRV could be a potential noninvasive biomarker for the prediction of LNM in CC patients.
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Affiliation(s)
- Jingfeng Wang
- School of Medical Imaging, Bengbu Medical College, Bengbu, Anhui, 233030, People's Republic of China.,Anhui Key Laboratory of Computational Medicine and Intelligent Health, Bengbu Medical College, Bengbu, Anhui, 233030, People's Republic of China
| | - Jian Liu
- Department of Gynecologic Oncology, First Affiliated Hospital, Bengbu Medical College, Bengbu, Anhui, 233004, People's Republic of China
| | - Longfei Gao
- Department of Gynecologic Oncology, First Affiliated Hospital, Bengbu Medical College, Bengbu, Anhui, 233004, People's Republic of China
| | - Guangqiao Li
- School of Medical Imaging, Bengbu Medical College, Bengbu, Anhui, 233030, People's Republic of China.,Anhui Key Laboratory of Computational Medicine and Intelligent Health, Bengbu Medical College, Bengbu, Anhui, 233030, People's Republic of China
| | - Yilin Sun
- Department of Gynecologic Oncology, First Affiliated Hospital, Bengbu Medical College, Bengbu, Anhui, 233004, People's Republic of China
| | - Bo Shi
- School of Medical Imaging, Bengbu Medical College, Bengbu, Anhui, 233030, People's Republic of China.,Anhui Key Laboratory of Computational Medicine and Intelligent Health, Bengbu Medical College, Bengbu, Anhui, 233030, People's Republic of China
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Chen KH, Brown CL, Wells JL, Rothwell ES, Otero M, Levenson RW, Fredrickson BL. Physiological linkage during shared positive and shared negative emotion. J Pers Soc Psychol 2021; 121:1029-1056. [PMID: 32897091 PMCID: PMC8261768 DOI: 10.1037/pspi0000337] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Physiological linkage refers to the degree to which peoples' physiological responses change in coordinated ways. Here, we examine whether and how physiological linkage relates to incidents of shared emotion, distinguished by valence. Past research has used an "overall average" approach and characterized how physiological linkage over relatively long time periods (e.g., 10-15 min) reflects psychological and social processes (e.g., marital satisfaction, empathy). Here, we used a "momentary" approach and characterized whether physiological linkage over relatively short time periods (i.e., 15 s) reflects shared positive emotion, shared negative emotion, or both, and whether linkage during shared emotions relates to relational functioning. Married couples (156 dyads) had a 15-min conflict conversation in the laboratory. Using behavioral coding, each second of conversation was classified into 1 of 4 emotion categories: shared positive emotion, shared negative emotion, shared neutral emotion, or unshared emotion. Using a composite of 3 peripheral physiological measures (i.e., heart rate, skin conductance, finger pulse amplitude), we computed momentary in-phase and antiphase linkage to represent coordinated changes in the same or opposite direction, respectively. We found that shared positive emotion was associated with higher in-phase and lower antiphase linkage, relative to the other 3 emotion categories. Greater in-phase physiological linkage during shared positive emotion was also consistently associated with higher-quality interactions and relationships, both concurrently and longitudinally (i.e., 5 to 6 years later). These findings advance our understanding of the nature of physiological linkage, the emotional conditions under which it occurs, and its possible associations with relational functioning. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Affiliation(s)
- Kuan-Hua Chen
- Institute of Personality and Social Research, University of California, Berkeley
- Department of Psychology, University of California, Berkeley
| | - Casey L. Brown
- Department of Psychology, University of California, Berkeley
| | - Jenna L. Wells
- Department of Psychology, University of California, Berkeley
| | - Emily S. Rothwell
- Department of Psychology, University of California, Davis
- Department of Psychological and Brain Sciences, University of Massachusetts, Amherst
| | - Marcela Otero
- Department of Psychology, University of California, Berkeley
- Sierra Pacific Mental Illness Research Education and Clinical Centers, VA Palo Alto Health Care System
- Department of Psychiatry and Behavioral Sciences, Stanford University
| | - Robert W. Levenson
- Institute of Personality and Social Research, University of California, Berkeley
- Department of Psychology, University of California, Berkeley
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Gonzalez JE, Jewell SR, Stelly SP, Cooke WH. Controlled breathing and autonomic rhythms: Influence of auditory versus visual cues. Auton Neurosci 2021; 236:102896. [PMID: 34656965 DOI: 10.1016/j.autneu.2021.102896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 08/26/2021] [Accepted: 10/08/2021] [Indexed: 10/20/2022]
Abstract
We compared standard metrics of autonomic control in 20 humans (10 female) during spontaneous and controlled breathing. Subjects controlled breathing at 0.25 Hz following a metronome (auditory) or scrolling waveforms (visual). Respiratory rates and heart rates were lower during spontaneous breathing compared with auditory and visual. One heart rate variability metric was higher during visual compared with spontaneous breathing, but baroreflex sensitivity and muscle sympathetic nerve activity were not affected by breathing cues. A majority of subjects (86%) perceived that breathing to auditory cues was more difficult compared with visual cues, but this elevated perceived stress did not manifest physiologically.
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Affiliation(s)
- Joshua E Gonzalez
- Department of Kinesiology and Integrative Physiology, Michigan Technological University, Houghton, MI, United States of America
| | - Stephanie R Jewell
- Department of Kinesiology and Integrative Physiology, Michigan Technological University, Houghton, MI, United States of America
| | - Steven P Stelly
- Department of Kinesiology and Integrative Physiology, Michigan Technological University, Houghton, MI, United States of America
| | - William H Cooke
- Department of Kinesiology and Integrative Physiology, Michigan Technological University, Houghton, MI, United States of America; Health Research Institute, Michigan Technological University, Houghton, MI, United States of America.
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Arechavala RJ, Rochart R, Kloner RA, Liu A, Wu DA, Hung SM, Shimojo S, Fonteh AN, Kleinman MT, Harrington MG, Arakaki X. Task switching reveals abnormal brain-heart electrophysiological signatures in cognitively healthy individuals with abnormal CSF amyloid/tau, a pilot study. Int J Psychophysiol 2021; 170:102-111. [PMID: 34666107 PMCID: PMC8865562 DOI: 10.1016/j.ijpsycho.2021.10.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 10/03/2021] [Accepted: 10/12/2021] [Indexed: 11/07/2022]
Abstract
Electroencephalographic (EEG) alpha oscillations have been related to heart rate variability (HRV) and both change in Alzheimer’s disease (AD). We explored if task switching reveals altered alpha power and HRV in cognitively healthy individuals with AD pathology in cerebrospinal fluid (CSF) and whether HRV improves the AD pathology classification by alpha power alone. We compared low and high alpha event-related desynchronization (ERD) and HRV parameters during task switch testing between two groups of cognitively healthy participants classified by CSF amyloid/tau ratio: normal (CH-NAT, n = 19) or pathological (CH-PAT, n = 27). For the task switching paradigm, participants were required to name the color or word for each colored word stimulus, with two sequential stimuli per trial. Trials include color (cC) or word (wW) repeats with low load repeating, and word (cW) or color switch (wC) for high load switching. HRV was assessed for RR interval, standard deviation of RR-intervals (SDNN) and root mean squared successive differences (RMSSD) in time domain, and low frequency (LF), high frequency (HF), and LF/HF ratio in frequency domain. Results showed that CH-PATs compared to CH-NATs presented: 1) increased (less negative) low alpha ERD during low load repeat trials and lower word switch cost (low alpha: p = 0.008, Cohen’s d = −0.83, 95% confidence interval −1.44 to −0.22, and high alpha: p = 0.019, Cohen’s d = −0.73, 95% confidence interval −1.34 to −0.13); 2) decreasing HRV from rest to task, suggesting hyper-activated sympatho-vagal responses. 3) CH-PATs classification by alpha ERD was improved by supplementing HRV signatures, supporting a potentially compromised brain-heart interoceptive regulation in CH-PATs. Further experiments are needed to validate these findings for clinical significance.
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Affiliation(s)
| | - Roger Rochart
- Neurosciences, Huntington Medical Research Institutes, Pasadena, CA 91105, USA
| | - Robert A Kloner
- Cardiovascular Research, Huntington Medical Research Institutes, Pasadena, CA 91105, USA; Division of Cardiovascular Medicine, Dept of Medicine, Keck School of Medicine at University of Southern California, Los Angeles, CA 90033, USA
| | - Anqi Liu
- Department of Computing and Mathematical Sciences (CMS), California Institute of Technology, Pasadena, CA 91125, USA; Department of Computer Science, Whiting School of Engineering, Johns Hopkins University, Baltimore, MD 21218, USA
| | - Daw-An Wu
- Division of Biology and Biological Engineering, California Institute of Technology, Pasadena, CA 91125, USA
| | - Shao-Min Hung
- Division of Biology and Biological Engineering, California Institute of Technology, Pasadena, CA 91125, USA
| | - Shinsuke Shimojo
- Division of Biology and Biological Engineering, California Institute of Technology, Pasadena, CA 91125, USA
| | - Alfred N Fonteh
- Neurosciences, Huntington Medical Research Institutes, Pasadena, CA 91105, USA
| | | | - Michael G Harrington
- Neurology, Keck School of Medicine at University of Southern California, Los Angeles, CA 90033, USA
| | - Xianghong Arakaki
- Neurosciences, Huntington Medical Research Institutes, Pasadena, CA 91105, USA.
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Manresa-Rocamora A, Sarabia JM, Javaloyes A, Flatt AA, Moya-Ramón M. Heart Rate Variability-Guided Training for Enhancing Cardiac-Vagal Modulation, Aerobic Fitness, and Endurance Performance: A Methodological Systematic Review with Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:10299. [PMID: 34639599 PMCID: PMC8507742 DOI: 10.3390/ijerph181910299] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 09/25/2021] [Accepted: 09/27/2021] [Indexed: 12/25/2022]
Abstract
PURPOSE This systematic review with meta-analysis was conducted to establish whether heart rate variability (HRV)-guided training enhances cardiac-vagal modulation, aerobic fitness, or endurance performance to a greater extent than predefined training while accounting for methodological factors. METHODS We searched Web of Science Core Collection, Pubmed, and Embase databases up to October 2020. A random-effects model of standardized mean difference (SMD) was estimated for each outcome measure. Chi-square and the I2 index were used to evaluate the degree of homogeneity. RESULTS Accounting for methodological factors, HRV-guided training was superior for enhancing vagal-related HRV indices (SMD+ = 0.50 (95% confidence interval (CI) = 0.09, 0.91)), but not resting HR (SMD+ = 0.04 (95% CI = -0.34, 0.43)). Consistently small but non-significant (p > 0.05) SMDs in favor of HRV-guided training were observed for enhancing maximal aerobic capacity (SMD+ = 0.20 (95% CI = -0.07, 0.47)), aerobic capacity at second ventilatory threshold (SMD+ = 0.26 (95% CI = -0.05, 0.57)), and endurance performance (SMD+ = 0.20 (95% CI = -0.09, 0.48)), versus predefined training. No heterogeneity was found for any of the analyzed aerobic fitness and endurance performance outcomes. CONCLUSION Best methodological practices pertaining to HRV index selection, recording position, and approaches for establishing baseline reference values and daily changes (i.e., fixed or rolling HRV averages) require further study. HRV-guided training may be more effective than predefined training for maintaining and improving vagal-mediated HRV, with less likelihood of negative responses. However, if HRV-guided training is superior to predefined training for producing group-level improvements in fitness and performance, current data suggest it is only by a small margin.
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Affiliation(s)
- Agustín Manresa-Rocamora
- Sports Research Centre, Department of Sport Sciences, Miguel Hernández University of Elche, 03202 Elche, Spain; (A.M.-R.); (J.M.S.); (A.J.)
- Institute for Health and Biomedical Research (ISABIAL Foundation), Miguel Hernandez University, 03550 Alicante, Spain
| | - José Manuel Sarabia
- Sports Research Centre, Department of Sport Sciences, Miguel Hernández University of Elche, 03202 Elche, Spain; (A.M.-R.); (J.M.S.); (A.J.)
- Institute for Health and Biomedical Research (ISABIAL Foundation), Miguel Hernandez University, 03550 Alicante, Spain
| | - Alejandro Javaloyes
- Sports Research Centre, Department of Sport Sciences, Miguel Hernández University of Elche, 03202 Elche, Spain; (A.M.-R.); (J.M.S.); (A.J.)
| | - Andrew A. Flatt
- Department of Health Sciences and Kinesiology, Georgia Southern University (Armstrong Campus), Savannah, GA 31419, USA;
| | - Manuel Moya-Ramón
- Sports Research Centre, Department of Sport Sciences, Miguel Hernández University of Elche, 03202 Elche, Spain; (A.M.-R.); (J.M.S.); (A.J.)
- Institute for Health and Biomedical Research (ISABIAL Foundation), Miguel Hernandez University, 03550 Alicante, Spain
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Morales Tellez JF, Moeyersons J, Testelmans D, Buyse B, Borzée P, Van Hoof C, Groenendaal W, Van Huffel S, Varon C. Technical aspects of cardiorespiratory estimation using subspace projections and cross entropy. Physiol Meas 2021; 42. [PMID: 34571494 DOI: 10.1088/1361-6579/ac2a70] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 09/27/2021] [Indexed: 11/12/2022]
Abstract
BACKGROUND Respiratory sinus arrhythmia (RSA) is a form of cardiorespiratory coupling. Its quantification has been suggested as a biomarker to diagnose different diseases. Two state-of-the-art methods, based on subspace projections and entropy, are used to estimate the RSA strength and are evaluated in this paper. Their computation requires the selection of a model order, and their performance is strongly related to the temporal and spectral characteristics of the cardiorespiratory signals. OBJECTIVE To evaluate the robustness of the RSA estimates to the selection of model order, delays, changes of phase and irregular heartbeats as well as to give recommendations for their interpretation on each case. APPROACH Simulations were used to evaluate the model order selection when calculating the RSA estimates explained before, as well as 3 different scenarios that can occur in signals acquired in non-controlled environments and/or from patient populations: the presence of irregular heartbeats; the occurrence of delays between heart rate variability (HRV) and respiratory signals; and the changes over time of the phase between HRV and respiratory signals. MAIN RESULTS It was found that using a single model order for all the calculations suffices to characterize the RSA estimates correctly. In addition, the RSA estimation in signals containing more than 5 irregular heartbeats in a period of 5 minutes might be misleading. Regarding the delays between HRV and respiratory signals, both estimates are robust. For the last scenario, the two approaches tolerate phase changes up to 54°, as long as this lasts less than one fifth of the recording duration. SIGNIFICANCE Guidelines are given to compute the RSA estimates in non-controlled environments and patient populations.
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Affiliation(s)
- John Fredy Morales Tellez
- ESAT - STADIUS, Stadius Centre for Dynamical Systems, Signal Processing and Data Analytics, KU Leuven, Leuven, Flanders, BELGIUM
| | - Jonathan Moeyersons
- Department of Electrical Engineering (ESAT), KU Leuven, Leuven, Flanders, BELGIUM
| | - Dries Testelmans
- Department of Pneumology, KU Leuven University Hospitals Leuven, Leuven, BELGIUM
| | - Bertien Buyse
- Department of Respiratory Diseases, KUL UZ Gasthuisberg, Leuven, Flanders, BELGIUM
| | - Pascal Borzée
- Department of Pneumology, KU Leuven University Hospitals Leuven, Leuven, BELGIUM
| | | | | | - Sabine Van Huffel
- Department of Electrical Engineering (ESAT), KU Leuven, Leuven, Flanders, BELGIUM
| | - Carolina Varon
- Department of Electrical Engineering (ESAT), KU Leuven, Leuven, Flanders, BELGIUM
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44
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Lafère P, Lambrechts K, Germonpré P, Balestra A, Germonpré FL, Marroni A, Cialoni D, Bosco G, Balestra C. Heart Rate Variability During a Standard Dive: A Role for Inspired Oxygen Pressure? Front Physiol 2021; 12:635132. [PMID: 34381372 PMCID: PMC8350129 DOI: 10.3389/fphys.2021.635132] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Accepted: 06/18/2021] [Indexed: 01/02/2023] Open
Abstract
Introduction: Heart rate variability (HRV) during underwater diving has been infrequently investigated because of environment limitations and technical challenges. This study aims to analyze HRV changes while diving at variable hyperoxia when using open circuit (OC) air diving apparatus or at constant hyperoxia using a closed-circuit rebreather (CCR). We used HRV analysis in time and frequency domain adding nonlinear analysis which is more adapted to short-time analysis and less dependent on respiratory rate (Sinus respiratory arrhythmia). Materials and Methods: 18 males, 12 using OC (30 mfw for 20 min) and 6 using CCR (30 mfw for 40 min.). HRV was recorded using a polar recorder. Four samples of R-R intervals representing the dive were saved for HRV analysis. Standard deviation of normal-to-normal intervals (SDNN), square root of the mean squared differences between successive RR intervals (rMSSD), and average RR intervals (RR) in time-domain; low frequency (LF) and high frequency (HF) in frequency domain were investigated. Nonlinear analysis included fractal dimension (FrD). Results: SDNN and rMSSD were significantly increased during descent and at depth with OC, not with CCR. Mean RR interval was longer at depth with OC, but only during ascent and after the dive with CCR. HF power was higher than baseline during the descent both with OC and CCR and remained elevated at depth for OC. The LF/HF ratio was significantly lower than baseline for descent and at depth with both OC and CCR. After 30 min of recovery, the LF/HF ratio was higher than baseline with both OC and CCR. Nonlinear analysis detected differences at depth for OC and CCR. Discussion: Increased parasympathetic tone was present during diving. RR duration, SDNN; rMSSD, HF spectral power all increased during the dive above pre-dive levels. Conversely, HF power decreased (and the LF/HF increased) 30 min after the dive. Using FrD, a difference was detected between OC and CCR, which may be related to differences in partial pressure of oxygen breathed during the dive.
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Affiliation(s)
- Pierre Lafère
- Environmental, Occupational & Ageing Physiology Laboratory, Haute Ecole Bruxelles-Brabant, Brussels, Belgium.,DAN Europe Research Division, Roseto degli Abruzzi, Italy.,Laboratoire ORPHY, EA4324, Université de Bretagne Occidentale, Brest, France
| | - Kate Lambrechts
- Environmental, Occupational & Ageing Physiology Laboratory, Haute Ecole Bruxelles-Brabant, Brussels, Belgium
| | - Peter Germonpré
- Environmental, Occupational & Ageing Physiology Laboratory, Haute Ecole Bruxelles-Brabant, Brussels, Belgium.,DAN Europe Research Division, Roseto degli Abruzzi, Italy.,Centre for Hyperbaric Oxygen Therapy, Military Hospital "Queen Astrid", Brussels, Belgium
| | - Ambre Balestra
- Environmental, Occupational & Ageing Physiology Laboratory, Haute Ecole Bruxelles-Brabant, Brussels, Belgium
| | - Faye Lisa Germonpré
- Centre for Hyperbaric Oxygen Therapy, Military Hospital "Queen Astrid", Brussels, Belgium
| | | | - Danilo Cialoni
- DAN Europe Research Division, Roseto degli Abruzzi, Italy.,Environmental Physiology and Medicine Laboratory, Department of Biomedical Sciences, University of Padova, Padova, Italy
| | - Gerardo Bosco
- Environmental Physiology and Medicine Laboratory, Department of Biomedical Sciences, University of Padova, Padova, Italy
| | - Costantino Balestra
- Environmental, Occupational & Ageing Physiology Laboratory, Haute Ecole Bruxelles-Brabant, Brussels, Belgium.,DAN Europe Research Division, Roseto degli Abruzzi, Italy.,Physical Activity Teaching Unit, Motor Sciences Department, Université Libre de Bruxelles (ULB), Brussels, Belgium
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45
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Ponomarenko VI, Karavaev AS, Borovkova EI, Hramkov AN, Kiselev AR, Prokhorov MD, Penzel T. Decrease of coherence between the respiration and parasympathetic control of the heart rate with aging. CHAOS (WOODBURY, N.Y.) 2021; 31:073105. [PMID: 34340353 DOI: 10.1063/5.0056624] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 06/16/2021] [Indexed: 06/13/2023]
Abstract
The study of coordinated behavior between different systems of the human body provides useful information on the functioning of the body. The peculiarities of interaction and coordinated dynamics of the heart rate and respiration are of particular interest. We investigated the coherence of the processes of respiration and autonomic control of the heart rate for people of different ages in the awake state, in sleep with rapid eye movement, and in deep sleep. Our analysis revealed a monotonic decrease in the coherence of these processes with increasing age. This can be explained by age-related changes in the system of autonomic control of circulation. For all age groups, we found a qualitatively similar dynamics of the coherence between the studied processes during a transition from the awake state to sleep.
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Affiliation(s)
- V I Ponomarenko
- Kotelnikov Institute of Radioengineering and Electronics of Russian Academy of Sciences, Saratov Branch, Zelyonaya Street, 38, Saratov 410019, Russia
| | - A S Karavaev
- Kotelnikov Institute of Radioengineering and Electronics of Russian Academy of Sciences, Saratov Branch, Zelyonaya Street, 38, Saratov 410019, Russia
| | - E I Borovkova
- Institute of Physics, Saratov State University, Astrakhanskaya Street, 83, Saratov 410012, Russia
| | - A N Hramkov
- Institute of Physics, Saratov State University, Astrakhanskaya Street, 83, Saratov 410012, Russia
| | - A R Kiselev
- Institute of Cardiological Research, Saratov State Medical University, B. Kazachaya Street, 112, Saratov 410012, Russia
| | - M D Prokhorov
- Kotelnikov Institute of Radioengineering and Electronics of Russian Academy of Sciences, Saratov Branch, Zelyonaya Street, 38, Saratov 410019, Russia
| | - T Penzel
- Institute of Physics, Saratov State University, Astrakhanskaya Street, 83, Saratov 410012, Russia
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46
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Ackermann S, Laborde S, Borges U, Mosley E. Commentary: Photoplethysmography for Quantitative Assessment of Sympathetic Nerve Activity (SNA) During Cold Stress. Front Physiol 2021; 12:602745. [PMID: 34248652 PMCID: PMC8262254 DOI: 10.3389/fphys.2021.602745] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Accepted: 05/21/2021] [Indexed: 11/15/2022] Open
Affiliation(s)
- Stefan Ackermann
- Institute of Psychology, Department of Performance Psychology, German Sport University Cologne, Cologne, Germany
| | - Sylvain Laborde
- Institute of Psychology, Department of Performance Psychology, German Sport University Cologne, Cologne, Germany.,Normandie Université Caen, UFR STAPS, EA 4260, Normandy, France
| | - Uirassu Borges
- Institute of Psychology, Department of Performance Psychology, German Sport University Cologne, Cologne, Germany.,Institute of Psychology, Department of Health and Social Psychology, German Sport University Cologne, Cologne, Germany
| | - Emma Mosley
- Department of Sport Science and Performance, Southampton Solent University, Southampton, United Kingdom
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47
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Morales J, Moeyersons J, Armanac P, Orini M, Faes L, Overeem S, Van Gilst M, Van Dijk J, Van Huffel S, Bailon R, Varon C. Model-Based Evaluation of Methods for Respiratory Sinus Arrhythmia Estimation. IEEE Trans Biomed Eng 2021; 68:1882-1893. [PMID: 33001798 DOI: 10.1109/tbme.2020.3028204] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Respiratory sinus arrhythmia (RSA) refers to heart rate oscillations synchronous with respiration, and it is one of the major representations of cardiorespiratory coupling. Its strength has been suggested as a biomarker to monitor different conditions, and diseases. Some approaches have been proposed to quantify the RSA, but it is unclear which one performs best in specific scenarios. The main objective of this study is to compare seven state-of-the-art methods for RSA quantification using data generated with a model proposed to simulate, and control the RSA. These methods are also compared, and evaluated on a real-life application, for their ability to capture changes in cardiorespiratory coupling during sleep. METHODS A simulation model is used to create a dataset of heart rate variability, and respiratory signals with controlled RSA, which is used to compare the RSA estimation approaches. To compare the methods objectively in real-life applications, regression models trained on the simulated data are used to map the estimates to the same measurement scale. Results, and conclusion: RSA estimates based on cross entropy, time-frequency coherence, and subspace projections showed the best performance on simulated data. In addition, these estimates captured the expected trends in the changes in cardiorespiratory coupling during sleep similarly. SIGNIFICANCE An objective comparison of methods for RSA quantification is presented to guide future analyses. Also, the proposed simulation model can be used to compare existing, and newly proposed RSA estimates. It is freely accessible online.
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48
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Effect of Line-Magnet Stimulation on HRV: A Double-Blind, Randomized, Crossover Trial. Healthcare (Basel) 2021; 9:healthcare9040421. [PMID: 33916473 PMCID: PMC8067433 DOI: 10.3390/healthcare9040421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 03/30/2021] [Accepted: 03/30/2021] [Indexed: 11/21/2022] Open
Abstract
The acupuncture point mapped into the body meridian line has been the subject of extensive research; however, the scientific basis of the body meridian line remains unknown. In the present study, a pair of line-magnets was attached along the heart meridian line between HT4 and HT6 (intervention), and heart rate variability (HRV) was examined in a double-blind, randomized, crossover trial. Forty-five healthy young adults were randomly assigned into two groups and received two interventions in a different order. The only difference between the interventions was that the magnet pole was swapped. The results showed that the frequency-domain (LF, LF/HF) properties of HRV, which reflects underlying autonomic nervous system activity, changed when the magnetic pole’s direction along the heart meridian line was changed. This finding suggests that a line-magnet attached along to the heart meridian line may affect the cardiovascular system.
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49
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D'Addio G, De Felice A, Donisi L, Braghiroli A, Maniscalco M. Heart rate turbulence in obstructive sleep apnea syndrome: The effect of short-term CPAP therapy. Eur J Intern Med 2021; 86:111-114. [PMID: 33390320 DOI: 10.1016/j.ejim.2020.12.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 12/24/2020] [Indexed: 11/18/2022]
Affiliation(s)
- Giovanni D'Addio
- Bioengineering Unit, Istituti Clinici Scientifici Maugeri IRCCS, Telese Terme (BN), Italy
| | - Alberto De Felice
- Pulmonary Rehabilitation Division, Istituti Clinici Scientifici Maugeri IRCCS, Telese Terme (BN), Italy
| | - Leandro Donisi
- Bioengineering Unit, Istituti Clinici Scientifici Maugeri IRCCS, Telese Terme (BN), Italy; Department of Advanced Biomedical Sciences, University of Naples "Federico II", Napoli, Italy
| | - Alberto Braghiroli
- Pulmonary Rehabilitation Division, Istituti Clinici Scientifici Maugeri IRCCS, Veruno, Italy
| | - Mauro Maniscalco
- Pulmonary Rehabilitation Division, Istituti Clinici Scientifici Maugeri IRCCS, Telese Terme (BN), Italy.
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50
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Manresa-Rocamora A, Flatt AA, Casanova-Lizón A, Ballester-Ferrer JA, Sarabia JM, Vera-Garcia FJ, Moya-Ramón M. Heart rate-based indices to detect parasympathetic hyperactivity in functionally overreached athletes. A meta-analysis. Scand J Med Sci Sports 2021; 31:1164-1182. [PMID: 33533045 DOI: 10.1111/sms.13932] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 11/24/2020] [Accepted: 01/28/2021] [Indexed: 11/29/2022]
Abstract
Investigations into the sensitivity of heart rate-(HR) derived indices for tracking parasympathetic nervous system (PNS) changes in functionally overreached (F-OR) endurance-trained athletes have produced equivocal findings. Lack of clarity may be a result of methodological inconsistencies. Therefore, the aims of this systematic review and meta-analysis were (a) to determine the sensitivity of resting and post-exercise vagal-related HR variability (HRV) and HR recovery (HRR) indices to detect PNS modulation in F-OR and non-overreached (non-OR) athletes, and (b) to investigate the influence of methodological factors on the sensitivity of HR-based indices to detect PNS hyperactivity in F-OR athletes. We searched CENTRAL, Scopus, PubMed, Embase, and Web of Science up to May 2020 for the following terms: male and female endurance-trained athletes, controlled and uncontrolled studies that carried out an overload training period, and PNS modulation measured in resting and post-exercise, pre- and post-overload training period. A random-effects model of standardized mean difference (SMD) was estimated for each outcome measure based on the training-induced fatigue status (F-OR vs non-OR athletes), and the influence of methodological issues to detect PNS hyperactivity in F-OR was assessed by subgroup analyses. Pooled analysis showed that resting vagal-related HRV indices did not detect PNS hyperactivity in F-OR athletes (SMD+ = -0.01; 95% confidence interval [CI] = -0.51, 0.50), and no statistical difference (P = .600) was found with non-OR athletes (SMD+ = 0.15; 95% CI = -0.14, 0.45). However, subgroup analysis based on HRV parameter showed a moderate statistical increase in weekly averaged HRV in F-OR athletes (SMD+ = 0.81; 95% CI = 0.35, 1.26), while isolated HRV values did not reach statistical significance (SMD+ = -0.45; 95% CI = -0.96, 0.06). We observed a moderate and statistically significant increase in HRR indices among F-OR athletes (SMD+ = 0.65; 95% CI = 0.44, 0.87), no changes for non-OR athletes (SMD+ = 0.10; 95% CI = -0.15, 0.34), and statistically significant differences between F-OR and non-OR athletes (P < .001). Insufficient data prevented meta-analysis for post-exercise vagal-related HRV indices. Our findings show that when methodological factors are considered, HR-based indices are sensitive to increased PNS modulation in F-OR.
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Affiliation(s)
- Agustín Manresa-Rocamora
- Department of Sport Sciences, Sports Research Centre, Miguel Hernández University of Elche, Elche, Spain
| | - Andrew A Flatt
- Department of Health Sciences and Kinesiology, Georgia Southern University, Georgia, USA
| | - Antonio Casanova-Lizón
- Department of Sport Sciences, Sports Research Centre, Miguel Hernández University of Elche, Elche, Spain
| | - Juan A Ballester-Ferrer
- Department of Sport Sciences, Sports Research Centre, Miguel Hernández University of Elche, Elche, Spain
| | - José M Sarabia
- Department of Sport Sciences, Sports Research Centre, Miguel Hernández University of Elche, Elche, Spain.,Institute for Health and Biomedical Research (ISABIAL-FISABIO Foundation), Miguel Hernandez University, Alicante, Spain
| | - Francisco J Vera-Garcia
- Department of Sport Sciences, Sports Research Centre, Miguel Hernández University of Elche, Elche, Spain
| | - Manuel Moya-Ramón
- Department of Sport Sciences, Sports Research Centre, Miguel Hernández University of Elche, Elche, Spain.,Institute for Health and Biomedical Research (ISABIAL-FISABIO Foundation), Miguel Hernandez University, Alicante, Spain
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