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PloS One 2017Insomnia disorder is a widespread sleep disorder with a prevalence of approximately 10%. Even though the link between insomnia and cardiovascular activity is not exactly... (Review)
Review
BACKGROUND
Insomnia disorder is a widespread sleep disorder with a prevalence of approximately 10%. Even though the link between insomnia and cardiovascular activity is not exactly clear, it is generally assumed that cardiovascular autonomic modifications could occur as a result of sleeplessness, or, alternatively, that autonomic alterations could be an expression of a hyper-arousal state. This review investigates whether cardiovascular measures are different between insomniacs and controls.
METHODS
Electronic databases were systematically searched, and 34 studies were identified. Heart rate variability features, the association of cardiac and EEG activity, physiologic complexity measures, and cardiovascular activity, assessed by measures such as pre-ejection time, blood pressure, and heart rate dynamics were studied. Given the heterogeneity of the studies, a narrative synthesis of the findings was performed.
RESULTS
This review study found overall differences in cardiovascular activity between insomniacs and controls in most of the observational studies (21/26), while the expression of cardiovascular regulation varied between the examined insomniac groups. All the studies that investigated the association of cardiac activity and EEG power reported an altered relation between autonomic activity and EEG parameters in insomniacs.
CONCLUSION
Autonomic regulation tends to be consistent between insomniacs, as long as they are grouped according to their respective phenotype, as shown in the insomnia subgroup with objectively short sleep duration. Our hypothesis is that these differences in the expression of cardiovascular activity could be explained by the heterogeneity of the disorder. Therefore, the determination of insomnia phenotypes, and the study of cardiovascular measures, rather than heart rate variability alone, will give more insight into the link between insomnia and cardiovascular regulation. This study suggests that cardiovascular activity differs between insomniacs and controls. These new findings are of interest to clinicians and researchers for a more accurate insomnia assessment, and the development of personalized technological solutions in insomnia.
Topics: Autonomic Nervous System; Cardiovascular System; Electroencephalography; Heart Rate; Humans; Polysomnography; Sleep Initiation and Maintenance Disorders
PubMed: 29059210
DOI: 10.1371/journal.pone.0186716 -
The Cochrane Database of Systematic... Mar 2015Frey's syndrome is a rare disorder, the symptoms of which include sweating, flushing and warming over the preauricular and temporal areas following a gustatory stimulus.... (Review)
Review
BACKGROUND
Frey's syndrome is a rare disorder, the symptoms of which include sweating, flushing and warming over the preauricular and temporal areas following a gustatory stimulus. It often occurs in patients who have undergone parotidectomy, submandibular gland surgery, radical neck dissection, infection and traumatic injury in the parotid region, and is caused by the aberrant regrowth of facial autonomic nerve fibres. Currently there are several options used to treat patients with Frey's syndrome; for example, the topical application of anticholinergics and antiperspirants, and the intradermal injection of botulinum toxin. It is uncertain which treatment is most effective and safe.
OBJECTIVES
To assess the efficacy and safety of different interventions for the treatment of Frey's syndrome.
SEARCH METHODS
We searched the Cochrane Ear, Nose and Throat Disorders Group Trials Register; the Cochrane Central Register of Controlled Trials (CENTRAL); PubMed; EMBASE; CINAHL; Web of Science; ICTRP and additional sources for published and unpublished trials. The date of the search was 28 April 2014.
SELECTION CRITERIA
We included randomised or quasi-randomised controlled trials (RCTs) in participants diagnosed with Frey's syndrome using a clinical standard such as Minor's starch-iodine test. We planned to include trials in which participants received any intervention versus no treatment (observation) or an alternative intervention, with or without a second active treatment. Our primary outcome measures were success rate (as assessed clinically by Minor's starch-iodine test, the iodine-sublimated paper histogram method, blotting paper technique or another method) and adverse events. Our secondary outcome measure was success rate as assessed by patients (disappearance or improvement of symptoms).
DATA COLLECTION AND ANALYSIS
We used the standard methodological procedures expected by The Cochrane Collaboration.
MAIN RESULTS
We identified no RCTs or quasi-RCTs that fulfilled the inclusion criteria. Our searches retrieved eight potentially relevant studies, but after assessment of the full-text reports we excluded all of them due to the absence of randomisation or because the patients did not have Frey's syndrome. We excluded one randomised controlled trial that compared two different doses of botulinum toxin in patients with Frey's syndrome because the comparator was not an alternative treatment.
AUTHORS' CONCLUSIONS
We are unable to establish the efficacy and safety of the different methods used for the treatment of Frey's syndrome.RCTs are urgently needed to assess the effectiveness of interventions for the treatment of Frey's syndrome. Future RCTs should include patients with Frey's syndrome of different ranges of severity and report these patients separately. Studies should investigate all possibly effective treatments (such as anticholinergics, antiperspirants and botulinum toxin) compared to control groups using different treatments or placebo. Subjective assessment of Frey's syndrome should be considered as one of the outcome measures.
Topics: Humans; Sweating, Gustatory
PubMed: 25781421
DOI: 10.1002/14651858.CD009959.pub2 -
The Journal of Neuropsychiatry and... 2022Functional neurological disorder (FND) is a core neuropsychiatric condition. To date, promising yet inconsistently identified neural circuit profiles have been observed... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
Functional neurological disorder (FND) is a core neuropsychiatric condition. To date, promising yet inconsistently identified neural circuit profiles have been observed in patients with FND, suggesting that gaps remain in our systems-level neurobiological understanding. As such, other important physiological variables, including autonomic, endocrine, and inflammation findings, need to be contextualized for a more complete mechanistic picture.
METHODS
The investigators conducted a systematic review and meta-analysis of available case-control and cohort studies of FND. PubMed, PsycINFO, and Embase databases were searched for studies from January 1, 1900, to September 1, 2020, that investigated autonomic, endocrine, and inflammation markers in patients with FND. Sixty-six of 2,056 screened records were included in the review, representing 1,699 patients; data from 20 articles were used in the meta-analysis.
RESULTS
Findings revealed that children and adolescents with FND, compared with healthy control subjects (HCs), have increased resting heart rate (HR); there is also a tendency toward reduced resting HR variability in patients with FND across the lifespan compared with HCs. In adults, peri-ictal HR differentiated patients with functional seizures from those with epileptic seizures. Other autonomic and endocrine profiles for patients with FND were heterogeneous, with several studies highlighting the importance of individual differences.
CONCLUSIONS
Inflammation research in FND remains in its early stages. Moving forward, there is a need for the use of larger sample sizes to consider the complex interplay between functional neurological symptoms and behavioral, psychological, autonomic, endocrine, inflammation, neuroimaging, and epigenetic/genetic data. More research is also needed to determine whether FND is mechanistically (and etiologically) similar or distinct across phenotypes.
Topics: Adolescent; Cohort Studies; Conversion Disorder; Humans; Inflammation; Nervous System Diseases; Neuroimaging; Seizures
PubMed: 34711069
DOI: 10.1176/appi.neuropsych.21010025 -
Clinical Autonomic Research : Official... Feb 2020Autonomic dysfunction is a known consequence of chronic and excessive alcohol consumption. The aim of this systematic review was to characterise this phenomenon,...
PURPOSE
Autonomic dysfunction is a known consequence of chronic and excessive alcohol consumption. The aim of this systematic review was to characterise this phenomenon, describe the frequency at which it occurs and to explore the best management strategies.
METHODS
A systematic, computer-based search was conducted using the PubMed database. All studies identified by the search were evaluated independently by at least three authors. For inclusion, studies had to report human subjects consuming ethanol in excess. Case reports and non-original studies were excluded from this review.
RESULTS
A total of 55 studies were included in this review. According to cardiovascular reflex tests, 16-73% of chronic alcohol abusers suffer from autonomic dysfunction. The most commonly occurring symptom is erectile dysfunction, whilst other features such as postural dizziness are rare. The most important risk factor for this condition is total lifetime dose of ethanol, although there is mixed evidence supporting the role of other risk factors. The only management strategy currently explored in the literature is abstinence, which appears to lead to significant improvement in autonomic investigations.
CONCLUSION
Current literature includes studies of highly heterogeneous populations, consuming differing volumes of alcohol over variable periods of time and utilising a number of different autonomic test batteries and criteria to diagnose autonomic dysfunction. Therefore, further research using homogeneous methods for measuring autonomic dysfunction in the field is needed. Despite this limitation, our review demonstrated that autonomic dysfunction is very common among alcohol abusers.
Topics: Alcohol Drinking; Alcoholism; Autonomic Nervous System Diseases; Erectile Dysfunction; Female; Humans; Male; Primary Dysautonomias
PubMed: 31222483
DOI: 10.1007/s10286-019-00618-8 -
The Journals of Gerontology. Series A,... Feb 2024Falls are a common cause of injury, hospitalization, functional decline, and residential care admission among older adults. Cardiovascular disorders are recognized risk... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Falls are a common cause of injury, hospitalization, functional decline, and residential care admission among older adults. Cardiovascular disorders are recognized risk factors for falls. This systematic review assesses the association between cardiovascular disorders and falls in older adults.
METHODS
Systematic searches were conducted on MEDLINE and Embase, encompassing all literature published prior to December 31, 2022. Included studies addressed persons aged 50 years and older, and assessed the association between cardiovascular disorders and falls or the efficacy of cardiovascular-based interventions to reduce falls. Two reviewers independently extracted data and assessed study quality utilizing a modified Newcastle-Ottawa scale for observational studies, and the Cochrane Risk of Bias 2 tool for interventional studies. A systematic narrative analysis of all cardiovascular outcomes, and meta-analyses of unadjusted odds ratios (ORs) were performed.
RESULTS
One hundred and eighty-four studies were included: 181 observational and 3 interventional. Several cardiovascular disorders, including stroke, coronary artery disease, valvular heart disease, arterial stiffness, arrhythmia, orthostatic hypotension, and carotid sinus hypersensitivity, were consistently associated with falls. In meta-analysis of unadjusted ORs, the largest positive pooled associations with falls during a 12-month reporting interval were for stroke (OR: 1.90, 95% confidence interval [CI]: 1.70-2.11), peripheral arterial disease (OR: 1.82, 95% CI: 1.12-2.95), atrial fibrillation (OR: 1.52, 95% CI: 1.27-1.82), and orthostatic hypotension (OR: 1.39, 95% CI: 1.18-1.64).
CONCLUSIONS
Several cardiovascular disorders are associated with falls. These results suggest the need to incorporate cardiovascular assessments for patients with falls. This review informed the cardiovascular recommendations in the new World Guidelines for falls in older adults.Clinical Trials Registration Number: CRD42021272245.
Topics: Humans; Middle Aged; Aged; Hypotension, Orthostatic; Accidental Falls; Cardiovascular Diseases; Risk Factors; Stroke
PubMed: 37738307
DOI: 10.1093/gerona/glad221 -
Neuroscience and Biobehavioral Reviews Jun 2024Depersonalisation-derealisation disorder (DDD) is characterised by distressing experiences of separation from oneself and/or one's surroundings, potentially resulting... (Review)
Review
Depersonalisation-derealisation disorder (DDD) is characterised by distressing experiences of separation from oneself and/or one's surroundings, potentially resulting from alterations in affective, cognitive, and physiological functions. This systematic review aimed to synthesise current experimental evidence of relevance to proposed mechanisms underlying DDD, to appraise existing theoretical models, and to inform future research and theoretical developments. Studies were included if they tested explicit hypotheses in DDD samples, with experimental manipulations of at least one independent variable, alongside behavioural, subjective, neurological, affective and/or physiological dependent variables. Some evidence for diminished subjective responsivity to aversive images and sounds, and hyperactivation in neurocircuits associated with emotional regulation when viewing aversive images emerged, corroborating neurobiological models of DDD. Inconsistencies were present regarding behavioural and autonomic responsivity to facial expressions, emotional memory, and self-referential processing. Common confounds included small sample sizes, medication, and comorbidities. Alterations in affective reactivity and regulation appear to be present in DDD; however, further research employing more rigorous research designs is required to provide stronger evidence for these possible mechanisms.
PubMed: 38944228
DOI: 10.1016/j.neubiorev.2024.105783 -
Frontiers in Psychiatry 2022Misophonia is a disorder characterized by negative physical and emotional reactions to certain trigger sounds, such as chewing food. Up to 50% of population samples...
Misophonia is a disorder characterized by negative physical and emotional reactions to certain trigger sounds, such as chewing food. Up to 50% of population samples endorse some symptoms of misophonia, with about 20% having symptoms that impair normal life functioning. Most misophonia patients exhibit intense negative emotions and autonomic arousal (the fight-flight-freeze response) in response to a trigger, similarly to how someone with post-traumatic stress disorder (PTSD) might respond to a trauma trigger. Curiously, misophonia trigger sounds are often most distressing when coming from a specific person, suggesting the disorder may be responsive to interpersonal relationship factors. Treatment of misophonia is currently limited to the use of hearing modifications (e.g., earplugs or headphones) and psychotherapy, but many patients continue to suffer despite these best efforts. Phase 3 clinical trials suggest that MDMA is efficacious at treating the symptoms of autonomic arousal, negative emotions, and interpersonal suffering found in PTSD. As such, we propose that MDMA may represent an ideal treatment for some suffering from severe misophonia. In this perspective article, we review the symptoms of misophonia, and outline how MDMA may be uniquely suited for treating it, perhaps using a protocol analogous to the MAPS Phase 3 studies for PTSD.
PubMed: 36440420
DOI: 10.3389/fpsyt.2022.983285 -
Respiratory Care Dec 2015Cardiovascular autonomic neuropathy is one of the factors implicated in the high morbidity and mortality rate in patients with COPD. Thus, several studies and... (Review)
Review
Cardiovascular autonomic neuropathy is one of the factors implicated in the high morbidity and mortality rate in patients with COPD. Thus, several studies and nonsystematic reviews have increasingly reported autonomic function impairment in these subjects. For a better understanding, this systematic review was performed to evaluate not only the evidence for autonomic function impairment, but also factors influencing it. The results of the studies reviewed showed a strong level of evidence to support the impairment of heart rate variability in the time domain. A similar evidence level was also found to support impairment in baroreceptor sensitivity and muscle sympathetic nerve activity. Furthermore, this review identified physical activity level, muscle function, and circadian rhythm as the major influencing factors (strong evidence) of autonomic function in subjects with COPD. However, no definite conclusion could be reached for factors such as dyspnea, anxiety, body composition, pulmonary function, age, breathing frequency, ventilatory effort, quality of life, and disease severity due to limited, conflicting, or lack of existing evidence. The results of this review highlight relevant clinical messages for clinicians and other health-care providers regarding the role autonomic function can play as an important physiological marker for prognostication and stratification. Hence, autonomic function outcomes should be identified and considered during management of patients with COPD. Moreover, this review can serve as basis for future research aimed at assessing the interventions for autonomic function abnormalities in these patients.
Topics: Autonomic Nervous System; Autonomic Nervous System Diseases; Circadian Rhythm; Heart Rate; Humans; Motor Activity; Muscles; Pressoreceptors; Pulmonary Disease, Chronic Obstructive
PubMed: 26487747
DOI: 10.4187/respcare.04174 -
Cardiology Research and Practice 2020Stress is regulated by the autonomous nervous system, increasing the sympathetic modulation when a threat is perceived. A multifactorial response usually leads to... (Review)
Review
Stress is regulated by the autonomous nervous system, increasing the sympathetic modulation when a threat is perceived. A multifactorial response usually leads to significant behavioural modifications and alterations on homeostasis and physical and psychological status. Moreover, stress is an emotional response that can lead to psychosocial and psychophysiological adversity. Regarding military population, military operations and combat exposure are important stressors that influence acute and chronic stress response in soldiers, affecting their performance and health. A bibliographic search was carried out between April and May 2019, focusing on recent studies (2013-2019) that analysed psychophysiological response, stress, stress regulation, heart rate, heart rate variability, and posttraumatic stress disorder in military population. Autonomic and cardiovascular chronic stress seems to be modulated by experience and previous specific training of each military unit. Physical exercise, music embedded with binaural beat technology, bidirectional sensory motor rhythm training, heart rate variability biofeedback, and transcutaneous vagal nerve stimulation are the main techniques applied to balance stress and to recover body homeostasis. Since military population are usually exposed to multiple stressors, knowing previous training and experience, together with developing techniques to balance stress, is the main practical application in this field of study to balance autonomic and cardiovascular systems.
PubMed: 32850146
DOI: 10.1155/2020/7986249 -
Revista Paulista de Pediatria : Orgao... 2023To evaluate the relationship between birth weight and the autonomic nervous system in adulthood through a systematic review. (Review)
Review
OBJECTIVE
To evaluate the relationship between birth weight and the autonomic nervous system in adulthood through a systematic review.
DATA SOURCE
This is a systematic review of publications without limitation of year and language. We included studies involving the autonomic nervous system and birth weight in adults. Manuscripts were selected based on electronic searches of Medical Literature Analysis and Retrieval System Online (MEDLINE), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Web of Science Cochrane Library and Scopus databases, using "Autonomic Nervous System" OR "Heart Rate" OR "Heart Rate Variability" AND "Birth Weight" as a search strategy. This review is registered on the International Prospective Register of Systematic Reviews - PROSPERO (ID: CRD42020165622).
DATA SYNTHESIS
We found 894 articles; 215 were excluded for duplicity. Of the remaining 679 studies, 11 remained. Two were excluded because they did not specifically treat the autonomic nervous system or birth weight. There were nine publications, two cohort and seven cross-sectional studies. The main findings were that extreme, very low, low or high birth weight may have some impact on the autonomic nervous system in adult life.
CONCLUSIONS
Birth weight outside the normality rate may have a negative influence on the autonomic nervous system, causing autonomic dysfunction and increasing the risk of cardiovascular diseases in adult life. Thus, the importance of the follow-up of health professionals from pregnancy to gestation and throughout life, with preventive care being emphasized.
Topics: Adult; Female; Humans; Pregnancy; Autonomic Nervous System; Birth Weight; Cardiovascular Diseases; Cross-Sectional Studies; Systematic Reviews as Topic
PubMed: 37937677
DOI: 10.1590/1984-0462/2024/42/2023002