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The Korean Journal of Gastroenterology... Feb 2024Achalasia is an esophageal motility disorder characterized by dysphagia and noncardiac chest pain. Impairment of vagal function has been reported in achalasia. This...
BACKGROUND/AIMS
Achalasia is an esophageal motility disorder characterized by dysphagia and noncardiac chest pain. Impairment of vagal function has been reported in achalasia. This study evaluated autonomic nervous system (ANS) dysfunctions in patients with achalasia to establish a correlation between an ANS dysfunction and the clinical symptoms of achalasia.
METHODS
Nineteen patients with achalasia (six males/13 females; mean age, 47.1±16.3 years) and 10 healthy controls (four males/six females; 34.8±10.7 years) were enrolled prospectively at Gangnam Severance Hospital between June 2013 and June 2014. All patients completed a questionnaire on ANS dysfunction symptoms and underwent a heart rate variability (HRV) test.
RESULTS
ANS dysfunction symptoms were present in 13 patients with achalasia (69%) and three controls (30%). The ANS dysfunction score was significantly higher in patients with achalasia than in the controls (p=0.035). There were no significant differences in the standard deviation of all normal R-R intervals, high frequency (HF), low frequency (LF), and LF/HF ratio in the HRV test. In subgroup analysis comparing female achalasia patients with controls, the cardiac activity was significantly higher in the female achalasia patients than in the controls (p=0.036). The cardiac activity (p=0.004) and endurance to stress (p=0.004) were significantly higher in the achalasia patients with ANS dysfunction symptoms than the achalasia patients without ANS dysfunction symptoms.
CONCLUSIONS
ANS dysfunction symptoms are common in patients with achalasia. Female achalasia patients and those with ANS dysfunction symptoms showed increased cardiac activity. Hence, more attention should be paid to cardiac overload in achalasia patients who are female or have ANS dysfunction symptoms.
Topics: Male; Humans; Female; Adult; Middle Aged; Autonomic Nervous System; Esophageal Achalasia; Heart; Heart Rate
PubMed: 38389461
DOI: 10.4166/kjg.2023.144 -
Applied Psychophysiology and Biofeedback Dec 2022Heart rate variabfility (HRV) has been a focal point throughout my academic history. To put into perspective, I have published studies spanning seven decades focusing on... (Review)
Review
Heart rate variabfility (HRV) has been a focal point throughout my academic history. To put into perspective, I have published studies spanning seven decades focusing on HRV (1969-2022). My interest in HRV started early in graduate school and continues to be an important portal informing my theoretical perspective. The current paper tracks some of this history, which started as an empirical observation and moved through several scientific stages including development of quantitative methods and investigations of neural mechanisms. Along this journey a variety of hypotheses were tested including the relative sensitivity of HRV metrics to neural mechanisms, psychological processes, and medical diagnoses. In addition, the research led to the identification of portal of intervention that have become strategies to optimize mental and physical health. These apparent disparate programs of inquiry have been tightly merged as the Polyvagal Theory evolved. In the sections below, I have shared my personal journey through these stages of scientific inquiry and my attempts to integrate the new knowledge in an expansive theoretical model.
Topics: Humans; Heart Rate; Autonomic Nervous System; Vagus Nerve
PubMed: 36136145
DOI: 10.1007/s10484-022-09559-x -
Progress in Brain Research 2023This systematic review explores the influence of silence on the autonomic nervous system. The Polyvagal Theory has been used as a reference model to describe the...
This systematic review explores the influence of silence on the autonomic nervous system. The Polyvagal Theory has been used as a reference model to describe the autonomic nervous system by explaining its role in emotional regulation, social engagement, and adaptive physiological responses. PubMed, Scopus, PsycInfo, EMBASE, and Google Scholar were systematically searched up until July 2023 for relevant studies. The literature search yielded 511 results, and 37 studies were eventually included in this review. Silence affects the autonomic nervous system differently based on whether it is inner or outer silence. Inner silence enhances activity of the ventral vagus, favoring social engagement, and reducing sympathetic nervous system activity and physiological stress. Outer silence, conversely, can induce a heightened state of alertness, potentially triggering vagal brake removal and sympathetic nervous system activation, though with training, it can foster inner silence, preventing such activation. The autonomic nervous system response to silence can also be influenced by other factors such as context, familiarity with silence, presence and quality of outer noise, and empathy.
Topics: Humans; Autonomic Nervous System; Vagus Nerve; Emotional Regulation; Empathy; Recognition, Psychology
PubMed: 37714570
DOI: 10.1016/bs.pbr.2023.08.001 -
Journal of Neural Engineering Mar 2021Bioelectronic medicine (BM) is an emerging new approach for developing novel neuromodulation therapies for pathologies that have been previously treated with... (Review)
Review
Bioelectronic medicine (BM) is an emerging new approach for developing novel neuromodulation therapies for pathologies that have been previously treated with pharmacological approaches. In this review, we will focus on the neuromodulation of autonomic nervous system (ANS) activity with implantable devices, a field of BM that has already demonstrated the ability to treat a variety of conditions, from inflammation to metabolic and cognitive disorders. Recent discoveries about immune responses to ANS stimulation are the laying foundation for a new field holding great potential for medical advancement and therapies and involving an increasing number of research groups around the world, with funding from international public agencies and private investors. Here, we summarize the current achievements and future perspectives for clinical applications of neural decoding and stimulation of the ANS. First, we present the main clinical results achieved so far by different BM approaches and discuss the challenges encountered in fully exploiting the potential of neuromodulatory strategies. Then, we present current preclinical studies aimed at overcoming the present limitations by looking for optimal anatomical targets, developing novel neural interface technology, and conceiving more efficient signal processing strategies. Finally, we explore the prospects for translating these advancements into clinical practice.
Topics: Autonomic Nervous System; Forecasting; Signal Processing, Computer-Assisted
PubMed: 33592597
DOI: 10.1088/1741-2552/abe6b9 -
Acta Cardiologica Aug 2023The role of the autonomic nervous system in the onset of supraventricular and ventricular arrhythmias is well established. It can be analysed by the spontaneous... (Review)
Review
The role of the autonomic nervous system in the onset of supraventricular and ventricular arrhythmias is well established. It can be analysed by the spontaneous behaviour of the heart rate with ambulatory ECG recordings, through heart rate variability measurements. Input of heart rate variability parameters into artificial intelligence models to make predictions regarding the detection or forecast of rhythm disorders is becoming routine and neuromodulation techniques are now increasingly used for their treatment. All this warrants a reappraisal of the use of heart rate variability for autonomic nervous system assessment.Measurements performed over long periods such as 24H-variance, total power, deceleration capacity, and turbulence are suitable for estimating the individual basal autonomic status. Spectral measurements performed over short periods provide information on the dynamics of systems that disrupt this basal balance and may be part of the triggers of arrhythmias, as well as premature atrial or ventricular beats. All heart rate variability measurements essentially reflect the modulations of the parasympathetic nervous system which are superimposed on the impulses of the adrenergic system. Although heart rate variability parameters have been shown to be useful for risk stratification in patients with myocardial infarction and patients with heart failure, they are not part of the criteria for prophylactic implantation of an intracardiac defibrillator, because of their high variability and the improved treatment of myocardial infarction. Graphical methods such as Poincaré plots allow quick screening of atrial fibrillation and are set to play an important role in the e-cardiology networks. Although mathematical and computational techniques allow manipulation of the ECG signal to extract information and permit their use in predictive models for individual cardiac risk stratification, their explicability remains difficult and making inferences about the activity of the ANS from these models must remain cautious.
Topics: Humans; Heart Rate; Artificial Intelligence; Autonomic Nervous System; Heart; Myocardial Infarction; Atrial Fibrillation; Heart Atria
PubMed: 36803313
DOI: 10.1080/00015385.2023.2177371 -
Brain and Nerve = Shinkei Kenkyu No... Mar 2022Parasympathetic nervous system activity dominates during non-rapid eye movement (REM) sleep, whereas the sympathetic nervous system is dominant during REM sleep. The...
Parasympathetic nervous system activity dominates during non-rapid eye movement (REM) sleep, whereas the sympathetic nervous system is dominant during REM sleep. The balance between the sympathetic and parasympathetic nervous systems reduces the heart rate and blood pressure during non-REM sleep and increases these parameters during REM sleep and wakefulness. Heart rate variability analysis, a non-invasive method of autonomic nervous system analysis, may be useful in screening for obstructive sleep apnea and also to predict orthostatic hypotension secondary to autonomic disturbances in patients with REM sleep behavior disorder.
Topics: Autonomic Nervous System; Heart Rate; Humans; REM Sleep Behavior Disorder; Sleep; Sympathetic Nervous System; Wakefulness
PubMed: 35260527
DOI: 10.11477/mf.1416202024 -
Developmental Psychobiology Dec 2022The purpose of this study was to investigate the role of skin conductance level reactivity (SCLR) and respiratory sinus arrhythmia reactivity (RSAR) in preschoolers'...
The purpose of this study was to investigate the role of skin conductance level reactivity (SCLR) and respiratory sinus arrhythmia reactivity (RSAR) in preschoolers' social dominance, as well as potential gender differences in these associations. Reactivity was assessed in response to viewing videos of social exclusion and a post-aggression discussion. In a community sample of 94 preschool children followed over one calendar year, reactivity to the post-aggression discussion, but not exclusion, video was related to social dominance. Specifically, increased RSAR to the post-aggression discussion video was positively associated with concurrent social dominance for both boys and girls. Longitudinally, for boys only, coactivation (i.e., increases in SCLR accompanied by increases in RSAR) to the post-aggression discussion video, which may reflect dysregulated, emotionally labile reactions to stress, was associated with relatively low levels of social dominance across the course of the year. Overall, findings contribute to a growing literature documenting the role of autonomic reactivity in preschoolers' social adjustment and extend this work to their capacity to achieve and maintain socially dominant positions with peers.
Topics: Male; Female; Humans; Galvanic Skin Response; Autonomic Nervous System; Social Dominance; Respiratory Sinus Arrhythmia; Aggression
PubMed: 36426790
DOI: 10.1002/dev.22336 -
Neurophysiologie Clinique = Clinical... Apr 2023
Topics: Humans; Nervous System Diseases; Autonomic Nervous System; Autonomic Nervous System Diseases
PubMed: 36966706
DOI: 10.1016/j.neucli.2023.102857 -
Diabetologia Oct 2020Increasing evidence suggests that, although pancreatic islets can function autonomously to detect and respond to changes in the circulating glucose level, the brain... (Review)
Review
Increasing evidence suggests that, although pancreatic islets can function autonomously to detect and respond to changes in the circulating glucose level, the brain cooperates with the islet to maintain glycaemic control. Here, we review the role of the central and autonomic nervous systems in the control of the endocrine pancreas, including mechanisms whereby the brain senses circulating blood glucose levels. We also examine whether dysfunction in these systems might contribute to complications of type 1 diabetes and the pathogenesis of type 2 diabetes. Graphical abstract.
Topics: Animals; Autonomic Nervous System; Blood Glucose; Central Nervous System; Diabetes Mellitus, Type 2; Glucagon; Humans; Insulin; Insulin Secretion; Islets of Langerhans; Sensory Receptor Cells
PubMed: 32894319
DOI: 10.1007/s00125-020-05204-6 -
American Journal of Physiology.... Jul 2020In the central nervous system (CNS), nuclei of the brain stem play a critical role in the integration of peripheral sensory information and the regulation of autonomic... (Review)
Review
In the central nervous system (CNS), nuclei of the brain stem play a critical role in the integration of peripheral sensory information and the regulation of autonomic output in mammalian physiology. The nucleus tractus solitarius of the brain stem acts as a relay center that receives peripheral sensory input from vagal afferents of the nodose ganglia, integrates information from within the brain stem and higher central centers, and then transmits autonomic efferent output through downstream premotor nuclei, such as the nucleus ambiguus, the dorsal motor nucleus of the vagus, and the rostral ventral lateral medulla. Although there is mounting evidence that sex and sex hormones modulate autonomic physiology at the level of the CNS, the mechanisms and neurocircuitry involved in producing these functional consequences are poorly understood. Of particular interest in this review is the role of estrogen, progesterone, and 5α-reductase-dependent neurosteroid metabolites of progesterone (e.g., allopregnanolone) in the modulation of neurotransmission within brain-stem autonomic neurocircuits. This review will discuss our understanding of the actions and mechanisms of estrogen, progesterone, and neurosteroids at the cellular level of brain-stem nuclei. Understanding the complex interaction between sex hormones and neural signaling plasticity of the autonomic nervous system is essential to elucidating the role of sex in overall physiology and disease.
Topics: Animals; Autonomic Nervous System; Brain Stem; Female; Gonadal Steroid Hormones; Humans; Male; Nerve Net; Neuronal Plasticity
PubMed: 32493037
DOI: 10.1152/ajpregu.00357.2019