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Frontiers in Psychology 2023Positive psychological factors play a pivotal role in improving cardiovascular outcomes. Gratitude interventions are among the most effective positive psychological...
Positive psychological factors play a pivotal role in improving cardiovascular outcomes. Gratitude interventions are among the most effective positive psychological interventions, with potential clinical applications in cardiology practice. To better understand the potential clinical effects of gratitude interventions in cardiovascular disease, four databases (Web of Science, Scopus, PubMed, and PsycArticles) were searched from 2005 to 2023 for relevant studies. Randomized controlled trials of gratitude interventions as the intervention and that reported physiological or psychosocial outcomes were eligible for inclusion. In total, 19 studies were identified, reporting results from 2951 participants from 19 to 71 years old from both healthy populations and those with clinical diagnoses. The studies showed that gratitude not only promotes mental health and adherence to healthy behaviors but also improves cardiovascular outcomes. Gratitude may have a positive impact on biomarkers of cardiovascular disease risk, especially asymptomatic heart failure, cardiovascular function, and autonomic nervous system activity.
PubMed: 37809310
DOI: 10.3389/fpsyg.2023.1243598 -
Neurology International Sep 2023The aim of this systematic review with meta-analysis was to determine differences in cardiovascular autonomic parameters between patients with myasthenia gravis (MG) and... (Review)
Review
The aim of this systematic review with meta-analysis was to determine differences in cardiovascular autonomic parameters between patients with myasthenia gravis (MG) and healthy controls (HCs). Two reviewers searched four electronic databases, namely PubMed, Web of Science, EMBASE, and SCOPUS, from database inception to 7 July 2023 for studies investigating cardiovascular autonomic parameters in MG vs. HCs. A random-effects meta-analysis was performed to compute Hedges' g ± 95% confidence intervals (CI). Out of a total of 2200 records, 8 observational studies with a sample size of 301 patients with MG and 454 HCs were included in the systematic review. Meta-analysis revealed lower values of expiration/inspiration ratio (g = -0.45, I = 74.7), baroreflex sensitivity (g = -0.56, 95%CI -0.80, -0.33; I = 0.3), percentage of adjacent NN intervals differing by more than 50 ms (g = -1.2, I = 82.8), square root of the mean of squared differences between successive beat intervals (g = -1.94, I = 95.1), mean of the standard deviations of all NN intervals (g = -0.83, 95%CI -1.37, -0.28; I = 55.5), and high frequency of HRV during tilt (g = -0.75, 95%CI -0.11, -0.39; I = 0). MG patients vs. HCs had higher systolic blood pressure (g = 0.39; I = 56.1), sympathovagal balance at rest/during tilt (LF/HF-RRI, g = 0.44; I = 0; LF/HF-RRI, g = 0.86; I = 0; LF/HF, g = 0.40; I = 0). As a group, MG patients have altered cardiac autonomic function, including decreased parasympathetic function, lower baroreflex sensitivity, and higher sympathovagal balance at rest and during orthostatic challenges.
PubMed: 37755362
DOI: 10.3390/neurolint15030071 -
Frontiers in Immunology 2023Sepsis is a systemic inflammation caused by a maladjusted host response to infection. In severe cases, it can cause multiple organ dysfunction syndrome (MODS) and even... (Review)
Review
Sepsis is a systemic inflammation caused by a maladjusted host response to infection. In severe cases, it can cause multiple organ dysfunction syndrome (MODS) and even endanger life. Acupuncture is widely accepted and applied in the treatment of sepsis, and breakthroughs have been made regarding its mechanism of action in recent years. In this review, we systematically discuss the current clinical applications of acupuncture in the treatment of sepsis and focus on the mechanisms of acupuncture in animal models of systemic inflammation. In clinical research, acupuncture can not only effectively inhibit excessive inflammatory reactions but also improve the immunosuppressive state of patients with sepsis, thus maintaining immune homeostasis. Mechanistically, a change in the acupoint microenvironment is the initial response link for acupuncture to take effect, whereas PROKR2 neurons, high-threshold thin nerve fibres, cannabinoid CB2 receptor (CB2R) activation, and Ca influx are the key material bases. The cholinergic anti-inflammatory pathway of the vagus nervous system, the adrenal dopamine anti-inflammatory pathway, and the sympathetic nervous system are key to the transmission of acupuncture information and the inhibition of systemic inflammation. In MODS, acupuncture protects against septic organ damage by inhibiting excessive inflammatory reactions, resisting oxidative stress, protecting mitochondrial function, and reducing apoptosis and tissue or organ damage.
Topics: Animals; Humans; Sepsis; Acupuncture Therapy; Inflammation; Vagus Nerve
PubMed: 37753078
DOI: 10.3389/fimmu.2023.1242640 -
Journal of Neurology Dec 2023Autonomic dysfunctions are prevalent in several cerebellar disorders, but they have not been systematically investigated in spinocerebellar ataxias (SCAs). Studies... (Review)
Review
BACKGROUND
Autonomic dysfunctions are prevalent in several cerebellar disorders, but they have not been systematically investigated in spinocerebellar ataxias (SCAs). Studies investigating autonomic deficits in SCAs are fragmented, with each one focusing on different autonomic dysfunctions and different SCA subtypes.
METHODS
Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement, we conducted a systematic review of the literature to assess the presence of autonomic dysfunctions in various SCAs. PubMed served as the primary database, and the Rayyan web application was employed for study screening.
RESULTS
We identified 46 articles investigating at least one autonomic function in patients with SCA. The results were analyzed and categorized based on the genetic subtype of SCA, thereby characterizing the specific autonomic deficits associated with each subtype.
CONCLUSION
This review confirms the presence of autonomic dysfunctions in various genetic subtypes of SCA, underscoring the cerebellum's role in the autonomic nervous system (ANS). It also emphasizes the importance of investigating these functions in clinical practice.
Topics: Humans; Spinocerebellar Ataxias; Cerebellum; Primary Dysautonomias; Autonomic Nervous System
PubMed: 37749264
DOI: 10.1007/s00415-023-11993-8 -
JCPP Advances Sep 2023Self-injurious thoughts and behaviours (SITBs) have been associated with dysfunction of the Autonomic Nervous System (ANS) in children and young people, suggesting that...
BACKGROUND
Self-injurious thoughts and behaviours (SITBs) have been associated with dysfunction of the Autonomic Nervous System (ANS) in children and young people, suggesting that objective ANS measures may aid assessment of suicide risk, but a systematic synthesis of this literature is currently lacking.
METHODS
Following a pre-registered protocol (PROSPERO CRD42022327605), we conducted a systematic search of PubMed, Medline, Embase, PsycINFO, and Web of Science, for empirical studies published until 10th May 2022 that compared indices of ANS functioning in individuals aged 0-25 years with versus without SITBs, or reported continuous associations between ANS measures and SITBs. Study quality was assessed with the Newcastle-Ottawa Scales. Pooled effect sizes (Hedge's g) were estimated with random-effects meta-analytic models.
RESULTS
Twenty studies (1979 participants) were included in our systematic review, with 16 included in meta-analyses. Results suggested that SITBs were associated with altered cardiac indices of arousal ( = -0.328, < 0.001), which was driven by lower heart rate variability in individuals with SITBs ( = -0.375, = 0.025). Overall results for electrodermal activity were not significant ( = 0.026, = 0.857), but subgroup analyses showed increased activity in studies of individuals who engaged specifically in non-suicidal self-harm ( = 0.249, = 0.014) but decreased activity in the remaining studies ( = -0.567, = 0.004).
CONCLUSIONS
Our systematic review and meta-analysis found evidence of reduced parasympathetic regulation as well as more tentative evidence of altered electrodermal activity in children and young people displaying SITBs. Future longitudinal studies should test the clinical utility of these markers for detecting and monitoring suicide risk.
PubMed: 37720589
DOI: 10.1002/jcv2.12148 -
Diving and Hyperbaric Medicine Sep 2023Hypoxia can cause central nervous system dysfunction and injury. Hypoxia is a particular risk during rebreather diving. Given its subtle symptom profile and its... (Review)
Review
INTRODUCTION
Hypoxia can cause central nervous system dysfunction and injury. Hypoxia is a particular risk during rebreather diving. Given its subtle symptom profile and its catastrophic consequences there is a need for reliable hypoxia monitoring. Electroencephalography (EEG) is being investigated as a real time monitor for multiple diving problems related to inspired gas, including hypoxia.
METHODS
A systematic literature search identified articles investigating the relationship between EEG changes and acute cerebral hypoxia in healthy adults. Quality of clinical evidence was assessed using the Newcastle-Ottawa scale.
RESULTS
Eighty-one studies were included for analysis. Only one study investigated divers. Twelve studies described quantitative EEG spectral power differences. Moderate hypoxia tended to result in increased alpha activity. With severe hypoxia, alpha activity decreased whilst delta and theta activities increased. However, since studies that utilised cognitive testing during the hypoxic exposure more frequently reported opposite results it appears cognitive processing might mask hypoxic EEG changes. Other analysis techniques (evoked potentials and electrical equivalents of dipole signals), demonstrated sustained regulation of autonomic responses despite worsening hypoxia. Other studies utilised quantitative EEG analysis techniques, (Bispectral index [BISTM], approximate entropy and Lempel-Ziv complexity). No change was reported in BISTM value, whilst an increase in approximate entropy and Lempel-Ziv complexity occurred with worsening hypoxia.
CONCLUSIONS
Electroencephalographic frequency patterns change in response to acute cerebral hypoxia. There is paucity of literature on the relationship between quantitative EEG analysis techniques and cerebral hypoxia. Because of the conflicting results in EEG power frequency analysis, future research needs to quantitatively define a hypoxia-EEG response curve, and how it is altered by concurrent cognitive task loading.
Topics: Adult; Humans; Diving; Hypoxia; Electroencephalography; Central Nervous System; Hypoxia, Brain
PubMed: 37718302
DOI: 10.28920/dhm53.3.268-280 -
Autonomic Neuroscience : Basic &... Nov 2023The autonomic nervous system interacts with the immune system via the inflammatory response. Heart rate variability (HRV), a marker of autonomic activity, is associated... (Review)
Review
PURPOSE
The autonomic nervous system interacts with the immune system via the inflammatory response. Heart rate variability (HRV), a marker of autonomic activity, is associated with inflammation, and nosocomial infections/sepsis, and has clinical implications for the monitoring of at-risk patients. Due to the vagal tone's influence on anti-inflammatory immune response, this association may predominately be reflected by vagally-mediated HRV indices. However, HRV's predictive significance on inflammation/infection remains unclear.
METHODS
843 studies examining the associations/prognostic value of HRV indices on inflammation, and nosocomial infection/sepsis were screened in this systematic review. According to inclusion and exclusion criteria, 68 associative studies and 14 prediction studies were included.
RESULTS
HRV and pro-inflammatory state were consistently associated in healthy subjects and patient groups. Pro-inflammatory state was related to reduced total power HRV including vagally- and non-vagally-mediated HRV indices. Similar, compared to controls, HRV reductions were observed during nosocomial infections/sepsis. Only limited evidence supports the predictive value of HRV in the development of nosocomial infections/sepsis. Reduced very low frequency power HRV showed the highest predictive value in adults, even with different clinical conditions. In neonates, an increased heart rate characteristic score, combining reduced total power HRV, decreased complexity, and vagally-dominated asymmetry, predicted sepsis.
CONCLUSIONS
Pro-inflammatory state is related to an overall reduction in HRV rather than a singular reduction in vagally-mediated HRV indices, reflecting the complex autonomic-regulatory changes occurring during inflammation. The potential benefit of using continuous HRV monitoring for detecting nosocomial infection-related states, and the implications for clinical outcome, need further clarification.
PubMed: 37651781
DOI: 10.1016/j.autneu.2023.103116 -
World Journal of Clinical Cases Aug 2023It is common for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection to occur in the gastrointestinal tract, which can present itself as an initial...
BACKGROUND
It is common for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection to occur in the gastrointestinal tract, which can present itself as an initial symptom. The severity of coronavirus disease 2019 (COVID-19) is often reflected in the prevalence of gastrointestinal symptoms. COVID-19 can damage the nerve supply to the digestive system, leading to gastrointestinal autonomic dysfunction. There is still much to learn about how COVID-19 affects the autonomic nervous system and the gastrointestinal tract.
AIM
To thoroughly explore the epidemiology and clinical aspects of COVID-19-induced gastrointestinal autonomic dysfunction, including its manifestations, potential mechanisms, diagnosis, differential diagnosis, impact on quality of life, prognosis, and management and prevention strategies.
METHODS
We conducted a thorough systematic search across various databases and performed an extensive literature review. Our review encompassed 113 studies published in English from January 2000 to April 18, 2023.
RESULTS
According to most of the literature, gastrointestinal autonomic dysfunction can seriously affect a patient's quality of life and ultimate prognosis. Numerous factors can influence gastrointestinal autonomic nervous functions. Studies have shown that SARS-CoV-2 has a well-documented affinity for both neural and gastrointestinal tissues, and the virus can produce various gastrointestinal symptoms by reaching neural tissues through different pathways. These symptoms include anorexia, dysgeusia, heartburn, belching, chest pain, regurgitation, vomiting, epigastric burn, diarrhea, abdominal pain, bloating, irregular bowel movements, and constipation. Diarrhea is the most prevalent symptom, followed by anorexia, nausea, vomiting, and abdominal pain. Although COVID-19 vaccination may rarely induce autonomic dysfunction and gastrointestinal symptoms, COVID-19-induced autonomic effects significantly impact the patient's condition, general health, prognosis, and quality of life. Early diagnosis and proper recognition are crucial for improving outcomes. It is important to consider the differential diagnosis, as these symptoms may be induced by diseases other than COVID-19-induced autonomic dysfunction. Treating this dysfunction can be a challenging task.
CONCLUSION
To ensure the best possible outcomes for COVID-19 patients, it is essential to take a multidisciplinary approach involving providing supportive care, treating the underlying infection, managing dysfunction, monitoring for complications, and offering nutritional support. Close monitoring of the patient's condition is crucial, and prompt intervention should be taken if necessary. Furthermore, conducting thorough research on the gastrointestinal autonomic dysfunction caused by COVID-19 is vital to manage it effectively.
PubMed: 37621592
DOI: 10.12998/wjcc.v11.i22.5252 -
PloS One 2023It is unknown whether patients with chronic musculoskeletal pain (CMP) show autonomic dysregulation after exercise, and the interventional effects of exercise on the...
BACKGROUND
It is unknown whether patients with chronic musculoskeletal pain (CMP) show autonomic dysregulation after exercise, and the interventional effects of exercise on the autonomic dysregulation have not been elucidated. The objectives of this study were to reveal acute autonomic responses after aerobic and resistance exercises and the interventional effects of both exercises on autonomic dysregulation in patients with CMP.
METHODS
A systematic search using nine electronic databases was performed based on three key search terms: "chronic musculoskeletal pain," "autonomic nervous system," and "exercise." Data were extracted from measurements of the autonomic nervous system and pain.
RESULTS
We found a total of 1170 articles; 17 were finally included, incorporating 12 observational and five interventional studies. Although a comparator has not been specified, healthy controls were compared to patients with CMP in observational studies. Three of five interventional studies were pre-post study with healthy controls as a comparator or no controls. The other two interventional studies were randomized controlled trial with a different treatment e.g., stretching. There were four good, 10 fair, and three poor-quality articles. The total number of participants was 617, of which 551 were female. There was high heterogeneity among the five disease conditions and nine outcome measures. Following one-time exposure to aerobic and resistance exercises, abnormal autonomic responses (sympathetic activation and parasympathetic withdrawal), which were absent in healthy controls, were observed in patients with CMP. The effects of aerobic and resistance exercise as long-term interventions were unclear since we identified both positive effects and no change in the autonomic activities in patients with CMP.
CONCLUSIONS
This study indicates dysfunctional autonomic responses following one-time exposure to exercise and inconsistent interventional effects in the autonomic activities in patients with CMP. Appropriate therapeutic dose is necessary for studying the management of autonomic regulation and pain after exercise.
Topics: Humans; Female; Male; Resistance Training; Musculoskeletal Pain; Exercise; Exercise Therapy; Autonomic Nervous System; Randomized Controlled Trials as Topic
PubMed: 37578955
DOI: 10.1371/journal.pone.0290061 -
European Surgical Research. Europaische... 2023The vagus nerve has an important role in satiety, metabolism, and autonomic control in upper gastrointestinal function. However, the role and effects of vagal nerve... (Meta-Analysis)
Meta-Analysis
INTRODUCTION
The vagus nerve has an important role in satiety, metabolism, and autonomic control in upper gastrointestinal function. However, the role and effects of vagal nerve therapy on weight loss remain controversial. This systematic review and meta-analysis assessed the effects of vagal nerve therapy on weight loss, body mass index (BMI), and obesity-related conditions.
METHODS
MEDLINE, EMBASE, and CINAHL databases were searched for studies up to April 2022 that reported on percentage excess weight loss (%EWL) or BMI at 12 months or remission of obesity-related conditions following vagal nerve therapy from January 2000 to April 2022. Weighted mean difference (WMD) was calculated, meta-analysis was performed using random-effects models, and between-study heterogeneity was assessed.
RESULTS
Fifteen studies, of which nine were randomised controlled trials, of 1,447 patients were included. Vagal nerve therapy led to some improvement in %EWL (WMD 17.19%; 95% confidence interval [CI]: 10.94-23.44; p < 0.001) and BMI (WMD -2.24 kg/m2; 95% CI: -4.07 to -0.42; p = 0.016). There was a general improvement found in HbA1c following vagal nerve therapy when compared to no treatment given. No major complications were reported.
CONCLUSIONS
Vagal nerve therapy can safely result in a mild-to-moderate improvement in weight loss. However, further clinical trials are required to confirm these results and investigate the possibility of the long-term benefit of vagal nerve therapy as a dual therapy combined with standard surgical bariatric interventions.
Topics: Humans; Obesity; Vagus Nerve; Weight Loss; Body Mass Index; Randomized Controlled Trials as Topic
PubMed: 37544303
DOI: 10.1159/000533358