scholarly journals Patients with Impaired Descending Nociceptive Inhibitory System Present Altered Cardiac Vagal Control at Rest

2018 ◽  
Vol 1 (21;1) ◽  
pp. E409-E418
Author(s):  
Leandro Nogueira

Background: Patients with chronic musculoskeletal pain have a higher chance of presenting impairment in cardiovascular autonomic modulation, which may have implications for cardiovascular events. The autonomic nervous system plays an important role in pain modulation. However, it is unclear whether patients with inefficient descending nociceptive inhibition have poorer cardiovascular autonomic modulation. Objective: To compare the cardiovascular autonomic modulation of patients with musculoskeletal pain who had normal versus impaired functioning of descending nociceptive inhibitory system (DNIS). Study Design: A cross-sectional study. Setting: Physiotherapy outpatient service. Methods: Fifty-six patients with musculoskeletal pain were included. Conditioned pain modulation was assessed by the difference of algometric values held in the dorsal forearm and tibialis anterior muscle, before and after a thermal pain stimulus was employed via the cold pressure test (CPT). Patients with inefficient DNIS in both sites were classified as impaired responders (n = 14). The others were classified as normal responders (n = 42). Cardiac autonomic modulation was monitored at rest by heart rate variability (HRV). The blood pressure response to the CPT was used as a proxy of sympathetic responsiveness. Results: Most of the patients were women (60%) and had chronic pain (75%). The groups had similar demographic characteristics. Patients with impaired DNIS showed lower HRV [RMSSD (P = 0.020), SDRR (P = 0.009), HF (ms2 ) (P = 0.027), LF (ms2 ) (P = 0.004), and total power (P = 0.002)]. The blood pressure response to CPT was similar between groups (systolic pressure, P = 0.813; diastolic pressure, P = 0.709). Limitation: Physical activity level, emotional changes, and visceral pathologies can alter the autonomic nervous system and may represent potential confounders. The low number of patients may have biased the results. Conclusion: Patients with impaired DNIS presented lower resting HRV, indicating an altered vagal control of the heart. In contrast, the blood pressure response to a sympathoexcitatory stimulus was preserved. The study was approved by the Research Ethics Committee of Augusto Motta University Centre (CAAE number: 46245215.9.0000.5235), and all patients signed the Informed Consent Form. Key words: Musculoskeletal pain, autonomic nervous system, heart rate, chronic pain, diffuse noxious inhibitory control, blood pressure, sympathetic nervous system, parasympathetic nervous system

2017 ◽  
Vol 4 (2) ◽  
pp. 406 ◽  
Author(s):  
Sidheshwar Virbhadraappa Birajdar ◽  
Sheshrao Sakharam Chavan ◽  
Sanjay A. Munde ◽  
Yuvraj P. Bende

Background: Neuropathy is a common complication of diabetes mellitus and it may affect both the peripheral nerves and autonomic nervous system. It’s prevalence ranges from 1% to 90%. The present study is therefore designed to investigate autonomic nervous system involvement in diabetes mellitus by using simple bedside tests and to study its association with other diabetic angiopathies.Methods: 100 patients of diabetes mellitus were selected in the study. In Autonomic function tests for evaluating parasympathetic damage E: I ratio, 30:75 ratio and Valsalva ratio test was performed. Sympathetic damage was diagnosed by Blood pressure response to standing test and Blood pressure response to sustained handgrip test.Results: Abnormal E:I ratio was noticed in only 24 patients. The 30:15 ratio was found to be abnormal in 38 patients while the Valsalva Ratio was abnormal in 34 patients. Postural hypotension was observed in only 8% patients. The sustained hand grip test was abnormal in 10 patients. The prevalence of cardiac autonomic neuropathy was 58%. The association between the presence of autonomic neuropathy and peripheral neuropathy was statistically significant. However, the association between autonomic neuropathy and retinopathy and nephropathy was not statistically significant.Conclusions: The overall prevalence of autonomic neuropathy in diabetes mellitus was 58%. There was parasympathetic preponderance over sympathetic nervous system in the involvement of diabetic autonomic neuropathy. There was statistically significant association of diabetic autonomic neuropathy with peripheral neuropathy as compared to retinopathy and nephropathy.


1988 ◽  
Vol 254 (1) ◽  
pp. H45-H51
Author(s):  
D. S. Martin ◽  
J. R. McNeill

Superior mesenteric arterial flow, aortic blood pressure, and heart rate were recorded, and plasma arginine vasopressin (AVP) concentrations were measured in conscious unrestrained cats during intravenous infusions of AVP (0.1–8.1 mU.kg-1. min-1). Responses to AVP were studied when autonomic nervous system (ANS) function remained intact and when the cholinergic limb of the system had been antagonized by methscopolamine nitrate (0.5 mg/kg) or by pirenzepine (60 micrograms/kg). Elevations in the circulating levels of AVP to approximately 30 and 600 fmol/ml in cats with intact ANS function were associated with decreases in superior mesenteric arterial conductance (SMAC, ml.min-1.kg-1.mmHg-1) of approximately 9 and 50%. The relationship between the dose of AVP and the decreases in SMAC for methscopolamine-treated cats was displaced slightly but significantly to the left of that for intact cats. The relationship between the dose of AVP and the increases in arterial pressure for methscopolamine-treated cats was also significantly displaced to the left of that for intact cats; however, the magnitude of the displacement was much greater than that for the dose-conductance relationship. In contrast to the findings with methscopolamine, pirenzepine did not significantly influence either the dose-conductance or dose-blood pressure response curves. These results are consistent with three conclusions. First, physiologically (less than 30 fmol/ml) and pathophysiologically (less than 600 fmol/ml) relevant concentrations of AVP are capable of inducing intestinal vasoconstriction, even in the presence of intact autonomic function. Second, the cholinergic limb of the autonomic nervous system plays a major role in buffering the vasopressor effects of AVP.(ABSTRACT TRUNCATED AT 250 WORDS)


2016 ◽  
Vol 17 (5) ◽  
pp. 498
Author(s):  
Alyssa Conte Da Silva ◽  
Juliana Falcão Padilha ◽  
Jefferson Luiz Brum Marques ◽  
Cláudia Mirian De Godoy Marques

Introdução: Existem poucos estudos que evidenciam a manipulação vertebral relacionada à modulação autonômica cardíaca. Objetivo: Revisar a literatura sobre os efeitos da manipulação vertebral sobre a modulação autonômica cardíaca. Métodos: Foi realizada uma busca bibliográfica nas bases de dados da saúde Medline, Pubmed e Cinahl, no período correspondido entre setembro e novembro de 2014. Foram utilizados os descritores em inglês Spinal Manipulation, Cardiac Autonomic Modulation, Autonomic Nervous System, Heart Rate Variability, além de associações entre eles. Resultados: Foram encontrados 190 artigos, sendo excluídos 39 por serem repetidos, restando 151. Destes, 124 não se encaixaram nos critérios de inclusão e após leitura crítica e análise dos materiais foram selecionados 7 artigos. Grande parte dos estudos revelou que a manipulação da coluna, independente do segmento, demonstra alterações autonômicas, tanto em nível simpático quanto parassimpático. Conclusão: Existem diferentes metodologias para avaliação da modulação autonômica cardíaca, sendo a Variabilidade da Frequência cardíaca através do eletrocardiograma a mais utilizada. A manipulação vertebral exerceu influência, na maioria dos artigos, sobre a modulação autonômica cardíaca.Palavras-chave: manipulação da coluna, sistema nervoso autônomo, variabilidade da frequência cardíaca. 


Author(s):  
Vladimir A. Fokin ◽  
Dmitrii M. Shlyapnikov ◽  
Svetlana V. Red’ko

In accordance with the requirements of paragraph 3.2.6 of sanitary rules and norms «Sanitary and epidemiological requirements for physical factors at workplace», in the event of exceeding noise level at workplace above 80 dBA, an employer is obliged to assess the health risk of workers and confirm an acceptable risk to their health. The connection between the incidence of occupational and occupationally conditioned diseases with noise exposure exceeding the maximum permissible levels (80 dBA) was estimated. The assessment was carried out at a food industry enterprise of Perm Region. Assessing the relationship between morbidity and noise exposure is the first step in evaluation of occupational health risks for workers exposed to noise exceeding MAL. If a reliable relationship between morbidity and noise exposure is established, an assessment of occupational risk is conducted. The odds ratio (OR) for diseases characterized by high blood pressure and disorders of autonomic nervous system was <1 (confidence interval CI=0.11–1.61 and CI=0.08–2.78, respectively). The relative risk (RR) for diseases characterized by high blood pressure and disorders of autonomic nervous system was <1. The received data testify absence of connection of morbidity with exposure to industrial noise, calculation of etiological share of responses and levels of risk is not required.


2015 ◽  
Vol 28 (3) ◽  
pp. 627-636 ◽  
Author(s):  
Gustavo Henrique de Oliveira Mondoni ◽  
Luiz Carlos Marques Vanderlei ◽  
Bruno Saraiva ◽  
Franciele Marques Vanderlei

AbstractIntroduction It is known that physical exercise is beneficial and precipitates adjustments to the autonomic nervous system. However, the effect of exercise on cardiac autonomic modulation in children, despite its importance, is poorly investigated.Objective To bring together current information about the effects of exercise on heart rate variability in healthy and obese children.Methods The literature update was performed through a search for articles in the following databases; PubMed, PEDro, SciELO and Lilacs, using the descriptors “exercise” and “child” in conjunction with the descriptors “autonomic nervous system”, “sympathetic nervous system”, “parasympathetic nervous system” and also with no descriptor, but the key word of this study, “heart rate variability”, from January 2005 to December 2012.Results After removal of items that did not fit the subject of the study, a total of 9 articles were selected, 5 with healthy and 4 with obese children.Conclusion The findings suggest that exercise can act in the normalization of existing alterations in the autonomic nervous system of obese children, as well as serve as a preventative factor in healthy children, enabling healthy development of the autonomic nervous system until the child reaches adulthood.


2010 ◽  
Vol 72 (5) ◽  
pp. 442-449 ◽  
Author(s):  
Jose M. Martinez ◽  
Amir Garakani ◽  
Horacio Kaufmann ◽  
Cindy J. Aaronson ◽  
Jack M. Gorman

1940 ◽  
Vol 43 (2) ◽  
pp. 236-240 ◽  
Author(s):  
E. Gellhorx ◽  
C. W. Darrow ◽  
L. Yesinick

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