Effect of Endurance Training on the Autonomic Nervous System Function of Young Male

In this study, healthy young males were randomized into groups with moderate intensity training (n = 24), high intensity training (n = 24) and utmost intensity training (n = 24). At the end of 8-week training period, HRV measurements demonstrated a marked increase of RMSSD (P = 0.003), PNN50 (P = 0.002), HF (P = 0.002), SDNN (P = 0.002) and LF (P = 0.003) in the moderate intensity group and a decreasing tendency in LFn and LF/HF;however, in the utmost intensity group HFn (P = 0.012) decreased prominently while its LF (P = 0.032), LFn (P = 0.039) and LF/HF (P = 0.015) increased significantly. Nevertheless marked changes were not found in the above indexes of the high intensity group. While resting HR of the three groups declined significantly at the end of 8 weeks (P was 0.001, 0.0001 and 0.001 respectively);RMSSD, PNN50, HF, LF and SDNN were significantly higher in the moderate intensity group than in the other two groups (P P = 0.012) was significantly lower but its LFn and LF/HF were markedly higher (P was 0.025 and 0.015 respectively);LF/HF of both the high and utmost intensity group was significantly higher (P was 0.033 and 0.037 respectively). Despite a significant reduction of plasma NE in all the three groups at the end of 8-week training period (P was 0.016, 0, 0.031 respectively), plasma NE level of moderate and high intensity group was much lower than that of the utmost intensity group (P was 0.001, 0 respectively). Utmost and moderate endurance training results in altered sympathetic and parasympathetic balance towards sympathetic dominance and parasympathetic dominance respectively;whereas high intensity endurance training almost has no effect on ANS function. CPT and HUTT reveal the potential danger posed by utmost intensity endurance training.

The Effect of Brief, Low-Intensity Stretching Gymnastics on Autonomic Nervous System Activity and Cognitive Function

Purpose: Stretching exercise and gymnastics both have beneficial effects, such as improvement of autonomic nervous system activity and mood. Additionally, studies on the effects of exercise on cognitive function have been conducted covering a wide range of age groups and have attracted much attention. However, conventional studies have set up programs with implementation times of 20 to 30 minutes. Therefore, shorter stretching programs are needed in order to fit them more easily into one’s free time. We examined the effects of a short 7-minute stretching gymnastics regime on the autonomic nervous system activity and cognitive function in 21 healthy participants. Methods: In this study, the participants performed a 10-minute cognitive task, followed by either Stretch Well Gymnastics, Stretch Band Gymnastics, or Radio Gymnastics sessions on different days. The participants then performed the cognitive task again. Heart rate was measured continuously throughout the experiment and we analyzed the heart rate variability. The cognitive tasks completed by all of the participants were evaluated for inhibitory control and cognitive flexibility. Results: A significant increase was shown in the sympathetic nerve activity during the Stretch Well Gymnastics, compared to the Radio Gymnastics and Stretch Band Gymnastics. Parasympathetic nerve levels were significantly increased after the gymnastics, compared to during the gymnastics, although there were no significant differences between any of the tasks. Additionally, in both the Stroop task and the number-Letter task, reaction times were faster in all of the sessions. In particular, the Stroop task showed the highest values for the Radio Gymnastics sessions, with marginally significantly lower scores for the Stretch Well Gymnastics sessions. Conclusion: The results showed that these heart rate variability responses supported the effects of autonomic activity associated with conventional low-intensity exercise. Additionally, stretching gymnastics for less than 10 minutes showed a positive effect on inhibitory function and cognitive flexibility.

Effects of mammography positioning on the autonomic nervous function

The physical and psychological burden on patients during mammography was analyzed using the autonomic function index in 34 adult females. The indices included heart rate (HR), high frequency (HF) of the R-R interval on an electrocardiogram, and the ratio of HF to LF (low frequency) (LF/HF). HR is an indicator of the degree of mental and physical activity, HF indicates the parasympathetic index and LF/HF indicates the sympathetic index. For the mediolateral oblique (MLO) view in mammography, autonomic function indices were measured before and during mammography. Statistical analysis was performed by the Mann-Whitney U test and the significance level was set at 5%. The autonomic function indices were compared before and during mammography and all showed no significant differences. The average value before imaging and the reference value at rest were compared. The results showed that HR increased 1.3-fold, HF increased 0.4-fold, and LF/HF increased 3.2-fold over reference values. Chronological changes during mammography showed that HF increased and LF/HF decreased from 120 seconds after the start of imaging. From these observations, it is evident that the state before mammography is not the same as the resting state and that the sympathetic index is dominant before imaging. They also suggest that some aspects of the psychological burden experienced during mammography are not due to the pain of breast compression alone.

Clinical Study on Evaluation of Autonomic Nervous Dysfunction Based on Imaging Urodynamic Examination with Slow Filling and Synchronous Blood Pressure Monitoring in the Patients with Cervicothoracic Spinal Cord Injury

Objective: Explore the rule of autonomic nervous dysfunction in the patients with urination disorder after high level spinal cord injury, and seek a safe, objective and accurate method to evaluate autonomic nervous function. Patients and Method: 48 patients with dysuria after cervicothoracic SCI were selected. Before, during and after imaging urodynamic examination with slow filling in supine position, blood pressure and ECG were monitored simultaneously. The symptoms of sweating, shivering, headache, flushing and chills were observed and recorded. The study of the relationship among the changes of blood pressure, heart rate and urodynamic indexes and the above symptoms was analyzed. Results: They were divided into three groups: group A (no obvious abnormality), group B (hyperactivity) and group C (hypoactivity) according to their BP, HR and existing the symptoms or not. Conclusion: The incidence of autonomic dysfunction in the high level SCI patients with dysuria was very high (79.17%), most of them were hyperactivity, and a few were low function. The changes of SBP and DBP in the hypoactivity group all appeared an increasing and then declining trend, while the change of HR in the low function one was lower than normal and decreased continuously. The main inducements of AD are neurogenic detrusor overactivity, detrusor sphincter dyssynergia, elevated abdominal pressure and abnormal bladder sensitivity. The asymptomatic patients had a higher occurrence rate (43.75%). Only by imaging urodynamic examination with slow filling and synchronous blood pressure monitoring, can autonomic nervous function of the patients be evaluated safely, objectively, early and accurately.

Autonomic and endocrine control of cardiovascular function

The function of the heart is to contract and pump oxygenated blood to the body and deoxygenated blood to the lungs.To achieve this goal,a normal human heart must beat regularly and continuously for one's entire life.Heartbeats originate from the rhythmic pacing discharge from the sinoatrial(SA) node within the heart itself.In the absence of extrinsic neural or hormonal influences,the SA node pacing rate would be about 100 beats per minute.Heart rate and cardiac output,however,must vary in response to the needs of the body's cells for oxygen and nutrients under varying conditions.In order to respond rapidly to the changing requirements of the body's tissues,the heart rate and contractility are regulated by the nervous system,hormones,and other factors.Here we review how the cardiovascular system is controlled and influenced by not only a unique intrinsic system,but is also heavily influenced by the autonomic nervous system as well as the endocrine system.

Autonomic functions and gastric motility in children with functional abdominal pain disorders

BACKGROUND Abdominal pain-predominant functional gastrointestinal disorders(AP-FGIDs)are the most common cause of recurrent abdominal pain in children. Despite its high prevalence, the underlying pathophysiology of this condition is poorly understood.AIM To assess the role of gastric dysmotility and autonomic nervous system dysfunction in the pathophysiology of AP-FGIDs.METHODS One hundred children, fulfilling Rome III criteria for AP-FGIDs, and 50 healthy controls, aged 5 to 12 years, were recruited after obtaining parental consent. All patients were investigated for underlying organic disorders. Gastric motility and cardiovascular autonomic functions were assessed using validated non-invasive techniques.RESULTS The main gastric motility parameters assessed(gastric emptying rate [45.7 vs 59.6 in controls], amplitude [48.7 vs 58.2], frequency of antral contractions [8.3 vs 9.4],and antral motility index [4.1 vs 6.4]) were significantly lower in children with AP-FGIDs(P < 0.05). The post-prandial antral dilatation at 1 min after the test meal significantly correlated with the severity of abdominal pain(P < 0.05).Assessment of autonomic functions in AP-FGID patients showed neither a significant difference compared to the control group, nor a correlation with gastric motility abnormalities(P > 0.05). The duration of pain episodes negatively correlated with the parasympathetic tone(maladaptive parasympathetic tone)(P< 0.05).CONCLUSION Children with AP-FGIDs have abnormal gastric motility but normal cardiovascular autonomic functions. There is no relationship between abnormal gastric motility and autonomic functions. The pathogenesis of AP-FGIDs is not related to cardiovascular autonomic dysfunction.

Evaluation of functional, autonomic and inflammatory outcomes in children with asthma

Asthma is common in childhood. This respiratory disease is characterized by persistent inflammation of the airways even when the child is not in thethroes of an attack. Chronic inflammation is caused by an imbalance between pro-inflammatory and antiinflammatory mechanisms as well as autonomic dysfunction, which plays an important role in the pathogenesis and control of this condition. The impact of these physiopathological aspects leads to inactivity and a sedentary lifestyle, which exerts an influence on functional capacity and control of the disease. The main objective of non-pharmacological therapy is the clinical control of asthma and the minimization of airway obstruction and hyperinflation during an attack. These factors can be controlled with noninvasive ventilation. The aim or the present review was to describe important neural, inflammatory and functional mechanisms that affect children with asthma.

The relationship between sleep condition and autonomic nervous function in women in their 70s with type 2 diabetes mellitus

The aim of this study was to determine the relationship between sleep condition and autonomic nervous function of women in their 70s with type 2 diabetes mellitus by analyzing the activity counts (AC) on actigraphs and heart rate variability (HRV). Ten healthy women in their 30s to 40s as control and four women patients with type 2 diabetes in their 70s wore the electrocardiograph and an actigraph for 24 hours while keeping a diary of activities, including their sleep and food intake. The Pittsburgh Sleep Quality Index was used to assess subjective sleep conditions. The subjective sleeping results were significantly correlated with those measured by the AC and HRV. However, AC and HRV correlation pattern showed different activity in the patients with type 2 diabetes mellitus. The quality of sleep of those with chronic diabetes was not good even if their HbA1c was well controlled. Furthermore, their automatic nervous function was different from the control group. The sleeping hours of patients with type 2 diabetes were shorter or longer than those of healthy women. Ultimately, this study maintains that it is important to examine automatic nervous functions using objective examination index during the early stage of diabetes mellitus.

Endothelial and Autonomic Assessments in the Management of COVID-19

Background: The goal of this peer review is to outline the benefits of the TM Flow system and Lifeprobes Kiosk assessing the endothelial and autonomic system functions in the management of COVID-19 for triage of the patients at risk and diagnostic of autonomic nervous system dysfunction to understand the long COVID symptoms. Material and Methods: The TM Flow system is a non-invasive medical device that relies on pulse oximetry, blood pressure measurements, and very low electrical current stimulation of the skin via disposable electrodes to provide instantaneous assessments of patients’ vital signs, endothelial function, sudomotor and autonomic nervous system functions, and ankle brachial index measurements. The Lifeprobes Kiosk performs automated pre-consultation patient assessments via an online patient check-in form and medical questionnaire, as well as determines the patient’s vital signs, endothelial function markers and estimated body composition. COVID-19: Current Scientific Data: In the majority of cases, COVID-19 infection will manifest through mild to moderate symptoms (such as cough, runny nose, sore throat, headache, muscle aches, and fever) which would resolve without the need for special treatment or hospitalization. On the other hand, older individuals and those who suffer from underlying medical conditions—such as obesity, diabetes, cardiovascular disease, chronic respiratory disease, and/or cancer—are more susceptible to developing serious illness, often with a fatal outcome. Available evidence further indicates that COVID-19 vaccines reduce the number of new cases, while also lessening the risk of complications that would require hospitalization. However, these findings do not apply to the new delta variant, which leads to more severe complications in younger people than previous variants, even in those who have been vaccinated and/or do not have any underlying medical problems. Research conducted to date indicates that COVID-19 complications result from endothelial dysfunction or damage. In addition, COVID-19 patients are increasingly reporting a wide range of debilitating conditions long after they have tested negative for the presence of the virus, giving rise to the term “Long COVID” which has been attributed to autonomic nervous system dysfunction and small fiber neuropathy. TM Flow markers have been investigated by several clinical studies in the US, India, and Brazil. The clinical studies showed the relevance of the TM Flow endothelial and autonomic nervous markers. Conclusion: Findings yielded by peer-reviewed clinical studies confirm that the TM Flow system and Lifeprobes Kiosk are beneficial and effective non-invasive tools that provide immediate results. Therefore, both should be employed for the triage of COVID-19 patients to expediently identify those at risk of complications, as this would reduce the hospitalization and mortality rates. The TM Flow system is also capable of diagnosing “Long COVID” symptoms related to the autonomic nervous system and small fiber neuropathy.

Autonomic Nervous Function in Vasovagal Syncope of Children and Adolescents

Syncope is defined as a transient loss of consciousness due to global cerebral hypoperfusion, accompanied by loss of muscle tone and failure to maintain an active position. Vasovagal syncope (VVS) is the most common presentation of syncope, and its diagnostic criteria include:(1) absence of any other evident etiology for syncope or presyncope,(2) positive response to head-up tilt test with evident vasovagal reaction (hypotension and/or bradycardia), and (3) no concomitant chronic or acute disease [1, 2]. The onset of VVS peaks initially in childhood and adolescence, and accounts for 60%–70% of all syncopal cases. Clinicians pay great attention to syncope among children and adolescents, due to its high prevalence and its impact on patients’ quality of life. Affected individuals often experience mental stress, economic burdens, and accidental bodily injuries related to syncope [2]. While the pathogenesis of VVS is not fully understood, autonomic nervous dysfunction has been identified as a contributing mechanism. The examination of autonomic nervous function can provide important information about patients with syncope.

Changes before and after improvement of subjective sleep state of a man diagnosed with pre-diabetes and sleep disorder

The purpose of this case study was to examine the changes before and after improvements of the subjective sleep status of Mr A, a 40-year-old man diagnosed with pre-diabetes and a sleep disorder. Data were collected using a Holter monitor for 24 hours a day for 3 days to assess autonomic nervous activity by recording bed-time and waking time activity (activity counts: ACs). Mr. A kept a diary of activities and completed the Pittsburgh Sleep Quality Index (PSQI) questionnaire. The study revealed that subjective sleeping hours correlated almost precisely with those measured by the actigraph and as described in the diary. Both the parasympathetic and sympathetic nervous system activities were imbalanced. However, no correlation was observed between the ACs and autonomic nervous activity. Subjective sleep state according to the PSQI score improved remarkably by dietary and exercise therapy from 13 to 3 points, after six months, with corresponding high level sleep satisfaction level. Significant correlations were observed between ACs and high-frequency spectral power of R-R intervals, and between ACs and the low-frequency/high frequency ratio of spectral power of R-R intervals. Although Mr. A’s sleep satisfaction level has improved, the autonomic nervous system activity remained different from that of healthy people.

Effects of Communication Robot on Distress Reduction in Mammography

Mammography is obviously useful for the early detection and diagnosis of breast diseases in women. However, it usually involves anxieties and pains. This paper aimed to explore effects of the communication robot on distress reduction in mammography. Nineteen healthy women participated in the examination. They were randomly assigned to either an experimental group (n = 9) or a control group (n = 10). The participants in the experimental group talked and played with a communication robot before mammography. PALRO (FUJISOFT Inc., Tokyo, Japan) was used as the communication robot, which was a chatty, comforting robot. PALRO can communicate with the human and has several specific applications such as dancing, singing and talking about knowledge of various things. Autonomic nervous activities were observed before and during mammography. Degrees of subjective pain associated with mammography were also assessed using a visual analogue scale (VAS). As a result, autonomic nervous activities between the experimental group and the control group were not significantly different. Unfortunately, the communication robot did not help to intensify parasympathetic nerve activities, which became dominant at rest or a relaxed state. On the other hand, the VAS scores for pain in the experimental group were significantly smaller than ones in the control group (p < 0.01). This result suggested that the communication robot was useful for relieving degrees of subjective pain associated with mammography. In conclusion, communication with a robot before mammography would yield positive emotions and it would be related to the pain alleviation during mammography.

不典型多系统萎缩误诊分析并文献复习

目的探讨多系统萎缩(MSA)的临床特征并分析误诊原因及防范措施。方法回顾分析2022年2月至2023年6月2例不典型MSA患者的临床资料。结果1例女性,因小便失禁1年,双下肢无力21 d入院,颈椎磁共振成像示颈椎椎管狭窄、脊髓受压,尿动力学检查示膀胱收缩无力、膀胱感觉减退,症状进行性加重至无法行走,伴双下肢感觉减退,诊断为脊髓炎。后经肌电图、头颅磁共振成像+磁共振血管造影+弥散加权成像及全脊髓磁共振成像检查,结合临床症状,确诊为MSA。误诊时间1年。另1例女性,因四肢乏力行走缓慢5年入院,上述症状进行性加重;左侧中枢性面瘫,构音障碍,舌肌纤颤,肌张力增高,大小鱼际肌肉萎缩;四肢腱反射(+++),双下肢病理征(+);初步考虑肌萎缩侧索硬化。完善头颅磁共振成像+磁敏感加权成像、肌电图检查诊断为MSA。误诊时间10 d。2例确诊后予多巴丝肼片及盐酸普拉克索片后症状均有所好转。1例随访1年病情进展需长期卧床,另1例随访2个月,无任何不适。结论MSA是一种神经系统退行性疾病,起病隐匿,且首发症状多样,病情进展快,初期易误诊。在临床上,详尽的病史采集及查体,完备的临床评估,详细的自主神经功能检查及神经影像学检查是避免误诊的关键。

伴自主神经功能障碍的帕金森病患者的睡眠结构及其与快速眼动睡眠障碍的相关性

目的探讨伴发自主神经功能障碍的帕金森病(PD)患者的睡眠结构及其与快速眼动睡眠障碍(RBD)的关系。方法收集48例PD患者的一般资料。根据皮肤交感反应(SSR)检查,将患者分为SSR正常组及SSR障碍组。应用统一PD评定量表第三部分(UPDRS-Ⅲ)、Hoehn-Yahr(H-Y)分级、汉密尔顿焦虑量表(HAMA14)、汉密尔顿抑郁量表(HAMD24)、匹兹堡睡眠指数量表(PSQI)、MMSE、蒙特利尔认知评估量表(MoCA)、自主神经症状量表(SCOPA-AUT)评估患者的运动、非运动症状及自主神经功能;RBD筛查量表(RBDSQ)评定患者RBD症状;多导睡眠监测(PSG)记录睡眠参数。结果与SSR正常组比较,SSR障碍组病程显著延长,H-Y分级及HAMA14、HAMD24、PSQI、SCOPA-AUT、RBDSQ量表评分显著升高(P<0.05~0.01)。与SSR正常组相比,SSR障碍组患者睡眠效率及非快速眼动期(NREM)-Ⅱ期睡眠百分比显著下降,觉醒指数、NREM-Ⅰ期睡眠百分比、周期性腿动指数(PLMI)显著增高(P<0.05~0.01)。SSR障碍组周期性腿动和RBD比率均显著高于SSR正常组(χ^2=4.463,P=0.035;χ^2=8.889,P=0.003)。RBDSQ与SCOPA-AUT评分、NREM-Ⅰ期睡眠百分比、REM期睡眠百分比、呼吸暂停-低通气指数、PLMI和觉醒指数呈正相关(均P<0.01),与总睡眠时间、睡眠潜伏期、REM潜伏期、睡眠效率、NREM-Ⅱ期睡眠百分比、NREM-Ⅲ期睡眠百分比呈负相关(均P<0.01),与总觉醒时间无相关性。结论伴自主神经功能障碍的PD患者病程长,病情重,容易存在焦虑、抑郁情绪,客观存在睡眠结构紊乱,RBD发生率高。PD患者RBD的严重程度与自主神经功能障碍程度密切相关。

交感神经皮肤反应电位在躯体化障碍中的应用

目的:探讨交感神经皮肤反应(SSR)电位在躯体化障碍中的应用。方法:用自编主诉不适症状量表对56例躯体化障碍患者进行访谈,并对这些患者和50名正常对照者进行SSR测定,将所得结果进行分析。结果:躯体化障碍组与正常对照组相比较,SSR波潜伏期延长和波幅降低,差异有显著性意义(P<0.05)。SSR潜伏期与消化系统、呼吸循环、皮肤、泌尿生殖系统症状的严重程度呈正相关;SSR波幅与神经系统症状的严重程度呈正相关,与病程、症状总数目以及呼吸循环系统、皮肤、泌尿生殖系统症状的严重程度呈负相关(P<0.05或P<0.01)。结论:SSR能较好地反映自主神经功能紊乱,可以作为躯体化障碍的一项客观电生理参考指标用于临床。

中医治疗植物神经功能紊乱性心律失常的临床研究

[目的]探讨中医治疗植物神经功能紊乱性心律失常的疗效及发病机制。[方法]所有病例均通过详细体检,常规十二导联心电图、心脏超声、胸部X线检查等,排除各类器质性心脏病。辩证给予中药治疗,连续服用两周为1疗程。[结果]治愈17例,占47.22%;显效者16例,占44.44%;有效者2例,占5.56%。总有效率为97.22%。[结论]情绪因素在此类疾病的发生发展过程中起着重要作用,患者应经常保持精神愉悦、心情乐观、情绪稳定。中医治疗该病疗效确切、副作用少、应用范围广。

舒心解郁汤联合生物反馈治疗老年冠心病伴抑郁障碍的临床研究

目的:探讨舒心解郁汤联合生物反馈对老年冠心病(CHD)伴抑郁障碍患者自主神经功能、心率变异性及抗氧化应激平衡的影响。方法:将300例老年冠心病伴抑郁障碍患者按照随机数字表法分为治疗组和对照组,每组150例。所有患者均给予常规冠心病治疗和舍曲林抗抑郁治疗,对照组给予生物反馈治疗,治疗组给予舒心解郁汤联合生物反馈治疗,比较两组患者自主神经功能、心率变异性及氧化/抗氧化应激指标,评价治疗有效性与安全性。结果:治疗组总有效率高于对照组(P<0.05);治疗后两组患者汉密尔顿抑郁量表(HAMD-17项)评分、抑郁自评量表(SDS)评分、中医证候积分均显著降低(P<0.05),且治疗组患者治疗后各评分显著低于对照组(P<0.05);治疗后两组患者全部窦性心搏RR间期标准差(SDNN)、相邻RR间期差值的均方根(RMSSD)、相邻NN之间>50 ms的个数占总窦性心搏个数的百分比(PNN50)均显著提高(P<0.05),且治疗组患者治疗后各指标均显著高于对照组(P<0.05);治疗后两组患者血清超氧化物歧化酶(SOD)、总氧化能力(T-AOC)、谷胱甘肽过氧化物酶(GSH-Px)显著提高(P<0.05),丙二醛(MDA)显著降低(P<0.05),且治疗组患者治疗后血清SOD、T-AOC、GSH-Px显著高于对照组(P<0.05),MDA显著低于对照组(P<0.05);两组患者治疗2周、4周、8周后不良反应症状量表(TESS)评分比较,差异无统计学意义(P>0.05)。结论:舒心解郁汤联合生物反馈治疗老年冠心病伴抑郁障碍能显著缓解患者抑郁情绪,提高HRV时域指标,改善其自主神经功能状态,促进氧化/抗氧化应激平衡,且安全性高,不良反应小。

直立调节障碍患者交感神经皮肤反应研究

目的 :观察直立调节障碍患者的自主神经功能状况 ,评价交感神经皮肤反应 (SSR)在晕厥鉴别诊断中的应用价值。方法 :对 32例直立调节试验阳性的晕厥患者 (病例组 )进行电刺激SSR检测 ,并以 32例健康志愿者作对照。结果 :病例组SSR潜伏期延长 (1 5 4± 0 2 8s) ,波幅降低 (1 16± 0 33mV) ,与对照组SSR潜伏期 (1 36± 0 2 1s)和波幅 (1 87± 0 5 9mV)相比差异均有显著性意义 (P <0 0 1)。结论 :直立调节障碍患者存在交感神经功能障碍 ,在晕厥的鉴别诊断中 ,SSR是一种有实用价值的神经电生理方法。

抑郁障碍患者自主神经功能研究进展

越来越多的临床证据表明,自主神经系统功能障碍在抑郁障碍中起着重要作用。抑郁障碍患者经常伴有各种躯体症状,主要包括心血管相关症状、失眠、胃肠道不适等;这些可能归因于自主神经系统不平衡,这也通常预示着抑郁程度更严重并且预后更差。本文将系统回顾抑郁障碍患者自主神经功能包括心率变异性及胃动力的改变情况。