Autism spectrum disorder (ASD) represents a serious neurodevelopmental disorder associated with autonomic nervous system dysregulation. The aim was to study complex cardiovascular autonomic regulation using heart rate variability (HRV) and systolic blood pressure variability (SBPV) linear/non-linear analysis at rest and during orthostasis, and to assess plasma levels of epidermal growth factor (EGF) and vascular endothelial growth factor (VEGF) in autistic children. Twenty-five ASD boys and 25 age and gender-matched children at the age 7-15 years were examined. After venous blood taking, continuous ECG and blood pressure biosignals were recorded at rest and during orthostasis. Evaluated parameters: RR intervals, high- and low-frequency band of HRV spectral analysis (HF-HRV, LF-HRV), symbolic dynamics parameters 0V%, 1V%, 2LV%, 2UV%, low- and high-frequency band of SBPV (LF-SBPV, HF-SBPV), systolic, diastolic, mean blood pressure, EGF, VEGF plasma levels. RR intervals were significantly shortened and the HF-HRV, LF-SBPV, HF-SBPV parameters were significantly lower at rest, the HF-HRV and LF-SBPV remained lower during orthostasis in autistic children compared to controls (p<0.05). EGF plasma levels were significantly lower in ASD compared to controls (p=0.046). No significant differences were found in remaining parameters. Our study revealed tachycardia, cardiovagal underactivity, and blunted sympathetic vasomotor regulation at rest and during orthostasis in autistic children. Additionally, complex heart rate dynamics are similar in autistic children than controls. Furthermore, EGF was reduced in autistic children without significant correlations with any autonomic parameters. We suggest that the abnormal complex cardiovascular reflex control could contribute to understanding the pathway linking autonomic features and autism.
- MeSH
- autonomní nervový systém patofyziologie MeSH
- baroreflex MeSH
- biologické markery krev MeSH
- dítě MeSH
- epidermální růstový faktor krev MeSH
- krevní tlak * MeSH
- lidé MeSH
- mladiství MeSH
- poruchy autistického spektra krev diagnóza patofyziologie MeSH
- srdce inervace MeSH
- srdeční frekvence * MeSH
- vaskulární endoteliální růstový faktor A krev MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- mladiství MeSH
- mužské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
Cardiovascular complications contribute to higher morbidity and mortality in patients with anorexia nervosa. We aimed to study biomarkers of cardiovascular risk in anorexic, normal-weight, and obese adolescents with focus on complex cardiovascular autonomic regulation and early arteriosclerotic damage. We examined 20 adolescent girls with anorexia nervosa, 20 obese girls, and 20 healthy normal-weight controls. Collected data: body composition analysis, 5 min recordings of R-R intervals and beat-to-beat blood pressure (BP), and arterial stiffness evaluated using cardio-ankle vascular index (CAVI). Evaluated parameters: beat-to-beat heart rate and BP variability, haemodynamic parameters (total peripheral resistance (TPR) cardiac output), CAVI, and anthropometric indices, including novel body roundness index (BRI). Adolescents with anorexia nervosa had increased CAVI associated with lower arterial constriction indexed by low-frequency band of BP variability compared with normal-weight peers (p = 0.03, p = 0.04, respectively) and obese adolescents (p < 0.01, p = 0.01, respectively). After normalization of CAVI and TPR by BRI, the relationship between CAVI and TPR was significant for all groups with the highest slope in the anorexia nervosa group (R2 = 0.724, p < 0.01). This is the first study revealing early arteriosclerotic damage in anorexic girls with increased CAVI. Complex analysis of cardiovascular autonomic regulation, and early arteriosclerotic, hemodynamic, and anthropometric changes in spectrum anorexia nervosa, normal weight, and obesity could help to understand the mechanisms of increased cardiovascular risk in malnutrition. Novelty Girls with anorexia nervosa showed signs of early arteriosclerotic damage indexed by CAVI. Insufficient sympathetic cardiovascular control was found already in adolescents with anorexia nervosa. The effect of body composition on CAVI was best predicted by novel body roundness index.
- MeSH
- dítě MeSH
- hemodynamika fyziologie MeSH
- lidé MeSH
- mentální anorexie * epidemiologie patofyziologie MeSH
- mladiství MeSH
- obezita dětí a dospívajících * epidemiologie patofyziologie MeSH
- průřezové studie MeSH
- tuhost cévní stěny fyziologie MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- mladiství MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- MeSH
- autonomní nervový systém MeSH
- baroreflex fyziologie MeSH
- biofeedback (psychologie) fyziologie klasifikace metody MeSH
- bradykardie diagnóza etiologie MeSH
- dýchání MeSH
- elektrokardiografie metody využití MeSH
- endokrinní systém MeSH
- lidé MeSH
- mezioborová komunikace MeSH
- neurofeedback fyziologie klasifikace metody MeSH
- neurofyziologie metody trendy MeSH
- neuropsychologie * metody trendy MeSH
- periodicita MeSH
- psychofyziologie * metody trendy MeSH
- srdeční frekvence * fyziologie MeSH
- statistika jako téma MeSH
- tachykardie diagnóza etiologie MeSH
- zpětná vazba MeSH
- Check Tag
- lidé MeSH
The reactions of human organism to changes of internal or external environment termed as stress response have been at the center of interest during recent decades. Several theories were designed to describe the regulatory mechanisms which maintain the stability of vital physiological functions under conditions of threat or other environmental challenges. However, most of the models of stress reactivity were focused on specific aspects of the regulatory outcomes - physiological (e.g. neuroendocrine), psychological or behavioral regulation. Recently, a novel complex theory based on evolutionary and developmental biology has been introduced. The Adaptive Calibration Model of stress response employs a broad range of the findings from previous theories of stress and analyzes the responsivity to stress with respect to interindividual differences as a consequence of conditional adaptation - the ability to modify developmental trajectory to match the conditions of the social and physical environment. This review summarizes the contributions of the most important models in the field of stress response and emphasizes the importance of complex analysis of the psycho-physiological mechanisms. Moreover, it outlines the implications for nonpharmacological treatment of stress-related disorders with the application of biofeedback training as a promising tool based on voluntary modification of neurophysiological functions.
Attention deficit/hyperactivity disorder (ADHD) is associated with complex neurocardiac integrity. We aimed to study heart rate time asymmetry as a nonlinear qualitative feature of heart rate variability indicating complexity of cardiac autonomic control at rest and in response to physiological stress (orthostasis) in children suffering from ADHD. Twenty boys with ADHD and 20 healthy age-matched boys at the age of 8 to 12 years were examined. The continuous ECG was recorded in a supine position and during postural change from lying to standing (orthostasis). Time irreversibility indices - Porta's (P%), Guzik's (G%) and Ehlers' (E) - were evaluated. Our analysis showed significantly reduced heart rate asymmetry indices at rest (P%: 49.8 % vs. 52.2 %; G%: 50.2 % vs. 53.2 %; p<0.02), and in response to orthostatic load (P%: 52.4 % vs. 54.5 %, G%: 52.3 % vs. 54.5 %; p<0.05) associated with tachycardia in ADHD children compared to controls. Concluding, our study firstly revealed the altered heart rate asymmetry pattern in children suffering from ADHD at rest as well as in response to posture change from lying to standing (orthostasis). These findings might reflect an abnormal complex cardiac regulatory system as a potential mechanism leading to later cardiac adverse outcomes in ADHD.
- MeSH
- dítě MeSH
- hyperkinetická porucha patofyziologie MeSH
- lidé MeSH
- postura těla MeSH
- srdce patofyziologie MeSH
- srdeční frekvence * MeSH
- studie případů a kontrol MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
Úvod: Variabilita frekvencie srdca – oscilácie frekvencie srdca okolo priemernej hodnoty – sú výsledkom interakcie regulaèných vplyvov autonómneho nervového systému, predovšetkým vagovej aktivity, na činnosť sinoatriálneho uzla. Dynamická rovnováha sympatikového/parasympatikového nervového systému je známkou adaptability a flexibili- ty „zdravého“ fyziologického systému. Predpokladá sa, že narušenie tej- to rovnováhy patrí medzi najvýznamnejšie patofyziologické mechaniz- my vedúce ku zvýšenému riziku kardiovaskulárnych ochorení, a preto sledovanie tzv. „kardiálneho rizika“ je veľmi dôležité práve pri psychic- kých poruchách. Metodika: Analýza zmien frekvencie srdca „od úderu k úderu“ použitím konvenèných- lineárnych (časová a spektrálna analýza) a nových ne- lineárnych metód (symbolická dynamika, časo vá ireverz ibilita) umožòuje odhaliť latentné a klinicky asymptomatické príznaky dysregulácie èinnosti srdca, čo predstavuje významný prínos nielen z hľadiska diagnostického, ale i terapeutického. Osobitnou otázkou je detský a adolescentný vek ako kri- tické a vulnerabilné vývojo vé obdobie pr e možnosť výskytu prvých diskrét- nych príznakov zmenenej regulácie chronotropnej èinnosti srdca. Z tohto h¾adiska sme sa zamerali na sledovanie možnej zmeny kardiálnej vagovej regulácie pri psychických poruchách (depresívna porucha, ADHD) práve v tomto vekovom období, a to použitím komplexného prístupu lineárnej a nelineárnej analýzy variability frekvencie srdca. Výsledky: Pri obidvoch psychických poruchách parametre lineárnej a nelineárnej analýzy VFS odhalili zníženú veľkosť , ako aj zmenu kom- plexity variability frekvencie srdca v pokoji, ako aj v odpovedi na stres (ortostatický test). Nelineárna analýza variability frekvencie srdca sa zda- la byť senzitívnejšou na zisť ovanie diskrétnych zmien kardiálnej regulá- cie v odpovedi na stres. Záver: Predpokladáme, že zmeny komplexnej neurokardiálnej regu- lácie pri psychických poruchách sú prítomné už v detskom a adolescent- nom veku. Hodnotenie variability frekvencie srdca tak môže poskytnúť dôležité informácie z hľadiska diagnostického, ako aj pri sledovaní tera- peutických intervencií.
Introduction: The interplay of sympathetic and parasympathetic outputs of the central autonomic network through sinoatrial node pro- duces the complex beat-to-beat oscillations in the heart rate around its mean value - heart rate variability (HRV). The dynamic sympathovagal balance repres ents the adaptability and flexibility of the healthy physio- logical syste m. It is supposed that autonomic imbalance could represent the important pathophysiological mechanism contributing to the higher risk of cardiovascular morbidity. Therefore, the assessment of the so-cal- led „cardiac risk“ is crucial especially in mental disorders. Methods: The analysis of the heart rate „beat-to-beat“ oscillations using traditional-linear methods (time and spectral analysis), and novel nonlinear approach (symbolic dynamics, time irreversibility) might de- tect clinically latent and asymptomatic signs of cardiac vagal regulati- on. Importantly, the childhood and adolescence could be a critical and vulnerable age period to a potential depression-induced cardiac autono- mic dysregulation due to developmental and brain maturational chan- ges. This question is still unanswered. From this point of view, we focu- sed on the evaluation of cardiac autonomic control in mental disorders (depressive disorder, ADHD) already in adolescent age. Results: We have found decreased magnitude and altered comple- xity of the heart rate variability at rest as well as in response to stress in both mental disorders. It seems that the HRV nonlinear analysis is more sensitive to detect discrete alteration in the neurocardiac regulation in response to stress (orthostatic test). Conclusion: These findings revealed discrete abnormalities of the car- diac autonomic regulation in mental disorders already in adolescent age. Thus, the HRV noninvasive complex analysis could provide important in- formation concerning diagnostic and therapeutic various points of view.
- Publikační typ
- abstrakt z konference MeSH
Východisko: Kresba postavy patrí medzi projektívne metódy a jej využitie je dôležité z hľadiska liečby obezity v detskom a adolescentnom veku. Cieľom tejto práce bolo poukázať na využitie kresby postavy v rámci nefarmakologickej terapie (NT) detskej a adolescentnej obezity. Metodika: Kresba postavy bola využitá pred samotným začiatkom NT a bola hodnotená z hľadiska osobnostných charakteristík u pacientov s obezitou. Výsledky: Kresba postavy odhalila zmeny vo vnímaní seba samého (zníženie sebahodnotenia, neistota v sociálnom fungovaní) a motivačný prvok participovať na danom programe u pacientov s obezitou. Kompletný nefarmakologický program absolvovalo len 25 probandov, t.j. 36,7 % z celkového počtu 68 prihlásených detí a adolescentov. Záver: Kresba postavy sa ukázala ako vhodný prostriedok neverbálnej komunikácie na vyjadrenie postojov dieťaťa k obezite.
The nonpharmacological therapeutic interventions including individual approach to the children are very important in childhood obesity treatment. Aim of the study is to refer to Figure drawing as a projective method in a nonpharmacological treatment (NT) of child and adolescent overweight and obesity. Method: The method of Figure drawing was applied before the NT beginning. Results: Figure drawing revealed the changes in individual characteristics (e.g. self-determination) and motivation factor to participate on the NT in patients with obesity. The group of 25 patients from total selected group of 68 probands completed all nonpharmacological treatment. Conclusion: Figure drawing reflecting individual characteristics could be suitable method of nonverbal communication to express the attitudes of subject with obesity.
Poruchy príjmu potravy patria medzi závažné medicínske ochorenia v detskom a adolescentnom veku. Do popredia vystupuje zmena hmotnosti – obezita alebo podvýživa (napr. pri mentálnej anorexii), ktoré majú vplyv na takmer všetky fyziologické funkcie organizmu vrátane aktivity autonómneho nervového systému. V súčasnosti je málo prác, zaoberajúcich sa problematikou mentálnej anorexie a zmien autonómneho nervového systému. Typickým nálezom pri mentálnej anorexii je bradykardia so zvýšenou parasympatikovou aktivitou, ktorá sa však pri dlhšom trvaní ochorenia môže výrazne až abnormálne znížiť. Závery týkajúce sa hodnotenia sympatikovej aktivity nie sú zatiaľ jednoznačné. Na sledovanie zmien aktivity sympatikovej a parasympatikovej časti autonómneho nervového systému sa v súčasnosti používajú lineárne a nelineárne metódy analýzy variability frekvencie srdca a tlaku krvi, ako aj vyšetrenie kardiovaskulárnych testov. Aj kvôli pokračujúcemu nárastu a závažnosti porúch príjmu potravy v detskom a adolescentnom veku je potrebné pokračovať v monitorovaní zmien aktivity autonómneho nervového systému, ako aj sledovať efekt liečby a terapeutických postupov.
Disorders of food intake belong to serious medical diseases at the child and adolescent age. The most prominent symptom is changed body mass – obesity or malnutrition (e.g. in mental anorexia), which influence almost all physiological functions of the organism including activity of autonomic nervous system. At the present time there are few papers dealing with the problem of mental anorexia and changes in autonomic nervous system. Bradycardia with increased parasympathetic activity is a typical finding in mental anorexia and may decrease significantly or even abnormally after some time. The conclusions concerning the evaluation of sympathetic activity are not unambiguous. The determination of changes in the activity of sympathetic and parasympathetic part of autonomic nervous system presently employs linear and nonlinear methods for analysis of variability in heart rate and blood pressure as well as the examination by cardiovascular tests. It is also for the increasing rate and severity of food intake disorders at the child and adolescent age that monitoring of the changes in autonomic nervous activity should be continued and the effects of therapy and therapeutic procedures should be investigated.
- MeSH
- autonomní nervový systém patofyziologie patologie MeSH
- bradykardie diagnóza etiologie MeSH
- finanční podpora výzkumu jako téma MeSH
- komorbidita MeSH
- krevní tlak genetika MeSH
- lidé MeSH
- mentální anorexie komplikace metabolismus MeSH
- nemoci autonomního nervového systému etiologie MeSH
- parasympatický nervový systém abnormality fyziologie metabolismus MeSH
- srdeční frekvence fyziologie MeSH
- sympatický nervový systém abnormality fyziologie metabolismus MeSH
- Check Tag
- lidé MeSH
