BMC Musculoskeletal Disorders | |
Heart rate variability in sciatica patients referred to spine surgery: a case control study | |
Arto J Hautala3  Mikko P Tulppo3  Antti M Kiviniemi3  Eero Kyllönen1  Jukka Puolitaival1  Jaro Karppinen2  Jarmo Södervall1  | |
[1] Department of Physical and Rehabilitation Medicine, Institute of Clinical Medicine, University of Oulu, Oulu, Finland;Finnish Institute of Occupational Health, Work and Health Ability, and Disability Prevention Centre, Oulu, Finland;Department of Exercise and Medical Physiology, Verve Research, Kasarmintie 13, P.O. Box 404, Oulu, 90101, Finland | |
关键词: Vagal activity; Sympathovagal balance; Sciatica; Back pain; Autonomic nervous system; | |
Others : 1132710 DOI : 10.1186/1471-2474-14-149 |
|
received in 2012-10-08, accepted in 2013-04-23, 发布年份 2013 | |
【 摘 要 】
Background
A chronic pain condition may result in altered autonomic nervous system regulation in various patient populations. We evaluated whether autonomic regulation differs between sciatica patients referred to spine surgery and age-matched healthy controls analyzed with heart rate variability techniques (HRV).
Methods
HRV of patients (n = 201) and healthy controls (n = 138) were measured in standing conditions (5 min). High frequency (HF) power as an index of cardiac vagal modulation and the low-to-high-frequency (LF/HF) ratio and short-term fractal scaling exponent α1 as indices of sympathovagal balance were analyzed. Pain intensity was assessed on a Visual Analog Scale (VAS) and perceived disability with Oswestry Disability Index.
Results
The Oswestry and VAS scores were higher in the patients than in the controls (p < 0.0001 for both). HF power was markedly lower for the patients compared to the controls (p < 0.0001). The LF/HF ratio and α1 were higher in the patients than in the controls (p < 0.01 for both). After adjusting for sex, smoking, BMI, and leisure-time physical activity, HF power (p = 0.011) and α1 (p = 0.012) still differed between the groups. Among the patients, HF power was slightly associated with the duration of chronic pain (r = −.232, p = 0.003).
Conclusions
Sciatica patients referred to spine surgery had altered cardiac autonomic regulation expressed as decreased vagal activity and an increased sympathovagal balance toward sympathetic dominance when compared with age-matched healthy controls.
【 授权许可】
2013 Södervall et al.; licensee BioMed Central Ltd.
【 预 览 】
Files | Size | Format | View |
---|---|---|---|
20150304053659970.pdf | 201KB | download | |
Figure 1. | 37KB | Image | download |
【 图 表 】
Figure 1.
【 参考文献 】
- [1]Breivik H, Collett B, Ventafridda V, Cohen R, Gallacher D: Survey of chronic pain in Europe: prevalence, impact on daily life, and treatment. Eur J Pain 2006, 10:287-333.
- [2]Konstantinou K, Dunn KM: Sciatica: review of epidemiological studies and prevalence estimates. Spine (Phila Pa 1976) 2008, 33:2464-2472.
- [3]Kaaria S, Kaila-Kangas L, Kirjonen J, Riihimaki H, Luukkonen R, Leino-Arjas P: Low back pain, work absenteeism, chronic back disorders, and clinical findings in the low back as predictors of hospitalization due to low back disorders: a 28-year follow-up of industrial employees. Spine (Phila Pa 1976) 2005, 30:1211-1218.
- [4]Riihimaki H, Tola S, Videman T, Hanninen K: Low-back pain and occupation. A cross-sectional questionnaire study of men in machine operating, dynamic physical work, and sedentary work. Spine (Phila Pa 1976) 1989, 14:204-209.
- [5]Abasolo L, Carmona L, Lajas C, Candelas G, Blanco M, Loza E, Hernandez-Garcia C, Jover JA: Prognostic factors in short-term disability due to musculoskeletal disorders. Arthritis Rheum 2008, 59:489-496.
- [6]Cohen H, Neumann L, Shore M, Amir M, Cassuto Y, Buskila D: Autonomic dysfunction in patients with fibromyalgia: application of power spectral analysis of heart rate variability. Semin Arthritis Rheum 2000, 29:217-227.
- [7]Cohen H, Neumann L, Alhosshle A, Kotler M, Abu-Shakra M, Buskila D: Abnormal sympathovagal balance in men with fibromyalgia. J Rheumatol 2001, 28:581-589.
- [8]Terkelsen AJ, Molgaard H, Hansen J, Finnerup NB, Kroner K, Jensen TS: Heart rate variability in complex regional pain syndrome during rest and mental and orthostatic stress. Anesthesiology 2012, 116:133-146.
- [9]Hallman DM, Lindberg LG, Arnetz BB, Lyskov E: Effects of static contraction and cold stimulation on cardiovascular autonomic indices, trapezius blood flow and muscle activity in chronic neck-shoulder pain. Eur J Appl Physiol 2011, 111:1725-1735.
- [10]Gockel M, Lindholm H, Niemisto L, Hurri H: Perceived disability but not pain is connected with autonomic nervous function among patients with chronic low back pain. J Rehabil Med 2008, 40:355-358.
- [11]Huikuri HV, Castellanos A, Myerburg RJ: Sudden death due to cardiac arrhythmias. N Engl J Med 2001, 345:1473-1482.
- [12]Bauer A, Kantelhardt JW, Barthel P, Schneider R, Makikallio T, Ulm K, Hnatkova K, Schomig A, Huikuri H, Bunde A: Deceleration capacity of heart rate as a predictor of mortality after myocardial infarction: cohort study. Lancet 2006, 367:1674-1681.
- [13]Huikuri HV, Makikallio TH, Airaksinen KE, Seppanen T, Puukka P, Raiha IJ, Sourander LB: Power-law relationship of heart rate variability as a predictor of mortality in the elderly. Circulation 1998, 97:2031-2036.
- [14]Kleiger RE, Miller JP, Bigger JT Jr, Moss AJ: Decreased heart rate variability and its association with increased mortality after acute myocardial infarction. Am J Cardiol 1987, 59:256-262.
- [15]Bigger JT Jr, Fleiss JL, Steinman RC, Rolnitzky LM, Kleiger RE, Rottman JN: Frequency domain measures of heart period variability and mortality after myocardial infarction. Circulation 1992, 85:164-171.
- [16]Kiviniemi AM, Tulppo MP, Wichterle D, Hautala AJ, Tiinanen S, Seppanen T, Makikallio TH, Huikuri HV: Novel spectral indexes of heart rate variability as predictors of sudden and non-sudden cardiac death after an acute myocardial infarction. Ann Med 2007, 39:54-62.
- [17]Fairbank JC, Pynsent PB: The Oswestry Disability Index. Spine (Phila Pa 1976) 2000, 25:2940-2952. discussion 2952
- [18]Sriwatanakul K, Kelvie W, Lasagna L, Calimlim JF, Weis OF, Mehta G: Studies with different types of visual analog scales for measurement of pain. Clin Pharmacol Ther 1983, 34:234-239.
- [19]TaskForce: Heart rate variability: standards of measurement, physiological interpretation and clinical use. Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology. Circulation 1996, 93:1043-1065.
- [20]Tulppo MP, Makikallio TH, Takala TE, Seppanen T, Huikuri HV: Quantitative beat-to-beat analysis of heart rate dynamics during exercise. Am J Physiol 1996, 271:H244-H252.
- [21]Huikuri HV, Makikallio TH, Peng CK, Goldberger AL, Hintze U, Moller M: Fractal correlation properties of R-R interval dynamics and mortality in patients with depressed left ventricular function after an acute myocardial infarction. Circulation 2000, 101:47-53.
- [22]Makikallio TH, Huikuri HV, Makikallio A, Sourander LB, Mitrani RD, Castellanos A, Myerburg RJ: Prediction of sudden cardiac death by fractal analysis of heart rate variability in elderly subjects. J Am Coll Cardiol 2001, 37:1395-1402.
- [23]Peng CK, Havlin S, Stanley HE, Goldberger AL: Quantification of scaling exponents and crossover phenomena in nonstationary heartbeat time series. Chaos 1995, 5:82-87.
- [24]Huikuri HV, Pikkujämsä SM, Airaksinen KE, Ikäheimo MJ, Rantala AO, Kauma H, Lilja M, Kesäniemi YA: Sex-related differences in autonomic modulation of heart rate in middle-aged subjects. Circulation 1996, 94:122-125.
- [25]Hautala AJ, Karjalainen J, Kiviniemi AM, Kinnunen H, Makikallio TH, Huikuri HV, Tulppo MP: Physical activity and heart rate variability measured simultaneously during waking hours. Am J Physiol Heart Circ Physiol 2010, 298:H874-H880.
- [26]Hayano J, Yamada M, Sakakibara Y, Fujinami T, Yokoyama K, Watanabe Y, Takata K: Short- and long-term effects of cigarette smoking on heart rate variability. Am J Cardiol 1990, 65:84-88.
- [27]Fagard RH, Pardaens K, Staessen JA: Influence of demographic, anthropometric and lifestyle characteristics on heart rate and its variability in the population. J Hypertens 1999, 17:1589-1599.
- [28]Barakat A, Vogelzangs N, Licht CM, Geenen R, Macfarlane GJ, de Geus E, Smit JH, Penninx BW, Dekker J: Dysregulation of the autonomic nervous system is associated with pain intensity, not with the presence of chronic widespread pain. Arthritis Care Res (Hoboken) 2012, 64:1209-1216.
- [29]Kang JH, Chen HS, Chen SC, Jaw FS: Disability in patients with chronic neck pain: heart rate variability analysis and cluster analysis. Clin J Pain 2012, 28:797-803.
- [30]Kraychete DC, Sakata RK, Issy AM, Bacellar O, Santos-Jesus R, Carvalho EM: Serum cytokine levels in patients with chronic low back pain due to herniated disc: analytical cross-sectional study. Sao Paulo Med J 2010, 128:259-262.
- [31]Nagashima H, Morio Y, Yamane K, Nanjo Y, Teshima R: Tumor necrosis factor-alpha, interleukin-1beta, and interleukin-6 in the cerebrospinal fluid of patients with cervical myelopathy and lumbar radiculopathy. Eur Spine J 2009, 18:1946-1950.
- [32]Lampert R, Bremner JD, Su S, Miller A, Lee F, Cheema F, Goldberg J, Vaccarino V: Decreased heart rate variability is associated with higher levels of inflammation in middle-aged men. Am Heart J 2008, 156:759 e751-757.
- [33]Haensel A, Mills PJ, Nelesen RA, Ziegler MG, Dimsdale JE: The relationship between heart rate variability and inflammatory markers in cardiovascular diseases. Psychoneuroendocrinology 2008, 33:1305-1312.
- [34]Kiviniemi AM, Hautala AJ, Seppänen T, Mäkikallio TH, Huikuri HV, Tulppo MP: Saturation of high-frequency oscillations of R-R intervals in healthy subjects and patients after acute myocardial infarction during ambulatory conditions. Am J Physiol Heart Circ Physiol 2004, 287:H1921-1927.
- [35]Goldberger JJ, Challapalli S, Tung R, Parker MA, Kadish AH: Relationship of heart rate variability to parasympathetic effect. Circulation 2001, 103:1977-1983.
- [36]Kiviniemi AM, Hautala AJ, Kinnunen H, Tulppo MP: Endurance training guided individually by daily heart rate variability measurements. Eur J Appl Physiol 2007, 101:743-751.
- [37]Malliani A, Pagani M, Lombardi F, Cerutti S: Cardiovascular neural regulation explored in the frequency domain. Circulation 1991, 84:482-492.
- [38]Montano N, Ruscone TG, Porta A, Lombardi F, Pagani M, Malliani A: Power spectrum analysis of heart rate variability to assess the changes in sympathovagal balance during graded orthostatic tilt. Circulation 1994, 90:1826-1831.
- [39]Tulppo MP, Hughson RL, Mäkikallio TH, Airaksinen KE, Seppänen T, Huikuri HV: Effects of exercise and passive head-up tilt on fractal and complexity properties of heart rate dynamics. Am J Physiol Heart Circ Physiol 2001, 280:H1081-1087.
- [40]Tulppo MP, Kiviniemi AM, Hautala AJ, Kallio M, Seppänen T, Mäkikallio TH, Huikuri HV: Physiological background of the loss of fractal heart rate dynamics. Circulation 2005, 112:314-319.
- [41]Hautala AJ, Makikallio TH, Seppanen T, Huikuri HV, Tulppo MP: Short-term correlation properties of R-R interval dynamics at different exercise intensity levels. Clin Physiol Funct Imaging 2003, 23:215-223.