Sympathetic-Parasympathetic Activation During Spontaneous Attacks of Cluster Headache: Evaluation by Spectral Analysis of Heart-Rate Fluctuations

Cephalalgia ◽  
1995 ◽  
Vol 15 (6) ◽  
pp. 504-510 ◽  
Author(s):  
M De Marinis ◽  
S Strano ◽  
M Granata ◽  
C Urani ◽  
S Lino ◽  
...  

Twenty-four hour ECG Holter and blood-pressure monitorings were performed in eight patients suffering from cluster headache. Spectral analysis of heart-rate fluctuation was used to assess the autonomic balance under basal conditions, after head-up tilt, and during a spontaneous attack. Normal autonomic balance was found at rest and during sympathetic activation obtained with head-up tilt in the interparoxysmal period. Before the onset of headache, an increase in the low-frequency (LF) component of the power spectrum was apparent in all patients. This sign of sympathetic activation was followed by an increase in the high-frequency (HF) component that developed about 2000 beats after the onset of headache and rapidly overcame the LF component until the end of pain. Significant differences were found when comparing the spectral parameters [total spectral values (TP), power of the LF and HF components and LF/HF ratio] obtained before, during and after headache. During the attack, blood pressure increased and heart rate decreased in all subjects. There appears to be a primary activation of both sympathetic and parasympathetic functions in cluster headache attacks. The sympathetic component seems to be involved mostly in the development of the attack, whereas the parasympathetic activation seems to occur, following the onset of the attack, independently of the pain.

1997 ◽  
Vol 93 (4) ◽  
pp. 309-316 ◽  
Author(s):  
Michel White ◽  
Marc Courtemanche ◽  
Duncan J. Stewart ◽  
Mario Talajic ◽  
Ethel Mikes ◽  
...  

1. There is an increase in circulating levels of vasoconstrictive hormones and an alteration in baroreceptor responsiveness with aging. The role of changes in endothelium-dependent and -independent vasoconstrictive hormones in relation to age and gender, with simultaneous assessment of autonomic balance in response to head-up tilt, has been incompletely studied. 2. Sixteen young [25 ± 3 years (mean ± SEM)] and 16 older normal volunteers (68 ± 7 years) underwent a 30 min head-up tilt test at 60°. Haemodynamics were measured every 5 min and blood samples for neurohormone measurement were drawn at baseline, 5, 10, 15 and 30 min into the test. Heart rate variability was analysed in 5 min segments at the baseline, and during the test. The younger subjects exhibited a greater increase in heart rate and diastolic blood pressure, despite lower absolute levels of noradrenaline (norepinephrine) and endothelin-1. Analysis of heart rate variability yielded a decrease in both high- and low-frequency bands in the aged; power at low-frequency decreased only in the young subjects. The age-related differences in blood pressure and noradrenaline levels were markedly attenuated in the female subjects. In addition, endothelin-1 levels and power spectral measurements at low frequency were the lowest in younger females throughout the tilt. 3. Despite attenuated cardiovascular response to tilt, both systemic adrenergic ‘drive’ and endothelin-1 levels increase in parallel with aging. Thus, endothelium-dependent and -independent vasoconstrictive hormone levels increase with age in the resting state and in response to neurohumoral stimulation in humans.


2004 ◽  
Vol 96 (6) ◽  
pp. 2333-2340 ◽  
Author(s):  
Tomi Laitinen ◽  
Leo Niskanen ◽  
Ghislaine Geelen ◽  
Esko Länsimies ◽  
Juha Hartikainen

In elderly subjects, heart rate responses to postural change are attenuated, whereas their vascular responses are augmented. Altered strategy in maintaining blood pressure homeostasis during upright position may result from various cardiovascular changes, including age-related cardiovascular autonomic dysfunction. This exploratory study was conducted to evaluate impact of age on cardiovascular autonomic responses to head-up tilt (HUT) in healthy subjects covering a wide age range. The study population consisted of 63 healthy, normal-weight, nonsmoking subjects aged 23–77 yr. Five-minute electrocardiogram and finger blood pressure recordings were performed in the supine position and in the upright position 5 min after 70° HUT. Stroke volume was assessed from noninvasive blood pressure signals by the arterial pulse contour method. Heart rate variability (HRV) and systolic blood pressure variability (SBPV) were analyzed by using spectral analysis, and baroreflex sensitivity (BRS) was assessed by using sequence and cross-spectral methods. Cardiovascular autonomic activation during HUT consisted of decreases in HRV and BRS and an increase in SBPV. These changes became attenuated with aging. Age correlated significantly with amplitude of HUT-stimulated response of the high-frequency component ( r = -0.61, P < 0.001) and the ratio of low-frequency to high-frequency power of HRV ( r = -0.31, P < 0.05) and indexes of BRS (local BRS: r = -0.62, P < 0.001; cross-spectral baroreflex sensitivity in the low-frequency range: r = -0.38, P < 0.01). Blood pressure in the upright position was maintained well irrespective of age. However, the HUT-induced increase in heart rate was more pronounced in the younger subjects, whereas the increase in peripheral resistance was predominantly observed in the older subjects. Thus it is likely that whereas the dynamic capacity of cardiac autonomic regulation decreases, vascular responses related to vasoactive mechanisms and vascular sympathetic regulation become augmented with increasing age.


1997 ◽  
Vol 60 (2) ◽  
pp. 121-131 ◽  
Author(s):  
Gianfranco Piccirillo ◽  
Santagada Elvira ◽  
Carmela Bucca ◽  
Emanuela Viola ◽  
Mauro Cacciafesta ◽  
...  

2017 ◽  
Vol 95 (7) ◽  
pp. 803-810 ◽  
Author(s):  
Yi-Hsien Lin ◽  
Yia-Ping Liu ◽  
Yu-Chieh Lin ◽  
Po-Lei Lee ◽  
Che-Se Tung

Rapid immersion of a rat’s limbs into 4 °C water, a model of cold stress, can elicit hemodynamic perturbations (CEHP). We previously reported that CEHP is highly relevant to sympathetic activation and nitric oxide production. This study identifies the role of nitric oxide in CEHP. Conscious rats were pretreated with the nitric oxide synthase inhibitor L-NAME (NG-nitro-l-arginine methyl ester) alone or following the removal of sympathetic influences using hexamethonium or guanethidine. Rats were then subjected to a 10 min cold-stress trial. Hemodynamic indices were telemetrically monitored throughout the experiment. The analyses included measurements of systolic blood pressure; heart rate; dicrotic notch; short-term cardiovascular oscillations and coherence between blood pressure variability and heart rate variability in regions of very low frequency (0.02–0.2 Hz), low frequency (0.2–0.6 Hz), and high frequency (0.6–3.0 Hz). We observed different profiles of hemodynamic reaction between hexamethonium and guanethidine superimposed on L-NAME, suggesting an essential role for a functional adrenal medulla release of epinephrine under cold stress. These results indicate that endogenous nitric oxide plays an important role in the inhibition of sympathetic activation and cardiovascular oscillations in CEHP.


2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Yurii M. Ishbulatov ◽  
Anatoly S. Karavaev ◽  
Anton R. Kiselev ◽  
Margarita A. Simonyan ◽  
Mikhail D. Prokhorov ◽  
...  

Abstract A mathematical model is proposed for the autonomic control of cardiovascular system, which takes into account two separated self-exciting sympathetic control loops of heart rate and peripheral vascular tone. The control loops are represented by self-exciting time-delay systems and their tone depends on activity of the aortic, carotid, and lower-body baroreceptors. The model is used to study the dynamics of the adaptive processes that manifest in a healthy cardiovascular system during the passive head-up tilt test. Computer simulation provides continuous observation of the dynamics of the indexes and variables that cannot be measured in the direct experiment, including the noradrenaline concentration in vessel wall and heart muscle, tone of the sympathetic and parasympathetic control, peripheral vascular resistance, and blood pressure. In the supine and upright positions, we estimated the spectral characteristics of the model variables, especially in the low-frequency band, and the original index of total percent of phase synchronization between the low-frequency oscillations in heart rate and blood pressure signals. The model demonstrates good quantitative agreement with the dynamics of the experimentally observed indexes of cardiovascular system that were averaged for 50 healthy subjects.


1997 ◽  
Vol 93 (1) ◽  
pp. 21-28 ◽  
Author(s):  
Laure Cloarec-Blanchard ◽  
Christian Funck-Brentano ◽  
Margorzata Lipski ◽  
Patrice Jaillon ◽  
Isabelle MacQuin-Mavier

1. Changes in the low-frequency (LF) components of blood pressure and heart rate variability and in the ratio of LF to high-frequency (HF) components of heart rate variability (LF/HF ratio) are used to assess acute changes in sympathetic control of blood pressure or heart rate and in sympathovagal balance that occur in response to physiological or pharmacological stimuli. Before these spectral indexes can be used to assess the effects of drug therapy or other clinical interventions on reflex sympathetic activity, their repeatability must be evaluated. 2. Intra-observer repeatability was studied by analysing changes in the LF components (expressed as absolute or normalized units) of cardiovascular variability and in the LF/HF ratio during sympathetic activation induced by nitroglycerin infusion (n = 10 subjects) or 60° head-up tilt (n = 13 subjects) repeated on two occasions, 2 days and 1 week apart respectively, in healthy young male volunteers. Repeatability was estimated as recommended by Bland and Altman. 3. Bland and Altman's plots of the repeatability of changes in the LF components and LF/HF ratio showed that measurements were sufficiently repeatable to be used over periods of time of up to 1 week in clinical studies. 4. The sample-size tables derived from our results show that expression of spectral components as normalized units, and use of a cross-over design, minimize the number of subjects to be included in clinical studies conducted using similar designs and LF component changes as endpoints.


2005 ◽  
Vol 289 (5) ◽  
pp. H1968-H1975 ◽  
Author(s):  
Rubens Fazan ◽  
Mauro de Oliveira ◽  
Valdo José Dias da Silva ◽  
Luis Fernando Joaquim ◽  
Nicola Montano ◽  
...  

The goal of this study was to determine the baroreflex influence on systolic arterial pressure (SAP) and pulse interval (PI) variability in conscious mice. SAP and PI were measured in C57Bl/6J mice subjected to sinoaortic deafferentation (SAD, n = 21) or sham surgery ( n = 20). Average SAP and PI did not differ in SAD or control mice. In contrast, SAP variance was enhanced (21 ± 4 vs. 9.5 ± 1 mmHg2) and PI variance reduced (8.8 ± 2 vs. 26 ± 6 ms2) in SAD vs. control mice. High-frequency (HF: 1–5 Hz) SAP variability quantified by spectral analysis was greater in SAD (8.5 ± 2.0 mmHg2) compared with control (2.5 ± 0.2 mmHg2) mice, whereas low-frequency (LF: 0.1–1 Hz) SAP variability did not differ between the groups. Conversely, LF PI variability was markedly reduced in SAD mice (0.5 ± 0.1 vs. 10.8 ± 3.4 ms2). LF oscillations in SAP and PI were coherent in control mice (coherence = 0.68 ± 0.05), with changes in SAP leading changes in PI (phase = −1.41 ± 0.06 radians), but were not coherent in SAD mice (coherence = 0.08 ± 0.03). Blockade of parasympathetic drive with atropine decreased average PI, PI variance, and LF and HF PI variability in control ( n = 10) but had no effect in SAD ( n = 6) mice. In control mice, blockade of sympathetic cardiac receptors with propranolol increased average PI and decreased PI variance and LF PI variability ( n = 6). In SAD mice, propranolol increased average PI ( n = 6). In conclusion, baroreflex modulation of PI contributes to LF, but not HF PI variability, and is mediated by both sympathetic and parasympathetic drives in conscious mice.


1995 ◽  
Vol 78 (1) ◽  
pp. 212-216 ◽  
Author(s):  
S. Mukai ◽  
J. Hayano

We investigated the responses of the frequency components of heart rate (HR) and blood pressure (BP) variabilities to progressive changes in autonomic activity induced by the graded head-up tilt technique in 12 normal subjects (age 19–27 yr) under the condition of frequency-controlled respiration (0.25 Hz). During low-level tilt (0–30 degrees), the R-R interval was unchanged and the amplitude of the high-frequency (HF; 0.25 Hz) component of HR variability showed only a slight insignificant decrease. The amplitude of the low-frequency (LF; 0.04–0.15 Hz) component of HR variability increased progressively as the angle increased (P < 0.05). During high-level tilt (30–90 degrees), the R-R interval and the HF amplitude of HR variability decreased progressively with tilt angle (P < 0.001 for both). The LF amplitude of HR variability peaked at a tilt angle of 30 degrees. The LF-to-HF ratio of HR variability and the LF amplitude of systolic and diastolic BP variabilities increased progressively as the tilt angle increased from 0 to 60 degrees (P < 0.001), although systolic and diastolic BPs were unchanged. These results suggest that mixed autonomic responses to orthostatic stress, which are thought to be mediated by both cardiopulmonary and arterial baroreflex mechanisms, can be distinguished by changes in the frequency components of HR and BP variabilities.


2007 ◽  
Vol 292 (4) ◽  
pp. R1502-R1509 ◽  
Author(s):  
Paolo Castiglioni ◽  
Marco Di Rienzo ◽  
Arsenio Veicsteinas ◽  
Gianfranco Parati ◽  
Giampiero Merati

It is still unclear whether the low-frequency oscillation in heart rate is generated by an endogenous neural oscillator or by a baroreflex resonance. Our aim was to investigate this issue by analyzing blood pressure and heart rate variability and the baroreflex function in paraplegic subjects with spinal cord injury below the fourth thoracic vertebra. These subjects were selected because they represent a model of intact central neural drive to the heart, with a partially impaired autonomic control of the vessels. In our study, arterial blood pressure and ECG were recorded in 33 able-bodied controls and in 33 subjects with spinal cord lesions between the fifth thoracic and the fourth lumbar vertebra 1) during supine rest (lowest sympathetic activation), 2) sitting on a wheelchair (light sympathetic activation), and 3) during exercise (moderate sympathetic activation). Blood pressure and heart rate spectra, coherence, and baroreflex function (sequence technique) were estimated in each condition. Compared with controls, paraplegic subjects showed a reduction of the low-frequency power of blood pressure and heart rate, and, unlike controls, a 0.1-Hz peak did not appear in their spectra. Sympathetic activation increased the 0.1-Hz peak of blood pressure and heart rate and the coherence at 0.1 Hz in controls only. Paraplegic subjects also had significantly lower baroreflex effectiveness and greater blood pressure variability. In conclusion, the disappearance of the 10-s oscillation of heart rate and blood pressure in subjects with spinal cord lesion supports the hypothesis of the baroreflex nature of this phenomenon.


1996 ◽  
Vol 91 (1) ◽  
pp. 35-43 ◽  
Author(s):  
John E. Sanderson ◽  
Leata Y. C. Yeung ◽  
Dickens T. K. Yeung ◽  
Richard L. C. Kay ◽  
Brian Tomlinson ◽  
...  

1. Autonomic dysfunction is a major feature of congestive cardiac failure and may have an important role in determining progression and prognosis. The low-frequency/high-frequency ratio derived from power spectral analysis of heart rate variability has been proposed as a non-invasive method to assess sympatho-vagal balance. However, the effects of different respiratory rates or posture are rarely accounted for, but may be relevant in patients with heart failure in whom clinical improvement is accompanied by a fall in respiratory rate and an increased proportion of the day in the upright position. 2. We have assessed the effect of controlled respiration at different rates (10, 15, 20 breaths/min or 0.17, 0.25 and 0.33 Hz), while supine and standing, on power spectral analysis of heart rate and blood pressure variability in 11 patients with heart failure and 10 normal subjects. 3. Heart rate variance and low-frequency power (normalized units) were reduced in patients with heart failure (absent in six). During controlled breathing while supine, the power of the high-frequency component was significantly greater at 10 breaths/min than at 20 breaths/min in patients with heart failure, whether expressed in absolute units (P = 0.005) or percentage of total power (P = 0.03). 4. On standing, controlled breathing in patients with heart failure produced less change in high-frequency power (P = 0.054), but the low-frequency/high-frequency ratio at lower respiratory rates was reduced (P = 0.05). In normal subjects, as expected, respiratory rate had a highly significant effect on high-frequency power. Also, in normal subjects there was the expected increase in heart rate low-frequency power (P = 0.04) moving from supine to standing with an increase in the low-frequency/high-frequency ratio (P = 0.003), while in the patients with heart failure this was absent, reflecting blunted cardiovascular reflexes. 5. Systolic blood pressure low- and high-frequency components and their ratio were significantly affected by respiration (P > 0.03) and change in posture (P > 0.03) in both patients with heart failure and normal subjects, with a significant increase in the low-frequency/high-frequency ratio (P = 0.03) on standing in patients with heart failure, indicating that autonomic modulation of blood pressure is still operating in heart failure. 6. Thus, respiratory rate and changes in posture have a significant effect on measurements derived from spectral analysis of heart rate and blood pressure variability. Studies that use power spectral analysis as a measure of sympatho-vagal balance should control for these variables.


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