scholarly journals Vagally mediated heart rate variability in headache patients—a systematic review and meta-analysis

Cephalalgia ◽  
2015 ◽  
Vol 36 (3) ◽  
pp. 265-278 ◽  
Author(s):  
Julian Koenig ◽  
DeWayne P Williams ◽  
Andrew H Kemp ◽  
Julian F Thayer

Objective Vagal nerve activity—indexed by heart rate variability (HRV)—has been linked to altered pain processing and inflammation, both of which may underpin headache disorders and lead to cardiovascular disease (CVD). Here we examined the evidence for differences in parasympathetic (vagal) activity indexed by time- and frequency-domain measures of HRV in patients with headache disorders compared to healthy controls (HCs). Methods A systematic review and meta-analysis was conducted on studies investigating group differences in vagally mediated HRV (vmHRV) including time- (root-mean-square of successive R-R-interval differences (RMSSD)) and frequency- (high-frequency HRV) domain measures. Studies eligible for inclusion were identified by a systematic search of the literature, based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Results Seven studies reporting a total of 10 comparisons of patients with headache disorders (HF-HRV n = 67, RMSSD n = 122) and HCs (HF-HRV n = 64, RMSSD n = 125) were eligible for inclusion. Random-effects meta-analysis revealed a significant main effect on RMSSD ( Z = 2.03, p = 0.04; Hedges’ g = −0.63; 95% CI (−1.24, –0.02); k = 6) and similar pooled effect size estimates for HF-HRV when breathing was controlled ( g = −0.30; 95% CI (−0.69; 0.10)) but not when breathing was not controlled ( g = 0.02; 95% CI (−0.69; 0.74)). Controlling for breathing had no effect on RMSSD. Conclusion vmHRV is reduced in patients with headache disorders, findings associated with a medium effect size. Suggestions for future research in this area are provided, emphasizing a need to investigate the impact of headache disorders and commonly comorbid conditions—including mental disorders—as well as the investigation of the risk for CVD in migraine in particular. We further emphasize the need for large-scale studies to investigate HRV as a mechanism mediating the association of migraine and CVD.

2017 ◽  
Vol 15 (1) ◽  
pp. 80-88 ◽  
Author(s):  
Vanessa Pereira da Silva ◽  
Bruno Ribeiro Ramalho Oliveira ◽  
Roger Gomes Tavares Mello ◽  
Helena Moraes ◽  
Andrea Camaz Deslandes ◽  
...  

Background: Decreased heart rate variability (HRV) indexes indicate low vagal activity and may be associated with development of dementia. The neurodegenerative process is associated with the cardiovascular autonomic control. Objective: The aim of this systematic review was to investigate the effect size (ES) magnitude of the HRV indexes in the evaluation of autonomic dysfunction in older persons with dementia. Methods: PubMed (Medline), Web of Science, Scopus, Scielo, Lilacs, and APA Psycnet were consulted. Complete original articles published in English or Portuguese, investigating the association between autonomic dysfunction and dementia, using the HRV indexes were included. Results: The search identified 97 potentially relevant articles. After screening the full text, eight articles were included in the qualitative analysis and six were included in the quantitative analysis. Almost all indexes showed a negative ES for all types of dementia and mild cognitive impairment. The most common frequency band of the power spectrum density function was the high frequency, which was reported by six studies. The meta-analysis of high frequency power in Alzheimer's disease group showed high heterogeneity and inconsistent results. Conclusion: The negative effect size suggests an autonomic dysfunction in all types of dementia as well as mild cognitive impairment. However, further analysis is necessary to support these results.


2019 ◽  
Vol 8 (10) ◽  
pp. 1638 ◽  
Author(s):  
Rådmark ◽  
Sidorchuk ◽  
Osika ◽  
Niemi

Mindfulness Based Interventions (MBIs) have recently been increasingly used in clinical settings, and research regarding their effects on health has grown rapidly. However, with regard to the physiological effects of mindfulness practices, studies have reported associations that vary in strength and direction. Therefore, in this systematic review and meta-analysis, we aimed to systematically identify, appraise, and summarize the existing data from randomized and non-randomized controlled trials that examine physiological effects of the standardized MBIs by focusing on pro-inflammatory cytokines and C-reactive protein, and commonly used heart rate variability parameters. The following electronic databases were searched: MEDLINE (via Ovid), PsychINFO (via Ovid), PubMed, Web of Science, EMBASE, CINAHL, ProQuest (Dissertations and Theses), and ClinicalTrails.gov. The systematic review identified 10 studies to be included in the meta-analysis, comprising in total 607 participants. The meta-analysis ended up with mixed and inconclusive results. This was assumedly due to the small number of the original studies and, in particular, to the lack of large, rigorously conducted RCTs. Therefore, the current meta-analysis highlights the necessity of larger, more rigorously conducted RCTs on physiological outcomes with standardized MBIs being compared to various forms of active controls, and with more long-term follow-ups.


2016 ◽  
Vol 1;19 (1;1) ◽  
pp. E55-E78 ◽  
Author(s):  
Julian Koenig

Background: A large body of scientific literature derived from experimental studies emphasizes the vital role of vagal-nociceptive networks in acute pain processing. However, research on vagal activity, indexed by vagally-mediated heart rate variability (vmHRV) in chronic pain patients (CPPs), has not yet been summarized. Objectives: To systematically investigate differences in vagus nerve activity indexed by timeand frequency-domain measures of vmHRV in CPPs compared to healthy controls (HCs). Study Design: A systematic review and meta-analysis, including meta-regression on a variety of populations (i.e., clinical etiology) and study-level (i.e., length of HRV recording) covariates. Setting: Not applicable (variety of studies included in the meta-analysis) Methods: Eight computerized databases (PubMed via MEDLINE, PsycNET, PsycINFO, Embase, CINAHL, Web of Science, PSYNDEX, and the Cochrane Library) in addition to a hand search were systematically screened for eligible studies based on pre-defined inclusion criteria. A metaanalysis on all empirical investigations reporting short- and long-term recordings of continuous time- (root-mean-square of successive R-R-interval differences [RMSSD]) and frequency-domain measures (high-frequency [HF] HRV) of vmHRV in CPPs and HCs was performed. True effect estimates as adjusted standardized mean differences (SMD; Hedges g) combined with inverse variance weights using a random effects model were computed. Results: CPPs show lower vmHRV than HCs indexed by RMSSD (Z = 5.47, P < .0001; g = -0.24;95% CI [-0.33, -0.16]; k = 25) and HF (Z = 4.54, P < .0001; g = -0.30; 95% CI [-0.44, -0.17]; k = 61).Meta-regression on covariates revealed significant differences by clinical etiology, age, gender, and length of HRV recording. Limitations: We did not control for other potential covariates (i.e., duration of chronic pain, medication intake) which may carry potential risk of bias. Conclusion(s): The present meta-analysis is the most extensive review of the current evidence on vagal activity indexed by vmHRV in CPPs. CPPs were shown to have lower vagal activity, indexed by vmHRV, compared to HCs. Several covariates in this relationship have been identified. Further research is needed to investigate vagal activity in CPPs, in particular prospective and longitudinal follow-up studies are encouraged. Key words: Vagus nerve, heart rate variability, chronic pain, irritable bowel syndrome, fibromyalgia, primary headache disorders, meta-analysis, systematic review


Author(s):  
Jeffrey Cayaban Pagaduan ◽  
Yung-Sheng Chen ◽  
James William Fell ◽  
Sam Shi Xuan Wu

Abstract To date, there is no quantitative review examining the influence of heart rate variability biofeedback (HRV BFB) on the athlete population. Such an undertaking may provide valuable information on the autonomic and respiration responses of athletes when performing HRV BFB. Thus, purpose of this preliminary systematic review and meta-analysis on the effects of HRV BFB on HRV and respiration of athletes. Searches of Springerlink, SportDiscus, Web of Science, PROQUEST Academic Research Library, Google Scholar, and ScienceDirect were conducted for studies that met the following criteria: (1) experimental studies involving athletes that underwent randomized control trial; (2) availability of HRV BFB as a treatment compared with a control (CON)/placebo (PLA); (3) any pre and post HRV variable and/or breathing frequency as dependent variable/s; and, (4) peer-reviewed articles written in English. Four out of 660 studies involving 115 athletes (25 females and 90 males) ages 16–30 years old were assessed in this review. Preliminary findings suggest the promising ability of HRV BFB to improve respiratory mechanics in athlete population. More work is needed to determine the autonomic modulatory effect of HRV BFB in athletes.


2014 ◽  
Vol 2014 ◽  
pp. 1-19 ◽  
Author(s):  
Joanne W. Y. Chung ◽  
Vincent C. M. Yan ◽  
Hongwei Zhang

Aim.To summarize all relevant trials and critically evaluate the effect of acupuncture on heart rate variability (HRV).Method.This was a systematic review with meta-analysis. Keyword search was conducted in 7 databases for randomized controlled trials (RCTs). Data extraction and risk of bias were done.Results.Fourteen included studies showed a decreasing effect of acupuncture on low frequency (LF) and low frequency to high frequency ratio (LF/HF ratio) of HRV for nonhealthy subjects and on normalized low frequency (LF norm) for healthy subjects. The overall effect was in favour of the sham/control group for high frequency (HF) in nonhealthy subjects and for normalized high frequency (HF norm) in healthy subjects. Significant decreasing effect on HF and LF/HF ratio of HRV when acupuncture was performed on ST36 among healthy subjects and PC6 among both healthy and nonhealthy subjects, respectively.Discussion.This study partially supports the possible effect of acupuncture in modulating the LF of HRV in both healthy and nonhealthy subjects, while previous review reported that acupuncture did not have any convincing effect on HRV in healthy subjects. More published work is needed in this area to determine if HRV can be an indicator of the therapeutic effect of acupuncture.


2019 ◽  
Vol 49 (3) ◽  
pp. 417-435 ◽  
Author(s):  
Ward C. Dobbs ◽  
Michael V. Fedewa ◽  
Hayley V. MacDonald ◽  
Clifton J. Holmes ◽  
Zackary S. Cicone ◽  
...  

2018 ◽  
Vol 213 ◽  
pp. 23-33 ◽  
Author(s):  
Tatiana Dias de Carvalho ◽  
Thais Massetti ◽  
Talita Dias da Silva ◽  
Tânia Brusque Crocetta ◽  
Regiani Guarnieri ◽  
...  

2018 ◽  
Vol 79 (4) ◽  
pp. 465-466 ◽  
Author(s):  
T. Benichou ◽  
B. Pereira ◽  
M. Mermillod ◽  
P. Daniela ◽  
I. Tauveron ◽  
...  

Heart ◽  
2020 ◽  
Vol 106 (15) ◽  
pp. 1142-1147 ◽  
Author(s):  
Xintao Li ◽  
Bo Guan ◽  
Tong Su ◽  
Wei Liu ◽  
Mengyao Chen ◽  
...  

BackgroundCoronavirus disease 2019 (COVID-19) has produced a significant health burden worldwide, especially in patients with cardiovascular comorbidities. The aim of this systematic review and meta-analysis was to assess the impact of underlying cardiovascular comorbidities and acute cardiac injury on in-hospital mortality risk.MethodsPubMed, Embase and Web of Science were searched for publications that reported the relationship of underlying cardiovascular disease (CVD), hypertension and myocardial injury with in-hospital fatal outcomes in patients with COVID-19. The ORs were extracted and pooled. Subgroup and sensitivity analyses were performed to explore the potential sources of heterogeneity.ResultsA total of 10 studies were enrolled in this meta-analysis, including eight studies for CVD, seven for hypertension and eight for acute cardiac injury. The presence of CVD and hypertension was associated with higher odds of in-hospital mortality (unadjusted OR 4.85, 95% CI 3.07 to 7.70; I2=29%; unadjusted OR 3.67, 95% CI 2.31 to 5.83; I2=57%, respectively). Acute cardiac injury was also associated with a higher unadjusted odds of 21.15 (95% CI 10.19 to 43.94; I2=71%).ConclusionCOVID-19 patients with underlying cardiovascular comorbidities, including CVD and hypertension, may face a greater risk of fatal outcomes. Acute cardiac injury may act as a marker of mortality risk. Given the unadjusted results of our meta-analysis, future research are warranted.


BMJ Open ◽  
2019 ◽  
Vol 9 (6) ◽  
pp. e024886 ◽  
Author(s):  
Klaus Munkholm ◽  
Asger Sand Paludan-Müller ◽  
Kim Boesen

ObjectivesTo investigate whether the conclusion of a recent systematic review and network meta-analysis (Ciprianiet al) that antidepressants are more efficacious than placebo for adult depression was supported by the evidence.DesignReanalysis of a systematic review, with meta-analyses.Data sources522 trials (116 477 participants) as reported in the systematic review by Ciprianiet aland clinical study reports for 19 of these trials.AnalysisWe used the Cochrane Handbook’s risk of bias tool and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach to evaluate the risk of bias and the certainty of evidence, respectively. The impact of several study characteristics and publication status was estimated using pairwise subgroup meta-analyses.ResultsSeveral methodological limitations in the evidence base of antidepressants were either unrecognised or underestimated in the systematic review by Ciprianiet al. The effect size for antidepressants versus placebo on investigator-rated depression symptom scales was higher in trials with a ‘placebo run-in’ study design compared with trials without a placebo run-in design (p=0.05). The effect size of antidepressants was higher in published trials compared with unpublished trials (p<0.0001). The outcome data reported by Ciprianiet aldiffered from the clinical study reports in 12 (63%) of 19 trials. The certainty of the evidence for the placebo-controlled comparisons should be very low according to GRADE due to a high risk of bias, indirectness of the evidence and publication bias. The mean difference between antidepressants and placebo on the 17-item Hamilton depression rating scale (range 0–52 points) was 1.97 points (95% CI 1.74 to 2.21).ConclusionsThe evidence does not support definitive conclusions regarding the benefits of antidepressants for depression in adults. It is unclear whether antidepressants are more efficacious than placebo.


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