Evaluation of Realistic Sensation Using Biological Reaction Measurements for Food Videos Presented by KMMD

We have prototyped a KANSEI multimedia display (KMMD) that is able to release scent through the screen in order to realize collaboration between images and scents. Two types of “sukiyaki” food videos were presented to subjects using this device, and a method for objectively evaluating the realistic sensation of the food videos was examined using biological reaction measurements. The sukiyaki scent was added to one type of video to improve appetite. Viewers’ saliva flow rate, line of sight, pupil diameter, autonomic nerve activity, and cerebral blood flow were measured at the same time, and changes in these measured values were analyzed. As a result, the scent was effective in improving the sensation, as if the food was present in front of the eyes and increasing the saliva flow rate. Additionally, in a realistic scene, it was found that the line of sight follows the performer’s eating behavior as if the viewers themselves are eating. The sympathetic nervous system temporarily increases, mydriasis occurs, and the frontal lobe is activated. Furthermore, the possibility of objective evaluation of realistic sensations was demonstrated by the correlation between appetite, accompanied by salivary sensation, and the biological reaction measurement results.

Dependence of Heart Rate Variability Indices on the Mean Heart Rate in Women with Well-Controlled Type 2 Diabetes

Heart rate variability (HRV) is a method used to evaluate the presence of cardiac autonomic neuropathy (CAN) because it is usually attributed to oscillations in cardiac autonomic nerve activity. Recent studies in other pathologies suggest that HRV indices are strongly related to mean heart rate, and this does not depend on autonomic activity only. This study aimed to evaluate the correlation between the mean heart rate and the HRV indices in women patients with well-controlled T2DM and a control group. HRV was evaluated in 19 T2DM women and 44 healthy women during basal supine position and two maneuvers: active standing and rhythmic breathing. Time-domain (SDNN, RMSSD, pNN20) and frequency-domain (LF, HF, LF/HF) indices were obtained. Our results show that meanNN, age, and the maneuvers are the main predictors of most HRV indices, while the diabetic condition was a predictor only for pNN20. Given the known reduced HRV in patients with T2DM, it is clinically important that much of the HRV indices are dependent on heart rate irrespective of the presence of T2DM. Moreover, the multiple regression analyses evidenced the multifactorial etiology of HRV.

Attenuation of Food Intake by Fragrant Odors: Comparison between Osmanthus fragrans and Grapefruit Odors

Odors affect various physiological and mental activities. Previous studies in rats have shown that the odors of grapefruit and Osmanthus fragrans (OSM, fragrant tea olive) attenuate food intake, leading to a reduction in body weight gain, but it is not yet clear whether the causative mechanisms underlying these effects are the same for both odors. The first part of the present study revealed that grapefruit odor had no effect on the expression of feeding-related neuropeptides, in contrast to the previous finding that OSM odor suppresses orexigenic and activates anorexigenic neuropeptides in the hypothalamus of the rat. The second part revealed that OSM odor activated the parasympathetic nerve, in contrast to the previous finding demonstrating that grapefruit odor activates sympathetic nerve activity. The third part was performed to confirm the previous findings about the effects of OSM odor on appetitive reactions in humans. In human subjects, we found that continuous exposure to OSM odor attenuated appetite and consumption of snacks (cookies) and improved mood, when evaluated using the POMS (Profile of Mood States) data from university students. In conclusion, OSM odor attenuated appetite and decreased food intake in humans, and the underlying causative mechanisms differed from those mediating the effects of grapefruit odor, specifically in terms of the expression of hypothalamic feeding-related neuropeptides and autonomic nerve activity.

Severe bradycardia at the termination of seizure during electroconvulsive therapy

Background Few cases of asystole or severe bradycardia occurring after the termination of seizure in the third phase with the dominance of parasympathetic nervous system activity during electroconvulsive therapy (ECT) have been reported. We describe a case of severe bradycardia occurring at the termination of seizure. Case presentation The patient had been diagnosed with bipolar disorder more than 9 years earlier. No adverse hemodynamic events had been observed in over 100 sessions of ECT performed during a 9-year period. ECT was usually induced by propofol and suxamethonium. On this ECT, the heart rate gradually decreased before seizure termination, and severe bradycardia (5–6 beats/min) was identified lasting 15–20 s. Atropine administration immediately before electrical stimulus prevented any further bradycardia during the next session of ECT. Conclusions This case report indicates that attention should be paid to adverse cardiac events related to autonomic nerve activity even before such events occur during ECT.

QT Variability Index is Correlated with Autonomic Nerve Activity in Healthy Children

The QT variability index (QTVI), which measures the instability of myocardial repolarization, is usually calculated from a single electrocardiogram (ECG) recording and can be easily applied in children. It is well known that frequency analysis of heart rate variability (HRV) can detect autonomic balance, but it is not clear whether QTVI is correlated with autonomic tone. Therefore, we evaluated the association between QTVI and HRV to elucidate whether QTVI is correlated with autonomic nerve activity. Apparently, healthy 320 children aged 0–7 years who visited Fujita Health University Hospital for heart checkup examinations were included. The RR and QT intervals of 60 continuous heart beats were measured, and the QTVI was calculated using the formula of Berger et al. Frequency analysis of HRV, including the QTVI analysis region, was conducted for 2 min and the ratio of low-frequency (LF) components to high-frequency (HF) components (LF/HF) and HF/(LF + HF) ratio was calculated as indicators of autonomic nerve activity. Then, the correlations between QTVI and these parameters were assessed. QTVI showed a significant positive correlation with LF/HF ratio (r = 0.45, p < 0.001) and negative correlation with HF/(LF + HF) ratio (r = −0.429, p < 0.001). These correlations remained after adjustment for sex and age. QTVI, which is calculated from non-invasive ECG and can detect abnormal myocardial repolarization, is significantly correlated with frequency analysis of HRV parameters. QTVI reflects autonomic nerve balance in children.

Sleep apnea in men is associated with altered lipid metabolism, glucose tolerance, insulin sensitivity, and body fat percentage

Purpose Obstructive sleep apnea (OSA) is associated with obesity and risk for type 2 diabetes. In this community-based study, we thoroughly investigated fatty acid metabolism, incretin response, glucose tolerance, insulin secretion and insulin sensitivity, and autonomic nerve activity in men with or without OSA. Methods Fifteen men without diabetes but with signs of severe OSA, defined as apnea–hypopnea index (AHI) >30, and 15 age- and BMI-matched men without OSA (AHI < 5) were recruited from a community-based cohort. Assessments included clinical and anthropometric measurements, a 2-h oral glucose tolerance test (OGTT), and autonomic nerve activity using heart rate variability (HRV). Results Men with OSA had higher body fat % than BMI-matched men without OSA (p = 0.046) and it was associated with markers of insulin resistance. The area under the curve for nonesterified fatty acids (NEFA) during OGTT was higher in men with OSA (p = 0.021) and fasting NEFA levels were numerically higher (p = 0.097). The plasma glucose at fasting and during OGTT was higher in men with OSA (p < 0.001). Incretin response was similar between groups. Fasting and OGTT-derived indices indicated impaired insulin sensitivity in men with OSA. Compared with men without OSA, Matsuda index (p = 0.068) and Gutt index (p < 0.01) were lower in men with OSA. The HRV measures did not differ between groups. Conclusions Our study suggests that fatty acid handling, glucose tolerance, and insulin sensitivity are impaired in men with severe OSA. This might partly be explained by the increased body fat percentage.

Rationale and Design of the EMPYREAN Study: Investigation on the Effect of Empagliflozin on Cardiac Sympathetic and Parasympathetic Nerve Activity in Japanese Patients with Type 2 Diabetes

Background: A sodium glucose cotransporter 2 (SGLT2) inhibitor was recently found to reduce heart failure hospitalization in the EMPA-REG OUTCOMES trial. We have hypothesized that autonomic nerve activity may be modulated by SGLT2 inhibition. The current study aims to investigate the impact of empagliflozin on sympathetic and parasympathetic nerve activity in patients with type 2 diabetes mellitus.Methods: This ongoing study is a prospective, randomized, open-label, multicenter investigation of 134 patients with type 2 diabetes mellitus. The patients are randomly allocated to receive either empagliflozin or sitagliptin with the treatment goal of the Japan Diabetes Society guidelines. Ambulatory electrocardiographic monitoring is performed at the baseline and at 12 and 24 weeks of treatment. Analyses of heart rate variability are performed using the MemCalc method, which is a combination of the maximum entropy method for spectral analysis and the non-linear least squares method for square analysis. The primary endpoint is the change in the low frequency (LF; 0.04-0.15 Hz) / high frequency (HF; 0.15-0.4 Hz) ratio from baseline to 24 weeks.Discussion: This investigation on the effect of EMPagliflozin on cardiac sYmpathetic and parasympathetic neRve activity in JapanEse pAtieNts with type 2 diabetes (EMPYREAN study) offers an important opportunity to understand the impact of SGLT2 inhibition on autonomic nerve activity in patients with type 2 diabetes.Trial Registration: UMIN Clinical Trials Registry identifier UMIN000029194. Registered 19 September 2017, https://upload.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000033375