Eyeball pressure stimulation induces subtle sympathetic activation in patients with a history of moderate or severe traumatic brain injury
| Autor: | Katharina M. Hösl, Sankanika Roy, Max J. Hilz, F. Ammon, Jörg Markus, Carmen de Rojas Leal, Steven R. Flanagan, Ruihao Wang, Mao Liu, Dafin F. Muresanu, Julia Koehn |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Male medicine.medical_specialty Sympathetic Nervous System Traumatic brain injury Diastole Blood Pressure Stimulation 030204 cardiovascular system & hematology Eye Young Adult 03 medical and health sciences 0302 clinical medicine Heart Rate Physiology (medical) Internal medicine Brain Injuries Traumatic Respiration Pressure medicine Humans In patient business.industry Baroreflex medicine.disease Sensory Systems Neurology Cardiology Female Neurology (clinical) business 030217 neurology & neurosurgery |
| Zdroj: | Clinical Neurophysiology. 129:1161-1169 |
| ISSN: | 1388-2457 |
| Popis: | Objective After traumatic brain injury (TBI), there may be persistent central-autonomic-network (CAN) dysfunction causing cardiovascular-autonomic dysregulation. Eyeball-pressure-stimulation (EPS) normally induces cardiovagal activation. In patients with a history of moderate or severe TBI (post-moderate-severe-TBI), we determined whether EPS unveils cardiovascular-autonomic dysregulation. Methods In 51 post-moderate-severe-TBI patients (32.7 ± 10.5 years old, 43.1 ± 33.4 months post-injury), and 30 controls (29.1 ± 9.8 years), we recorded respiration, RR-intervals (RRI), systolic and diastolic blood-pressure (BPsys, BPdia), before and during EPS (120 sec; 30 mmHg), using an ocular-pressure-device (Okulopressor®). We calculated spectral-powers of mainly sympathetic low (LF: 0.04–0.15 Hz) and parasympathetic high (HF: 0.15–0.5 Hz) frequency RRI-fluctuations, sympathetically mediated LF-powers of BPsys, and calculated normalized (nu) LF- and HF-powers of RRI. We compared parameters between groups before and during EPS by repeated-measurement-analysis-of-variance with post-hoc analysis (significance: p Results At rest, sympathetically mediated LF-BPsys-powers were significantly lower in the patients than the controls. During EPS, only controls significantly increased RRIs and parasympathetically mediated HFnu-RRI-powers, but decreased LF-RRI-powers, LFnu-RRI-powers, and LF-BPsys-powers; in contrast, the patients slightly though significantly increased BPsys upon EPS, without changing any other parameter. Conclusions In post-moderate-severe-TBI patients, autonomic BP-modulation was already compromised at rest. During EPS, our patients failed to activate cardiovagal modulation but slightly increased BPsys, indicating persistent CAN dysregulation. Significance Our findings unveil persistence of subtle cardiovascular-autonomic dysregulation even years after TBI. |
| Databáze: | OpenAIRE |
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