Key result
Pharmacological and therapeutic interventions significantly changed low and high frequency HRV parameters and the LF/HF ratio in 8 patients with paroxystic sympathetic hyperactivity.
Why the study?
Paroxystic sympathetic hyperactivity in brain injury presents diagnostic and therapeutic challenges, prompting investigation into whether frequency domain heart rate variability changes reflect pharmacological or therapeutic measures.
Do pharmacological and therapeutic interventions alter heart rate variability frequency domains in patients with paroxystic sympathetic hyperactivity?
Observational (n=8)
Do pharmacological and therapeutic interventions alter heart rate variability frequency domains in patients with paroxystic sympathetic hyperactivity?
Heart rate variability frequency parameters change significantly following interventions in patients with paroxystic sympathetic hyperactivity, suggesting potential for on-line monitoring of therapeutic effects.
HRV frequency shifts may support real-time monitoring of PSH interventions; leaves open whether this improves outcomes in larger prospective studies.
BACKGROUND: Patients suffering brain injury may experience paroxystic sympathetic hyperactivity, presenting diagnostic and therapeutic challenges in neurointensive rehabilitation. The syndrome has been modelled as peripheral and central excitatory:inhibitory ratios of autonomous nervous activity. Another model represents the symptoms as oscillations of the two components of the autonomous nervous system. In therapeutic framework, the syndrome is perceived as the patient misconstruing sensory input relating to body positioning. OBJECTIVE: To investigate whether changes in frequency domain of heart rate variability reflect pharmacological and/or therapeutic measures in rehabilitation. METHODS: ECG was recorded before and after pharmacological and therapeutic interventions in eight patients with high probability of the syndrome in a neurointensive step-down unit. Recordings were analysed off-line in frequency parameters. Appropriate statistical methods were applied. RESULTS: Low, high frequency and the LF/HF ratio changed significantly following therapeutic as well as pharmacological interventions. DISCUSSION: The cohort was small, the setting the immediate postictal period of intensive care with multidisciplinary rehabilitation. Still, changes in frequency domain were detected following therapeutic efforts. This opens up the venue of on-line monitoring of the intended therapeutic effect.
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Honoré et al. (2019) conducted an observational in Paroxystic sympathetic hyperactivity (n=8). Pharmacological and therapeutic interventions vs. Baseline (before intervention) was evaluated on Changes in frequency domain of heart rate variability (low frequency, high frequency, and LF/HF ratio). Pharmacological and therapeutic interventions significantly changed low and high frequency HRV parameters and the LF/HF ratio in 8 patients with paroxystic sympathetic hyperactivity.