Heart rate variability and phantom pain in male amputees: Application of linear and nonlinear methods

Abstract

Abstract-Phantom-limb pain (PLP) is a phenomenon that may appear among people with amputation. Some studies reveal that 70% of people with amputation experience PLP years postamputation. There is a lack of scientific evidence about the cause of PLP. It has been hypothesized that the autonomic nervous system (ANS) could be involved in the mechanism that triggers PLP, but this hypothesis remains unclear. The aim of this study was to correlate ANS function, through heart rate variability (HRV) analysis, with PLP in adult males with amputation. The study population comprised 35 subjects, with 27 reporting PLP often or always. The rest of the subjects did not report any PLP. In order to calculate linear and nonlinear parameters of HRV, all subjects underwent 10 min of resting heart rate monitoring. The study did not find correlations between HRV parameters and PLP. Most of the subjects showed decreased values in linear parameters of HRV while nonlinear values were normal. HRV is not implicated in PLP. Linear and nonlinear methods for HRV analysis might reflect different physiological phenomena; while linear values place people with amputation at cardiovascular risk, nonlinear values indicate normality.

Effects of spinal cord stimulation on heart rate variability in patients with Failed Back Surgery Syndrome

“…HRV has the potential to assess the role of the ANS in normal healthy individuals as well as in patients with chronic diseases [20]. An increased heart rate and reduced HRV has been found in several chronic pain disorders [21–25]. Not only is HRV a plausible modality in the diagnosing process of pain, the use of HRV can also be considered as outcome parameter in measuring the therapeutic effect in chronic pain treatments [26, 27].…”

Variabilidade Da Frequência Cardíaca Em Diferentes Posições Corporais E Durante Masr Em Amputado Unilateral De Membro Inferior

“…Contraditoriamente aos resultados por nós encontrados, Cachadiña et al 9 avaliaram 35 amputados em repouso na posição supino, e verificaram que todos os sujeitos apresentaram uma redução nos valores de BF, indicando baixa modulação da atividade simpática. Entretanto, é importante ressaltar que eles avaliaram sujeitos em diferentes níveis de amputação com e sem presença de dor no membro residual.…”

“…Peles et al 3 observaram a resposta no domínio da frequência da análise da VFC em supinação e ortostase de amputados traumáticos, em que encontraram um predomínio da modulação parassimpática em ortostase. Já Cachadiña et al 9 avaliaram a VFC em homens amputados com dor fantasma, concluindo que a disfunção autonômica também parece estar envolvida nas alterações cardiovasculares do amputado como reflexo de uma atividade simpática anormal do membro residual. Contudo, nestes estudos, não foram avaliados os índices autonômicos cardíacos durante o repouso em supinação, sedestação, ortostase e na MASR de homens amputados traumáticos.…”

The effect of pre-emptive analgesia on the level of postoperative pain in women undergoing surgery for breast neoplasm

“…Also, the studies conducted by Sarabia Cachadiña et al . [ 22 ] on the relationship between the pulse and pain felt by patients after amputations of the lower extremity did not show a significant dependence between these factors, at the same time failing to prove the usefulness of measuring heart rate for the evaluation of pain intensity.…”