Heart Rate Variability as an Indicator of Nociceptive Pain in Disorders of Consciousness?

Riganello, Francesco; Chatelle, Camille; Schnakers, Caroline; Laureys, Steven

doi:10.1016/j.jpainsymman.2018.09.016

Cited by 25 publications

(28 citation statements)

References 57 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…(Riganello, 2016) in which neural structures are involved in cognitive, affective, and autonomic regulations] modulates a different response to the noxious stimulus, among HC, MCS, and UWS patients. The clear decreasing modulation in UWS patients supported the idea of a correlation with the reduced level of consciousness (Riganello et al, 2018a).…”

Section: Discussionsupporting

confidence: 62%

See 1 more Smart Citation

The Trace Conditional Learning of the Noxious Stimulus in UWS Patients and Its Prognostic Value in a GSR and HRV Entropy Study

Cortese

Riganello

Arcuri

et al. 2020

Front. Hum. Neurosci.

Self Cite

View full text Add to dashboard Cite

Section: Discussionsupporting

confidence: 62%

“…As the sequence of heartbeats is non-linear, the HRV is better described by the mathematical chaos as the HRV entropy analysis. Reduced HRV entropy suggests a less complex autonomic response to noxious stimuli in UWS patients (Riganello et al, 2018a;Tobaldini et al, 2018) and discriminates them from MCS patients (Riganello et al, 2018b).…”

Section: Introductionmentioning

confidence: 98%

The Trace Conditional Learning of the Noxious Stimulus in UWS Patients and Its Prognostic Value in a GSR and HRV Entropy Study

Cortese

Riganello

Arcuri

et al. 2020

Front. Hum. Neurosci.

Self Cite

View full text Add to dashboard Cite

“…In a Evoked Response Potential (ERP) study based on nociceptive repeated laser stimulation MCS showed partially preserved cortical activations, higher ERP γ-power magnitude and Standard Deviation of Normal-to-Normal intervals (SDNN) compared to VS/UWS patients (Calabrò et al, 2017). Other studies on nociceptive stimulation documented a correlation between the level of consciousness and HRV-entropy (Riganello et al, 2018a; Tobaldini et al, 2018), with lower values of entropy detected in VS/UWS than in MCS patients or in healthy subjects, and correlated to the CRS-R total scores (Riganello et al, 2018a). The above results indicate a decrease of complexity in the modulation of the response to noxious stimuli in VS/UWS subjects and a less complex ANS modulation in the two way brain-heart interaction compared to MCS.…”

Section: Hrv and Docmentioning

confidence: 94%

“…These observations were mostly based on regional brain activation in response to stimulus conditions in controlled setups; stimulus-related functional changes in the autonomic nervous system (ANS) function have also been described. Still highly debated, e.g., in subjects in a VS/UWS, these observations challenge the current definitions and our understanding of both responsiveness and consciousness, with an impact on the clinical decision-making process (Laureys et al, 2010; Riganello et al, 2016, 2018a, 2018b). The extent to which regional brain activations can be considered equivalent to, or compatible with behavioral responses in indicating (residual or covert) consciousness remains controversial and the current standards by which patients surviving severe brain injury should be regarded as being conscious or unconscious have been questioned (Celesia, 2013; Celesia and Sannita, 2013).…”

Section: Introductionmentioning

confidence: 99%

Measures of CNS-Autonomic Interaction and Responsiveness in Disorder of Consciousness

Riganello

Larroque²,

Perri

et al. 2019

Front. Neurosci.

Self Cite

View full text Add to dashboard Cite

Neuroimaging studies have demonstrated functional interactions between autonomic (ANS) and brain (CNS) structures involved in higher brain functions, including attention and conscious processes. These interactions have been described by the Central Autonomic Network (CAN), a concept model based on the brain-heart two-way integrated interaction. Heart rate variability (HRV) measures proved reliable as non-invasive descriptors of the ANS-CNS function setup and are thought to reflect higher brain functions. Autonomic function, ANS-mediated responsiveness and the ANS-CNS interaction qualify as possible independent indicators for clinical functional assessment and prognosis in Disorders of Consciousness (DoC). HRV has proved helpful to investigate residual responsiveness in DoC and predict clinical recovery. Variability due to internal (e.g., homeostatic and circadian processes) and environmental factors remains a key independent variable and systematic research with this regard is warranted. The interest in bidirectional ANS-CNS interactions in a variety of physiopathological conditions is growing, however, these interactions have not been extensively investigated in DoC. In this brief review we illustrate the potentiality of brain-heart investigation by means of HRV analysis in assessing patients with DoC. The authors’ opinion is that this easy, inexpensive and non-invasive approach may provide useful information in the clinical assessment of this challenging patient population.

show abstract

“…Different approaches of investigation based on Heart Variability Analysis (HRV), Galvanik Skin Response (GSR), or Laser Evocated Potential (LEP) have shown the possibility to observe pain processing in UWS/VS patients ( de Tommaso et al, 2015 ; Riganello et al, 2018a ; Cortese et al, 2020 ).…”

Section: Introductionmentioning

confidence: 99%

Addressing Pain for a Proper Rehabilitation Process in Patients With Severe Disorders of Consciousness

2021

View full text Add to dashboard Cite

Consciousness constitutes a fundamental prerequisite in the individual appraisal and experience of pain. In the same way, a person needs to be able to report on pain perception. Patients who suffered a severe brain injury with disorders of consciousness (DOC) represent a spectrum of pathologies affecting patients' capacity to interact with the external world. In these patients, the most relevant aspects in response to pain are physiologic and behavioral. The treatments and management of pain are challenging issues in these patients, arising serious ethical concerns and bringing emotional load among medical staff, caregivers, and relatives. In this review, we report the importance of having a correct pain management in DOC patients, to individuate the best pharmacological treatment that can make the difference in detecting a behavioral response, indicative of a change in the level of consciousness, and in planning a more effective rehabilitative approach.

show abstract

Heart Rate Variability as an Indicator of Nociceptive Pain in Disorders of Consciousness?

Cited by 25 publications

References 57 publications

The Trace Conditional Learning of the Noxious Stimulus in UWS Patients and Its Prognostic Value in a GSR and HRV Entropy Study

The Trace Conditional Learning of the Noxious Stimulus in UWS Patients and Its Prognostic Value in a GSR and HRV Entropy Study

Measures of CNS-Autonomic Interaction and Responsiveness in Disorder of Consciousness

Addressing Pain for a Proper Rehabilitation Process in Patients With Severe Disorders of Consciousness

Contact Info

Product

Resources

About