Optimizing Autonomic Function Analysis via Heart Rate Variability Associated With Motor Activity of the Human Colon

Abstract

The parameters of heart rate variability (HRV) can non-invasively assess some autonomic activities, and HRV is influenced by many bodily actions. Although parasympathetic activity is the primary driver of colonic propulsive activity, and sympathetic activity a major inhibitor of colonic motility, they are rarely measured and almost play no role in diagnosis of colon motor dysfunction or in standard treatments. Here we set out to optimize HRV analysis of autonomic nervous system changes related to human colon motility. The electrocardiogram and impedance were recorded in synchrony with colonic motor patterns by high-resolution manometry. Respiratory sinus arrhythmia (RSA), root mean square of successive differences of beat-to-beat intervals (RMSSD), the Baevsky Index or Sympathetic Index (SI), and the ratios of SI/RSA and SI/RMSSD were shown to indicate a marked increase in parasympathetic and withdrawal of sympathetic activity during the high-amplitude propagating pressure waves (HAPWs). Strong associations were seen with HAPWs evoked by a meal and rectal bisacodyl indicating a marked increase in parasympathetic and withdrawal of sympathetic activity during the gastrocolic reflex and the defecation reflex. When HAPWs occurred in quick succession, parasympathetic activation (RSA and RMSSD) occurred in a rhythmic fashion. Hence, during propulsive motor patterns, an overall shift in autonomic activity toward increased parasympathetic control was shown to be reflected in HRV. HRV assessment may therefore be valuable in the assessment of autonomic dysfunction related to colonic dysmotility.

Heart Rate Variability as an Indicator of Autonomic Nervous System Disturbance in Behcet’s Disease

“…Whereas in other studies, the LF component of HRV has been found to be not sensitive enough to assess the sympathetic activity. 24 Indeed, heart rate oscillations in the LF zone are related to the activity of the baroreflex system 25 and both the parasympathetic and sympathetic systems are thought to be involved. As a consequence, the LF/HF ratio should be interpreted with caution, taking into consideration all these limitations and contributing factors.…”

Sleep Deficiency Is Associated With Exacerbation of Symptoms and Impairment of Anorectal and Autonomic Functions in Patients With Functional Constipation

“…Meanwhile, the Baevsky Index or Sympathetic Index (SI) was calculated to represent sympathetic tone according to the formula . The most frequent RR interval was transformed into the mode (Mo), which is expressed in seconds ( Ali et al, 2021 ). A 50 ms bin width was used for calculating the amplitude of mode (AMo), which is expressed as a percentage of the total number of intervals measured.…”

Modulation of the autonomic nervous system by one session of spinal low-level laser therapy in patients with chronic colonic motility dysfunction

“…Patients with chronic constipation may not be able to generate spontaneous bowel movements. Constipation is the inability to generate one or more defecation reflexes that are orchestrated by the extrinsic autonomic nervous system involving propulsive motor activity and anal sphincter relaxation ( Bharucha et al, 1993 ; Rao et al, 2016 ; Camilleri et al, 2017 ; Callaghan et al, 2018 ; Milkova et al, 2020 ; Ali et al, 2021 ). A propulsive colonic motor pattern may start with triggering of afferent neurons whose cell bodies lie within the DRG of the lumbar and sacral portions of the spinal cord ( Brookes et al, 2009 ).…”

“…HRV analysis is explored to evaluate autonomic functioning and dysfunction ( Shields, 2009 ; Huizinga et al, 2018 ; Barbier et al, 2022 ; Liu et al, 2022 ). We used HRV successfully to show that propulsive motor patterns generated by the human colon are associated with an increase in parasympathetic activity and a decrease in sympathetic activity ( Yuan et al, 2020 ; Ali et al, 2021 ). HRV is also used to assess success of treatment of autonomic dysfunction in animal models ( Ouyang et al, 2020 ) and human studies ( Karpyak et al, 2004 ; Euteneuer et al, 2022 ).…”

“…It was, therefore, important to investigate whether or not LLLT can trigger autonomic nerves. The aim of the present study was to examine whether one treatment session of LLLT would show autonomic reactivity, assessed via HRV ( Thayer et al, 2012 ; Baevsky and Chernikova, 2017 ; Ali et al, 2021 ), which would prove its ability to activate autonomic spinal nerves.…”