Tu1437 Autonomic Nervous Function Assessed by Two Complementary Methods -Baroreceptor Sensitivity and Heart Rate Variability - in Patients With Irritable Bowel Syndrome (IBS)

Gunterberg, Veronica; Strid, Hans; Tygesen, Hans; Osika, Walter; Friberg, Peter; Simrén, Magnus

doi:10.1016/s0016-5085(12)63231-4

Cited by 4 publications

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“…Baroreflex activity was found to be affected by afferent stimulation, and that may play an important role in the pathophysiology of both chronic pain and comorbid (somatic and mental) disorders . For example, BRS is reduced in patients with IBS irrespective of its specific subpopulations compared to healthy subjects, and this reduction increases with IBS duration and severity . However, the similarly reduced BRS in IBS patients was found to be related to opposite pain killing and pain aggravating (related either to affect or sensation) mechanisms depending on mediation of this BRS reduction through BP or heart rate (HR) regulation processes .…”

Section: Introductionmentioning

confidence: 99%

“…8,23 For example, BRS is reduced in patients with IBS irrespective of its specific subpopulations compared to healthy subjects, and this reduction increases with IBS duration and severity. 7,8,24,25 However, the similarly reduced BRS in IBS patients was found to be related to opposite pain killing and pain aggravating 1 (related either to affect or sensation) mechanisms depending on mediation of this BRS reduction through BP or heart rate (HR) regulation processes. 8 This complexity in the baroreflex mechanism has required investigation to personalize diagnostic and treatment strategies in chronic pain disorders.…”

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confidence: 99%

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Asymmetries in reciprocal baroreflex mechanisms and chronic pain severity: Focusing on irritable bowel syndrome

Davydov

Naliboff

Shahabi

et al. 2017

Neurogastroenterology Motil

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Section: Introductionmentioning

confidence: 99%

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confidence: 99%

Asymmetries in reciprocal baroreflex mechanisms and chronic pain severity: Focusing on irritable bowel syndrome

Davydov

Naliboff

Shahabi

et al. 2017

Neurogastroenterology Motil

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“…For example, baroreceptor sensitivity (BRS) values at rest were found to be reduced in patients with IBS compared to a control group [18,20,21]. BRS is an autonomic measure of integrative sympathetic and parasympathetic regulation of cardiovascular processes assessed by blood pressure (BP) level and heart rate variability (HRV), and its resting values were found to be associated with mood regulation in our previous studies in healthy subjects and patients with major depression [22,23].…”

Section: Introductionmentioning

confidence: 99%

Baroreflex mechanisms in Irritable Bowel Syndrome: Part I. Traditional indices

Davydov

Naliboff

Shahabi

et al. 2016

Physiology & Behavior

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Objective This study was conducted to present evidence of differences in autonomic regulation of cardiovascular activity and its role in the severity of specific (disease-related) and non-specific (negative affect and chronic pain-related) symptoms in individuals with Irritable Bowel Syndrome (IBS). Methods Seventy-eight female patients with IBS and 27 healthy women age 18–62 years were assessed for IBS symptoms, negative affect, and baroreceptor sensitivity (BRS), blood pressure (BP), heart rate, and heart rate variability (HRV) at rest. Direct and indirect regression effects were examined with application of the bootstrap procedure to validate findings. Results IBS was reliably related to lower resting BRS, higher BP, and higher negative affect compared to healthy controls. Longer disease duration (chronicity) was related to BRS decrease coupled with systolic BP increase (95% CIs = -0.14 to -0.01). Three autonomic mechanisms associated with BRS decrease were found to further regulate severity of IBS symptoms. Lower BRS was related to higher IBS severity in general if the effect was transferred through the decrease of low frequency power of HRV (e.g., 95% CIs = -0.039 to -0.001 for abdominal pain severity). However, lower BRS was related to lower IBS severity in general if the effect was transferred through diastolic BP increase (95% CIs = 0.01 to 0.11 for abdominal pain severity). Lower BRS was related to higher abdominal pain severity coupled with high negative affect if the effect was transferred through the decrease of higher frequency power of HRV (95% CIs = -0.026 to -0.003). Conclusions These findings indicate that different cardiovascular mechanisms are associated with IBS development and the increase and decrease of severity of IBS symptoms. Their assessment suggests ways to personalize treatment of IBS.

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“…The assessment of CNS dysfunction could be improved with addition of brain imaging, which could provide both structural 50 and functional information about the CNS 51 . Furthermore, including heart rate variability and other ANS measures could strengthen the assessment of the ANS function 52 . Moreover, more detailed assessment of GI motor, sensory and secretory function at different levels in the GI tract could be considered.…”

Section: Discussionmentioning

confidence: 99%

Associations among neurophysiology measures in irritable bowel syndrome (IBS) and their relevance for IBS symptoms

Midenfjord

Polster

Sjövall

et al. 2020

Sci Rep

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Abnormal gut-brain interactions are common in irritable bowel syndrome (iBS), but the associations between neurophysiological measures and their relation to gastrointestinal (Gi) symptoms are poorly understood. Our aim was to explore these relationships and define the most relevant neurophysiology measures for Gi symptom severity in iBS. iBS patients underwent small intestinal motility (manometry; fasted and fed contraction frequency, phase III time) and secretion (transmural potential difference), rectal sensorimotor (barostat; sensory thresholds, tone response, compliance), autonomic nervous system (baroreceptor sensitivity and effectiveness), and colonic motor function (transit time) examinations. Gi symptom severity (GSRS-iBS), and anxiety and depression (HAD) as a proxy measure of central nervous system (CNS) dysfunction, were assessed. In total 281 IBS patients (Rome II criteria) were included (74% females, median age 36 [interquartile range 28-50] years). Significant correlations between neurophysiology measures were stronger within, rather than between, different neurophysiological examinations. the strongest neurophysiology-symptom correlations occurred between a combination of cnS and visceral sensitivity parameters, and GSRS-iBS total score and pain domain (ρ = 0.40, p < 0.001, and ρ = 0.38, p < 0.001). Associations between GI symptoms in IBS and individual and combinations of neurophysiological factors occurred, primarily in cnS and visceral sensitivity measures, providing new insights into the clinical presentation of iBS. Irritable bowel syndrome (IBS) is a common and complex functional gastrointestinal (GI) disorder where gut-brain interactions 1,2 , and alterations in the gut microenvironment 3 are considered to be central in the pathophysiology. Abdominal pain, related to defecation and associated with changes in stool form or frequency, are the characteristic clinical features of this female predominant disease 1 with 5-10% prevalence worldwide 4-6. The disease leads to high costs for society, due to increased use of health care services 7 , as well as lowered work productivity and higher absenteeism from work 8,9. Different abnormalities involved in gut-brain interactions are present in IBS, leading to a complex clinical presentation, but to date the pathophysiology is not completely understood. Various pathophysiological factors have been brought forward as important for symptom generation in IBS, but none of these is present in all patients with IBS. IBS patients have been reported to have increased psychological distress 10,11 , visceral hypersensitivity 12 , altered colonic motility 13 , aberrant autonomic nervous system (ANS) function 14,15 , rectal sensorimotor dysfunction 16,17 , and dysfunction of motility 18-20 and secretion 21 of the small intestine, in comparison with healthy controls. Although these abnormalities have been described individually in IBS, the associations among these aberrant measures, and the interactions between these parameters and the patient reported IBS symptom ...

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Tu1437 Autonomic Nervous Function Assessed by Two Complementary Methods -Baroreceptor Sensitivity and Heart Rate Variability - in Patients With Irritable Bowel Syndrome (IBS)

Cited by 4 publications

References 0 publications

Asymmetries in reciprocal baroreflex mechanisms and chronic pain severity: Focusing on irritable bowel syndrome

Asymmetries in reciprocal baroreflex mechanisms and chronic pain severity: Focusing on irritable bowel syndrome

Baroreflex mechanisms in Irritable Bowel Syndrome: Part I. Traditional indices

Associations among neurophysiology measures in irritable bowel syndrome (IBS) and their relevance for IBS symptoms

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