Water Immersion-Induced Skin Wrinkling Is Related to Heart Rate Variability

Abstract

Water immersion-induced skin wrinkling (WISW) is dependent on intact peripheral sympathetic function. WISW was hypothesized to reflect autonomic function in subjects without peripheral neuropathy. We prospectively studied 70 healthy subjects (aged 31 ± 8 years, 63% females) without cardiovascular risk factors or neurological disease. All subjects underwent short-term heart rate variability (HRV) studies. Time and frequency domain variables were derived including the HRV index. WISW was graded using a previously validated scale of 1–4 of which 18.6% of subjects exhibited grade 1 (minimal) WISW and 35.7% had grade 2 WISW. On multivariate analysis using the HRV index, WISW was independently related to height and the HRV index. We conclude that WISW is related to central autonomic function.

Review of the Role of the Brain in Chemotherapy-Induced Peripheral Neuropathy

“…Finally, considering the role of the brain could provide insight into the autonomic components of CIPN (Verstappen et al, 2003;Nahman-Averbuch et al, 2014). For example, peripheral neuropathy often involves dysfunction in the reflexive wrinkling of glabrous skin during water immersion (Ng et al, 2013;Wilder-Smith, 2015), which appears to be related to central autonomic function (Win et al, 2010), which is mediated by the brain (Sklerov et al, 2019).…”

Water Immersion-Induced Skin Wrinkling: More Accurately Reflects Neurovascular Coupling rather than Just Neural Function

“…Since decreased HRV is generally considered predictive of adverse cardiovascular events, it was suggested that WISW might be a useful prognostic indicator in patients with various cardiovascular diseases. In another study, our group found WISW responses to be less marked in patients with heart failure [12]. Since heart failure is associated with neuro-hormonal…”

Reduced water induced skin wrinkling in congestive heart failure

“…HRV is considered a direct measure of central autonomic function [5]. In addition to HRV, we found patient height predictive of WISW degree, possibly as a reflection of fingertip surface area [4]. Accordingly, we are curious as to whether the authors found WISW related to body size.…”

“…Among 70 healthy subjects we found decreased WISW to be associated with reduced short term heart rate variability (HRV) [4]. HRV is considered a direct measure of central autonomic function [5].…”