Associations Between Colonic Motor Patterns and Autonomic Nervous System Activity Assessed by High-Resolution Manometry and Concurrent Heart Rate Variability

Yuan, Yuhong; Ali, Mir Wasif; Mathewson, Karen J.; Sharma, Kartik; Faiyaz, Mahi; Tan, Wei; Parsons, Sean P.; Zhang, Kailai K.; Milkova, Natalija; Liu, Lijun; Ratcliffe, Elyanne M.; Armstrong, David; Schmidt, Louis A.; Chen, Jihong; Huizinga, Jan D.

doi:10.3389/fnins.2019.01447

Cited by 23 publications

(25 citation statements)

References 57 publications

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“…Ferguson et al ( 76 ) investigated the relationship between autonomic nervous system activity and gastrointestinal symptoms in children with autism, finding a significant correlation between lower gastrointestinal tract symptoms, such as constipation, and lower parasympathetic tone. This supports the idea that, to a certain extent, lower gastrointestinal motility is controlled by parasympathetic activity ( 77 ). Parasympathetic activity at baseline was particularly strongly related to lower gastrointestinal symptoms in participants who reported a co-occurring anxiety disorder.…”

Section: Autism and Co-morbiditiessupporting

confidence: 87%

Autism Spectrum Disorder in Children Is Not Associated With Abnormal Autonomic Nervous System Function: Hypothesis and Theory

2022

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The quest to understand the pathophysiology of autism spectrum disorder (ASD) has led to extensive literature that purports to provide evidence for autonomic dysfunction based on heart rate and heart rate variability (HRV), in particular respiratory sinus arrhythmia (RSA), a measure of parasympathetic functioning. Many studies conclude that autism is associated with vagal withdrawal and sympathetic hyperactivation based on HRV and electrodermal analyses. We will argue that a critical analysis of the data leads to the hypothesis that autonomic nervous system dysfunction is not a dominant feature of autism. Most children with ASD have normal parasympathetic baseline values and normal autonomic responses to social stimuli. The existing HRV and electrodermal data cannot lead to the conclusion of an over-excitation of the sympathetic nervous system. A small subgroup of ASD children in experimental settings has relatively low RSA values and relatively high heart rates. The data suggest that this is likely associated with a relatively high level of anxiety during study conditions, associated with co-morbidities such as constipation, or due to the use of psychoactive medication. Many studies interpret their data to conform with a preferred hypothesis of autonomic dysfunction as a trait of autism, related to the polyvagal theory, but the HRV evidence is to the contrary. HRV analysis may identify children with ASD having autonomic dysfunction due to co-morbidities.

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Section: Autism and Co-morbiditiessupporting

confidence: 87%

Autism Spectrum Disorder in Children Is Not Associated With Abnormal Autonomic Nervous System Function: Hypothesis and Theory

2022

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“…Raw data were obtained from a study that was reported on previously ( Milkova et al, 2020 ; Yuan et al, 2020 ). High-Resolution Colonic Manometry was performed using an 84-sensor water perfused catheter that detected luminal pressures at 1 cm intervals from the proximal colon to the anal sphincter.…”

Section: Methodsmentioning

confidence: 99%

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

et al. 2021

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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.

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“…ICC are still likely reduced but may not be severe enough for the ICC network to lose its function. In these patients, reduced autonomic functioning is the likely culprit (194,195). Autonomic defecation reflexes may not respond to normal physiological triggers.…”

Section: Slow Transit Constipationmentioning

confidence: 99%

Interstitial cells of Cajal and human colon motility in health and disease

Huizinga

Hussain

Chen

2021

American Journal of Physiology-Gastrointestinal and Liver Physi

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Our understanding of human colonic motility, and autonomic reflexes that generate motor patterns, has increased markedly through high-resolution manometry. Details of the motor patterns are emerging related to frequency and propagation characteristics that allow linkage to interstitial cells of Cajal (ICC) networks. In studies on colonic motor dysfunction requiring surgery, ICC are almost always abnormal or significantly reduced. However, there are still gaps in our knowledge about the role of ICC in the control of colonic motility and there is little understanding of a mechanistic link between ICC abnormalities and colonic motor dysfunction. This review will outline the various ICC networks in the human colon and their proven and likely associations with the enteric and extrinsic autonomic nervous systems. Based on our extensive knowledge of the role of ICC in the control of gastrointestinal motility of animal models and the human stomach and small intestine, we propose how ICC networks are underlying the motor patterns of the human colon. The role of ICC will be reviewed in the autonomic neural reflexes that evoke essential motor patterns for transit and defecation. Mechanisms underlying ICC injury, maintenance, and repair will be discussed. Hypotheses are formulated as to how ICC dysfunction can lead to motor abnormalities in slow transit constipation, chronic idiopathic pseudo-obstruction, Hirschsprung's disease, fecal incontinence, diverticular disease, and inflammatory conditions. Recent studies on ICC repair after injury hold promise for future therapies.

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Associations Between Colonic Motor Patterns and Autonomic Nervous System Activity Assessed by High-Resolution Manometry and Concurrent Heart Rate Variability

Cited by 23 publications

References 57 publications

Autism Spectrum Disorder in Children Is Not Associated With Abnormal Autonomic Nervous System Function: Hypothesis and Theory

Autism Spectrum Disorder in Children Is Not Associated With Abnormal Autonomic Nervous System Function: Hypothesis and Theory

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

Interstitial cells of Cajal and human colon motility in health and disease

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