Effects of regional brain injury on the newborn autonomic nervous system

Sender, Nira Schneebaum; Govindan, Rathinaswamy B.; Sulemanji, Mustafa; Al-Shargabi, Tareq; Lenin, R. B.; Ekşioğlu, Yaman Z.; Plessis, Adré J. du

doi:10.1016/j.earlhumdev.2014.10.003

Cited by 16 publications

(9 citation statements)

References 25 publications

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“…Similarly, the timing of our assessment of cortical injury by MRI may limit our ability to make firm conclusions about cortical injury in-vivo and its relation to HRV in real-time. However, that these findings could reflect a mechanistic link between regional injury and cerebral inputs regulating autonomic control of heart rate is consistent with animal and human studies that have described the role of the cortical autonomic network in regulation of HRV ( 22 , 23 ) We speculate that the depression of HRV in infants with isolated cortical injury supports the notion that cerebral cortical inputs are involved in regulation of the autonomic nervous system by term gestation ( 13 ). While our findings cannot confirm this mechanistic link, these data can provide ranges for HRV metrics that can reflect risk for BG versus WS involvement for the bedside clinician.…”

Section: Discussionsupporting

confidence: 90%

“…These studies have related HRV metrics to the presence and severity of brain injury, but not to the topography of injury. Recently, we demonstrated that injury at both the cerebral cortical and brain stem level was associated with ANS dysregulation in newborns with various types of brain injury( 13 ). These findings suggest that autonomic regulation can be mediated by both direct injury to the deep brain structures including the brainstem, as well as higher order cortical centers.…”

Section: Introductionmentioning

confidence: 99%

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Pattern of brain injury and depressed heart rate variability in newborns with hypoxic ischemic encephalopathy

et al. 2017

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Background Decreased heart rate variability (HRV) is a measure of autonomic dysfunction and brain injury in newborns with hypoxic ischemic encephalopathy (HIE). This study aimed to characterize the relationship between HRV and brain injury pattern by MRI in newborns with HIE undergoing therapeutic hypothermia. Methods HRV metrics were quantified in the time domain (αS, αL, and root mean square at short [RMSS] and long [RMSL] time scales) and frequency domain (relative low-[LF] and high-frequency [HF] power) during the time period 24–27 hours of life. Brain injury pattern by MRI was classified as no injury, pure cortical/white matter injury, mixed watershed/mild basal nuclei injury, predominant basal nuclei or global injury, and died. HRV metrics were compared across brain injury pattern groups using a random effects mixed model. Results Data from 74 infants were analyzed. Brain injury pattern was significantly associated with degree of HRV suppression. Specifically, negative associations were observed between pattern of brain injury and RMSS (estimate −0.224, SE 0.082, p=0.006), RMSL (estimate −0.189, SE 0.082, p=0.021), and LF power (estimate −0.044, SE 0.016, p=0.006). Conclusion Degree of HRV depression is related to pattern of brain injury. HRV monitoring may provide insights into pattern of brain injury at the bedside.

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Section: Discussionsupporting

confidence: 90%

Section: Introductionmentioning

confidence: 99%

Pattern of brain injury and depressed heart rate variability in newborns with hypoxic ischemic encephalopathy

et al. 2017

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“…78 In another study of term newborns with hypoxic-ischemic encephalopathy, infants with right cortical and/or cerebellar injury had reduced low frequency/high frequency HRV spectral analysis ratio compared to infants with left cortical and/or cerebellar injury in which was seen an increase in the low frequency/high frequency HRV spectral analysis ratio. 79 In adult brain injury patients, those with right hemisphere injury had less ability to perform under stress compared to patients with left hemisphere injury indicating differences in autonomic reactivity based on injured hemisphere. 80 Other adult studies also support the role of the cerebral cortex in modulation of the ANS, which receives sympathetic tone predominantly from the right hemisphere and parasympathetic tone from the left hemisphere.…”

Section: How Ans Failure During Transition May Lead To Brain Injurymentioning

confidence: 95%

The Critical Role of the Central Autonomic Nervous System in Fetal-Neonatal Transition

Mulkey

Plessis

2018

Seminars in Pediatric Neurology

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Objective: The objective of this article is to understand the complex role of the central autonomic nervous system in normal and complicated fetal-neonatal transition and how autonomic nervous system dysfunction can lead to brain injury. Findings: The central autonomic nervous system supports coordinated fetal transitional cardiovascular, respiratory, and endocrine responses to provide safe transition of the fetus at delivery. Fetal and maternal medical and environmental exposures can disrupt normal maturation of the autonomic nervous system in utero, cause dysfunction, and complicate fetal-neonatal transition. Brain injury may both be caused by autonomic nervous system failure and contribute directly to autonomic nervous system dysfunction in the fetus and newborn. Conclusion: The central autonomic nervous system has multiple roles in supporting transition of the fetus. Future studies should aim to improve real-time monitoring of fetal autonomic nervous system function and in supporting typical autonomic nervous system development even under complicated conditions.

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“…In our study, we found the value of SDNN and rMSSD could reflect better the functional status of the cardiac vagus nerve. Besides, the LF/HF ratio serves as an indicator of sympathovagal balance 46,47 . We observed a high imbalance in sympathetic modulation in hypertrophy rats.…”

Section: Discussionmentioning

confidence: 57%

The protective effect of isosteviol sodium on cardiac function and myocardial remodelling in transverse aortic constriction rat

Liu

Tang

et al. 2020

J Cellular Molecular Medi

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Cardiac hypertrophy is a compensatory response to pressure overload and a key risk factor for heart failure. 1-3 The cardiac function generally becomes deteriorative during the transition from compensated to decompensated cardiac hypertrophy. 4,5 The cardiac remodelling characterized by cardiac fibrosis that significantly reduces cardiac function and electrophysiological remodelling also occurs during the cardiac hypertrophy. 6-9 The process of cardiac hypertrophy is also accompanied by abnormal electrophysiological performance, which has a regulatory effect on cardiac isotropy. 10,11 Preventing pathological cardiac hypertrophy is a significant therapeutic goal that can postpone the progression of heart failure. 12 The aim of current pharmacotherapies such as diuretics and

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Effects of regional brain injury on the newborn autonomic nervous system

Cited by 16 publications

References 25 publications

Pattern of brain injury and depressed heart rate variability in newborns with hypoxic ischemic encephalopathy

Pattern of brain injury and depressed heart rate variability in newborns with hypoxic ischemic encephalopathy

The Critical Role of the Central Autonomic Nervous System in Fetal-Neonatal Transition

The protective effect of isosteviol sodium on cardiac function and myocardial remodelling in transverse aortic constriction rat

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