Spectral analysis of heart rate variability reveals an enhanced sympathetic activity in narcolepsy with cataplexy

Grimaldi, Daniela; Pierangeli, Giulia; Barletta, Giorgio; Terlizzi, Rossana; Plazzi, Giuseppe; Cevoli, Sabina; Franceschini, Christian; Montagna, Pasquale; Cortelli, Pietro

doi:10.1016/j.clinph.2010.01.028

Cited by 48 publications

(43 citation statements)

References 18 publications

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“…The lack of variability at HUTT was observed in patients with narcolepsy in which an exaggerated sympathetic nerve activity at rest was postulated [36]. Conversely, the sympathovagal balance in our group was unimpaired at rest, as already described in previous papers [11], but was altered in response to HUTT.…”

Section: Tablesupporting

confidence: 53%

Is autonomic nervous system involved in restless legs syndrome during wakefulness?

et al. 2014

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A B S T R A C TObjective: To investigate cardiovascular autonomic function in patients with restless leg syndrome (RLS) by means of cardiovascular reflexes and heart rate variability (HRV) during wakefulness. Methods: Twelve RLS patients and 14 controls underwent cardiovascular function tests including headup tilt test (HUTT), Valsalva maneuver, deep breathing, hand grip, and cold face. HRV analysis was performed in the frequency domain using both autoregressive (AR) and fast Fourier transform algorithms in rest supine condition and during HUTT.Results: There was a significant increase in systolic blood pressure values in supine rest condition and a trend toward a lower Valsalva ratio in RLS patients with respect to controls. The significant and physiological changes of HRV at HUTT detected in healthy subjects were not found in RLS patients. Conclusion: RLS patients exhibit a tendency toward hypertension, reduced amplitude of both sympathetic and parasympathetic responses at HUTT, as well as blunted parasympathetic drive to blood pressure changes. These findings, if confirmed by more controlled studies, might support the hypothesis of autonomic nervous system involvement during wakefulness and consequently an enhanced cardiovascular risk in RLS.

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Section: Tablesupporting

confidence: 53%

Is autonomic nervous system involved in restless legs syndrome during wakefulness?

et al. 2014

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“…We also did not find evidence of reductions in the magnitude of central autonomic and baroreflex changes in HP, which have been recently reported in narcoleptic patients in association with periodic leg movements during NREMS (9). Some (11,16), but not all (12), studies on narcoleptic patients reported an increased ratio between the low-and the high-frequency spectral power of heart rate variability during wakefulness, indicating a shift toward sympathetic modulation. Unfortunately, this spectral index does not have the same physiological interpretation in mice (18).…”

Section: Discussioncontrasting

confidence: 38%

Control of cardiovascular variability during undisturbed wake-sleep behavior in hypocretin-deficient mice

Silvani

Bastianini

Berteotti

et al. 2012

American Journal of Physiology-Regulatory, Integrative and Comp

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The central neural mechanisms underlying differences in cardiovascular variability between wakefulness, non-rapid-eye-movement sleep (NREMS), and rapid-eye-movement sleep (REMS) remain poorly understood. These mechanisms may involve hypocretin (HCRT)/orexin signaling. HCRT signaling is linked to wake-sleep states, involved in central autonomic control, and impaired in narcoleptic patients. Thus, we investigated whether HCRT signaling plays a role in controlling cardiovascular variability during spontaneous behavior in HCRT-deficient mice. HCRT-ataxin3 transgenic mice lacking HCRT neurons (TG), knockout mice lacking HCRT peptides (KO), and wild-type controls (WT) were instrumented with electrodes for sleep recordings and a telemetric blood pressure transducer. Fluctuations of systolic blood pressure (SBP) and heart period (HP) during undisturbed wake-sleep behavior were analyzed with the sequence technique, cross-correlation functions, and coherent averaging of SBP surges. During NREMS, all mice had lower SBP variability, greater baroreflex contribution to HP control at low frequencies, and greater amplitude of the central autonomic and baroreflex changes in HP associated with SBP surges than during wakefulness. During REMS, all mice had higher SBP variability and depressed central autonomic and baroreflex HP controls relative to NREMS. HP variability during REMS was higher than during NREMS in WT only. TG and KO also had lower amplitude of the cardiac baroreflex response to SBP surges during REMS than WT. These results indicate that chronic lack of HCRT signaling may cause subtle alterations in the control of HP during spontaneous behavior. Conversely, the integrity of HCRT signaling is not necessary for the occurrence of physiological sleep-dependent changes in SBP variability.

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“…Both MSNA and HR values were correlated to hypocretin values in line with a direct effect of hypocretin on autonomic regulation [130]. On the contrary, another two studies using HRV found increased sympathetic-vagal balance during wakefulness preceding sleep [131] and an enhanced sympathetic activity at rest [132] in NT1 patients compared to controls.…”

Section: Accepted Manuscriptmentioning

confidence: 71%

Cardiovascular autonomic dysfunctions and sleep disorders

Calandra-Buonaura

Provini

Guaraldi

et al. 2016

Sleep Medicine Reviews

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Spectral analysis of heart rate variability reveals an enhanced sympathetic activity in narcolepsy with cataplexy

Cited by 48 publications

References 18 publications

Is autonomic nervous system involved in restless legs syndrome during wakefulness?

Is autonomic nervous system involved in restless legs syndrome during wakefulness?

Control of cardiovascular variability during undisturbed wake-sleep behavior in hypocretin-deficient mice

Cardiovascular autonomic dysfunctions and sleep disorders

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