TY - JOUR
T1 - Preserved cardiac autonomic dynamics during sleep in subjects with spinal cord injuries
AU - Tobaldini, Eleonora
AU - Proserpio, Paola
AU - Sambusida, Katrina
AU - Lanza, Andrea
AU - Redaelli, Tiziana
AU - Frigerio, Pamela
AU - Fratticci, Lara
AU - Rosa, Silvia
AU - Casali, Karina R.
AU - Somers, Virend K.
AU - Nobili, Lino
AU - Montano, Nicola
N1 - Funding Information:
Dr. Somers has served as a consultant for Respicardia, Neu Pro, and ResMed and is an investigator on studies funded with grants from the Phillips Respironics Foundation. Other authors have no disclosures.
Funding Information:
Dr. Somers was supported by NIH HL65176 . This publication was also supported by Grant Number UL1 TR000135 from the National Center for Advancing Translational Sciences (NCATS). Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the NIH.
Publisher Copyright:
© 2014 Elsevier B.V.
PY - 2015/6/1
Y1 - 2015/6/1
N2 - Background: Spinal cord injuries (SCI) are associated with altered cardiovascular autonomic control (CAC). Sleep is characterized by modifications of autonomic control across sleep stages; however, no data are available in SCI subjects on CAC during sleep. We aim to assess cardiac autonomic modulation during sleep in subjects with SCI. Patients and methods: 27 participants with a neurological and radiological diagnosis of cervical (Cerv, n = 12, ie, tetraplegic) and thoracic SCI (Thor, n = 15, ie, paraplegic) and healthy subjects (Controls) were enrolled. Overnight polysomnographic (PSG) recordings were obtained in all participants. Electrocardiography and respiration were extracted from PSG, divided into sleep stages [wakefulness (W), non-REM sleep (NREM) and REM] for assessment of CAC, using symbolic analysis (SA) and corrected conditional entropy (CCE). SA identified indices of sympathetic and parasympathetic modulation and CCE evaluated the degree of complexity of the heart period time series. Results: SA revealed a reduction of sympathetic and predominant parasympathetic control during NREM compared to W and REM in SCI patients, independent of the level of the lesion, similar to the Controls. In all three groups, complexity of autonomic regulation was higher in NREM compared to W and REM. Conclusions: In subjects with SCI, cardiac autonomic control changed across sleep stages, with a reduction of sympathetic and an increase of parasympathetic modulation during NREM compared to W and REM, and a parallel increase of complexity during NREM, which was similar to the Controls. Cardiac autonomic dynamics during sleep are maintained in SCI, independent of the level of the lesion.
AB - Background: Spinal cord injuries (SCI) are associated with altered cardiovascular autonomic control (CAC). Sleep is characterized by modifications of autonomic control across sleep stages; however, no data are available in SCI subjects on CAC during sleep. We aim to assess cardiac autonomic modulation during sleep in subjects with SCI. Patients and methods: 27 participants with a neurological and radiological diagnosis of cervical (Cerv, n = 12, ie, tetraplegic) and thoracic SCI (Thor, n = 15, ie, paraplegic) and healthy subjects (Controls) were enrolled. Overnight polysomnographic (PSG) recordings were obtained in all participants. Electrocardiography and respiration were extracted from PSG, divided into sleep stages [wakefulness (W), non-REM sleep (NREM) and REM] for assessment of CAC, using symbolic analysis (SA) and corrected conditional entropy (CCE). SA identified indices of sympathetic and parasympathetic modulation and CCE evaluated the degree of complexity of the heart period time series. Results: SA revealed a reduction of sympathetic and predominant parasympathetic control during NREM compared to W and REM in SCI patients, independent of the level of the lesion, similar to the Controls. In all three groups, complexity of autonomic regulation was higher in NREM compared to W and REM. Conclusions: In subjects with SCI, cardiac autonomic control changed across sleep stages, with a reduction of sympathetic and an increase of parasympathetic modulation during NREM compared to W and REM, and a parallel increase of complexity during NREM, which was similar to the Controls. Cardiac autonomic dynamics during sleep are maintained in SCI, independent of the level of the lesion.
KW - Autonomic nervous system
KW - Entropy measures
KW - Sleep
KW - Spinal cord injury
KW - Symbolic analysis
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U2 - 10.1016/j.sleep.2014.12.023
DO - 10.1016/j.sleep.2014.12.023
M3 - Article
C2 - 25953303
AN - SCOPUS:84938964687
SN - 1389-9457
VL - 16
SP - 779
EP - 784
JO - Sleep Medicine
JF - Sleep Medicine
IS - 6
ER -