Preserved cardiac autonomic dynamics during sleep in subjects with spinal cord injuries

Preserved cardiac autonomic dynamics during sleep in subjects with spinal cord injuries

Autor Tobaldini, Eleonora Google Scholar
Proserpio, Paola Google Scholar
Sambusida, Katrina Google Scholar
Lanza, Andrea Google Scholar
Redaelli, Tiziana Google Scholar
Frigerio, Pamela Google Scholar
Fratticci, Lara Google Scholar
Rosa, Silvia Google Scholar
Casali, Karina R. Autor UNIFESP Google Scholar
Somers, Virend K. Google Scholar
Nobili, Lino Google Scholar
Montano, Nicola Google Scholar
Instituição Ca Granda IRCCS Fdn
Univ Milan
Mayo Clin & Mayo Fdn
Osped Niguarda Ca Granda
L Sacco Hosp Vialba
Universidade Federal de São Paulo (UNIFESP)
Resumo 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. (C) 2014 Elsevier B.V. All rights reserved.
Assunto Sleep
Spinal cord injury
Autonomic nervous system
Symbolic analysis
Entropy measures
Idioma Inglês
Financiador NIH
National Center for Advancing Translational Sciences (NCATS)
Número do financiamento NIH: HL65176
National Center for Advancing Translational Sciences (NCATS): UL1 TR000135
Data 2015-06-01
Publicado em Sleep Medicine. Amsterdam: Elsevier B.V., v. 16, n. 6, p. 779-784, 2015.
ISSN 1389-9457 (Sherpa/Romeo, fator de impacto)
Editor Elsevier B.V.
Extensão 779-784
Fonte http://dx.doi.org/10.1016/j.sleep.2014.12.023
Direito de acesso Acesso restrito
Tipo Artigo
Web of Science WOS:000355136200016
URI http://repositorio.unifesp.br/handle/11600/39133

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