TY - JOUR
T1 - Sympathetic and parasympathetic activities evaluated by heart-rate variability in head injury of various severities
AU - Su, Chain Fa
AU - Kuo, Terry B.
AU - Kuo, Jon Son
AU - Lai, Hsien Yong
AU - Chen, Hsing I.
PY - 2005/6
Y1 - 2005/6
N2 - Objective: To investigate the autonomic function in patients with brain damage of various extents. The purposes were to correlate the parameters derived from spectral analysis of the heart-rate variability (HRV) with the classic Glasgow coma scale (GCS), and to evaluate the possible clinical application of HRV in the autonomic functions in patients with various severities of brain-stem injury. Methods: A total of 90 patients was divided into 5 groups based on the GCS: I: 15, II: 9-14, III: 4-8, no pupil dilatation, IV: 4-8, pupil dilatation, and V: 3, brain death. Electrocardiogram was recorded for frequency-domain analysis of RR intervals. HRV were categorized into the low-frequency (LF, 0.04-0.15 Hz) and high-frequency power (HF, 0.15-0.40 Hz), LF to HF power ratio (LF/HF), normalized powers (LF and HF%). These HRV parameters were correlated with the severity of brain damage. Results: The LF, HF, LF%, and LF/HF in Group I were essentially similar to those in the normal subjects. LF and HF decreased from Group I to IV. All parameters were nearly absent in Group V. Conclusions: The increases in LF% and LF/HF with the decrease in HF indicate augmented sympathetic and attenuated parasympathetic drive. These changes were related to the severity of brain-stem damage. Both LF and HF were nearly abolished in brain death. Significance: Our analysis indicates that HRV may be an useful tool for evaluating the autonomic functions in patients with brain damage of various degrees.
AB - Objective: To investigate the autonomic function in patients with brain damage of various extents. The purposes were to correlate the parameters derived from spectral analysis of the heart-rate variability (HRV) with the classic Glasgow coma scale (GCS), and to evaluate the possible clinical application of HRV in the autonomic functions in patients with various severities of brain-stem injury. Methods: A total of 90 patients was divided into 5 groups based on the GCS: I: 15, II: 9-14, III: 4-8, no pupil dilatation, IV: 4-8, pupil dilatation, and V: 3, brain death. Electrocardiogram was recorded for frequency-domain analysis of RR intervals. HRV were categorized into the low-frequency (LF, 0.04-0.15 Hz) and high-frequency power (HF, 0.15-0.40 Hz), LF to HF power ratio (LF/HF), normalized powers (LF and HF%). These HRV parameters were correlated with the severity of brain damage. Results: The LF, HF, LF%, and LF/HF in Group I were essentially similar to those in the normal subjects. LF and HF decreased from Group I to IV. All parameters were nearly absent in Group V. Conclusions: The increases in LF% and LF/HF with the decrease in HF indicate augmented sympathetic and attenuated parasympathetic drive. These changes were related to the severity of brain-stem damage. Both LF and HF were nearly abolished in brain death. Significance: Our analysis indicates that HRV may be an useful tool for evaluating the autonomic functions in patients with brain damage of various degrees.
KW - Autonomic function
KW - Brain-stem
KW - Critical care
KW - Heart-rate variability
KW - Intracranial hypertension
KW - Power spectral analysis
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U2 - 10.1016/j.clinph.2005.01.010
DO - 10.1016/j.clinph.2005.01.010
M3 - Article
C2 - 15978489
AN - SCOPUS:20544452498
SN - 1388-2457
VL - 116
SP - 1273
EP - 1279
JO - Electroencephalography and Clinical Neurophysiology - Electromyography and Motor Control
JF - Electroencephalography and Clinical Neurophysiology - Electromyography and Motor Control
IS - 6
ER -