Effects of a startle on heart rate in patients with multiple system atrophy
Identifieur interne : 004482 ( Main/Exploration ); précédent : 004481; suivant : 004483Effects of a startle on heart rate in patients with multiple system atrophy
Auteurs : Josep Valls-Solé [Espagne] ; Misericordia Veciana [Espagne] ; Lucia Leon [Espagne] ; Francesc Valldeoriola [Espagne]Source :
- Movement Disorders [ 0885-3185 ] ; 2002-05.
English descriptors
- KwdEn :
- Acoustic Stimulation, Autonomic Nervous System (physiopathology), Electrocardiography, Female, Heart Rate, Humans, Male, Middle Aged, Multiple System Atrophy (physiopathology), Multiple System Atrophy (psychology), Reflex, Startle, autonomic function, bradykinesia, brainstem, heart rate, multiple system atrophy, startle.
- MESH :
- physiopathology : Autonomic Nervous System, Multiple System Atrophy.
- psychology : Multiple System Atrophy.
- Acoustic Stimulation, Electrocardiography, Female, Heart Rate, Humans, Male, Middle Aged, Reflex, Startle.
Abstract
The patient cooperation usually required for neurophysiological assessment of autonomic cardioregulatory function is difficult to obtain from patients with bradykinesia. A particularly interesting condition occurs in multiple system atrophy (MSA), which features both bradykinesia and autonomic dysfunction. Another characteristic of patients with MSA is their normal motor reaction to a startling stimulus. We used startle as a stimulus for testing autonomic cardioregulatory function in patients with MSA, thus avoiding the need for patient cooperation. In 10 healthy volunteers and 8 MSA patients, we recorded the electrocardiographic QRS complex with surface electrodes attached over the chest and delivered an acoustic startle stimulus after 8 seconds of baseline recording. We calculated the ratio between the pre‐stimulus and the post‐stimulus heart beat intervals (R–R ratio) by dividing the mean prestimulus R–R interval by the shortest R–R interval obtained within 10 seconds poststimulus. Healthy volunteers had a significant shortening of the R–R interval. The peak of the effect occurred after 2 to 5 seconds, with a mean R–R ratio of 1.14 (S.D. = 0.09). In contrast, R–R shortening was markedly reduced in patients, even though they had a normal motor response. The mean R–R ratio in patients was 1.03 (S.D. = 0.03), significantly lower than in healthy volunteers (P < 0.01). Our results demonstrate an abnormally reduced modulation of the heart beat frequency in patients with MSA, compatible with a dysfunction on pathways responsible for autonomic regulation. The method described here may be useful in the assessment of cardioregulatory function in poorly cooperative patients with normal startle responses. © 2002 Movement Disorder Society
Url:
DOI: 10.1002/mds.10093
Affiliations:
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Le document en format XML
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<term>Multiple System Atrophy (psychology)</term>
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<front><div type="abstract" xml:lang="en">The patient cooperation usually required for neurophysiological assessment of autonomic cardioregulatory function is difficult to obtain from patients with bradykinesia. A particularly interesting condition occurs in multiple system atrophy (MSA), which features both bradykinesia and autonomic dysfunction. Another characteristic of patients with MSA is their normal motor reaction to a startling stimulus. We used startle as a stimulus for testing autonomic cardioregulatory function in patients with MSA, thus avoiding the need for patient cooperation. In 10 healthy volunteers and 8 MSA patients, we recorded the electrocardiographic QRS complex with surface electrodes attached over the chest and delivered an acoustic startle stimulus after 8 seconds of baseline recording. We calculated the ratio between the pre‐stimulus and the post‐stimulus heart beat intervals (R–R ratio) by dividing the mean prestimulus R–R interval by the shortest R–R interval obtained within 10 seconds poststimulus. Healthy volunteers had a significant shortening of the R–R interval. The peak of the effect occurred after 2 to 5 seconds, with a mean R–R ratio of 1.14 (S.D. = 0.09). In contrast, R–R shortening was markedly reduced in patients, even though they had a normal motor response. The mean R–R ratio in patients was 1.03 (S.D. = 0.03), significantly lower than in healthy volunteers (P < 0.01). Our results demonstrate an abnormally reduced modulation of the heart beat frequency in patients with MSA, compatible with a dysfunction on pathways responsible for autonomic regulation. The method described here may be useful in the assessment of cardioregulatory function in poorly cooperative patients with normal startle responses. © 2002 Movement Disorder Society</div>
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