A systematic review to investigate whether birth weight affects the autonomic nervous system in adulthood / Uma revisão sistemática para investigar se o peso ao nascer afeta o sistema nervoso autônomo na vida adulta

ABSTRACT Objective: To evaluate the relationship between birth weight and the autonomic nervous system in adulthood through a systematic review. Data source: This is a systematic review of publications without limitation of year and language. We included studies involving the autonomic nervous system and birth weight in adults. Manuscripts were selected based on electronic searches of Medical Literature Analysis and Retrieval System Online (MEDLINE), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Web of Science Cochrane Library and Scopus databases, using "Autonomic Nervous System" OR "Heart Rate" OR "Heart Rate Variability" AND "Birth Weight" as a search strategy. This review is registered on the International Prospective Register of Systematic Reviews — PROSPERO (ID: CRD42020165622). Data synthesis: We found 894 articles; 215 were excluded for duplicity. Of the remaining 679 studies, 11 remained. Two were excluded because they did not specifically treat the autonomic nervous system or birth weight. There were nine publications, two cohort and seven cross-sectional studies. The main findings were that extreme, very low, low or high birth weight may have some impact on the autonomic nervous system in adult life. Conclusions: Birth weight outside the normality rate may have a negative influence on the autonomic nervous system, causing autonomic dysfunction and increasing the risk of cardiovascular diseases in adult life. Thus, the importance of the follow-up of health professionals from pregnancy to gestation and throughout life, with preventive care being emphasized.

RESUMO Objetivo: Avaliar a relação entre o peso ao nascer e o sistema nervoso autônomo na vida adulta por meio de uma revisão sistemática. Fontes de dados: Esta é uma revisão sistemática de publicações, sem limitação de ano e idioma. Incluímos estudos envolvendo o sistema nervoso autônomo e peso ao nascer em adultos. Os manuscritos foram selecionados das bases de dados eletrônicos Medical Literature Analysis and Retrieval System Online (MEDLINE), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Web of Science Cochrane Library e Scopus, utilizando "Autonomic Nervous System" OR "Heart Rate" OR "Heart Rate Variability" AND "Birth Weight" como estratégia de busca. Esta revisão está registrada pelo International Prospective Register of Systematic Reviews — PROSPERO (ID: CRD42020165622). Síntese dos dados: Nós encontramos 894 artigos. Deles, 215 foram excluídos por duplicidade. Entre os 679 remanescentes, 11 permaneceram, dos quais dois foram excluídos por não tratarem especificamente do sistema nervoso autônomo ou do peso ao nascer. Restaram nove publicações, sendo duas longitudinais e sete transversais. Os principais achados foram que o peso extremo baixo, muito baixo, baixo ou alto ao nascer pode ter algum impacto no sistema nervoso autônomo na vida adulta. Conclusões: O peso ao nascer fora da normalidade pode influenciar negativamente o sistema nervoso autônomo, causando disfunção autonômica e aumentando o risco de doenças cardiovasculares na vida adulta. Assim, ressalta-se a importância do acompanhamento dos profissionais de saúde desde a gravidez até a gestação, pré-natal e ao longo da vida, com cuidados preventivos para esta situação.

A systematic review to investigate whether birth weight affects the autonomic nervous system in adulthood.

OBJECTIVE: To evaluate the relationship between birth weight and the autonomic nervous system in adulthood through a systematic review. DATA SOURCE: This is a systematic review of publications without limitation of year and language. We included studies involving the autonomic nervous system and birth weight in adults. Manuscripts were selected based on electronic searches of Medical Literature Analysis and Retrieval System Online (MEDLINE), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Web of Science Cochrane Library and Scopus databases, using "Autonomic Nervous System" OR "Heart Rate" OR "Heart Rate Variability" AND "Birth Weight" as a search strategy. This review is registered on the International Prospective Register of Systematic Reviews - PROSPERO (ID: CRD42020165622). DATA SYNTHESIS: We found 894 articles; 215 were excluded for duplicity. Of the remaining 679 studies, 11 remained. Two were excluded because they did not specifically treat the autonomic nervous system or birth weight. There were nine publications, two cohort and seven cross-sectional studies. The main findings were that extreme, very low, low or high birth weight may have some impact on the autonomic nervous system in adult life. CONCLUSIONS: Birth weight outside the normality rate may have a negative influence on the autonomic nervous system, causing autonomic dysfunction and increasing the risk of cardiovascular diseases in adult life. Thus, the importance of the follow-up of health professionals from pregnancy to gestation and throughout life, with preventive care being emphasized.

Parkinson's disease effect on autonomic modulation: an analysis using geometric indices.

BACKGROUND: Parkinson's disease (PD) produces autonomic changes, indicating lower parasympathetic modulation and global variability, but these changes need further studying regarding geometric methods. OBJECTIVE: To investigate the autonomic modulation in individuals with PD using heart rate variability (HRV) indices obtained through geometric methods. METHODS: This is a cross-sectional study that assessed 50 individuals, split into two groups: PD group (PDG; n=26; 75.36±5.21 years) and control group (CG; n=24; 75.36±5.21 years). We evaluated the autonomic modulation by measuring the heart rate beat-to-beat for 30 min with the individual in supine rest using a heart rate monitor and assessed geometric indices (RRtri, TINN, SD1, SD2, SD1/SD2 ratio, and qualitative analysis of the Poincaré plot). RESULTS: Significant reductions were found in RRtri, TINN, SD1, and SD2 indices among PDG compared to CG. Regarding the SD1/SD2 ratio, no significant changes were detected between the groups. The Poincaré plot demonstrated that individuals with PD had lower beat-to-beat dispersion in RR intervals, in addition to greater long-term dispersion of RR intervals compared to CG. CONCLUSIONS: The results suggest a reduction in the parasympathetic autonomic modulation and global variability in individuals with PD compared to controls, regardless of sex, age, and body mass index.

Parkinson's disease effect on autonomic modulation: an analysis using geometric indices / Efeito da doença de Parkinson na modulação autonômica: análise por meio de índices geométricos

ABSTRACT Background: Parkinson's disease (PD) produces autonomic changes, indicating lower parasympathetic modulation and global variability, but these changes need further studying regarding geometric methods. Objective: To investigate the autonomic modulation in individuals with PD using heart rate variability (HRV) indices obtained through geometric methods. Methods: This is a cross-sectional study that assessed 50 individuals, split into two groups: PD group (PDG; n=26; 75.36±5.21 years) and control group (CG; n=24; 75.36±5.21 years). We evaluated the autonomic modulation by measuring the heart rate beat-to-beat for 30 min with the individual in supine rest using a heart rate monitor and assessed geometric indices (RRtri, TINN, SD1, SD2, SD1/SD2 ratio, and qualitative analysis of the Poincaré plot). Results: Significant reductions were found in RRtri, TINN, SD1, and SD2 indices among PDG compared to CG. Regarding the SD1/SD2 ratio, no significant changes were detected between the groups. The Poincaré plot demonstrated that individuals with PD had lower beat-to-beat dispersion in RR intervals, in addition to greater long-term dispersion of RR intervals compared to CG. Conclusions: The results suggest a reduction in the parasympathetic autonomic modulation and global variability in individuals with PD compared to controls, regardless of sex, age, and body mass index.

RESUMO Introdução: A doença de Parkinson (DP) produz alterações autonômicas, que indicam menor modulação parassimpática e variabilidade global, mas que devem ser investigadas quanto aos métodos geométricos. Objetivo: Investigar a modulação autonômica em indivíduos com DP, por meio de índices de variabilidade da frequência cardíaca (VFC) obtidos pelos métodos geométricos. Métodos: Estudo transversal, no qualforam avaliados 50 voluntários, divididos em dois grupos: o grupo doença de Parkinson (GDP; n=26; 75,36±5,21 anos) e o grupo controle (GC; n=24; 75,36±5,21 anos). Para a avaliação da modulação autonômica a frequência cardíaca foi captada batimento a batimento por meio de um cardiofrequencímetro com os indivíduos em decúbito dorsal por 30 min e índices geométricos da VFC foram avaliados (RRtri, TINN, SD1, SD2 e plot de Poincaré). Resultados: Houve reduções nos índices RRtri, TINN, SD1 e SD2 para o GDP em comparação ao GC. Para a relação SD1/SD2, diferenças significantes não foram observadas entre os grupos. O plot de Poincaré mostrou que indivíduos com DP têm menor dispersão batimento a batimento dos intervalos RR, bem como maior dispersão dos intervalos RR a longo prazo em relação ao GC. Conclusão: Os resultados sugerem haver diminuição da modulação autonômica parassimpática e da variabilidade global em indivíduos com DP em relação a indivíduos sem a doença, as quais são independentes de sexo, idade e índice de massa corporal.

Musical auditory stimulus acutely influences heart rate dynamic responses to medication in subjects with well-controlled hypertension.

Music can improve the efficiency of medical treatment when correctly associated with drug action, reducing risk factors involving deteriorating cardiac function. We evaluated the effect of musical auditory stimulus associated with anti-hypertensive medication on heart rate (HR) autonomic control in hypertensive subjects. We evaluated 37 well-controlled hypertensive patients designated for anti-hypertensive medication. Heart rate variability (HRV) was calculated from the HR monitor recordings of two different, randomly sorted protocols (control and music) on two separate days. Patients were examined in a resting condition 10 minutes before medication and 20 minutes, 40 minutes and 60 minutes after oral medication. Music was played throughout the 60 minutes after medication with the same intensity for all subjects in the music protocol. We noted analogous response of systolic and diastolic arterial pressure in both protocols. HR decreased 60 minutes after medication in the music protocol while it remained unchanged in the control protocol. The effects of anti-hypertensive medication on SDNN (Standard deviation of all normal RR intervals), LF (low frequency, nu), HF (high frequency, nu) and alpha-1 scale were more intense in the music protocol. In conclusion, musical auditory stimulus increased HR autonomic responses to anti-hypertensive medication in well-controlled hypertensive subjects.

Symbolic Analysis of Heart Rate Variability During Exposure to Musical Auditory Stimulation.

BACKGROUND: In recent years, the application of nonlinear methods for analysis of heart rate variability (HRV) has increased. However, studies on the influence of music on cardiac autonomic modulation in those circumstances are rare. OBJECTIVE: The research team aimed to evaluate the acute effects on HRV of selected auditory stimulation by 2 musical styles, measuring the results using nonlinear methods of analysis: Shannon entropy, symbolic analysis, and correlation-dimension analysis. DESIGN: Prospective control study in which the volunteers were exposed to music and variables were compared between control (no auditory stimulation) and during exposure to music. SETTING: All procedures were performed in a sound-proofed room at the Faculty of Science and Technology at São Paulo State University (UNESP), São Paulo, Brazil. PARTICIPANTS: Participants were 22 healthy female students, aged between 18 and 30 y. INTERVENTION: Prior to the actual intervention, the participants remained at rest for 20 min, and then they were exposed to one of the selected types of music, either classical baroque (64-84 dB) or heavy-metal (75-84 dB). Each musical session lasted a total of 5 min and 15 s. At a point occurring up to 1 wk after that day, the participants listened to the second type of music. The 2 types of music were delivered in a random sequence that depended on the group to which the participant was assigned. OUTCOME MEASURES: The study analyzed the following HRV indices through Shannon entropy; symbolic analysis-0V%, 1V%, 2LV%, and 2ULV%; and correlation-dimension analysis. RESULTS: During exposure to auditory stimulation by heavy-metal or classical baroque music, the study established no statistically significant variations regarding the indices for the Shannon entropy; the symbolic analysis-0V%, 1V%, and 2ULV%; and the correlation-dimension analysis. However, during heavy-metal music, the 2LV% index in the symbolic analysis was reduced compared with the controls. CONCLUSIONS: Auditory stimulation with the heavy-metal music reduced the parasympathetic modulation of HRV, whereas no significant changes occurred in cardiac autonomic modulation during exposure to the classical music.

The Effects of Musical Auditory Stimulation of Different Intensities on Geometric Indices of Heart Rate Variability.

BACKGROUND: Music has been proven to promote changes in cardiac autonomic modulation. However, it is not clear whether the effects of the auditory stimulation on heart rate variability (HRV) are dependent on its intensity. OBJECTIVE: The study intended to investigate the acute effects on the geometric HRV indices of auditory stimulation with heavy metal and baroque music using different intensities of auditory stimulation. DESIGN: The study was a nonrandomized, clinical trial. SETTING: The study was conducted at the facility of the Faculty of Sciences of the São Paulo State University, on the campus in Marilia, Brazil. PARTICIPANTS: Participants were 24 healthy women aged between 18 and 27 y. INTERVENTION: HRV was recorded for each participant for 10 min at rest. Subsequently, participants were exposed to baroque or heavy metal music through an earphone. They were exposed to 3 equivalent sound levels-60-70 decibels (dB), 70-80 dB, and 80-90 dB-for 5 min in each intensity range. After the first session of baroque or heavy metal music, participants rested for an additional 5 min. Then they were exposed to the other musical style. The first style played for each musical period was randomly selected for all individuals and then the other style would be played automatically for the second session. OUTCOME MEASURES: The HRV analysis was performed using the following geometrical methods: (1) the triangular index (RRtri), (2) the triangular interpolation of the RR interval histogram (TINN), and (3) the Poincaré plot, using SD1-the standard deviation of the instantaneous variability of the beat-to beat heart rate (HR), SD2-the standard deviation of the long-term, continuous, RR interval variability, and the SD1/SD2 ratio-the ratio between the short- and long-term variations among the RR intervals. RESULTS: The classic baroque music by Johann Pachelbel, "Canon in D Major," did not induce significant changes in the geometric indices of HRV at 60-70 dB, 70-80 dB, or 80-90 dB. However, auditory stimulation with heavy metal music, using "Heavy Metal Universe" by Gamma Ray, decreased the RRtri, TINN, and SD2 at 2 specific sound pressures (60-70 dB and 80-90 dB). CONCLUSIONS: Auditory stimulation with the selected baroque music did not alter cardiac autonomic modulation, but the selected, heavy metal style of music in the lower and higher intensities reduced the global component of HRV acutely.