Institute of Innovative Health Technologies, Ernst-Abbe-Hochschule Jena, Jena, Germany. Department of Pediatrics, Division of Oncology and Hematology, Charité Universitätsmedizin, Berlin, Germany.
Physiol Meas. 2018 Jul 20;39(7):074004. doi: 10.1088/1361-6579/aace9b.
The new interdisciplinary field of network physiology is increasingly becoming a focus of interest in medicine. Autonomic nervous system (ANS) dysfunction is well described in schizophrenia (SZO). However, the linear and nonlinear coupling between the ANS and central nervous system (CNS) has only been partly addressed until now. This coupling can be assumed to be a feedback-feedforward network, reacting with flexible and adaptive responses to internal and external factors.
For the first time, in this study we investigated linear and nonlinear short-term central-cardiorespiratory coupling of 17 patients suffering from paranoid SZO in comparison to 17 age-gender matched healthy subjects analyzing heart rate (HR), respiration (RESP), and the power of frontal electroencephalogram (EEG) activity (P ). The objective is to determine how the different regulatory aspects of the CNS-ANS affect the central-cardiorespiratory network (CCRN). To quantify these couplings within the CCRN normalized short time partial directed coherence and the new multivariate high-resolution joint symbolic dynamics were applied.
We found that the CCRN in SZO can be characterized as a bidirectional one, with stronger central driving mechanisms (P → HR) towards HR regulation than vice versa, and with stronger respiratory influence (RESP → P ) on central activity than vice versa. This suggests that the central-cardiorespiratory process (closed-loop) is mainly focused on adapting the HR via the sinoatrial node than focusing on respiratory regulation. On the other hand, the feedback-loop from ANS to CNS is strongly dominated via respiratory activity.
We demonstrated a considerably significantly different CCRN structure in SZO with a strong central influence on the cardiac system and a strong respiratory influence on the CNS. Moreover, this study provides a more in-depth understanding of the interplay of the central and autonomic regulatory network in healthy subjects and SZO patients.
网络生理学这一新的跨学科领域正日益成为医学关注的焦点。自主神经系统（ANS）功能障碍在精神分裂症（SZO）中已有很好的描述。然而，直到现在，ANS 和中枢神经系统（CNS）之间的线性和非线性耦合才部分得到解决。这种耦合可以被认为是一个反馈前馈网络，对内部和外部因素做出灵活和自适应的反应。
在这项研究中，我们首次调查了 17 名偏执型 SZO 患者与 17 名年龄和性别匹配的健康受试者之间的线性和非线性短期中枢-心肺耦合，分析心率（HR）、呼吸（RESP）和前额脑电图（EEG）活动的功率（P）。目的是确定 CNS-ANS 的不同调节方面如何影响中枢-心肺网络（CCRN）。为了在 CCRN 中量化这些耦合，应用了归一化短期偏部分向相干性和新的多变量高分辨率联合符号动力学。
我们发现 SZO 中的 CCRN 可以被描述为一个双向的网络，中心驱动机制（P → HR）对 HR 调节的影响大于相反方向，呼吸对中央活动的影响大于相反方向。这表明中心-心肺过程（闭环）主要集中在通过窦房结适应 HR，而不是专注于呼吸调节。另一方面，来自 ANS 到 CNS 的反馈环主要受呼吸活动的支配。
我们在 SZO 中展示了一个明显不同的 CCRN 结构，其中中心对心脏系统的影响很强，而呼吸对 CNS 的影响很强。此外，这项研究提供了对健康受试者和 SZO 患者中枢和自主调节网络相互作用的更深入了解。
