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帕金森病患者在重复短期干浸过程中的自主神经功能:来自线性和非线性心率变异性参数的证据。

Autonomic Function in Parkinson's Disease Subjects Across Repeated Short-Term Dry Immersion: Evidence From Linear and Non-linear HRV Parameters.

作者信息

Gerasimova-Meigal Liudmila, Meigal Alexander, Sireneva Nadezhda, Saenko Irina

机构信息

Department of Physiology and Pathophysiology, Petrozavodsk State University, Petrozavodsk, Russia.

Institute of Biomedical Problems, Russian Academy of Sciences (RAS), Moscow, Russia.

出版信息

Front Physiol. 2021 Oct 6;12:712365. doi: 10.3389/fphys.2021.712365. eCollection 2021.

Abstract

Several studies have shown that "dry" immersion appears as a promising method of rehabilitation for Parkinson's disease. Still, little is known about the cardiovascular reaction in "dry" immersion (DI), especially in Parkinson's disease (PD). Therefore, this study was aimed to evaluate the effect of repeated 45-min DI sessions on autonomic function in subjects with PD. The study group consisted of 20 subjects with PD [13 men, seven women, aged 51-66 years old, Hoehn & Yahr (H&Y) staged 1-3] were enrolled in the study according to inclusion and non-inclusion criteria. The DI program was comprised of seven 45-min DI sessions, applied within 25-30 days. Blood pressure (BP), heart rate (HR), and electrocardiogram (ECG) in the standard lead II were recorded at 1st, 4th, and 7th DI, before, on the 15, 30, and 40th min of DI session. Autonomic function was assessed with analysis of heart rate variability (HRV) using Kubios Standard version 2 software. Linear (time- and frequency-domain) and non-linear (correlation dimension, entropies, DFA1 and DFA2, percent of determinism, and recurrence) were computed. At baseline condition, time- and frequency-domain HRV parameters showed low variability of HR, which indicates reduced autonomic neurogenic control of HR. Throughout the DI session, systolic and diastolic BP has decreased by 5-7 mm Hg ( < 0.001), and time- and frequency-domain parameters of HRV have significantly increased, what can be regarded as compensatory mechanisms of hemodynamics during DI. The structure of the regulatory input to the heart seen by HRV was characterized by low complexity and reduced autonomic neurogenic control of HR. Across the program of DI sessions, the hypotensive effect was documented, but no notable modification of the HRV-parameters was found. The absence of long-term modification of the studied parameters can be attributed both to deconditioning environmental effect of DI and limited adaptation of the organism due to neurodegeneration in PD. That should be taken into consideration when planning rehabilitation measures in subjects of older age and chronic somatic diseases with modeled microgravity.

摘要

多项研究表明,“干式”浸入似乎是一种很有前景的帕金森病康复方法。然而,人们对“干式”浸入(DI)中的心血管反应知之甚少,尤其是在帕金森病(PD)患者中。因此,本研究旨在评估重复进行45分钟DI疗程对PD患者自主神经功能的影响。研究组由20名PD患者组成[13名男性,7名女性,年龄51 - 66岁,Hoehn & Yahr(H&Y)分级为1 - 3级],根据纳入和排除标准纳入研究。DI方案包括七个45分钟的DI疗程,在25 - 30天内进行。在第1次、第4次和第7次DI时,以及在DI疗程的第15、30和40分钟时,记录标准II导联的血压(BP)、心率(HR)和心电图(ECG)。使用Kubios Standard version 2软件通过分析心率变异性(HRV)来评估自主神经功能。计算线性(时域和频域)和非线性(关联维数、熵、DFA1和DFA2、确定性百分比和递归)参数。在基线状态下,时域和频域HRV参数显示HR变异性较低,这表明对HR的自主神经源性控制降低。在整个DI疗程中,收缩压和舒张压下降了5 - 7 mmHg(<0.001),HRV的时域和频域参数显著增加,这可被视为DI期间血流动力学的代偿机制。HRV所见的心脏调节输入结构的特点是复杂性低且对HR的自主神经源性控制降低。在整个DI疗程中,记录到了降压效果,但未发现HRV参数有明显改变。所研究参数缺乏长期改变可能归因于DI的去适应环境效应以及由于PD中的神经退行性变导致机体的适应性有限。在为老年和患有模拟微重力的慢性躯体疾病的受试者规划康复措施时应考虑到这一点。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/74ad/8526731/657bf92c1f60/fphys-12-712365-g0001.jpg

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