Rajan John, Gaur Girwar Singh, Shanmugavel Karthik, S Adinarayanan
Department of Physiology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry 605006, India.
Department of Anesthesiology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry 605006, India.
Korean J Physiol Pharmacol. 2024 May 1;28(3):253-264. doi: 10.4196/kjpp.2024.28.3.253.
Chronic neuropathic pain (CNP) is a complex condition often arising from neural maladaptation after nerve injury. Understanding CNP complications involves the intricate interplay between brain-heart dynamics, assessed through quantitative electroencephalogram (qEEG) and heart rate variability (HRV). However, insights into their interaction in chronic pain are limited. Resting EEG and simultaneous electrocardiogram (lead II) of the participants were recorded for qEEG and HRV analysis. Correlations between HRV and qEEG parameters were calculated and compared with age, sex, and body mass index (BMI)-matched controls. CNP patients showed reduced HRV and significant increases in qEEG power spectral densities within delta, theta, and beta frequency ranges. A positive correlation was found between low frequency/ high frequency (LF/HF) ratio in HRV analysis and theta, alpha, and beta frequency bands in qEEG among CNP patients. However, no significant correlation was observed between parasympathetic indices and theta, beta bands in qEEG within CNP group, unlike age, sex, and BMI-matched healthy controls. CNP patients display significant HRV reductions and distinctive qEEG patterns. While healthy controls exhibit significant correlations between parasympathetic HRV parameters and qEEG spectral densities, these relationships are diminished or absent in CNP individuals. LF/HF ratio, reflecting sympathovagal balance, correlates significantly with qEEG frequency bands (theta, alpha, beta), illuminating autonomic dysregulation in CNP. These findings emphasize the intricate brain-heart interplay in chronic pain, warranting further exploration.
慢性神经病理性疼痛(CNP)是一种复杂的病症,通常由神经损伤后的神经适应不良引起。了解CNP并发症涉及通过定量脑电图(qEEG)和心率变异性(HRV)评估的脑-心动态之间的复杂相互作用。然而,关于它们在慢性疼痛中相互作用的见解有限。记录参与者的静息脑电图和同步心电图(II导联)以进行qEEG和HRV分析。计算HRV与qEEG参数之间的相关性,并与年龄、性别和体重指数(BMI)匹配的对照组进行比较。CNP患者的HRV降低,并且在δ、θ和β频率范围内qEEG功率谱密度显著增加。在CNP患者中,HRV分析中的低频/高频(LF/HF)比值与qEEG中的θ、α和β频段之间存在正相关。然而,与年龄、性别和BMI匹配的健康对照组不同,在CNP组中,副交感神经指标与qEEG中的θ、β频段之间未观察到显著相关性。CNP患者表现出显著的HRV降低和独特的qEEG模式。虽然健康对照组在副交感神经HRV参数与qEEG谱密度之间表现出显著相关性,但在CNP个体中,这些关系减弱或不存在。反映交感-迷走神经平衡的LF/HF比值与qEEG频段(θ、α、β)显著相关,揭示了CNP中的自主神经调节异常。这些发现强调了慢性疼痛中复杂的脑-心相互作用,值得进一步探索。