Zhang Chao, Xu Hai-Peng, Zheng Hui-Fang, Wu Xiao-Lian, Du Hong-Gen, Jin Xin
Department of Rehabilitation, The First Affiliated Hospital of Zhejiang University of Traditional Chinese Medicine, Hangzhou, Zhejiang, China.
Department of Tuina, The First Affiliated Hospital of Zhejiang University of Traditional Chinese Medicine, Hangzhou, Zhejiang, China.
PLoS One. 2025 Jul 2;20(7):e0326357. doi: 10.1371/journal.pone.0326357. eCollection 2025.
This study investigates heart rate variability (HRV) in chronic nonspecific neck pain (CNNP) patients, revealing reduced HRV linked to pain intensity, anxiety, and cervical instability, and proposes HRV as an objective biomarker for comprehensive CNNP assessment.
According to the inclusion and exclusion criteria, 80 patients were included in the experimental group. In addition, 80 healthy individuals matched for age, sex, and other basic information were selected as the control group. The clinical outcome of patients was assessed using the visual analog scale and the self-rating anxiety scale. Subsequently, imaging studies were performed to assess cervical stability (atlantoaxial deviation, axis rotation), osteophytes, physiologic curvature, and disc herniation in patients. The frequency domain (low frequency, high frequency, and their ratio) and time domain (standard deviation of all normal-to-normal QRS intervals) HRV indexes were obtained from all subjects using the heart rate meters.
All HRV indexes were significantly lower in patients compared to controls, and pain and anxiety further reduced HRV indexes in patients. Pain intensity, anxiety, and disc herniation were significantly correlated with all the HRV indexes. Mild instability was not correlated with the HRV, but instability reaching a certain level (atlantoaxial deviation >0.1 mm or rotation of the axis >2 mm) was significantly correlated with the HRV indexes.
Chronic nonspecific neck pain associated with autonomic nervous system dysfunction, and heart rate variability provides an objective and comprehensive assessment of chronic nonspecific neck pain.
本研究调查慢性非特异性颈部疼痛（CNNP）患者的心率变异性（HRV），发现HRV降低与疼痛强度、焦虑及颈椎不稳定有关，并提出HRV作为全面评估CNNP的客观生物标志物。
根据纳入和排除标准，80例患者被纳入实验组。此外，选取80名年龄、性别及其他基本信息匹配的健康个体作为对照组。采用视觉模拟量表和自评焦虑量表评估患者的临床结局。随后，进行影像学研究以评估患者的颈椎稳定性（寰枢椎偏移、枢椎旋转）\u3001骨赘、生理曲度和椎间盘突出。使用心率仪从所有受试者获取频域（低频、高频及其比值）和时域（所有正常QRS波间期的标准差）HRV指标。
与对照组相比，患者的所有HRV指标均显著降低，且疼痛和焦虑进一步降低了患者的HRV指标。疼痛强度、焦虑和椎间盘突出与所有HRV指标均显著相关。轻度不稳定与HRV无关，但不稳定达到一定程度（寰枢椎偏移>0.1毫米或枢椎旋转>2毫米）与HRV指标显著相关。
慢性非特异性颈部疼痛与自主神经系统功能障碍有关，心率变异性为慢性非特异性颈部疼痛提供了客观全面的评估。
