Article (Scientific journals)
Heart Rate Variability as an indicator of nociceptive pain in disorders of consciousness?
Riganello, Francesco; Chatelle, Camille; Schnakers, Caroline et al.
2018In Journal of Pain and Symptom Management
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Keywords :
brain-heart integration; Disorders of Consciousness; heart rate variability
Abstract :
[en] CONTEXT: Heart rate variability (HRV) is thought to reflect the affective and physiological aspects of pain and is emerging as a possible descriptor of the functional brain organization contributing to homeostasis. OBJECTIVES: To investigate whether the short-term Complexity Index (CIs; short-term Complexity Index), a measure of HRV complexity, is useful to discriminate responses to potentially noxious and non-noxious stimulation in patients with different levels of consciousness. METHODS: Twenty-two patients (11 minimally conscious state [MCS], 11 vegetative state/unresponsive wakefulness syndrome [VS/UWS]) and 14 healthy controls [HC] were enrolled. We recorded the electrocardiographic response and calculated the CIs before (baseline), during, and following non-noxious and noxious stimulation. Mann-Whitney and Wilcoxon's tests were used to investigate differences in CIs according to the level of consciousness (i.e., HC vs patients and VS/UWS vs MCS) and the three conditions (i.e., baseline, non-noxious, noxious). The correlation between the three conditions and the Coma Recovery Scale-Revised (CRS-R) was investigated by Spearman's correlations. RESULTS: We observed higher CIs values in HC as compared with patients during baseline (p<.034) and following the noxious stimulation (p<.0001). We also found higher values in MCS vs VS/UWS patients following the noxious condition (p<.001) and lower values in the noxious vs non-noxious condition solely for the VS/UWS group (p<.007). A correlation was found between CIs in noxious condition and CRS-R scores. CONCLUSION: Our results suggest a less complex autonomic response to noxious stimuli in VS/UWS patients. Such method may help to better understand sympathovagal response to potentially painful stimulation in brain-injured patients.
Disciplines :
Neurology
Author, co-author :
Riganello, Francesco  ;  Université de Liège - ULiège > Doct. sc. méd. (paysage)
Chatelle, Camille  ;  Université de Liège - ULiège > GIGA : Coma Group
Schnakers, Caroline;  University of California, Los Angeles - UCLA > Neurosurgery > PhD
LAUREYS, Steven  ;  Centre Hospitalier Universitaire de Liège - CHU > Département de médecine interne > Coma Science Group
 These authors have contributed equally to this work.
Language :
English
Title :
Heart Rate Variability as an indicator of nociceptive pain in disorders of consciousness?
Publication date :
2018
Journal title :
Journal of Pain and Symptom Management
ISSN :
0885-3924
eISSN :
1873-6513
Publisher :
Elsevier
Peer reviewed :
Peer Reviewed verified by ORBi
Available on ORBi :
since 14 November 2018

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