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Heart Rate Variability as an indicator of nociceptive pain in disorders of consciousness?

Riganello, Francesco; Chatelle, Camille; Schnakers, Caroline et al.

2018 • In Journal of Pain and Symptom Management

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https://hdl.handle.net/2268/229338

DOI
10.1016/j.jpainsymman.2018.09.016

PubMed
30267843

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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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Scopus citations^®

25

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16

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14

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