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Adynamic response to cold pain reflects dysautonomia in type 1 diabetes and polyneuropathy

Cardiac autonomic neuropathy (CAN), widely assessed by heart rate variability (HRV), is a common complication of long-term diabetes. We hypothesized that HRV dynamics during tonic cold pain in individuals with type 1 diabetes mellitus (T1DM) could potentially demask CAN. Forty-eight individuals with...

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Autores principales: Arendt Nielsen, Thomas, Lundbye-Christensen, Søren, Krasimirova Dimitrova, Yoanna, Riahi, Sam, Brock, Birgitte, Mohr Drewes, Asbjørn, Brock, Christina
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group UK 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10344906/
https://www.ncbi.nlm.nih.gov/pubmed/37443134
http://dx.doi.org/10.1038/s41598-023-37617-9
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author Arendt Nielsen, Thomas
Lundbye-Christensen, Søren
Krasimirova Dimitrova, Yoanna
Riahi, Sam
Brock, Birgitte
Mohr Drewes, Asbjørn
Brock, Christina
author_facet Arendt Nielsen, Thomas
Lundbye-Christensen, Søren
Krasimirova Dimitrova, Yoanna
Riahi, Sam
Brock, Birgitte
Mohr Drewes, Asbjørn
Brock, Christina
author_sort Arendt Nielsen, Thomas
collection PubMed
description Cardiac autonomic neuropathy (CAN), widely assessed by heart rate variability (HRV), is a common complication of long-term diabetes. We hypothesized that HRV dynamics during tonic cold pain in individuals with type 1 diabetes mellitus (T1DM) could potentially demask CAN. Forty-eight individuals with long-term T1DM and distal symmetrical polyneuropathy and 21 healthy controls were included. HRV measures were retrieved from 24-h electrocardiograms. Moreover, ultra-short-term HRV recordings were used to assess the dynamic response to the immersion of the hand into 2 °C cold water for 120 s. Compared to healthy, the T1DM group had expectedly lower 24-h HRV measures for most components (p < 0.01), indicating dysautonomia. In the T1DM group, exposure to cold pain caused diminished sympathetic (p < 0.001) and adynamic parasympathetic (p < 0.01) HRV responses. Furthermore, compared to healthy, cold pain exposure caused lower parasympathetic (RMSSD: 4% vs. 20%; p = 0.002) and sympathetic responses (LF: 11% vs. 73%; p = 0.044) in the T1MD group. QRISK3-scores are negatively correlated with HRV measures in 24-h and ultra-short-term recordings. In T1DM, an attenuated sympathovagal response was shown as convincingly adynamic parasympathetic responses and diminished sympathetic adaptability, causing chronometric heart rhythm and rigid neurocardiac regulation threatening homeostasis. The findings associate with an increased risk of cardiovascular disease, emphasizing clinical relevance.
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spelling pubmed-103449062023-07-15 Adynamic response to cold pain reflects dysautonomia in type 1 diabetes and polyneuropathy Arendt Nielsen, Thomas Lundbye-Christensen, Søren Krasimirova Dimitrova, Yoanna Riahi, Sam Brock, Birgitte Mohr Drewes, Asbjørn Brock, Christina Sci Rep Article Cardiac autonomic neuropathy (CAN), widely assessed by heart rate variability (HRV), is a common complication of long-term diabetes. We hypothesized that HRV dynamics during tonic cold pain in individuals with type 1 diabetes mellitus (T1DM) could potentially demask CAN. Forty-eight individuals with long-term T1DM and distal symmetrical polyneuropathy and 21 healthy controls were included. HRV measures were retrieved from 24-h electrocardiograms. Moreover, ultra-short-term HRV recordings were used to assess the dynamic response to the immersion of the hand into 2 °C cold water for 120 s. Compared to healthy, the T1DM group had expectedly lower 24-h HRV measures for most components (p < 0.01), indicating dysautonomia. In the T1DM group, exposure to cold pain caused diminished sympathetic (p < 0.001) and adynamic parasympathetic (p < 0.01) HRV responses. Furthermore, compared to healthy, cold pain exposure caused lower parasympathetic (RMSSD: 4% vs. 20%; p = 0.002) and sympathetic responses (LF: 11% vs. 73%; p = 0.044) in the T1MD group. QRISK3-scores are negatively correlated with HRV measures in 24-h and ultra-short-term recordings. In T1DM, an attenuated sympathovagal response was shown as convincingly adynamic parasympathetic responses and diminished sympathetic adaptability, causing chronometric heart rhythm and rigid neurocardiac regulation threatening homeostasis. The findings associate with an increased risk of cardiovascular disease, emphasizing clinical relevance. Nature Publishing Group UK 2023-07-13 /pmc/articles/PMC10344906/ /pubmed/37443134 http://dx.doi.org/10.1038/s41598-023-37617-9 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Article
Arendt Nielsen, Thomas
Lundbye-Christensen, Søren
Krasimirova Dimitrova, Yoanna
Riahi, Sam
Brock, Birgitte
Mohr Drewes, Asbjørn
Brock, Christina
Adynamic response to cold pain reflects dysautonomia in type 1 diabetes and polyneuropathy
title Adynamic response to cold pain reflects dysautonomia in type 1 diabetes and polyneuropathy
title_full Adynamic response to cold pain reflects dysautonomia in type 1 diabetes and polyneuropathy
title_fullStr Adynamic response to cold pain reflects dysautonomia in type 1 diabetes and polyneuropathy
title_full_unstemmed Adynamic response to cold pain reflects dysautonomia in type 1 diabetes and polyneuropathy
title_short Adynamic response to cold pain reflects dysautonomia in type 1 diabetes and polyneuropathy
title_sort adynamic response to cold pain reflects dysautonomia in type 1 diabetes and polyneuropathy
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10344906/
https://www.ncbi.nlm.nih.gov/pubmed/37443134
http://dx.doi.org/10.1038/s41598-023-37617-9
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