Heart rate variability as a biomarker for autonomic nervous system response differences between children with chronic pain and healthy control children
Evans, Subhadra, Seidman, Laura C., Tsao, Jennie C. I., Lung, Kirsten C., Zeltzer, Lonnie K. and Naliboff, Bruce D. 2013, Heart rate variability as a biomarker for autonomic nervous system response differences between children with chronic pain and healthy control children, Journal of pain research, vol. 6, pp. 449-457, doi: 10.2147/JPR.S43849.
Studies in adults have demonstrated a relationship between lowered heart rate variability (HRV) and poor health. However, less is known about the role of autonomic arousal in children's well-being. The aim of the current study was to examine resting HRV in children with chronic pain compared to healthy control children and, further, to examine children's HRV following a series of acute experimental pain tasks in both groups. Participants included 104 healthy control children and 48 children with chronic pain aged 8-17 years. The laboratory session involved a 5-minute baseline electrocardiogram followed by four pain induction tasks: evoked pressure, cold pressor, focal pressure, and a conditioned pain modulation task. After the tasks were complete, a 5-minute post-task electrocardiogram recording was taken. Spectral analysis was used to capture high-frequency normalized power and the ratio of low-to-high frequency band power, signifying cardiac vagal tone and sympathetic balance, respectively. Results revealed that children with chronic pain had significantly lower resting HRV (signified by low high-frequency normalized power and high ratio of low-to-high frequency band power) compared to healthy children; moreover, a significant interaction between groups and time revealed that children with chronic pain displayed a static HRV response to the pain session compared to healthy children, whose HRV was reduced concomitant with the pain session. These findings suggest that children with chronic pain may have a sustained stress response with minimal variability in response to new acute pain stressors.
Field of Research
111499 Paediatrics and Reproductive Medicine not elsewhere classified 1103 Clinical Sciences 1115 Pharmacology And Pharmaceutical Sciences
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