Preserved cardiac autonomic dynamics during sleep in subjects with spinal cord injuries

Eleonora Tobaldini, Paola Proserpio, Katrina Sambusida, Andrea Lanza, Tiziana Redaelli, Pamela Frigerio, Lara Fratticci, Silvia Rosa, Karina R. Casali, Virend K. Somers, Lino Nobili, Nicola Montano

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Background: Spinal cord injuries (SCI) are associated with altered cardiovascular autonomic control (CAC). Sleep is characterized by modifications of autonomic control across sleep stages; however, no data are available in SCI subjects on CAC during sleep. We aim to assess cardiac autonomic modulation during sleep in subjects with SCI. Patients and methods: 27 participants with a neurological and radiological diagnosis of cervical (Cerv, n = 12, ie, tetraplegic) and thoracic SCI (Thor, n = 15, ie, paraplegic) and healthy subjects (Controls) were enrolled. Overnight polysomnographic (PSG) recordings were obtained in all participants. Electrocardiography and respiration were extracted from PSG, divided into sleep stages [wakefulness (W), non-REM sleep (NREM) and REM] for assessment of CAC, using symbolic analysis (SA) and corrected conditional entropy (CCE). SA identified indices of sympathetic and parasympathetic modulation and CCE evaluated the degree of complexity of the heart period time series. Results: SA revealed a reduction of sympathetic and predominant parasympathetic control during NREM compared to W and REM in SCI patients, independent of the level of the lesion, similar to the Controls. In all three groups, complexity of autonomic regulation was higher in NREM compared to W and REM. Conclusions: In subjects with SCI, cardiac autonomic control changed across sleep stages, with a reduction of sympathetic and an increase of parasympathetic modulation during NREM compared to W and REM, and a parallel increase of complexity during NREM, which was similar to the Controls. Cardiac autonomic dynamics during sleep are maintained in SCI, independent of the level of the lesion.

Original languageEnglish
Pages (from-to)779-784
Number of pages6
JournalSleep Medicine
Volume16
Issue number6
DOIs
Publication statusPublished - Jun 1 2015

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Spinal Cord Injuries
Sleep
Sleep Stages
Entropy
Thoracic Injuries
Wakefulness
REM Sleep
Healthy Volunteers
Electrocardiography
Respiration

Keywords

  • Autonomic nervous system
  • Entropy measures
  • Sleep
  • Spinal cord injury
  • Symbolic analysis

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Preserved cardiac autonomic dynamics during sleep in subjects with spinal cord injuries. / Tobaldini, Eleonora; Proserpio, Paola; Sambusida, Katrina; Lanza, Andrea; Redaelli, Tiziana; Frigerio, Pamela; Fratticci, Lara; Rosa, Silvia; Casali, Karina R.; Somers, Virend K.; Nobili, Lino; Montano, Nicola.

In: Sleep Medicine, Vol. 16, No. 6, 01.06.2015, p. 779-784.

Research output: Contribution to journalArticle

Tobaldini, E, Proserpio, P, Sambusida, K, Lanza, A, Redaelli, T, Frigerio, P, Fratticci, L, Rosa, S, Casali, KR, Somers, VK, Nobili, L & Montano, N 2015, 'Preserved cardiac autonomic dynamics during sleep in subjects with spinal cord injuries', Sleep Medicine, vol. 16, no. 6, pp. 779-784. https://doi.org/10.1016/j.sleep.2014.12.023
Tobaldini, Eleonora ; Proserpio, Paola ; Sambusida, Katrina ; Lanza, Andrea ; Redaelli, Tiziana ; Frigerio, Pamela ; Fratticci, Lara ; Rosa, Silvia ; Casali, Karina R. ; Somers, Virend K. ; Nobili, Lino ; Montano, Nicola. / Preserved cardiac autonomic dynamics during sleep in subjects with spinal cord injuries. In: Sleep Medicine. 2015 ; Vol. 16, No. 6. pp. 779-784.
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abstract = "Background: Spinal cord injuries (SCI) are associated with altered cardiovascular autonomic control (CAC). Sleep is characterized by modifications of autonomic control across sleep stages; however, no data are available in SCI subjects on CAC during sleep. We aim to assess cardiac autonomic modulation during sleep in subjects with SCI. Patients and methods: 27 participants with a neurological and radiological diagnosis of cervical (Cerv, n = 12, ie, tetraplegic) and thoracic SCI (Thor, n = 15, ie, paraplegic) and healthy subjects (Controls) were enrolled. Overnight polysomnographic (PSG) recordings were obtained in all participants. Electrocardiography and respiration were extracted from PSG, divided into sleep stages [wakefulness (W), non-REM sleep (NREM) and REM] for assessment of CAC, using symbolic analysis (SA) and corrected conditional entropy (CCE). SA identified indices of sympathetic and parasympathetic modulation and CCE evaluated the degree of complexity of the heart period time series. Results: SA revealed a reduction of sympathetic and predominant parasympathetic control during NREM compared to W and REM in SCI patients, independent of the level of the lesion, similar to the Controls. In all three groups, complexity of autonomic regulation was higher in NREM compared to W and REM. Conclusions: In subjects with SCI, cardiac autonomic control changed across sleep stages, with a reduction of sympathetic and an increase of parasympathetic modulation during NREM compared to W and REM, and a parallel increase of complexity during NREM, which was similar to the Controls. Cardiac autonomic dynamics during sleep are maintained in SCI, independent of the level of the lesion.",
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AU - Tobaldini, Eleonora

AU - Proserpio, Paola

AU - Sambusida, Katrina

AU - Lanza, Andrea

AU - Redaelli, Tiziana

AU - Frigerio, Pamela

AU - Fratticci, Lara

AU - Rosa, Silvia

AU - Casali, Karina R.

AU - Somers, Virend K.

AU - Nobili, Lino

AU - Montano, Nicola

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N2 - Background: Spinal cord injuries (SCI) are associated with altered cardiovascular autonomic control (CAC). Sleep is characterized by modifications of autonomic control across sleep stages; however, no data are available in SCI subjects on CAC during sleep. We aim to assess cardiac autonomic modulation during sleep in subjects with SCI. Patients and methods: 27 participants with a neurological and radiological diagnosis of cervical (Cerv, n = 12, ie, tetraplegic) and thoracic SCI (Thor, n = 15, ie, paraplegic) and healthy subjects (Controls) were enrolled. Overnight polysomnographic (PSG) recordings were obtained in all participants. Electrocardiography and respiration were extracted from PSG, divided into sleep stages [wakefulness (W), non-REM sleep (NREM) and REM] for assessment of CAC, using symbolic analysis (SA) and corrected conditional entropy (CCE). SA identified indices of sympathetic and parasympathetic modulation and CCE evaluated the degree of complexity of the heart period time series. Results: SA revealed a reduction of sympathetic and predominant parasympathetic control during NREM compared to W and REM in SCI patients, independent of the level of the lesion, similar to the Controls. In all three groups, complexity of autonomic regulation was higher in NREM compared to W and REM. Conclusions: In subjects with SCI, cardiac autonomic control changed across sleep stages, with a reduction of sympathetic and an increase of parasympathetic modulation during NREM compared to W and REM, and a parallel increase of complexity during NREM, which was similar to the Controls. Cardiac autonomic dynamics during sleep are maintained in SCI, independent of the level of the lesion.

AB - Background: Spinal cord injuries (SCI) are associated with altered cardiovascular autonomic control (CAC). Sleep is characterized by modifications of autonomic control across sleep stages; however, no data are available in SCI subjects on CAC during sleep. We aim to assess cardiac autonomic modulation during sleep in subjects with SCI. Patients and methods: 27 participants with a neurological and radiological diagnosis of cervical (Cerv, n = 12, ie, tetraplegic) and thoracic SCI (Thor, n = 15, ie, paraplegic) and healthy subjects (Controls) were enrolled. Overnight polysomnographic (PSG) recordings were obtained in all participants. Electrocardiography and respiration were extracted from PSG, divided into sleep stages [wakefulness (W), non-REM sleep (NREM) and REM] for assessment of CAC, using symbolic analysis (SA) and corrected conditional entropy (CCE). SA identified indices of sympathetic and parasympathetic modulation and CCE evaluated the degree of complexity of the heart period time series. Results: SA revealed a reduction of sympathetic and predominant parasympathetic control during NREM compared to W and REM in SCI patients, independent of the level of the lesion, similar to the Controls. In all three groups, complexity of autonomic regulation was higher in NREM compared to W and REM. Conclusions: In subjects with SCI, cardiac autonomic control changed across sleep stages, with a reduction of sympathetic and an increase of parasympathetic modulation during NREM compared to W and REM, and a parallel increase of complexity during NREM, which was similar to the Controls. Cardiac autonomic dynamics during sleep are maintained in SCI, independent of the level of the lesion.

KW - Autonomic nervous system

KW - Entropy measures

KW - Sleep

KW - Spinal cord injury

KW - Symbolic analysis

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