Adolescents with DGBI had significantly reduced 24-hour HRV (RMSSD 29.3 ms vs 54.6 ms in controls, p < 0.001) and blunted nocturnal rise in vagal modulation (p = 0.021).
Observational (n=27)
No
Does 24h heart rate variability differ between adolescents with disorders of gut-brain interaction and healthy controls?
Adolescents with disorders of gut-brain interaction exhibit reduced cardiovagal modulation (lower HRV) throughout the day and night, independent of psychological comorbidities.
Effect estimate: p < 0.001 for HRV differences (RMSSD, hf HRV, lf HRV)
Absolute Event Rate: 29.3% vs 54.6%
p-value: p=<0.001 (for HRV parameters) and 0.021 (for nocturnal rise in RMSSD)
Abstract Background Disorders of gut–brain interaction (DGBI) are common in pediatrics. Though the name clearly implies a neural contribution, the role of the autonomic nervous system remains unclear. Heart rate in healthy subjects (HC) follows a circadian pattern with dipping during the night with increased high frequency (hf) heart rate variability (HRV) and root mean square of successive differences (RMSSD). Our hypothesis was that reduced vagal modulation in adolescents with DGBI is associated with blunted rise in nocturnal vagal modulation. Methods An institutional review board (IRB) approved this study, which included children aged 12–18 years with a DGBI and carefully screened HC. All subjects underwent 24 h HRV recording. The following questionnaires/tools were included: Pain Catastrophizing Scale for Children (PCS-C), Pain Catastrophizing Scale for Parents (PCS-P), Revised Child Anxiety and Depression Scale (RCADS), Trauma Symptom Checklist for Children (TSCC), and Functional Disability Inventory (FDI). Results In total, 12 HC and 15 participants with DGBI participated (female individuals with DGBI versus HC: 93% versus 58%, p = 0.08). There was no age difference (median range HC 16.6 years 13.4, 18.2; DGBI 16.8 years 13.8, 18.7, p = 0.92). The 24 h, daytime and nighttime HRV demonstrated that RMSSD, low-frequency (lf) HRV, and high-frequency (hf) HRV were lower in the DGBI group ( p < 0.001). A nocturnal rise in RMSSD was present in the DGBI group, but less so in the HC group ( p = 0.021). Higher catastrophizing correlated with lower nocturnal RMSSD (PCS-C correlation coefficient CC: −0.46), depression (RCADS depression CC: −0.51), and post-traumatic stress disorder (PTSD; TSCC PTSD CC: −0.58). Conclusions HRV is reduced in patients with DGBI with a blunted rise in nocturnal RMSSD at night. As expected, vagal modulation is inversely correlated with catastrophizing, depression, PTDS, and FDI, with nocturnal HRV showing generally better correlations than daytime HRV.
Chelimsky et al. (Thu,) conducted a observational in Adolescents aged 12-18 years with disorders of gut–brain interaction (DGBI) including functional dyspepsia, irritable bowel syndrome, functional abdominal pain, and functional abdominal pain syndrome (n=27). Adolescents with DGBI had significantly reduced 24-hour HRV (RMSSD 29.3 ms vs 54.6 ms in controls, p < 0.001) and blunted nocturnal rise in vagal modulation (p = 0.021).