The Journal of Internal Korean Medicine (대한한방내과학회지)

The Society of Internal Korean Medicine (대한한방내과학회)
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Heart Rate Variability Analysis According to Clinical Characteristics in Patients with Burning Mouth Syndrome

구강작열감증후군 환자의 임상 특징에 따른 심박변이도 분석

  • Lee, Hyun-Jin (Dept. of Clinical Korean Medicine, Graduate School, Kyung Hee University) ;
  • Ha, Na-yeon (Dept. of Digestive Diseases, Kyung Hee University Korean Medicine Hospital) ;
  • Ko, Seok-Jae (Dept. of Clinical Korean Medicine, Graduate School, Kyung Hee University) ;
  • Park, Jae-Woo (Dept. of Clinical Korean Medicine, Graduate School, Kyung Hee University) ;
  • Kim, Jin-sung (Dept. of Clinical Korean Medicine, Graduate School, Kyung Hee University)
  • 이현진 (경희대학교 대학원 임상한의학과) ;
  • 하나연 (경희대학교한방병원 위장소화내과) ;
  • 고석재 (경희대학교 대학원 임상한의학과) ;
  • 박재우 (경희대학교 대학원 임상한의학과) ;
  • 김진성 (경희대학교 대학원 임상한의학과)
  • Received : 2022.02.22
  • Accepted : 2022.03.28
  • Published : 2022.03.30
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Abstract

Objectives: This study aimed to identify the characteristics of the heart rate variability (HRV) index in patients with burning mouth syndrome (BMS) and to evaluate the predictive value of HRV for Korean medical treatment responsiveness to tongue pain in BMS. Methods: Among BMS patients who visited the Oral Diseases Clinic of Kyung Hee University Korean Medicine Hospital from January 1, 2018, to May 31, 2021, we reviewed the clinical records of 217 women aged 50 years and over. HRV and unstimulated saliva flow rate (USFR) measurements were carried out, and all patients were asked to indicate their degree of tongue pain using the visual analog scale (VAS). The subjects were classified into subgroups according to the presence or absence of hyposalivation and VAS improvement, and each subgroup was compared using the HRV index. Logistic regression analysis was conducted to confirm whether cause-effect relationships were present between statistically significant values. Results: BMS patients had lower LF and HF than healthy people. Subgroup analysis demonstrated that there were some statistically significant differences in the HRV index according to salivation rate and degree of pain. In addition, as the LF/HF ratio increased, the pain improvement rate decreased after treatment. Conclusion: The autonomic nerve activity of BMS patients was lower than that of healthy people; however, autonomic balance was not impaired. In addition, tongue pain in BMS patients responded more favorably to Korean medical treatment when patients fell within a normal range of the LF/HF ratio, suggesting that autonomic imbalance could be used as one of the predictable factors in clinical practice.

Keywords

References

  1. He Y, Lin M, Li BQ. The treatment plan of burning mouth syndrome. Journal of Modern Stomatology 2003;17(6):564-6.
  2. Garcia-Medina MR. Sindrome de la boca que arde. Rev Asoc Odontol Argent 1994;82(2):140-5.
  3. Netto FO, Diniz IM, Grossmann SM, de Abreu MH, do Carmo MA, Aguiar MC. Risk factors in burning mouth syndrome: a case-control study based on patient records. Clin Oral Investig 2011;15(4):571-5. https://doi.org/10.1007/s00784-010-0419-5
  4. Cerchiari DP, de Moricz RD, Sanjar FA, Rapoport PB, Moretti G, Guerra MM. Burning mouth syndrome: etiology. Braz J Otorhinolaryngol 2006;72(3):419-23. https://doi.org/10.1016/S1808-8694(15)30979-4
  5. Zhou B, Zhou J. Zhuokou Decoction in the treatment of yin deficiency type burning mouth syndrome. Journal of Clinical Stomatology 2012;28(4):217-8. https://doi.org/10.3969/j.issn.1003-1634.2012.04.009
  6. Guo HQ. The Traditional Chinese Medicine Dialectical Treatment Burns Mouth Syndrome Clinical Observation. Journal of Disease Monitor & Control 2009(8):484-5.
  7. Heo J. Donguibogam. Seoul: Namsandang; 2004, p. 87-9, 94, 241, 418, 507, 779.
  8. Sgoifo A, Carnevali L, Alfonso Mde L, Amore M. Autonomic dysfunction and heart rate variability in depression. Stress 2015;18(3):343-52. https://doi.org/10.3109/10253890.2015.1045868
  9. Catai AM, Pastre CM, Godoy MF, Silva ED, Takahashi ACM, Vanderlei LCM. Heart rate variability: are you using it properly? Standardisation checklist of procedures. Braz J Phys Ther 2020;24(2):91-102. https://doi.org/10.1016/j.bjpt.2019.02.006
  10. Woo JM. The Concept and Clinical Application for the Measurement of Heart Rate Variability. Korean journal of psychosomatic medicine 2004;12(1):3-14.
  11. Kim GM, Woo JM. Determinants for heart rate variability in a normal Korean population. J Korean Med Sci 2011;26(10):1293-8. https://doi.org/10.3346/jkms.2011.26.10.1293
  12. Geovanini GR, Vasques ER, de Oliveira Alvim R, Mill JG, Andreao RV, Vasques BK, et al. Age and Sex Differences in Heart Rate Variability and Vagal Specific Patterns - Baependi Heart Study. Glob Heart 2020 Oct 21;15(1):71. https://doi.org/10.5334/gh.873
  13. Koenig J, Thayer JF. Sex differences in healthy human heart rate variability: a meta-analysis. Neurosci Biobehav Rev 2016;64:288-310. https://doi.org/10.1016/j.neubiorev.2016.03.007
  14. De Meersman RE. Heart rate variability and aerobic fitness. Am Heart J 1993;125(3):726-31. https://doi.org/10.1016/0002-8703(93)90164-5
  15. Ko WH, Nam SU, Ha NY, Hwang MN, Baek SY, Kim DY, et al. Characteristics of Digital Infrared Thermal Imaging and Quantitative Evaluations for Patients with Burning Mouth Syndrome: a Cross Sectional Study. J Int Korean Med 2018;39(4):699-707. https://doi.org/10.22246/jikm.2018.39.4.699
  16. Seon JK, Kim JS, Han GJ, Oh SW, Son JH, Kang K, et al. Clinical Characteristics and Evaluation of Yin-deficiency Syndrome in Patients with Burning Mouth Syndrome. J Int Korean Med 2011;32(4):473-86.
  17. Lee HN, Kim DY, Baek SY, Jeong HI, Lee HJ, Cho YJ, et al. Comparison of the Clinical Characteristics of Patients with Burning Mouth Syndrome due to Hyposalivation. J Int Korean Med 2020;41(5):838-47. https://doi.org/10.22246/jikm.2020.41.5.838
  18. Koszewicz M, Mendak M, Konopka T, Koziorowska -Gawron E, Budrewicz S. The characteristics of autonomic nervous system disorders in burning mouth syndrome and Parkinson disease. J Orofac Pain 2012;26(4):315-20.
  19. Hanada K. Glossodynia and the function of the autonomic nervous system-frequency spectrum analysis of RR intervals recorded electrocardiographically. Kokubyo Gakkai Zasshi 2003;70(2):124-30. https://doi.org/10.5357/koubyou.70.124
  20. Momota Y, Takano H, Kani K, Matsumoto F, Motegi K, Aota K, et al. Frequency analysis of heart rate variability: a useful assessment tool of linearly polarized near-infrared irradiation to stellate ganglion area for burning mouth syndrome. Pain Med 2013;14(3):351-7. https://doi.org/10.1111/pme.12008
  21. Nasri-Heir C, Zagury JG, Thomas D, Ananthan S. Burning mouth syndrome: Current concepts. J Indian Prosthodont Soc 2015;15(4):300-7. https://doi.org/10.4103/0972-4052.171823
  22. Navazesh M, Christensen CM. A comparison of whole mouth resting and stimulated salivary measurement procedures. J Dent Res 1982;61(10):1158-62. https://doi.org/10.1177/00220345820610100901
  23. Navazesh M, Kumar SK. Measuring salivary flow: challenges and opportunities. J Am Dent Assoc 2008;139:35S-40S. https://doi.org/10.14219/jada.archive.2008.0353
  24. Kim KY. Outlier detection in dental research. J Korean Acad Conserv Dent 2017;55(9):604-16.
  25. Headache Classification Committee of the International Headache S. The International Classification of Headache Disorders, 3rd edition (beta version). Cephalalgia 2013;33(9):629-808. https://doi.org/10.1177/0333102413485658
  26. Jimson S, Rajesh E, Krupaa RJ, Kasthuri M. Burning mouth syndrome. J Pharm Bioallied Sci 2015;7(Suppl 1):S194-6.
  27. Wu S, Zhang W, Yan J, Noma N, Young A, Yan Z. Worldwide prevalence estimates of burning mouth syndrome: A systematic review and meta-analysis. Oral Dis 2021;10.1111/odi.13868.
  28. Li BQ, Zhou HM, Hu T, et al. Medication guidelines for common diseases in stomatology. Chengdu: Sichuan Science and Technology Press; 1998, p. 225-32.
  29. Bigger Jr JT, Fleiss JL, Steinman RC, Rolnitzky LM, Kleiger RE, Rottman JN. Frequency domain measures of heart period variability and mortality after myocardial infarction. Circulation 1992;85(1):164-71. https://doi.org/10.1161/01.CIR.85.1.164
  30. Kleiger RE, Miller JP, Bigger Jr JT, Moss AJ. Decreased heart rate variability and its association with increased mortality after acute myocardial infarction. Am J Cardiol 1987;59(4):256-62. https://doi.org/10.1016/0002-9149(87)90795-8
  31. Hill LK, Hu DD, Koenig J, Sollers JJ, Kapuku G, Wang X, et al. Ethnic differences in resting heart rate variability: a systematic review and meta-analysis. Psychosom Med 2015;77(1):16-25. https://doi.org/10.1097/PSY.0000000000000133
  32. Ralevski E, Petrakis I, Altemus M. Heart rate variability in alcohol use: A review. Pharmacol Biochem Behav 2019;176:83-92. https://doi.org/10.1016/j.pbb.2018.12.003
  33. Dinas PC, Koutedakis Y, Flouris AD. Effects of active and passive tobacco cigarette smoking on heart rate variability. Int J Cardiol 2013;163(2):109-15. https://doi.org/10.1016/j.ijcard.2011.10.140
  34. Yang CH, Chen HY, Chen JL, Yang SH. Therapeutic efficacy of traditional Chinese medicine on quality of life and heart rate variability among patients in long-term care system in Taiwan. J Chin Med 2018;29:42-59.
  35. Miu AC, Heilman RM, Miclea M. Reduced heart rate variability and vagal tone in anxiety: trait versus state, and the effects of autogenic training. Auton Neurosci 2009;145(1-2):99-103. https://doi.org/10.1016/j.autneu.2008.11.010
  36. Jeong HS, Yang CS, Nam JS, Jang IS, Kim LH, Seo ES. Short Time Effect of Caffeine on Heart Rate Variability and the Effect of Acupuncture at Neiguan (PC6): A Randomized Double Blind Pilot Study. J Int Korean Med 2008;29(3):778-86.