• Korean Journal of Psychosomatic Medicine
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• v.31 no.2
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• pp.108-117
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• 2023

Objectives : Somatic symptom disorder (SSD) is characterized by the manifestation of a variety of physical symptoms, but little is known about differences in autonomic nervous system activity according to symptom severity, especially within patient groups. In this study, we examined differences in heart rate variability (HRV) across symptom severity in a group of SSD patients to analyze a representative marker of autonomic nervous system changes by symptoms severity. Methods : Medical records were retrospectively reviewed for patients who were diagnosed with SSD based on DSM-5 from September 18, 2020 to October 29, 2021. We applied inverse probability of treatment weighting (IPTW) methods to generate more homogeneous comparisons in HRV parameters by correcting for selection biases due to sociodemographic and clinical characteristic differences between groups. Results : There were statistically significant correlations between the somatic symptom severity and LF (nu), HF (nu), LF/HF, as well as SD1/SD2 and Alpha1/Alpha2. After IPTW estimation, the mild to moderate group was corrected to 27 (53.0%) and the severe group to 24 (47.0%), and homogeneity was achieved as the differences in demographic and clinical characteristics were not significant. The analysis of inverse probability weighted regression adjustment model showed that the severe group was associated with significantly lower RMSSD (β=-0.70, p=0.003) and pNN20 (β=-1.04, p=0.019) in the time domain and higher LF (nu) (β=0.29, p<0.001), lower HF (nu) (β=-0.29, p<0.001), higher LF/HF (β=1.41, p=0.001), and in the nonlinear domain, significant differences were tested for SampEn15 (β=-0.35, p=0.014), SD1/SD2 (β=-0.68, p<0.001), and Alpha1/Alpha2 (ß=0.43, p=0.001). Conclusions : These results suggest that differences in HRV parameters by SSD severity were showed in the time, frequency and nonlinear domains, specific parameters demonstrating significantly higher sympathetic nerve activity and reduced ability of the parasympathetic nervous system in SSD patients with severe symptoms.

• The Journal of Internal Korean Medicine
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• v.44 no.2
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• pp.231-243
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• 2023

Background: Diabetic polyneuropathy is the most common complication in diabetics, occurring in 50% of all cases. About 10-20% of all diabetics are accompanied by neurological pain, showing a tendency to increase with age. Clinical aspects are very diverse, from mild abnormalities on nerve conduction tests to severe abnormalities in all sensory, motor, and autonomic nerves; however, sensory symptoms usually precede motor symptoms. Patients typically express sensory symptoms, such as positive and negative symptoms, which decrease the quality of life and have marked clinical implications, such as increased morbidity and mortality. Although Western medical drugs, such as tricyclic antidepressants, anticonvulsants, and narcotic analgesics, are used for diabetic polyneuropathy, a standard treatment has not been established. Case report: A 65-year-old male with paresthesia and pain due to diabetic polyneuropathy was treated with Uchashinki-hwan, acupuncture, electroacupuncture, moxibustion, and Jungsongouhyul pharmacopuncture for 10 days. We used the Toronto Clinical Neuropathy Scoring System, EuroQol-5 Dimension, and Visual Analog Scale to evaluate symptoms. Subsequently, the Neuropathy Scoring System, EuroQol-5 Dimension, and subjective discomfort improved. Conclusion: The present case report suggests that combined Korean medicine treatment might be an effective treatment for paresthesia and pain with diabetic polyneuropathy. Several follow-up studies should be conducted to clarify the effectiveness of the treatment.

• Journal of Physiology & Pathology in Korean Medicine
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• v.24 no.3
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• pp.525-532
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• 2010

Dypepsia is the most common gastrointestinal disease and mainly occurs by stress or food. According to the cause of dyspepsia, the clinical characteristics and the curative process are different in patients. The purpose of this study is to compare acute dyspepsia patients depending on food factor and stress factor. For this study, we analyzed the cause, and the symptoms of 59 acute dyspepsia patients and divided them into two groups: one group is 27 acute dyspepsia patient group caused by stress factor (stress factor group). The other group is 32 acute dyspepsia patient group caused by food factor (food factor group). In addition, we carried out HRV test and compared HRV index between two groups. There was no significant difference in past illness involved in gastrointestinal tract diseases between two groups. There were big differences in the frequency of chest discomfort, thurst, lack of appetite, and exhaustion after meals between two groups. There were many changes of tongue fur in food factor group. But there were many changes of tongue body in stress factor group. The pulse pattern is mostly wiry in stress factor group. But, The pulse pattern is mostly slippery in food factor group. HF, TP were significantly lower than food factor group in stress factor group, it means autonomic nerve system was more suppressd in stress factor group than food factor group. Food factor group improved sooner than stress factor group. This study presented the clinically different characteristics (past medical history, symptoms, tongue diagnosis, pulse pattern, curative process) of acute dyspepsia depending on food factor and stress factor. Thus, it provides the necessity of oriental medical diagnosis and treatment called pattern identification for acute dyspepsia.

• The Korean Journal of Pain
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• v.6 no.2
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• pp.275-279
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• 1993

Reflex sympathetic dystrophy is a syndrome characterized by persistent, burning pain, hyperpathia, allodynia & hyperaesthesia in an extremity, with concurrent evidence of autonomic nervous system dysfunction. It generally develops after nerve injury, trauma, surgery, et al. The most successful therapies are directed towards blocking the sympathetic intervention to the affected extremity by regional sympathetic ganglion block or Bier block with sympathetic blocker; other traditional treatments include transcutaneous electrical stimulation, immobilization with cast & splint, physical therapy, psychotherapy, administration of sympathetic blocker, calcitonin, corticosteroid and analgesic agents. The purpose of this report is to evaluate and describe the effects of magnetic resonance following unsatisfactory results with traditional treatments of RSD. A 17 year old female patient, 1 year earlier, had received excision and drainage of pus at the right femoral triangle due to an injury caused by a stone. Afterwards, she experienced burning pain, knee joint stiffness, and muscle dystrophy of the right thigh, especially when standing and walking. Despite a year of number of traditional treatments such as: lumbar sympathetic block, continuous epidural analgesia, transcutaneous electrical stimulation, & administration of predisolone, her pain did not improve. Surprisingly, the patients was able to walk free from pain and difficulty after just one application of magnetic resonance. The patient has been successfully treated with further treatment of two to three times a week for approximately ten weeks. More recently, magnetic resonance has been demonstrated to produce effective results for the relief of pain in a variety of diseases. From our experiences we recognize magnetic resonance as a therapeutic modality which can provide excellent results for the treatment of RSD. It has been suggested that polysynaptic reflex which are disturbed in RSD may be modulated normally on the spinal cord level through the application of magnetic resonance.

• Journal of Acupuncture Research
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• v.38 no.3
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• pp.192-199
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• 2021

Background: In this retrospective study, we aimed to determine which diagnostic tests were associated with an improvement in Bell's palsy symptoms. Methods: There were 30 patients who visited Kyung Hee University Korean Medicine Hospital from April 1, 2017 to February 29, 2020, and who received East-West collaboration treatment for Bell's palsy. The tests included electroneurography (ENoG), electromyography (EMG), hematology, and heart rate variability (HRV) results which were used to determine if any test correlated with improvement of Bell's palsy symptoms. Results: The initial severity of symptoms did not correlate with the tests performed, with the exception of mean corpuscular hemoglobin concentration (p = 0.013). For both ENoG for oculi degeneration and mean EMG tests, the rate of nerve degeneration showed a significant negative correlation with the improvement of Bell's palsy symptoms. Amongst the HRV test indicators, the square root of the mean of the sum of the squares of differences between the adjacent normal R-R wave interval, the standard deviation of intervals, total power, very low frequency, and high frequency of the wave was negatively correlated with improvement of Bell's palsy symptoms. Similarly, glycosylated hemoglobin Type A1c (HbA1c) and erythrocyte sedimentation rate (ESR) showed a negative correlation with improvement of symptoms of Bell's palsy. With the exception of HbA1c and ESR, the remaining hematology test results showed no significant difference when comparing before and after treatment. Conclusion: ENoG, EMG, HRV test, HbA1c, and ESR negatively correlated with improvements in Bell's palsy symptoms and may determine the prognosis of Bell's palsy.

• Journal of Yeungnam Medical Science
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• v.10 no.2
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• pp.451-474
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• 1993

Lidocaline if frequently administered as a component of an anesthetic : for local or regional nerve blocks, to mitigate the autonomic response to laryngoscopy and tracheal intubation, to suppress the cough reflex, and for antiarrythmic therapy. Diazepam dectease the potential central nervous system (CNS) toxicity of local anesthetic agents but may modify the sitmulant action of lidocaine in addition to their own cardiovascular depressant. The potential cardiovascular toxicity of local anesthetics may be enhanced by the concomitant administration of diazepam. This study was designed to investigate the effects of lidocaine dose and pretreated diazepam to cardiovascular system and plasma concentration of lidocaine. Lidocaine in 100 mcg/kg/min, 200 mcg/kg/min, and 300 mcg/kg/min was given by sequential infusion to dogs anesthetized with halothane-nitrous oxide (Group I). And in group II, after diazepam pretreatment, lidocaine was infused by same way when lidocaine was administered in 100 mcg/kg/min, the low plasma levels ($3.97{\pm}0.22-4.48{\pm}0.36$ mcg/ml) caused a little reduction in cardiovascular hemodynamics. As administered in 200 mcg/kg/min, 300 mcg/kg/min, the higher plasma levels ($7.50{\pm}0.66-11.83{\pm}0.59$ mcg/ml) reduced mean arterial pressure (MAP), cardiac index (CI), stroke index (SI), left ventricular stroke work index (LVSWI), and right ventricular stroke work index (PVSWI) and increased pulmonary artery wedge pressure (PAWP), central venous pressure (CVP), systemic vascular resistance index (SVRI), but was associated with little changes of heart rate (HR), mean pulmonary artery pressure (MPAP), and pulmonary vascular resistance index (PVRI). When lidocaine with pretreated diazepam was administered in 100 mcg/kg/min, the low plasma level, the lower level than when only lidocaine administered, reduced MAP, but was not changed other cardiovascular hemodynamics. While lidocaine was infused in 200 mcg/kg/min, 300 mcg/kg/min in dogs pretreated diazepam, the higher plasma level ($7.64{\pm}0.79-13.79{\pm}0.82$ mcg/ml) was maintained and was associated with reduced CI, SI, LVSWI and incresed PAWP, CVP, SVRI but was a little changes of HR, MPAP, PVRI. After $CaCl_2$ administeration, CI, SI, SVRI, LVSWI was recovered but PAWP, CVP was rather increased than recovered. The foregoing results demonstrate that pretreated diazepam imposes no additional burden on cardiovascular system when a infusion of large dose of lidocaine is given to dogs anesthetized with halothanenitrous oxide. But caution may be advised if the addition of lidocaine is indicated in subjects who have impared autonomic nervous system and who are in hypercarbic, hypoxic, or acidotic states.

• Journal of Korean Society of Industrial and Systems Engineering
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• v.35 no.4
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• pp.227-234
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• 2012

In this study, the masking effect of olfactory stimulus on the awakening state due to sound stimuli while driving using Graphic Driving Simulator was observed through the response of autonomic nervous system. The test was conducted for 11 males in their twenties. The siren of ambulance car was presented to them as auditory stimulus for 30 secs while driving in a situation of high way in the condition of both peppermint and control, respectively, and LF/HF ratio of HRV (Heart Rate Variability), the activity index of sympathetic nerve, and GSR (Galvanic Skin Response) response were examined. The test was proceeded in the order of three stages, that is, sound stimuli (test 1), driving performance, and sound stimuli (test 2), and fragrance stimulus, driving performance, and sound stimuli (test 3), and the physiological signal of GSR, HRV was measured in the whole stages. As a result of test, comparing the results of before and after auditory stimulus test (1) (p < 0.01), test (2) (p < 0.05), and test (3) (p < 0.01), driving performance test (2) (p < 0.01), test (3) (p < 0.01), and olfactory stimulus test (3) (p < 0.05), respectively, GSR response increased, showing significant difference in all the tests. It indicates that when auditory stimulus was presented to the subjects, they were in the awakening state as sympathetic nervous system got activated. As a result of comparing auditory stimulus while driving before and after presenting olfactory stimulus, there was no significant difference in GSR response. The LF/HF ratio of HRV increased, showing a significant difference only in test (2) (p < 0.05), and in driving performance test (2) (p < 0.05) in auditory stimulus, however, it showed no significant difference in olfactory stimulus. As a result of comparing auditory stimulus while driving before and after presenting olfactory stimulus, there was a decrease, showing significant difference (p < 0.05) in LF/HF ratio of HRV. That is, it means that the activation of sympathetic nervous system decreased, and that parasympathetic nervous system got activated. From these results, it was observed that while driving, the awakening level due to auditory stimulus was settled with olfactory stimulus. In conclusion, it was drawn that while driving, olfactory stimulus could have the masking effect on auditory stimulus.

• Journal of Korean Society of Forest Science
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• v.108 no.3
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• pp.440-453
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• 2019

This study was carried out to investigate the effect of watching a two-dimensional (2D) forest video and a virtual reality (VR) forest video on stress reduction in adults. Experiments were conducted in an artificial climate room, and 40 subjects participated. After inducing stress in the subjects, subjects watched a 2D gray video, 2D forest video, or VR forest video for 5 mins. The autonomic nervous system activity was evaluated continuously in terms of measured heart rate variability during the experiment. After each experiment, the subject's psychological state was evaluated using a questionnaire. The 2D forest video decreased the viewer's stress index, increased HF, and reduced heart rate compared with the 2D gray video. The VR forest video had a greater stress index reduction effect, LF/HF increase effect, and heart rate reduction effect than the 2D gray video. Psychological measurements showed that subjects felt more comfortable, natural, and calm when watching the 2D gray video, 2D forest video or VR forest video. We also found that the 2D forest video and VR forest video increased positive emotions and reduced negative emotions compared to the 2D gray video. Based on these results, it can be concluded that watching the 2D forest and VR forest videos reduces the stress index and heart rate compared with watching the 2D gray video. Thus, it is considered that the 2D forest video increases the activity of the parasympathetic nervous system, and the VR forest video increases the activity of the sympathetic nervous system. The increased activity of the sympathetic nervous system upon watching the VR forest video is judged to be positive sympathetic nerve activity, such as novelty and curiosity, and not negative sympathetic activity, such as stress and tension. The results of this study are expected to be the basis for examining the visual effects of forest healing, with hope that the utilization of VR, the technology of the fourth industrial revolution in the forestry field, will broaden.

• Sleep Medicine and Psychophysiology
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• v.12 no.1
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• pp.50-57
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• 2005

Objectives: This study was designed to evaluate the differences in clinical characteristics and severity of symptoms between panic patients with and without comorbid major depressive disorder, and to ascertain the differences in the function of the autonomic nerve system measured by heart rate variability (HRV). Methods: The subjects were 60 patients who have panic disorder without major depressive disorder and 19 patients who met DSMIV criteria for both panic disorder and major depressive disorder. First, they drew up symptom checklists and self-rating scales, and were measured by Anxiety Disorder Inventory Schedule-Panic Attack & Agoraphobia (ADIS-P&A), Clinical Global Impression (CGI), Hamilton Rating Scale for Depression (HAM-D), Panic Disorder Severity Scale (PDSS) and Heart Rate Variability (HRV). For statistical analysis, we performed t-test to compare the scores of self reported scales and clinician’s rating scales in panic patients with comorbid major depressive disorder and those without major depressive disorder. ANCOVA was used to compare the variables of HRV, considering age as a covariate. Results: The subjective severities of depression and anxiety that comorbid patients complained of were higher than those of patients with only panic disorder. Futhermore, comorbid patients were more sensitive to anxiety and physical sensations, and they tend to be more negative in their thinking. The scores of clinician-rating scales such as CGI and PDSS were also higher in the comorbid patients. However, there were no significant differences in HRV variables between both groups, despite a tendency to low heart rate variability in the comorbid group. Conclusion: This study suggests that patients with panic disorder and comorbid major depressive disorder tend to complain of more symptoms and to be more sensitive to various symptoms than those with panic disorder without comorbid depression. However, in this study comorbid major depressive disorder did not have a significant impact on the HRV variables of patients with panic disorder.