• 고신대학교 의과대학 학술지
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• 제33권3호
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• pp.369-379
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• 2018

Objectives: Analysis of heart rate variability (HRV) has been used as a measure of cardiac autonomic function. According to the pNN50 statistic, the percentage of differences between successive normal RR intervals (RRI) that exceed 50 ms, has been known to reflect cardiac vagal modulation. Relatively little is known about the validity of pNN50 during general anesthesia (GA). Therefore, we evaluated the correlation of pNN50 with other variables such as HF, RMSSD, SD1 of HRV reflecting the vagal tone, and examined the validity of pNN50 in anesthetized patients. Methods: We assessed changes in RRI, pNN50, root mean square of successive differences of RRI (RMSSD), high frequency (HF) and standard deviation 1 (SD1) of $Poincar{\acute{e}}$ plots after GA using sevoflurane anesthesia. We also calculated the probability distributions for the family of pNNx statistics (x: 2-50 ms). Results: All HRV variables were significantly decreased during GA. HF power was not correlated with pNN50 during GA (r = 0.096, P = 0.392). Less than pNN47 was shown to have a correlation with other variables. Conclusions: These data suggest that pNN50 can not reflect the level of vagal tone during GA.

• 정신신체의학
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• 제31권2호
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• pp.108-117
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• 2023

연구목적 신체 증상 장애(Somatic Symptom Disorder, SSD)는 다양한 신체 증상의 발현을 특징으로 하며, 현재까지 환자군 내에서 증상 심각도에 따른 자율신경계 활성의 차이에 대해서는 연구된 바가 거의 없다. 이에 본 연구에서는 신체 증상 장애 환자군에서 심박변이도(Heart Rate Variability, HRV) 차이를 검정하여 증상 심각도에 따른 자율신경계 변화를 반영하는 대표적 지표를 분석하였다. 방 법 2020년 9월 18일부터 2021년 10월 29일까지 강남세브란스병원 정신건강의학과에 내원했던 환자 중, DSM-5 진단 기준에 따라 SSD로 진단받은 환자 총 51명의 의무기록을 후향적으로 수집하였다. 이후, 집단 간 인구사회학 및 임상적 선택편의 보정을 위해 역확률 가중치(Inverse Probability Treatment Weighting, IPTW)를 적용하여 HRV 지표 차이 검정을 실시하였다. 결 과 신체 증상 심각도와 LF (nu), HF (nu), LF/HF, 그리고 SD1/SD2, Alpha1/Alpha2는 통계적으로 유의한 상관관계를 보였으며, IPTW 적용 후 비중증군은 27명(53.0%), 중증군은 24명(47.0%)로 보정되었고, 인구사회학적 요인 및 임상적 특성 차이가 유의미하지 않아 동질성이 확보되었다. 본 모형 분석 결과 고위험군일수록 시간 영역의 RMSSD (β=-0.70, p=0.003), pNN20 (β=-1.04, p=0.019), 주파수 영역은 LF (nu) (β=0.29, p<0.001), HF (nu) (β=-0.29, p<0.001), LF/HF (β=1.41, p=0.001), 그리고 비선형 영역에서는 SampEn15 (β=-0.35, p=0.014), SD1/SD2 (β=-0.68, p<0.001), Alpha1/Alpha2 (β=0.43, p=0.001)에서 유의미한 차이가 검정되었다. 결 론 신체 증상 심각도에 따른 HRV 지표의 차이는 시간과 주파수 영역, 그리고 비선형 영역 전반에서 검정되었으며, 신체 증상이 심할수록 교감신경의 과활성화 및 부교감신경의 저하를 시사하는 HRV 지표들이 유의미하게 높은 경향성을 보였다.

• 대한한의학회지
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• 제35권4호
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• pp.24-35
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• 2014

Objectives: Although the autonomic nervous system (ANS) is thought to play an important role in treatment of obesity, no study has been conducted to investigate acupuncture's effects on this aspect of the ANS. This study aimed to describe the effects of acupuncture in the ANS by means of heart rate variability (HRV) analysis. Methods: A total of 46 obese women aged from 21 to 54 with body mass index ranging from 25.1 to $39.3kg/m^2$ were recruited and randomized into both the real acupuncture group (n=23) and sham acupuncture group (n=23). A total of 3 instances of HRV analysis were conducted before, during, and after treatment. Statistically significant differences between time and groups were analyzed using repeated measure analysis of variance. Results: All parameters of time domain analysis and frequency domain analysis except for the square root of the mean squared differences of successive normal sinus intervals (RMSSD) and very low frequency (VLF) showed significant differences between times. The mean of all R-R intervals (mean RR) showed significant level of interaction between time and group. Between groups, time domain analysis of standard deviation of the normal-to-normal intervals (SDNN), RMSSD and frequency domain analysis of total power (TP) and high frequency (HF) showed significant differences. Conclusions: The real acupuncture group showed deactivation of parasympathetic function and relative increase of sympathetic activity in obese subjects. Further studies are necessary to uncover the mechanisms of acupuncture in obesity treatment.

• 동의신경정신과학회지
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• 제21권4호
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• pp.21-39
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• 2010

Objectives : This study was to investigate the characteristics of the heart rate variability(HRV), types of insomnia and accompanying symptoms of 175 insomnia patients. Methods : For this study we carried out HRV, Inbody of 175 patients with insomnia who have come to Dongeui oriental hospital of Dongeui university from the period of Janaury 2008 to September 2010. We studied the association of the insomnia patients' age and gender with HRV, accompanying symptoms and the types of insomnia. The information of the accompanying symptoms and types of insomnia was based on each patients' progress note. Results : l. There was no significant differences in the characteristics of HRV between male and female. 2. The most frequent symptom shown among the insmonia patents' was headache(41.14%). 3. Comparing the symptoms between the gender, female patients had more dry mouth, alternative periodic chill and fever, and hot flush symptoms than the male patients. 4. Comparing the symptoms between the age groups(divided in two), the lower age group (20~59) had more dizziness and constipation symptoms than the higher age group (over 60). 5. Comparing the types of insomma between the age group, the higher age group (over 60) had more termination insomnia. 6. The types of insomnia of the entire insomnia patients were onset insomnia (73.1%), maintenance insomnia(20.6%), termination insomma(l7.1 %), shallow sleep (52.6%), listed by order of frequency. 7. The patients who takes hypnotics had more anorexia symptoms than the patients who doesn't take hypnotics. 8. There was no visible differences of the average fractal portrait between male and female. The age group of 20~30yrs. had the highest average fractal portrait, and the age group of 30~59yrs. the second highest, and the age group over 60yrs. the lowest. 9. The average of the regulation reserves of the autonomic nervous system(B2) - was lower than the regulation level of the ANS at the present (Bl). 10. When compared the priority of the function of the ANS, it showed that the proportion of HF($38.61{\pm}29.19%$)was the most, and than VLF($30.65{\pm}23.36%$), LF($20.04{\pm}19.13%$) the least. 11. The average of the compensation level of the central nervous system at present(Cl) - was lower than the compensation reserves of the CNS(C2). 12. The average of the control reserves of the cerebrum(D2) - was lower than the control level of the cerebrum at the present (Dl). 13. There was no visible differences between different sexes and ages in pulse rate. 14. The abdomen fat ratio above the line of the insomnia patients was 77.97% in male and 93.1% in female. Both sexes showed that insomnia patients had more abdomen fat that the standard, and female patients had more abd. fat than male patients. Conclusions : This study shows that the HRV of insomnia patients had no significant differences between gender. Fractal portrait, HF, LF and VLF of the insomnia patients are in inverse proportion to the age. The study of the Body Component Analysis showed that female had more abdomen fat than male, and both gender showed more abdomen fat than the standard. When looked into the accompanying symptoms of the insomnia patients, the symptoms show differences according to gender, age and hypnotics taking, as shown as below. In the entire patients, Headache was the most accompanying symptom. Female had more dry mouth, alternative periodic chill and fever, and hot flush symptoms than male. Higher age groups had more dizziness and constipation as accompanying symptoms than lower age groups. Patients who takes hypnotics had more anorexia than those who dont.

• 대한한방내과학회지
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• 제40권4호
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• pp.582-596
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• 2019

Objective: The aims of this study were to analyze the deficiency-excess pattern identification (虛實辨證) and compare it to the sputum cytokines of asthma patients. Method: 50 asthma patients who met the inclusion and exclusion criteria were included in this study. They were divided into two groups: deficiency and excess syndrome groups. Sputum examinations were performed including $TNF-{\alpha}$, Interleukin (IL)-4, IL-5, IL-10, and IL-13. The Quality of Life Questionnaire for Adult Korean Asthmatics (QLQAKA), the Visual Analog Scale(VAS), and heart rate variability (HRV) were also measured. We also conducted laboratory tests, including the hematological indexes. Results: Based on the pattern identification, 50 asthma patients can be divided into two categories of groups: the deficiency syndrome group (N=24) and the excess syndrome group (N=26). In the analysis of sputum cytokines, although the $TNF-{\alpha}$, IL-4 and IL-13 were at a higher level in the deficient pattern group than in the excess pattern group, it was insignificantly different. There was a negative correlation in the analysis of QLQAKA and VAS. In the analysis of HRV, although the mean value of VLF, LF, and HF in the deficiency syndrome group was higher than in the excess syndrome group, it was insignificantly different. There was no significant difference in the hematological tests between the deficiency and the excess syndrome group. The mean value of the IgE in the blood tests was five times greater than the reference value. Conclusion: The cytokines of sputum including $TNF-{\alpha}$, IL-4, IL-5, IL-10, and IL-13 were indifferent statistically. Reinforcing the healthy and eliminating the pathogenic factors should be considered.

• 한국융합학회논문지
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• 제9권1호
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• pp.387-392
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• 2018

이 연구의 목적은 폐쇄성수면무호흡환자들의 수면단계, AHI, 연령대 간 심박변이도의 통계적 유의성을 결정하는 것이다. 이 연구는 수면무호흡 성인 환자 40명을 대상으로 시간영역 및 주파수 영역에서 심박변이도의 주요 파라메타를 평가하였다. 비 램수면 단계는 3개 그룹 수면무호흡증 환자의 AHI 등급을 비교하여 통계적으로 검증되었다. NN50(p=0.043), pNN50(p=0.044), VLF peak(p=0.022) 및 LF/HF(p=0.028) 매개변수들은 대조군에서 수면무호흡증환자의 R-R 간격에서 통계적으로 유의하였다. 수면무호흡 환자들의 비 램수면(수면2단계)과 램수면 사이의 LF/HF(p=0.045)과 HF power(p=0.0395)파라메타들은 대조군 그룹에서 통계적 유의하였다. 우리는 이 연구에서 폐쇄성 수면무홉증환자들의 AHI, 수면단계 및 연령이 심박변이도 상관관계를 이해하는데 근거를 제시 할 수 있을 것이다.

• 생물정신의학
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• 제24권1호
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• pp.26-31
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• 2017

Objectives A normal circadian rhythm of autonomic nervous system function stands for the daily change of sympathetic and parasympathetic modulation, which can be measured by heart rate variability (HRV). Generally, patients in the intensive care unit (ICU) are prone to sleep-wake cycle dysregulation, therefore, it may have an influence on the circadian rhythm of autonomic nervous system. This study was designed to interpret possible dysregulation of autonomic nervous system in ICU patients by using HRV. Methods HRV was assessed every 3 hours in 21 ICU patients during a 7-minute period. The statistical differences of HRV features between the morning (AM 6 : 00-PM 12 : 00), and the afternoon (PM 12 : 00-PM 18 : 00) periods were evaluated in time domain and frequency domain. Results Patients showed significantly increased normalized power of low frequencey (nLF), absolute power of low frequencey (LF)/absolute power of high frequencey (HF) in the afternoon period as compared to the morning period. However, normalized power of high frequency (nHF) was significantly decreased in the afternoon period. There was no statistically significant difference between the morning period and the afternoon period in the time domain analysis. Conclusions The increased sympathetic tone in the afternoon period supports possible dysregulation in the circadian rhythm of autonomic nervous system in ICU patients. Future studies can help to interpret the association between autonomic dysregulation and negative outcomes of ICU patients.

• 대한한방내과학회지
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• 제25권4호
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• pp.25-33
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• 2004

Objective : The effects of Indium-Gallium-Aluminium-Phosphide(InGaAlP) laser transcutaneous irradiation on heart rate variability(HRV) in healthy adults are investigated with power spectrum analysis(PSA) of HRV. Methods : The control group consisted of 20 healthy volunteers (10 men, 10 women). The experiment was divided into 5 different periods, the pre-1st laser period(10 minutes), the 1st laser period(30 minutes), the post-1st laser period(5 minutes), the 2nd laser period( 30 minutes) and the post-2nd laser period(30 minutes). HRV was measured for 5 minutes at the pre-1 st laser period, the post-l st laser period and the post-2nd laser period. The laser period is the period in which InGaAlP laser transcutaneous Irradiation treatment occurs. Results : 1. SDNN of volunteers at post-1st laser period and post-2nd laser period significantly increased compared with that of the pre- 1 st laser period. 2, Ln(VLF) at post-I st laser period significantly increased compared with that of pre-1st laser period, while Ln(HF) at post-2nd laser period significantly decreased compared with those of pre- I st laser period and post-1st laser period, 3. Ln(TP) at post-1st laser period and post-2nd laser period significantly increased compared with that of pre-1st laser period, 4, LF/HF Ratio at post-2nd laser period significantly increased compared with those of pre-1st laser period and post-1st laser period. But the other variables did not significantly change. Conclusions : The results suggest that InGaAlp laser transcutaneous Irradiation in healthy adults is associated with the autonomic nervous systems. Further study is needed for investigating the effects of laser irradiation on autonomic nervous systems.

• 동의신경정신과학회지
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• 제21권4호
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• pp.163-173
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• 2010

Objectives : The objective of this study was to assess the effects of acupuncture applied at 114 and Liv3 points on heart rate variability (HRV) in normal subjects under mental stress. Methods: 36 healthy male and female subjects were recruited and randomized to a treatment group(18 subjects) or a control group (18 subjects). After 10-minutes rest period and instrumentation, both groups performed a mental stress test(Stroop color word test, Arithmetic test. four rule of arithmetic task) for l6-minutes. HRV was recorded before and after the mental stress. And then acupuncture needles were inserted on 114 and Liv3 for the study group. In the control group, they rested for l5-minutes. And Heart rate variability(HRV) was measured. Results: In the both groups, low frequency(LF) power, normalized low frequency power(LF(norm)) and ratio of low frequency to high frequency(LF/HF) was significantly increased after mental stress. Acupuncture induced significant decrease in low frequency(LF) power, normalized low frequency power(LF(norm)) and ratio of low frequency to high frequency (LF/HF) which was increased after mental stress test. In contrast, control group induced no changes. Conclusions : Acupuncture on 114 and Liv3 could be useful to decrease sympathetic activity and prevent the alteration of autonomic nervous system due to mental stress.

• 동의신경정신과학회지
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• 제20권2호
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• pp.85-99
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• 2009

Objectives : This study aimed to understand the influence of acupuncture on the human body by comparing changes within human bodies before and after people in normal health are treated with acupuncture at the acupoints HT7 and PC9, which are related to mental functions. Methods : The study was performed from January 3, 2008 to March 5, 2008 on 60 healthy males and females in their 20s. HRV, EEG, skin conductance response, respiration and peripheral skin temperature were measured for 5 minutes before acupuncture simulation was applied to the acupoints HT7 and PC9. During 20 minutes of acupuncture treatment, the same items were continuously measured to determine whether there had been any changes, and they were then measured for 5 minutes after the removal of the acupuncture needles in order to implement a comparative analysis. Results : 1. The HRV measurement showed that in the course of before, during and after acupuncture stimulation, heart rate, HF and HF norm decreased significantly (P<0.05) at HT7. LF, LF norm, and LF/HF ratio increased significantly (P>0.05), while heart rate, HF and HF norm decreased significantly (P<0.05) at PC9. 2. Skin conductance response increased significantly (P<0.05) at PC9 during and after the acupuncture simulation periods, compared with the pre acupuncture period. 3. the peripheral skin temperature increased significantly (P<0.05) both at HT7 and PC9 in the course of before, during and after acupuncture stimulation. 4. Compared with the pre-acupuncture period, respiration rate increased both at HT7 and at PC9 during and after the acupuncture simulation periods, but not in a statistically significance. 5. In the EEG measurement, when compared with the pre-acupuncture period at HT7, mid ${\beta}$ wave decreased significantly (P<0.05) during acupuncture treatment. Compared with the measurements during acupuncture treatment at PC9, low ${\beta}$ wave increased significantly (P<0.05) after the acupuncture needles were removed. Conclusions : When acupuncture treatment is applied at the acupoints HT7 and PC9, the activation of parasympathetic nerves decreases and the activation of sympathetic nerves increases in the HRV measurement. It was determined that PC9 makes the sympathetic nerves become highly activated in a skin conduction response. The effect of stability in the brain wave seemed to bo shown at HT7 than PC9.