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Heart Rate Variability and Gastric Electrical Response to a Cold Pressor Task in Youth with Functional Dyspepsia

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Abstract

Background/Aims

While stress has been implicated in functional dyspepsia (FD), the mechanisms by which stress results in symptoms are not well defined. The aim of the current study was to assess gastric myoelectric and autonomic changes in response to a physical stressor in youth with FD.

Methods

In a group of healthy controls and pediatric FD subjects, we recorded ECG and EGG signals 30 min before and 60 min after, a cold pressor task (CPT). Gastric EGG and heart rate variability (HRV) parameters were calculated in pre- and post-CPT stages and in short intervals.

Results

The pre-CPT percent tachygastria was higher in FD subjects as compared to controls. However, CPT did not induce any EGG changes in either controls or FD subjects and the two groups did not differ from each other post-CPT. The CPT resulted in an increase in HRV and standard deviation of NN intervals in controls; there was no change in any HRV parameter in FD subjects.

Conclusions

Acute physical stress does not appear to induce gastric electrical abnormalities in youth with FD. Youth with FD appear to lack the normal flexible autonomic response to a physical stressor.

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References

  1. Chitkara DK, Rawat DJ, Talley NJ. The epidemiology of childhood recurrent abdominal pain in western countries: a systematic review. Am J Gastroenterol. 2005;100:1868–1875. https://doi.org/10.1111/j.1572-0241.2005.41893.x.

    Article  PubMed  Google Scholar 

  2. Rasquin A, Di Lorenzo C, Forbes D, et al. Childhood functional gastrointestinal disorders: child/adolescent. Gastroenterology. 2006;130:1527–1537. https://doi.org/10.1053/j.gastro.2005.08.063.

    Article  PubMed  Google Scholar 

  3. Hyams JS, Di Lorenzo C, Saps M, Shulman RJ, Staiano A, Van Tilburg M. Childhood functional gastrointestinal disorders: child/adolescent. Gastroenterology. 2016;150:1456–1468. https://doi.org/10.1053/j.gastro.2016.02.015.

    Article  Google Scholar 

  4. Walker LS, Lipani TA, Greene JW, et al. Recurrent abdominal pain symptom subtypes based on the Rome II criteria for pediatric functional gastrointestinal disorders. J Pediatr Gastroenterol Nutr. 2004;38:187–191.

    Article  Google Scholar 

  5. Schurman JV, Friesen CA, Danda CE, et al. Diagnosing functional abdominal pain with the Rome II criteria: parent, child, and clinician agreement. J Pediatr Gasroenterol Nutr. 2005;41:291–295. https://doi.org/10.1097/01.mpg.0000178438.64675.c4.

    Article  Google Scholar 

  6. Edwards T, Friesen C, Schurman JV. Classification of pediatric functional gastrointestinal disorders related to abdominal pain using Rome III versus Rome IV criterions. BMC Gastroenterol. 2018;18:41. https://doi.org/10.1186/s12876-018-0769-z.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Robin SG, Keller C, Zwiener R, et al. Prevalence of pediatric functional gastrointestinal disorders utilizing the Rome IV criteria. J Pediatr. 2018;195:134–139. https://doi.org/10.1016/j.jpeds.2017.12.012.

    Article  PubMed  Google Scholar 

  8. Koloski NA, Jones M, Talley NJ. Evidence that independent gut-to-brain and brain-to-gut pathways operate in the irritable bowel syndrome and functional dyspepsia: a 1-year population-based prospective study. Aliment Pharmacol Ther. 2016;44:592–600. https://doi.org/10.1111/apt.13738.

    Article  CAS  PubMed  Google Scholar 

  9. Tougas G, Kamath M, Watteel G, et al. Modulation of neurocardiac function by esophageal stimulation in humans. Clin Soc. 1997;92:167–174. https://doi.org/10.1042/cs0920167.

    Article  CAS  Google Scholar 

  10. Tougas G. The autonomic nervous system in functional bowel disorder. Gut. 2000;47:iv78–iv80. https://doi.org/10.1136/gut.47.suppl_4.iv78.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Bharucha AE, Camilleri M, Low PA, Zinsmeister AR. Autonomic dysfunction In gastrointestinal motility disorder. Gut. 1993;34:397–401. https://doi.org/10.1136/gut.34.3.397.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Kamath VK, Fallen EL. Power spectral analysis of heart rate variability: a non-invasive signature of cardiac autonomic function. Crit Rev Biomed Eng. 1993;21:245–311.

    CAS  PubMed  Google Scholar 

  13. Shaffer F, Ginsberg JP. An overview of heart rate variability metrics and norms. Front Public Health. 2017;5:258. https://doi.org/10.3389/fpubh.2017.00258.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Pagani M, Lombardi F, Guzzetti S, et al. Power spectral analysis of heart rate and arterial pressure variabilities as a marker of sympatho-vagal interaction in man and conscious dog. Circ Res. 1986;59:178–193. https://doi.org/10.1161/01.res.59.2.178.

    Article  CAS  PubMed  Google Scholar 

  15. Akselrod S, Gordon D, Ubel FA, Shannon DC, Berger AC, Cohen RJ. Power spectral analysis of heart rate fluctuations: a quantitative probe of beat-to-beat cardiovascular control. Science. 1981;213:220–222. https://doi.org/10.1126/science.6166045.

    Article  CAS  PubMed  Google Scholar 

  16. Mazurak N, Seredyuk N, Sauer H, Teufel M, Enck P. Heart rate variability in the irritable bowel syndrome: a review of the literature. Neurogastroenterol Motil. 2012;24:206–216. https://doi.org/10.1111/j.1365-2982.2011.01866.x.

    Article  CAS  PubMed  Google Scholar 

  17. Arlt J, Jahn H, Kellner M, Ströhle A, Yassouridis A, Wiedemann K. Modulation of Sympathetic activity by corticotrophin-releasing hormone and atrial natriuretic peptide. Neuropeptides. 2003;37:362–368. https://doi.org/10.1016/j.npep.2003.09.006.

    Article  CAS  PubMed  Google Scholar 

  18. Walker LS, Stone AL, Smith CA, et al. Interacting influences of gender and chronic pain status on parasympathetically-mediated heart rate variability in adolescents and young adults. Pain. 2017;158:1509–1516. https://doi.org/10.1097/j.pain.0000000000000942.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Friesen CA, Lin Z, Schurman JV, Andre L, McCallum RW. Autonomic nervous system response to a solid meal and water loading in healthy children: its relation to gastric myoelectric activity. Neurogastroenterol Motil. 2007;19:376–382. https://doi.org/10.1111/j.1365-2982.2007.00906.x.

    Article  CAS  PubMed  Google Scholar 

  20. Chen J, Richards R, McCallum RW. Identification of gastric contraction from the cutaneous electrogastrogram. Am J Gastroenterol. 1994;89:79–85.

    CAS  PubMed  Google Scholar 

  21. Friesen CA, Lin Z, Hyman PE, et al. Electrogastrography in pediatric functional dyspepsia: relationship to gastric emptying and symptom severity. J Pediatr Gastroenterol Nutr. 2006;42:265–269. https://doi.org/10.1097/01.mpg.0000189367.99416.5e.

    Article  PubMed  Google Scholar 

  22. Chen JD, Lin X, Zhang M, Torres-Pinedo RB, Orr WC. Gastric myoelectrical activity in healthy children and children with functional dyspepsia. Dig Dis Sci. 1998;43:2384–2391. https://doi.org/10.1023/A:1026661627304.

    Article  CAS  PubMed  Google Scholar 

  23. Friesen CA, Lin Z, Garola R, et al. Chronic gastritis is not associated with gastric dysrhythmia or delayed solid emptying in children with dyspepsia. Dig Dis Sci. 2005;50:1012–1018. https://doi.org/10.1007/s10620-005-2696-4.

    Article  PubMed  Google Scholar 

  24. Leung MWY, Wong BPY, Chao NSY, Chung KW, Kwok WK, Liu KKW. Electrogastrography in the management of pediatric functional dyspepsia and motility disorder. J Pediatr Surg. 2006;41:2069–2072. https://doi.org/10.1016/j.jpedsurg.2006.08.008.

    Article  PubMed  Google Scholar 

  25. Riezzo G, Chiloiro M, Guerra V, Borrelli O, Salvia G, Cucchiara S. Comparison of gastric electrical activity and gastric emptying in healthy and dyspeptic children. Dig Dis Sci. 2000;45:517–524. https://doi.org/10.1023/A:1005493123557.

    Article  CAS  PubMed  Google Scholar 

  26. Von Baeyer CL, Piira T, Chambers CT, Trapanotto M, Zeltzer LK. Guidelines for the cold pressor task as an experimental pain stimulus for use with children. J Pain. 2005;6:218–227. https://doi.org/10.1016/j.jpain.2005.01.349.

    Article  Google Scholar 

  27. Birnie KA, Petter M, Boerner KE, Noel M, Chambers CT. Contemporary use of the cold pressor task in pediatric pain research: a systematic review of methods. J Pain. 2012;13:817–826. https://doi.org/10.1016/j.jpain.2012.06.005.

    Article  PubMed  Google Scholar 

  28. Riezzo G, Porcelli P, Guerra V, Giorgio I. Effects of different psychophysiological stressors on the cutaneous electrogastrogram in healthy subjects. Acch Physiol Biochem. 1996;104:282–286. https://doi.org/10.1076/apab.104.3.282.12899.

    Article  CAS  Google Scholar 

  29. Homma S. Correlations between anxiety and the stress responses of electrogastrography (EGG) induced by the mirror drawing test (MDT). J Smooth Muscle Res. 2014;50:1–7. https://doi.org/10.1540/jsmr.50.1.

    Article  PubMed  PubMed Central  Google Scholar 

  30. De Giorgi F, Sarnelli G, Cirillo C, et al. Increased severity of dyspeptic symptoms related to mental stress is associated with sympathetic hyperactivity and enhanced endocrine response in patients with postprandial distress syndrome. Neurogastroenterol Motil. 2013;25:31-e3. https://doi.org/10.1111/nmo.12004.

    Article  Google Scholar 

  31. Homma S. Correlations between the responses of electrogastrograms, heart rate and respiratory rate to the stress of the mirror drawing test in human subjects. J Smooth Muscle Res. 2006;42:9–19. https://doi.org/10.1540/jsmr.42.9.

    Article  PubMed  Google Scholar 

  32. Homma S. Local differences in electrogastrographic responses ti the stress of the mirror drawing test (MDT) as determined by multichannel electrogastrography. J Smooth Muscle Res. 2012;48:47–57. https://doi.org/10.1540/jsmr.48.47.

    Article  PubMed  Google Scholar 

  33. Dal K, Deveci OS, Kucukazman M, et al. Decreased parasympathetic activity in patients with functional dyspepsia. Eur J Gastroenterol Hepatol. 2014;26:748–752. https://doi.org/10.1097/meg.0000000000000111.

    Article  PubMed  Google Scholar 

  34. Lorena SL, Figueiredo MJ, Almeida JR, Mesquita MA. Autonomic function in patients with functional dyspepsia assessed by 24-h heart rate variability. Dig Dis Sci. 2002;47:27–31. https://doi.org/10.1023/A:1013246900041.

    Article  PubMed  Google Scholar 

  35. Jarrett M, Heitkemper M, Czyzewski D, Zeltzer L, Shulman RJ. Autonomic nervous system function in young children with functional abdominal pain or irritable bowel syndrome. J Pain. 2012;13:477–484. https://doi.org/10.1016/j.jpain.2012.02.007.

    Article  PubMed  PubMed Central  Google Scholar 

  36. Puzanovova M, Arbogast PG, Smith CA, Anderson J, Diedrich A, Walker LS. Autonomic activity and somatic symptoms in response to success versus failure on a cognitive task: a comparison of chronic abdominal pain patients and well children. J Psychosom Res. 2009;67:235–243. https://doi.org/10.1016/j.jpsychores.2009.02.007.

    Article  PubMed  PubMed Central  Google Scholar 

  37. Sharma RK, Balhara YP, Sagar R, Deepak KK, Mehta M. Heart rate variability study of childhood anxiety disorders. J Cardiovasc Dis Res. 2011;2:115–122. https://doi.org/10.4103/0975-3583.83040.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  38. Schurman JV, Friesen CA. Identifying potential pediatric chronic abdominal pain triggers using ecological momentary assessment. Clin Pract Pediatr Psychol. 2015;3:131–141. https://doi.org/10.1037/cpp0000095.

    Article  Google Scholar 

  39. Schurman JV, Danda CE, Friesen CA, Hyman PE, Simon SD, Cocjin JT. Variations in psychological profile among children with recurrent abdominal pain. J Clin Psychol Med Settings. 2008;15:241–251. https://doi.org/10.1007/s10880-008-9120-0.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Division of Sciences and Engineering, Department of Physical Engineering, Universidad de Guanajuato, Loma del Bosque 103 Lomas del Campestre, 37150, Leon, GTO, Mexico

    Francisco Miguel Vargas-Luna

  2. Division of Health Sciences, Department of Applied Science to Work, Universidad de Guanajuato, Loma del Bosque 103 Lomas del Campestre, 37150, Leon, GTO, Mexico

    María Raquel Huerta-Franco

  3. Division of Developmental and Behavioral Sciences, Children’s Mercy Kansas City, 2401 Gillham Road, Kansas City, MO, 64108, USA

    Jennifer V. Schurman & Amanda D. Deacy

  4. Division of Gastroenterology, Hepatology, and Nutrition, Children’s Mercy Kansas City, 2401 Gillham Road, Kansas City, MO, 64108, USA

    Amber Bagherian, Lisa Harvey & Craig A. Friesen

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  1. Francisco Miguel Vargas-Luna
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  3. Jennifer V. Schurman
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Correspondence to Craig A. Friesen.

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Vargas-Luna, F.M., Huerta-Franco, M.R., Schurman, J.V. et al. Heart Rate Variability and Gastric Electrical Response to a Cold Pressor Task in Youth with Functional Dyspepsia. Dig Dis Sci 65, 1074–1081 (2020). https://doi.org/10.1007/s10620-019-05848-4

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