Autonomic Nervous System Activity during Refractory Rise in Intracranial Pressure
Refractory intracranial hypertension (RIH) is a dramatic increase in intracranial pressure (ICP) that cannot be controlled by treatment. Recent reports suggest that the autonomic nervous system (ANS) activity may be altered during changes in ICP. Our study aimed to assess ANS activity during RIH and...
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ftpubmed:oai:pubmedcentral.nih.gov:8336253 2023-05-15T18:33:53+02:00 Autonomic Nervous System Activity during Refractory Rise in Intracranial Pressure Fedriga, Marta Czigler, Andras Nasr, Nathalie Zeiler, Frederick. A. Park, Soojin Donnelly, Joseph Papaioannou, Vasilios Frisvold, Shirin K Wolf, Stephan Rasulo, Frank Sykora, Marek Smielewski, Peter Czosnyka, Marek 2021-06-15 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8336253/ http://www.ncbi.nlm.nih.gov/pubmed/33280491 https://doi.org/10.1089/neu.2020.7091 en eng Mary Ann Liebert, Inc., publishers http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8336253/ http://www.ncbi.nlm.nih.gov/pubmed/33280491 http://dx.doi.org/10.1089/neu.2020.7091 Copyright 2021, Mary Ann Liebert, Inc., publishers J Neurotrauma Original Articles Text 2021 ftpubmed https://doi.org/10.1089/neu.2020.7091 2022-06-19T00:27:01Z Refractory intracranial hypertension (RIH) is a dramatic increase in intracranial pressure (ICP) that cannot be controlled by treatment. Recent reports suggest that the autonomic nervous system (ANS) activity may be altered during changes in ICP. Our study aimed to assess ANS activity during RIH and the causal relationship between rising in ICP and autonomic activity. We reviewed retrospectively 24 multicenter (Cambridge, Tromso, Berlin) patients in whom RIH developed as a pre-terminal event after acute brain injury (ABI). They were monitored with ICP, arterial blood pressure (ABP), and electrocardiography (ECG) using ICM+ software. Parameters reflecting autonomic activity were computed in time and frequency domain through the measurement of heart rate variability (HRV) and baroreflex sensitivity (BRS). Our results demonstrated that a rise in ICP was associated to a significant rise in HRV and BRS with a higher significance level in the high-frequency HRV (p < 0.001). This increase was followed by a significant decrease in HRV and BRS above the upper-breakpoint of ICP where ICP pulse-amplitude starts to decrease whereas the mean ICP continues to rise. Temporality measured with a Granger test suggests a causal relationship from ICP to ANS. The above results suggest that a rise in ICP interacts with ANS activity, mainly interfacing with the parasympathetic-system. The ANS seems to react to the rise in ICP with a response possibly focused on maintaining the cerebrovascular homeostasis. This happens until the critical threshold of ICP is reached above which the ANS variables collapse, probably because of low perfusion of the brain and the central autonomic network. Text Tromso Tromso PubMed Central (PMC) Tromso ENVELOPE(16.546,16.546,68.801,68.801) Journal of Neurotrauma 38 12 1662 1669 |
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English |
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Original Articles |
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Original Articles Fedriga, Marta Czigler, Andras Nasr, Nathalie Zeiler, Frederick. A. Park, Soojin Donnelly, Joseph Papaioannou, Vasilios Frisvold, Shirin K Wolf, Stephan Rasulo, Frank Sykora, Marek Smielewski, Peter Czosnyka, Marek Autonomic Nervous System Activity during Refractory Rise in Intracranial Pressure |
topic_facet |
Original Articles |
description |
Refractory intracranial hypertension (RIH) is a dramatic increase in intracranial pressure (ICP) that cannot be controlled by treatment. Recent reports suggest that the autonomic nervous system (ANS) activity may be altered during changes in ICP. Our study aimed to assess ANS activity during RIH and the causal relationship between rising in ICP and autonomic activity. We reviewed retrospectively 24 multicenter (Cambridge, Tromso, Berlin) patients in whom RIH developed as a pre-terminal event after acute brain injury (ABI). They were monitored with ICP, arterial blood pressure (ABP), and electrocardiography (ECG) using ICM+ software. Parameters reflecting autonomic activity were computed in time and frequency domain through the measurement of heart rate variability (HRV) and baroreflex sensitivity (BRS). Our results demonstrated that a rise in ICP was associated to a significant rise in HRV and BRS with a higher significance level in the high-frequency HRV (p < 0.001). This increase was followed by a significant decrease in HRV and BRS above the upper-breakpoint of ICP where ICP pulse-amplitude starts to decrease whereas the mean ICP continues to rise. Temporality measured with a Granger test suggests a causal relationship from ICP to ANS. The above results suggest that a rise in ICP interacts with ANS activity, mainly interfacing with the parasympathetic-system. The ANS seems to react to the rise in ICP with a response possibly focused on maintaining the cerebrovascular homeostasis. This happens until the critical threshold of ICP is reached above which the ANS variables collapse, probably because of low perfusion of the brain and the central autonomic network. |
format |
Text |
author |
Fedriga, Marta Czigler, Andras Nasr, Nathalie Zeiler, Frederick. A. Park, Soojin Donnelly, Joseph Papaioannou, Vasilios Frisvold, Shirin K Wolf, Stephan Rasulo, Frank Sykora, Marek Smielewski, Peter Czosnyka, Marek |
author_facet |
Fedriga, Marta Czigler, Andras Nasr, Nathalie Zeiler, Frederick. A. Park, Soojin Donnelly, Joseph Papaioannou, Vasilios Frisvold, Shirin K Wolf, Stephan Rasulo, Frank Sykora, Marek Smielewski, Peter Czosnyka, Marek |
author_sort |
Fedriga, Marta |
title |
Autonomic Nervous System Activity during Refractory Rise in Intracranial Pressure |
title_short |
Autonomic Nervous System Activity during Refractory Rise in Intracranial Pressure |
title_full |
Autonomic Nervous System Activity during Refractory Rise in Intracranial Pressure |
title_fullStr |
Autonomic Nervous System Activity during Refractory Rise in Intracranial Pressure |
title_full_unstemmed |
Autonomic Nervous System Activity during Refractory Rise in Intracranial Pressure |
title_sort |
autonomic nervous system activity during refractory rise in intracranial pressure |
publisher |
Mary Ann Liebert, Inc., publishers |
publishDate |
2021 |
url |
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8336253/ http://www.ncbi.nlm.nih.gov/pubmed/33280491 https://doi.org/10.1089/neu.2020.7091 |
long_lat |
ENVELOPE(16.546,16.546,68.801,68.801) |
geographic |
Tromso |
geographic_facet |
Tromso |
genre |
Tromso Tromso |
genre_facet |
Tromso Tromso |
op_source |
J Neurotrauma |
op_relation |
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8336253/ http://www.ncbi.nlm.nih.gov/pubmed/33280491 http://dx.doi.org/10.1089/neu.2020.7091 |
op_rights |
Copyright 2021, Mary Ann Liebert, Inc., publishers |
op_doi |
https://doi.org/10.1089/neu.2020.7091 |
container_title |
Journal of Neurotrauma |
container_volume |
38 |
container_issue |
12 |
container_start_page |
1662 |
op_container_end_page |
1669 |
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1766218520387911680 |