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Autonomic Function at Rest and in Response to Emotional and Rectal Stimuli in Women with Irritable Bowel Syndrome

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Abstract

Our aim was to study autonomic function in patients with Irritable bowel syndrome (IBS) without constipation and psychiatric comorbidity. Respiratory sinus arrhythmia (RSA) (representing cardiac vagal activity), skin conductance (representing sympathetic activity) and heart rate were measured at baseline and as a response to emotional stress and rectal discomfort in 33 women with IBS and 21 healthy women. Baseline heart rate was higher in the patients than in the healthy volunteers. Both groups had decreased RSA and increased heart rate and skin conductance level when exposed to emotional stress, but the autonomic responses did not differ significantly between the groups. At discomfort threshold the patients had increased heart rate response and skin conductance amplitude when compared to the healthy volunteers. Correlations between autonomic responses and the depression subscale of the Hospital Anxiety and Depression (HAD) score differed markedly between the diarrhea-predominant IBS patients and the IBS patients with alternating stool habits.

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References

  1. Drossman DA, Thompson WG, Talley NJ, Funch-Jensen P, Janssens J, Whitehead WE (1990) Identification of sub-groups of functional gastrointestinal disorders. Gastroenterol Int 3:159–172

    Google Scholar 

  2. Thompson WG, Longstreth GF, Drossman DA, Heaton KW, Irvine EJ, Müller-Lissner SA (1999) Functional bowel disorders and functional abdominal pain. Gut 45 (Suppl 2):II43–II47

    Article  PubMed  Google Scholar 

  3. Welgan P, Meshkinpour H, Beeler M (1988) Effect of anger on colon motor and myoelectric activity in irritable bowel syndrome. Gastroenterology 94:1150–1156

    PubMed  CAS  Google Scholar 

  4. Wood JR, Camilleri M, Low PA, Malagelada JR (1985) Brainstem tumor presenting as an upper gut motility disorder. Gastroenterology 89:1411–1414

    PubMed  CAS  Google Scholar 

  5. Berntson GG, Sarter M, Cacioppo JT (2003) Ascending visceral regulation of cortical affective information processing. Eur J Neurosci 18:2103–2109

    Article  PubMed  Google Scholar 

  6. Camilleri M (1990) Disorders of gastrointestinal motility in neurologic diseases. Mayo Clin Proc 65:825–846

    PubMed  CAS  Google Scholar 

  7. Bharucha AE, Camilleri M, Low PA, Zinsmeister AR (1993) Autonomic dysfunction in gastrointestinal motility disorders. Gut 34:397–401

    Article  PubMed  CAS  Google Scholar 

  8. Smart HL, Atkinson M (1987) Abnormal vagal function in irritable bowel syndrome. Lancet 2:475–478

    Article  PubMed  CAS  Google Scholar 

  9. Heitkemper M, Burr RL, Jarrett M, Hertig V, Lustyk MK, Bond EF (1998) Evidence for autonomic nervous system imbalance in women with irritable bowel syndrome. Dig Dis Sci 43:2093–2098

    Article  PubMed  CAS  Google Scholar 

  10. Orr WC, Elsenbruch S, Harnish MJ (2000) Autonomic regulation of cardiac function during sleep in patients with irritable bowel syndrome. Am J Gastroenterol 95:2865–2871

    Article  PubMed  CAS  Google Scholar 

  11. Karling P, Nyhlin H, Wiklund U, Sjöberg M, Olofsson BO, Bjerle P (1998) Spectral analysis of heart rate variability in patients with irritable bowel syndrome. Scand J Gastroenterol 33:572–576

    Article  PubMed  CAS  Google Scholar 

  12. Heitkemper M, Jarrett M, Cain K, Shaver J, Bond E, Woods NF, Walker E (1996) Increased urine catecholamines and cortisol in women with irritable bowel syndrome. Am J Gastroenterol 91:906–913

    PubMed  CAS  Google Scholar 

  13. Tousignant-Laflamme Y, Goffaux P, Bourgault P, Marchand S (2006) Different autonomic responses to experimental pain in IBS patients and healthy controls. J Clin Gastroenterol 40:814–820

    Article  PubMed  Google Scholar 

  14. Adeyemi EOA, Desai KD, Towsey M, Ghista D (1999) Characterization of autonomic dysfunction in patients with irritable bowel syndrome by means of heart rate variability studies. Am J Gastroenterol 94:816–823

    Article  PubMed  CAS  Google Scholar 

  15. van Orshoven NP, Andriesse GI, van Schelven LJ, Smout AJ, Akkermans LMA, Oey PL (2006) Subtle involvement of the parasympathetic nervous system in patients with irritable bowel syndrome. Clin Auton Res 16:33–39

    Article  PubMed  Google Scholar 

  16. Waring WS, Chui M, Japp A, Nicol EF, Ford MJ (2004) Autonomic cardiovascular responses are impaired in women with irritable bowel syndrome. J Clin Gastroenterol 38:658–663

    Article  PubMed  Google Scholar 

  17. Punyabati O, Deepak KK, Sharma MP, Dwivedi SN (2000) Autonomic nervous system reactivity in irritable bowel syndrome. Indian J Gastroenterol 19:122–125

    PubMed  CAS  Google Scholar 

  18. Tillisch K, Mayer EA, Labus JS, Stains J, Chang L, Naliboff BD (2005) Sex specific alterations in autonomic function among patients with irritable bowel syndrome. Gut 54:1396–1401

    Article  PubMed  CAS  Google Scholar 

  19. Aggarwal A, Cutts TF, Abell TL, Cardoso S, Familoni B, Bremer J, Karas J (1994) Predominant symptoms in irritable bowel syndrome correlate with specific autonomic nervous system abnormalities. Gastroenterology 106:945–950

    PubMed  CAS  Google Scholar 

  20. Lee CT, Chuang TY, Lu CL, Chen CY, Chang FY, Lee SD (1998) Abnormal vagal cholinergic function and psychological behaviors in irritable bowel syndrome patients: a hospital-based oriental study. Dig Dis Sci 43:1794–1799

    Article  PubMed  CAS  Google Scholar 

  21. Heitkemper M, Jarrett M, Cain KC, Burr R, Levy RL, Feld A, Hertig V (2001) Autonomic nervous system function in women with irritable bowel syndrome. Dig Dis Sci 46:1276–1284

    Article  PubMed  CAS  Google Scholar 

  22. Elsenbruch S, Orr WC (2001) Diarrhea- and constipation-predominant IBS patients differ in postprandial autonomic and cortisol responses. Am J Gastroenterol 96:460–466

    Article  PubMed  CAS  Google Scholar 

  23. Robert JJ, Elsenbruch S, Orr WC (2006) Sleep-related autonomic disturbances in symptom subgroups of women with irritable bowel syndrome. Dig Dis Sci 51:2121–2127

    Article  PubMed  Google Scholar 

  24. Emmanuel AV, Mason HJ, Kamm MA (2001) Relationship between psychological state and level of activity of extrinsic gut innervation in patients with a functional gut disorder. Gut 49:209–213

    Article  PubMed  CAS  Google Scholar 

  25. Moser M, Lehofer M, Hoehn-Saric R, McLeod DR, Hildebrandt G, Steinbrenner B, Voica M, Liebmann P, Zapotoczky HG (1998) Increased heart rate in depressed subjects in spite of unchanged autonomic balance? J Affect Disord 48:115–124

    Article  PubMed  CAS  Google Scholar 

  26. Gorman JM, Sloan RP (2000) Heart rate variability in depressive and anxiety disorders. Am Heart J 140:77–83

    Article  PubMed  CAS  Google Scholar 

  27. Cohen H, Benjamin J, Geva AB, Matar MA, Kaplan Z, Kotler M (2000) Autonomic dysregulation in panic disorder and in post-traumatic stress disorder: application of power spectrum analysis of heart rate variability at rest and in response to recollection of trauma or panic attacks. Psychiatry Res 96:1–13

    Article  PubMed  CAS  Google Scholar 

  28. Jarrett ME, Burr RL, Cain KC, Hertig V, Weisman P, Heitkemper MM (2003) Anxiety and depression are related to autonomic nervous system function in women with irritable bowel syndrome. Dig Dis Sci 48:386–394

    Article  PubMed  Google Scholar 

  29. Robert JJT, Orr WC, Elsenbruch S (2004) Modulation of sleep quality and autonomic functioning by symptoms of depression in women with irritable bowel syndrome. Dig Dis Sci 49:1250–1258

    Article  PubMed  Google Scholar 

  30. Van Oudenhove L, Demyttenaere K, Tack J, Aziz Q (2004) Central nervous system involvement in functional gastrointestinal disorders. Best Pract Res Clin Gastroenterol 18:663–680

    Article  PubMed  CAS  Google Scholar 

  31. Murray CDR, Flynn J, Ratcliffe L, Jacyna MR, Kamm MA, Emmanuel AV (2004) Effect of acute physical and psychological stress on gut autonomic innervation in irritable bowel syndrome. Gastroenterology 127:1695–1703

    Article  PubMed  Google Scholar 

  32. Elsenbruch S, Lovallo WR, Orr WC (2001) Psychological and physiological responses to postprandial mental stress in women with the irritable bowel syndrome. Psychosom Med 63:805–813

    PubMed  CAS  Google Scholar 

  33. Zigmond AS, Snaith RP (1983) The hospital anxiety and depression scale. Acta Psych Scand 67:361–370

    Article  CAS  Google Scholar 

  34. Sheehan D, Lecrubier Y, Janavs J, Knapp E, Weiller E, Bonora LI, Amorim P, Lepine JP, Sheehan MF, Baker RR, Sheehan KH (1994) Mini International Neuropsychiatric Interview (MINI). University of South Florida Institute for Research in Psychiatry, Tampa, Florida and INSERM-Hôpital de la Salpétrière, Paris, France

  35. Grossman P, Svebak S (1987) Respiratory sinus arrhythmia as an index of parasympathetic cardiac control during active coping. Psychophysiology 24:228–235

    Article  PubMed  CAS  Google Scholar 

  36. Dawson ME, Schell AM, Filion DL (1990) The electrodermal system. In: Cacioppo JT, Tassinary LG (eds) Principles of psychophysiology: physical, social, and inferential elements. Cambridge University Press, Cambridge, pp 295–324

    Google Scholar 

  37. Blomhoff S, Jacobsen MB, Spetalen S, Dahm A, Malt UF (2000) Perceptual hyperreactivity to auditory stimuli in patients with irritable bowel syndrome. Scand J Gastroenterol 35:583–589

    Article  PubMed  CAS  Google Scholar 

  38. Spetalen S, Jacobsen MB, Vatn MH, Blomhoff S, Sandvik L (2004) Visceral sensitivity in irritable bowel syndrome and healthy volunteers: reproducibility of the rectal barostat. Dig Dis Sci 49:1259–1264

    Article  PubMed  Google Scholar 

  39. Gupta V, Sheffield D, Verne GN (2002) Evidence for autonomic dysregulation in the irritable bowel syndrome. Dig Dis Sci 47:1716–1722

    Article  PubMed  Google Scholar 

  40. Payne A, Blanchard EB, Holt CS, Schwarz SP (1992) Physiological reactivity to stressors in irritable bowel syndrome patients, inflammatory bowel disease patients and non-patient controls. Behav Res Ther 30:293–300

    Article  PubMed  CAS  Google Scholar 

  41. Lee KT, Rhee PL, Kim J, Koh KC, Paik SW, Rhee JC, Kim JS (1997) Assessment of autonomic tone over a 24-hour period in patients with irritable bowel syndrome. Gastroenterology 112:A773

    Article  Google Scholar 

  42. Dickhaus B, Mayer EA, Firooz N, Stains J, Conde F, Olivas TI, Fass R, Chang L, Mayer M, Naliboff BD (2003) Irritable bowel syndrome patients show enhanced modulation of visceral perception by auditory stress. Am J Gastroenterol 98:135–143

    Article  PubMed  Google Scholar 

  43. Mayer EA, Munakata J, Mandelkern M, Hoh K, Kodner A, Naliboff B, Silverman DHS (1996) Correlation of cortical and subcortical brain activation with autonomic responses to rectal stimuli in humans. Gastroenterology 110:A715

    Google Scholar 

  44. Emmanuel AV, Kamm MA (2000) Laser Doppler flowmetry as a measure of extrinsic colonic innervation in functional bowel disease. Gut 46:212–217

    Article  PubMed  CAS  Google Scholar 

  45. Sinnreich R, Kark JD, Friedlander Y, Sapoznikov D, Luria MH (1998) Five minute recordings of heart rate variability for population studies: repeatability and age-sex characteristics. Heart 80:156–162

    PubMed  CAS  Google Scholar 

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Acknowledgments

We are grateful to the Department of Pathology, Ullevaal University Hospital, for giving the first author (S.S.) enough time to accomplish this study. This paper has been made possible through grants from the Norwegian Cancer Society and Wyeth Lederle.

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Authors and Affiliations

  1. Department of Medicine, Rikshospitalet University Hospital, Oslo, Norway

    Signe Spetalen

  2. Department of Pathology, Ullevaal University Hospital, 0407, Oslo, Norway

    Signe Spetalen

  3. Center for Clinical Research, Ullevaal University Hospital, Oslo, Norway

    Leiv Sandvik

  4. Department of Psychosomatic and Behavioural Medicine, Rikshospitalet University Hospital, Oslo, Norway

    Svein Blomhoff

  5. Oestfold Hospital Trust and University of Oslo, Oslo, Norway

    Morten B. Jacobsen

Authors
  1. Signe Spetalen
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  2. Leiv Sandvik
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  3. Svein Blomhoff
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  4. Morten B. Jacobsen
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Correspondence to Signe Spetalen.

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Spetalen, S., Sandvik, L., Blomhoff, S. et al. Autonomic Function at Rest and in Response to Emotional and Rectal Stimuli in Women with Irritable Bowel Syndrome. Dig Dis Sci 53, 1652–1659 (2008). https://doi.org/10.1007/s10620-007-0066-0

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  • DOI: https://doi.org/10.1007/s10620-007-0066-0

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