Kristen Sparrow • August 16, 2017
I copied a fair amount of this article because the methodology is of interesting to me because I’ve always wondered if the response to needling itself (seconds to minutes) tells us anything about the patient’s susceptibility to treatment or even innate resilience. This study discussed previously, touches on this idea. unfortunately, the researchers did not include HRV in their outcome measures. I included some of the text of the article which provides some worthwhile background.
This paragraph, in particular, addresses the significance of the subtle changes in the autonomic nervous system that can affect health and well-being.
“In clinical practice patients present with subclinical disturbances of sleep quality and/or personal well-being. In such cases, although patients often show no manifest organic deviations, the patients’ life quality may be markedly decreased. These states may indeed be precursors to later organic diseases. Functional disorders may even be associated with altered tone or reactivity of the sympathetic and parasympathetic nervous system (Thayer and Lane, 2007), the main components of the autonomic nervous regulation required for organismic function (Moser et al., 2006, 2008). On the other hand, patients with clear diagnoses might resist conventional therapy. Disturbances in the autonomic balance might be responsible for such disease resistance (Thayer and Lane, 2007).”
Aims and Objectives: The autonomic nervous system plays an important role in homeostasis and organismic recreation, control of immune function, inflammation, and bone growth. It also regulates blood pressure and orthostasis via vagal and sympathetic pathways. Besides recording of heart rate variability (HRV), which characterizes medium (1–5 min) and long term (circadian) autonomic tone or modulation, no gentle tests of short-term autonomic reactivity and control are available. In 1976 Nogier described a short time cardiovascular response (“Réflexe Auriculo Cardiaque”, RAC) which could be used to investigate short term autonomic reactions without changing system characteristics and thus being repeatable in short intervals. In this paper, we investigated the possible application of the Nogier reaction as a micro-test for the identification of a disturbed sensitivity or reactivity of the autonomic nervous system.
Methods: We statistically analyzed cardiovascular signals derived during the application of small repeated stimuli utilizing methods of signal averaging to characterize the physiological background. Specifically, the Nogier reaction was investigated using simultaneous recordings of ECG, pulse waves, and respiration.
Results: Significant fast (delay 1–5 s) and slower (delay 6–12 s) cardio-autonomic responses to different stimuli which characterize short term were observed. From time characteristics and type of signals where they occur we deduce that fast changes observed in heart rate are vagal reactions to the small stimuli whereas slower changes observed in pulse waves stem from sympathetic nervous system responses.
Conclusions: The investigated autonomic micro-test opens the possibility to differentially investigate both limbs of the autonomic nervous system with minimal stimuli. It can be performed within seconds and does not change the set point of the system in opposition to less subtle tests such as Valsalva maneuver. Therefore, it is well-suited for quick, repeated measurements of autonomic nervous system reactivity.
Not only in disease, but also in healthy subjects the ANS plays a role more important that previously assumed. Recent research has documented the importance of the autonomic nervous system for tasks like immune functioning or bone growth control, beside the long-known energy and humoral regulation. ANS control also is essential for orthostatic stability and baroreflex control (Moser et al., 1992) as well as neuromuscular control in microgravity (Gallasch et al., 1997). Autonomic receptors found at the cell surface of leucocytes have been traced during “information exchange” with autonomic nerve terminals along the wall of small blood vessels (Felten and Olschowka, 1987; Kin and Sanders, 2006). Concerning inflammation, a co-factor of many lifestyle diseases, an “inflammatory reflex” (Tracey, 2002) has been identified involving tissue located vagal afferents and efferents: macrophage cells in inflamed areas of the tissue produce inflammation signals, e.g., TNF alpha and interleukin-1 (Andersson and Tracey, 2012; Olofsson et al., 2012). These cytokines in turn attract and activate other lymphocytes from the nearby blood vessels. Vagal afferents carry receptors for these signals as well and “understand” the language of the immune cells reporting the inflammation location and strength to hypothalamic areas (Rosas-Ballina and Tracey, 2009). There this information is processed and vagal efferents leading to the inflamed area and to the spleen are activated (Olofsson et al., 2012). Nicotinergic acetylcholine receptors have been identified on the surface of macrophage cells. Upon vagal nerve stimulation and acetylcholine release, these receptors immediately down-regulate their cytokine production (Wang et al., 2003). This inflammatory reflex loop prevents over-activity of the immune system and allows the brain to locally control immune activity. It also represents the “first line” of inflammation control (Olofsson et al., 2012).
Disturbances of the vagal inflammation reflex are suspected to be responsible for a couple of diseases induced by chronic inflammation, including atherosclerosis, ulcerative colitis, Hashimoto disease, type 2 diabetes, and cancer (Medzhitov, 2010). Vagal modulation is reduced in most of these diseases (Huston and Tracey, 2011). Taken together, these findings suggest a common language between autonomic nervous and immune system and emphasize the role of the autonomic nervous system in immune responses.
With respect to the sympathetic system, adrenoceptors have been identified on the osteoblast cell surface. These receptors are able to block osteoblast activity and proliferation (Patel and Elefteriou, 2007). This may be one of the reasons why stress promotes osteoporosis. Another support to this hypothesis stems from the fact that beta blockers obviously prevent bone fractures (Reid, 2008). The sympathetic nervous system also influences pain perception, which is increased in nervous subjects (Liebmann et al., 1994, 1998; Lehofer et al., 1998).
In clinical practice patients present with subclinical disturbances of sleep quality and/or personal well-being. In such cases, although patients often show no manifest organic deviations, the patients’ life quality may be markedly decreased. These states may indeed be precursors to later organic diseases. Functional disorders may even be associated with altered tone or reactivity of the sympathetic and parasympathetic nervous system (Thayer and Lane, 2007), the main components of the autonomic nervous regulation required for organismic function (Moser et al., 2006, 2008). On the other hand, patients with clear diagnoses might resist conventional therapy. Disturbances in the autonomic balance might be responsible for such disease resistance (Thayer and Lane, 2007).