Does pain location influence heart rate variability? A comparative analysis of patients with neck or low back pain, and healthy controls

IF 2.3 3区心理学 Q2 BEHAVIORAL SCIENCES

Behavioural Brain Research Pub Date : 2025-09-09 DOI:10.1016/j.bbr.2025.115811

Luis Espejo-Antúnez , Carlos Fernández-Morales , Manuel Albornoz-Cabello , María de los Ángeles Cardero-Durán

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引用次数: 0

Abstract

Background/Objectives

Chronic neck pain (CNP) and chronic low back pain (CLBP) are prevalent musculoskeletal disorders linked to autonomic nervous system dysfunction, assessed through heart rate variability (HRV). This study aimed to compare HRV indices among subjects with CNP, CLBP, and healthy controls, examining whether pain location influences autonomic modulation.

Methods

An observational study was conducted involving 93 adults (31 per group: CNP, CLBP, and controls). HRV was measured using a Firstbeat Bodyguard® device, analyzing parameters including mean HR, minimum and maximum HR, rMSSD, SD1, SD2, stress score (SS), and sympathetic/parasympathetic ratio (S:PS). HRV data were analyzed following standard guidelines. Additional analyses included multinomial logistic regression and ROC curves to explore the predictive value of rMSSD.

Results

Both pain groups showed significantly higher sympathetic dominance (higher SS and S:PS ratio) compared to controls (p < 0.001, d = 1.0–1.3). Subjects with CNP exhibited significantly lower parasympathetic indices (rMSSD and SD1) compared to the CLBP group (both p < 0.01, d = 0.8) and healthy controls (p < 0.001, d = 2.2 and d = 2.3). No differences were observed in sympathetic dominance between CNP and CLBP groups. Logistic regression confirmed the predictive value of rMSSD for group classification, and ROC analyses showed high discriminatory capacity, particularly between CNP and healthy subjects (AUC = 0.932).

Conclusions

Significant differences in autonomic modulation were observed between patients with CNP, CLBP, and healthy subjects. CNP was associated with a greater reduction in parasympathetic activity, possibly due to mechanisms related to the anatomical proximity of the vagus nerve to the cervical region.

查看原文本刊更多论文

疼痛位置影响心率变异性吗？颈、腰痛患者与健康对照的比较分析。

背景/目的：慢性颈痛（CNP）和慢性腰痛（CLBP）是与自主神经系统功能障碍相关的常见肌肉骨骼疾病，可通过心率变异性（HRV）进行评估。本研究旨在比较CNP、CLBP和健康对照者的HRV指数，以检查疼痛位置是否影响自主神经调节。方法：对93名成年人进行观察性研究（每组31人：CNP、CLBP和对照组）。采用Firstbeat Bodyguard®设备测量HRV，分析参数包括平均HR、最小和最大HR、rMSSD、SD1、SD2、压力评分（SS）和交感/副交感神经比（S:PS）。HRV数据按照标准指南进行分析。其他分析包括多项逻辑回归和ROC曲线来探讨rMSSD的预测价值。结果：与对照组相比，两组患者交感优势度均显著升高（SS和S:PS比值均升高）（p < 0.001, d = 1.0 ~ 1.3）。与CLBP组（p < 0.01, d = 0.8）和健康对照组（p < 0.001, d = 2.2和d = 2.3）相比，CNP组的副交感神经指数（rMSSD和SD1）显著降低。CNP组和CLBP组交感优势无差异。Logistic回归证实了rMSSD对分组分类的预测价值，ROC分析显示具有较高的区分能力，特别是在CNP和健康受试者之间（AUC = 0.932）。结论：自主神经调节在CNP、CLBP患者和健康受试者之间存在显著差异。CNP与副交感神经活动的更大程度的减少有关，可能是由于迷走神经与颈椎区域的解剖接近有关的机制。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Behavioural Brain Research 医学-行为科学

CiteScore

5.60

自引率

0.00%

发文量

383

审稿时长

61 days

期刊介绍： Behavioural Brain Research is an international, interdisciplinary journal dedicated to the publication of articles in the field of behavioural neuroscience, broadly defined. Contributions from the entire range of disciplines that comprise the neurosciences, behavioural sciences or cognitive sciences are appropriate, as long as the goal is to delineate the neural mechanisms underlying behaviour. Thus, studies may range from neurophysiological, neuroanatomical, neurochemical or neuropharmacological analysis of brain-behaviour relations, including the use of molecular genetic or behavioural genetic approaches, to studies that involve the use of brain imaging techniques, to neuroethological studies. Reports of original research, of major methodological advances, or of novel conceptual approaches are all encouraged. The journal will also consider critical reviews on selected topics.