Psychological traits influence autonomic nervous system recovery following esophageal intubation in health and functional chest pain
Article first published online: 20 SEP 2013
© 2013 John Wiley & Sons Ltd
Neurogastroenterology & Motility
Volume 25, Issue 12, pages 950–e772, December 2013
How to Cite
Farmer, A. D., Coen, S. J., Kano, M., Worthen, S. F., Rossiter, H. E., Navqi, H., Scott, S. M., Furlong, P. L. and Aziz, Q. (2013), Psychological traits influence autonomic nervous system recovery following esophageal intubation in health and functional chest pain. Neurogastroenterology & Motility, 25: 950–e772. doi: 10.1111/nmo.12231
- Issue published online: 19 NOV 2013
- Article first published online: 20 SEP 2013
- Manuscript Accepted: 13 AUG 2013
- Manuscript Received: 26 JUN 2013
- Medical Research Council. Grant Number: MGAB1A1R
- autonomic nervous system;
- esophageal intubation;
- functional chest pain;
Esophageal intubation is a widely utilized technique for a diverse array of physiological studies, activating a complex physiological response mediated, in part, by the autonomic nervous system (ANS). In order to determine the optimal time period after intubation when physiological observations should be recorded, it is important to know the duration of, and factors that influence, this ANS response, in both health and disease.
Fifty healthy subjects (27 males, median age 31.9 years, range 20–53 years) and 20 patients with Rome III defined functional chest pain (nine male, median age of 38.7 years, range 28–59 years) had personality traits and anxiety measured. Subjects had heart rate (HR), blood pressure (BP), sympathetic (cardiac sympathetic index, CSI), and parasympathetic nervous system (cardiac vagal tone, CVT) parameters measured at baseline and in response to per nasum intubation with an esophageal catheter. CSI/CVT recovery was measured following esophageal intubation.
In all subjects, esophageal intubation caused an elevation in HR, BP, CSI, and skin conductance response (SCR; all p < 0.0001) but concomitant CVT and cardiac sensitivity to the baroreflex (CSB) withdrawal (all p < 0.04). Multiple linear regression analysis demonstrated that longer CVT recovery times were independently associated with higher neuroticism (p < 0.001). Patients had prolonged CSI and CVT recovery times in comparison to healthy subjects (112.5 s vs 46.5 s, p = 0.0001 and 549 s vs 223.5 s, p = 0.0001, respectively).
Conclusions & Inferences
Esophageal intubation activates a flight/flight ANS response. Future studies should allow for at least 10 min of recovery time. Consideration should be given to psychological traits and disease status as these can influence recovery.