Cardiac Autonomic Nervous System Activity in Children with Bladder and Bowel Dysfunction

Area of Science:

• Pediatric Urology
• Autonomic Nervous System Physiology
• Cardiovascular Regulation

Background:

• Bladder and bowel dysfunction frequently necessitates pediatric urology referral.
• The autonomic nervous system's role in bladder and bowel dysfunction remains under-investigated.
• Understanding autonomic profiles is crucial for elucidating dysfunction mechanisms.

Purpose of the Study:

• To compare autonomic nervous system activity in children with bladder and bowel dysfunction versus healthy controls.
• To investigate autonomic profiles using spectral analysis of heart rate variability and impedance cardiography.
• To test the hypothesis that children with dysfunction have a distinct autonomic profile.

Main Methods:

• Recruited 40 children with diagnosed bladder and bowel dysfunction and 19 healthy controls.
• Assessed cardiac autonomic activity at baseline and during voiding.
• Measured heart rate variability parameters (total power, high frequency) and pre-ejection period.

Main Results:

• Children with bladder and bowel dysfunction showed significantly lower total power and high frequency heart rate variability at baseline (p=0.001, p=0.002).
• A significantly smaller decrease in sympathetic nervous system activity was observed during voiding in children with dysfunction (p=0.05).

Conclusions:

• Children with bladder and bowel dysfunction display a distinct cardiac autonomic profile at rest and during voiding compared to controls.
• These findings suggest potential pathophysiological insights into bladder and bowel dysfunction.
• The identified differences may inform novel therapeutic targets for managing this condition.