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Related Concept Videos

Blood and Nerve Supply to the Bones01:29

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Bones are dynamic organs that require a rich supply of oxygen and nutrients. Around 5% to 10% of the cardiac output supplies blood to the bones. A typical long bone has three main sources: the nutrient artery, the metaphyseal and epiphyseal arteries, and the periosteal arteries.
Nutrient Artery
The nutrient artery is the main blood vessel that enters the diaphysis via the nutrient foramen. While most long bones have only one nutrient foramen, large bones, such as the femur, may have two. This...
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Related Experiment Video

Updated: Aug 7, 2025

Machine Learning Algorithms for Early Detection of Bone Metastases in an Experimental Rat Model
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Preliminary Study on Establishing a Heart Rate Variability-based Method for Objectively Evaluating Bone Metastasis

Keiko Nemoto Murofushi1, Makoto Komazawa2, Wataru Murofushi3

  • 1Division of Radiation Oncology, Department of Radiology, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan; kmurofushi0918@gmail.com.

In Vivo (Athens, Greece)
|March 7, 2023
PubMed
Summary

Heart rate variability (HRV) shows potential for objectively assessing bone metastasis pain. Mental status, like depression, can influence HRV, especially in mild pain cases.

Keywords:
Heart rate variabilitybone metastasisnumerical rating scalepainradiotherapy

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Area of Science:

  • Oncology
  • Cardiology
  • Psychiatry

Background:

  • Bone metastasis causes significant pain and impacts patient quality of life.
  • Objective pain assessment methods are crucial for effective cancer pain management.
  • Heart rate variability (HRV) offers a non-invasive physiological marker.

Purpose of the Study:

  • To develop an objective pain evaluation method for bone metastasis using HRV.
  • To investigate the correlation between pain intensity, mental status, and HRV parameters.

Main Methods:

  • Prospective study enrolling 11 patients with painful bone metastases undergoing radiotherapy.
  • Pain assessed via Numerical Rating Scale (NRS); anxiety/depression via Hospital Anxiety and Depression Scale (HADS).
  • Autonomic activity measured using HRV (R-R interval) via wearable device at multiple time points.

Main Results:

  • NRS scores correlated significantly with the low-frequency/high-frequency (LF/HF) ratio in patients with NRS ≥4 (p=0.03).
  • Resting LF/HF was higher than during physical activity, despite higher heart rate during activity.
  • A trend for positive correlation between NRS and mean LF/HF was observed in patients without significant depression (p=0.07).

Conclusions:

  • HRV measurements show promise for objective pain evaluation in bone metastasis.
  • Mental status, particularly depression, can confound HRV interpretation in cancer patients with mild pain.
  • Further research is needed to refine HRV as a pain biomarker in oncology.