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[Tests of autonomic nervous system functioning in children: normal values]
S Castelli1, R Domenici, C Meossi
1U.O. Pediatria, U.S.L. n. 6, Presidio Ospedaliero di Lucca.
Insights
This study establishes normal pediatric reference values for cardiovascular autonomic reflex tests, crucial for assessing autonomic function in children. These findings provide essential data for diagnosing autonomic dysfunction in pediatric populations.
Area of Science:
- Physiology
- Autonomic Nervous System
- Pediatric Cardiology
Context:
- Cardiovascular autonomic reflexes are vital for assessing autonomic nervous system (ANS) function.
- Standardized pediatric reference data for these tests were previously lacking.
- Autonomic function testing involves analyzing heart rate and arterial pressure variations in response to physiological stimuli.
Purpose:
- To standardize cardiovascular autonomic reflex tests in a healthy pediatric population.
- To establish normal reference values for these tests in children aged 8.3-15.7 years.
- To explore correlations between autonomic parameters and auxological features.
Summary:
- 198 healthy children (94 male, 104 female) underwent standardized autonomic function tests, including ECG and arterial pressure monitoring during breathing, Valsalva maneuver, postural changes, and isometric exercise.
- Eleven autonomic parameters were measured, and normal reference values were calculated.
- Significant differences in autonomic parameters were observed between sexes, but correlations with auxological features were not remarkable.
Impact:
- Provides the first comprehensive set of normal reference values for pediatric cardiovascular autonomic reflex testing.
- Enables more accurate diagnosis and monitoring of autonomic dysfunction in children.
- Facilitates future research into pediatric autonomic neuropathies and related conditions.
Abstract:
The study of cardiovascular autonomic reflexes is the most physiological and reliable test for the assessment of autonomic function: they consist of the analysis of variation of heart rate and arterial pressure provoked by many physiological stimuli. Up to now normal pediatric reference data were not available: we have standardized these tests in 198 normal children (94 M, 104 F), aged 8.3-15.7 years, without any symptom of possible autonomic dysfunction pathology. A complete auxological evaluation has been performed. Autonomic tests were performed by ECG recording and arterial pressure monitoring during normal and deep breathing, Valsalva manoeuvre, lying to standing postural change, isometric muscular contraction (sustained hand-grip and leg rising). Eleven autonomic parameters were obtained. Many statistical correlation between autonomic parameters and auxological features have been explored, without remarkable results. A significative difference emerged only between sexes. Normal reference values has been calculated. Their utility for the study of autonomic dysfunction is discussed.