Cardiac Autonomic Modulation in Subjects with Amyotrophic Lateral Sclerosis (ALS) during an Upper Limb Virtual Reality Task: A Prospective Control Trial

• Published in: BioMed research international Vol. 2022; pp. 4439681 - 11
• Main Authors: Silveira, Ana C., Moraes, Íbis A. P., Vidigal, Giovanna P., Simcsik, Amanda O., Rosa, Renata M., Favero, Francis M., Fernandes, Susi M. S., Garner, David M., Araújo, Luciano V., Massa, Marcelo, Vanderlei, Luiz C. M., Silva, Talita D., Monteiro, Carlos B. M.
• Format: Journal Article
• Language: English
• Published: United States Hindawi 2022; Hindawi Limited
• Subjects: Adult; Aged; Amyotrophic lateral sclerosis; Amyotrophic Lateral Sclerosis - physiopathology; Autonomic nervous system; Autonomic Nervous System - physiopathology; Computer applications; Data collection; Female; Heart Conduction System - physiopathology; Heart rate; Humans; Male; Middle Aged; Nervous system; Neurodegenerative diseases; Parasympathetic nervous system; Patients; Physiology; Prospective Studies; Recovery; Reduction; Rest; Severity of Illness Index; Sitting position; Software; Spheres; Surveys and Questionnaires; Sympathetic nervous system; Upper Extremity - physiopathology; Vagus nerve; Virtual Reality; Finland
• ISSN: 2314-6133; 2314-6141
• DOI: 10.1155/2022/4439681

Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease. As a result of the rapid progression and severity of the disease, people with ALS experience loss of functionality and independence. Furthermore, it has already been described presence of autonomic dysfunction. Despite the increasing use of virtual reality (VR) in the treatment of different diseases, the use of virtual reality environment as an intervention program for ALS patients is innovative. The benefits and limitations have not yet been proven. Our objective was to evaluate the autonomic function of individuals with amyotrophic lateral sclerosis throughout the virtual reality task. The analysis of autonomic function was completed before, during, and after the virtual reality task using the upper limbs; also, all steps lasted ten minutes in a sitting position. Heart rate variability (HRV) was taken via the Polar® RS800CX cardiofrequencymeter. The following questionnaire was enforced: Amyotrophic Lateral Sclerosis Functional Rating Scale-Revised (ALSFRS) and Fatigue Severity Scale (FSS). Different types of HRV were revealed for the groups, indicating that the ALS group has reduced HRV, with most of the representative indices of the sympathetic nervous system. Besides, the physiological process of reducing parasympathetic activity from rest to VR activity (vagal withdrawal), with reduction in HF (ms2) and an increase in HR from rest to activity, and a further increase throughout recovery, with withdrawal of sympathetic nervous system, occurs just for the control group (CG), with no alterations between rest, activity, and recovery in individuals with ALS. We could conclude that patients with ALS have the reduction of HRV with the sympathetic predominance when equated to the healthy CG. Besides that, the ALS individuals have no capability to adapt the autonomic nervous system when likened to the CG during therapy based on VR and their recovery.