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Based upon the hypothesis that prognosis in childhood heart failure depends on autonomic dysfunction, the author introduced a new heart failure model and a medical therapy with beta-blockers in 1996. The author used the analysis of heart rate variability (HRV) in 24 hours Holter ECG's for the understanding of the pathophysiology of childhood heart failure and for objective control of medical therapy. The success of this clinical model was the inspiration of a new approach to mental disease in childhood. In the last decades, an increase of new paediatric problems requiring medical care like eating disorders, behavioural and attention problems has been observed. All these diseases are related to autonomic dysfunction and have a high impact on cardiovascular prognosis. Based upon the hypothesis that behavioural problems are accompanied by changes in the autonomic nervous system, the author performed analysis of HRV in 24 hours Holter ECG's in these patient groups: healthy children with respect to school affiliation; a historical control group from literature published in 1997; attention deficit disorder with and without hyperactivity; anorexia nervosa and obesity. This data was compared to children with an increased cardiovascular risk due to congenital heart disease. In order to analyse the effect of autonomic function on human growth, we measured HRV in children with growth failure. A new HRV Score was established for the comparison of autonomic function in different age groups. The author could demonstrate a decrease of vagal activity in healthy children in children of today and speculate that insufficient vagal maturation may be a reason for an increasing prevalence of mental and cardiovascular disease. Looking for the reason of this vagal shift, caloric over nutrition, omega-3-fatty acid deficiency, high intensity of information and communication technology usage and some environmental toxins reduce HRV in childhood.
Open a Window into the Autonomic Nervous SystemQuantifying the amount of autonomic nervous system activity in an individual patient can be extremely important, because it provides a gauge of disease severity in a large number of diseases. Heart rate variability (HRV) calculated from both short-term and longer-term electrocardiograms is an ideal win
New edition of the classic complete reference book for cardiologists and trainee cardiologists on the theory and practice of electrocardiography, one of the key modalities used for evaluating cardiology patients and deciding on appropriate management strategies.
The Special Issue “Juvenile Onset Huntington’s Disease” highlights the growing interest in understanding the unique aspects of this ultra-rare disorder. After decades of research, gene therapy trials are underway for Adult Onset Huntington’s Disease (AOHD). However, patients with Juvenile Onset Huntington’s Disease (JOHD) are often excluded from these efforts, leaving many questions regarding its phenomenology. The current issue includes seven articles spanning work on the difficult emotional experiences of parents of children with JOHD; a review of the clinical manifestations of JOHD; behavioral issues in JOHD; CAG repeat and age of motor onset; autonomic nervous system dysfunction; and abnormality in MRI metabolic markers. Finally, a review of the therapeutic advances is included, highlighting future possibilities of clinical trials in JOHD subjects. The HD community—patients, family members at-risk for HD, caregivers, health-care professionals and scientists—is keen on expanding our understanding of JOHD. In the flurry of research on AOHD, those with JOHD were seemingly ‘left behind.’ The study of patients who are afflicted early in life with HD has become imperative, with this Special Issue representing just the beginning of the required effort to address this urgent need.
This book reports on the latest advances in complex and nonlinear cardiovascular physiology aimed at obtaining reliable, effective markers for the assessment of heartbeat, respiratory, and blood pressure dynamics. The chapters describe in detail methods that have been previously defined in theoretical physics such as entropy, multifractal spectra, and Lyapunov exponents, contextualized within physiological dynamics of cardiovascular control, including autonomic nervous system activity. Additionally, the book discusses several application scenarios of these methods. The text critically reviews the current state-of-the-art research in the field that has led to the description of dedicated experimental protocols and ad-hoc models of complex physiology. This text is ideal for biomedical engineers, physiologists, and neuroscientists. This book also: Expertly reviews cutting-edge research, such as recent advances in measuring complexity, nonlinearity, and information-theoretic concepts applied to coupled dynamical systems Comprehensively describes applications of analytic technique to clinical scenarios such as heart failure, depression and mental disorders, atrial fibrillation, acute brain lesions, and more Broadens readers' understanding of cardiovascular signals, heart rate complexity, heart rate variability, and nonlinear analysis
This is a comprehensive volume on issues and concerns relating to child and adolescent mental health in Asia, which includes contributions from experts in child psychiatry from Asia and other parts of the world. The chapters provide accurate and detailed accounts of the current state of knowledge integrating research approaches and findings from clinical studies. Each chapter discusses existing information, emphasizes areas of growth and provides fresh insights on a particular topic especially as these might relate to Asian populations. The book integrates various clinical and scientific perspectives on psychiatric disorders in children and adolescents with a focus on Asia. The various sections deal with important topics in child and adolescent psychiatry: the current understanding of mental disorders and the ways in which possible influences might work in the development of psychopathology; substance use disorders, their neurobiological correlates and implications for the developing brain; early environmental influences in the psychopathology of psychiatric disorders in children; issues of parenting, child rearing and cultural practices in Asia, which influence personality development and adaptation; life-long impact of early parental loss; early diagnosis and intervention in recognizing and treating psychopathology; psychopharmacology of neurodevelopmental disorders in children; non-pharmacological treatments for children; mental health gap, and telepsychiatry as an innovative model to provide services for children; and a pressing need for a comprehensive child mental health policy across nations.