Abstract

Background: Various disease processes are associated with an altered symapatho-vagal activity which reflects the auto - nomic balance. Altered ANS activity is reported in patients suffering from chronic pain by various workers with conflicting reasons. HRV is a simple, non-invasive tool to assess the autonomic activity in all age groups and the results are widely accepted as the diagnostic and prognostic method for autonomic activity. Objectives: The present study was planned to see the autonomic dysregulation, if any, in Indian patients suffering from chronic somatic pain with an aim to find the cause of the autonomic imbalance.
Materials and Methods: The short-term heart rate variability parameters computed by an amplifier (Biopac) after taking a 5-minute electrocardiogram recording in supine position from 33 female patients between the age group of 20 to 65 years and suffering from chronic somatic pain. They were compared with twenty-two age and sex matched controls (without any pain) after applying the exclusion criteria and following the conventional and recommended protocol. The RR interval time series was taken from the ECG of each subject and analyzed for HRV by using the above-mentioned software.
Results: The heart rate was increased in all patients with varying significance. The time domain and frequency domain parameters are also decreased in patients as compared to their respective controls. The HRV parameters were signifi - cantly reduced in elderly females than the younger ones. Conclusion: The change in heart rate signifies an increased sympathetic activity in patients suffering from chronic pain. However, the HRV analysis showed a variation in ANS activity in all with a significant change in elderly females. It seems as there may be some protection in young females by female sex hormones. The exact mechanisms are still elucidated, though psychological and behavioral attitude might be responsible for such varied changes.