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A Comparison With Standard Tests of Autonomic Function

Roy Freeman, MD; J. Philip Saul, MD; Mark S. Roberts, MD, MPP; Ronald D. Berger, MD, PhD; Christopher Broadbridge; Richard J. Cohen, MD, PhD

Arch Neurol. 1991;48(2):185-190.

Abstract
• Power spectral analysis of the heart rate was compared with standard tests of autonomic function performed on 15 insulin-dependent diabetic patients with symptoms of autonomic dysfunction. The high-frequency power, low-frequency power, and total power of the heart rate power spectrum measured in the supine position—possible measures of parasympathetic nervous system function—were significant predictors of the expiratory-inspiratory ratio, the beat-to-beat heart rate difference on deep respiration, the standard deviation of the resting heart rate, the 30:15 ratio, and the Valsalva ratio. The change in low-frequency power on moving from the supine to upright position, a possible measure of sympathetic nervous system function, was a modest predictor of the systolic and diastolic blood pressure fall in response to postural change, but a poor predictor of the blood pressure response to isometric exercise and a cold stimulus. This study supports the role of heart rate power spectral analysis as a clinical test of autonomic function in patients with known or suspected autonomic failure.

Author Affiliations
From the Divisions of Neurology (Dr Freeman and Mr Broadbridge) and General Medicine (Dr Roberts), New England Deaconess Hospital; Department of Neurology, Beth Israel Hospital (Dr Freeman); Department of Cardiology, Children's Hospital Medical Center (Drs Saul and Cohen); Division of Health Science and Technology, Harvard-Massachusetts Institute of Technology (Drs Saul, Berger, and Cohen); Department of Medicine, Cardiovascular Division, Brigham and Women's Hospital (Drs Berger and Cohen); and Harvard Medical School (Drs Freeman, Saul, Roberts, Berger, and Cohen), Boston, Mass.

Footnotes
Accepted for publication August 20, 1990.

Reprint requests to New England Deaconess Hospital, Division of Neurology, 110 Francis St, Boston, MA 02215 (Dr Freeman).

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