Autonomic and sensory nerve dysfunction in primary biliary cirrhosis

Katalin Keresztes, Ildikó Istenes, Aniko Folhoffer, P. Lakatos, Andrea Horvath, Timea Csak, Peter Varga, P. Kempler, F. Szalay

Research output: Article

37 Citations (Scopus)

Abstract

Aim: Cardiovascular autonomic and peripheral sensory neuropathy is a known complication of chronic alcoholic and non-alcoholic liver diseases. We aimed to assess the prevalence and risk factors for peripheral sensory nerve and autonomic dysfunction using sensitive methods in patients with primary biliary cirrhosis (PBC). Methods: Twenty-four AMA M2 positive female patients with clinical, biochemical and histological evidence of PBC and 20 age matched healthy female subjects were studied. Five standard cardiovascular reflex tests and 24-h heart rate variability (HRV) analysis were performed to define autonomic function. Peripheral sensory nerve function on median and peroneal nerves was characterized by current perception threshold (CPT), measured by a neuroselective diagnostic stimulator (Neurotron, Baltimore, MD). Results: Fourteen of 24 patients (58%) had at least one abnormal cardiovascular reflex test and thirteen (54%) had peripheral sensory neuropathy. Lower heart rate response to deep breathing (P = 0.001), standing (P = 0.03) and Valsalva manoeuvre (P = 0.01), and more profound decrease of blood pressure after standing (P = 0.03) was found in PBC patients than in controls. As a novel finding we proved that both time domain and frequency domain parameters of 24-h HRV were significantly reduced in PBC patients compared to controls. Each patient had at least one abnormal parameter of HRV. Lower CPT values indicated hyperaesthesia as a characteristic feature at peroneal nerve testing at three frequencies (2000 Hz: P = 0.005; 250 Hz: P = 0.002; 5 Hz: P = 0.004) in PBC compared to controls. Correlation of autonomic dysfunction with the severity and duration of the disease was observed. Lower total power of HRV correlated with lower CPT values at median nerve testing at 250 Hz (P = 0.0001) and at 5 Hz (P = 0.002), as well as with those at peroneal nerve testing at 2000 Hz (P = 0.01). Conclusion: Autonomic and sensory nerve dysfunctions are frequent in PBC. Twenty-four-hour HRV analysis is more sensitive than standard cardiovascular tests for detecting of both parasympathetic and sympathetic impairments. Our novel data suggest that hyperaesthesia is a characteristic feature of peripheral sensory neuropathy and might contribute to itching in PBC. Autonomic dysfunction is related to the duration and severity of PBC.

Original languageEnglish
Pages (from-to)3039-3043
Number of pages5
JournalWorld Journal of Gastroenterology
Volume10
Issue number20
Publication statusPublished - okt. 15 2004

Fingerprint

Autonomic Pathways
Biliary Liver Cirrhosis
Heart Rate
Peroneal Nerve
Peripheral Nervous System Diseases
Hyperesthesia
Median Nerve
Peripheral Nerves
Valsalva Maneuver
Abnormal Reflexes
Baltimore
Pruritus
Reflex
Liver Diseases
Healthy Volunteers
Respiration
Blood Pressure

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Keresztes, K., Istenes, I., Folhoffer, A., Lakatos, P., Horvath, A., Csak, T., ... Szalay, F. (2004). Autonomic and sensory nerve dysfunction in primary biliary cirrhosis. World Journal of Gastroenterology, 10(20), 3039-3043.

Autonomic and sensory nerve dysfunction in primary biliary cirrhosis. / Keresztes, Katalin; Istenes, Ildikó; Folhoffer, Aniko; Lakatos, P.; Horvath, Andrea; Csak, Timea; Varga, Peter; Kempler, P.; Szalay, F.

In: World Journal of Gastroenterology, Vol. 10, No. 20, 15.10.2004, p. 3039-3043.

Research output: Article

Keresztes, K, Istenes, I, Folhoffer, A, Lakatos, P, Horvath, A, Csak, T, Varga, P, Kempler, P & Szalay, F 2004, 'Autonomic and sensory nerve dysfunction in primary biliary cirrhosis', World Journal of Gastroenterology, vol. 10, no. 20, pp. 3039-3043.
Keresztes K, Istenes I, Folhoffer A, Lakatos P, Horvath A, Csak T et al. Autonomic and sensory nerve dysfunction in primary biliary cirrhosis. World Journal of Gastroenterology. 2004 okt. 15;10(20):3039-3043.
Keresztes, Katalin ; Istenes, Ildikó ; Folhoffer, Aniko ; Lakatos, P. ; Horvath, Andrea ; Csak, Timea ; Varga, Peter ; Kempler, P. ; Szalay, F. / Autonomic and sensory nerve dysfunction in primary biliary cirrhosis. In: World Journal of Gastroenterology. 2004 ; Vol. 10, No. 20. pp. 3039-3043.
@article{18c12b85996b4b69955dbecd6c418a64,
title = "Autonomic and sensory nerve dysfunction in primary biliary cirrhosis",
abstract = "Aim: Cardiovascular autonomic and peripheral sensory neuropathy is a known complication of chronic alcoholic and non-alcoholic liver diseases. We aimed to assess the prevalence and risk factors for peripheral sensory nerve and autonomic dysfunction using sensitive methods in patients with primary biliary cirrhosis (PBC). Methods: Twenty-four AMA M2 positive female patients with clinical, biochemical and histological evidence of PBC and 20 age matched healthy female subjects were studied. Five standard cardiovascular reflex tests and 24-h heart rate variability (HRV) analysis were performed to define autonomic function. Peripheral sensory nerve function on median and peroneal nerves was characterized by current perception threshold (CPT), measured by a neuroselective diagnostic stimulator (Neurotron, Baltimore, MD). Results: Fourteen of 24 patients (58{\%}) had at least one abnormal cardiovascular reflex test and thirteen (54{\%}) had peripheral sensory neuropathy. Lower heart rate response to deep breathing (P = 0.001), standing (P = 0.03) and Valsalva manoeuvre (P = 0.01), and more profound decrease of blood pressure after standing (P = 0.03) was found in PBC patients than in controls. As a novel finding we proved that both time domain and frequency domain parameters of 24-h HRV were significantly reduced in PBC patients compared to controls. Each patient had at least one abnormal parameter of HRV. Lower CPT values indicated hyperaesthesia as a characteristic feature at peroneal nerve testing at three frequencies (2000 Hz: P = 0.005; 250 Hz: P = 0.002; 5 Hz: P = 0.004) in PBC compared to controls. Correlation of autonomic dysfunction with the severity and duration of the disease was observed. Lower total power of HRV correlated with lower CPT values at median nerve testing at 250 Hz (P = 0.0001) and at 5 Hz (P = 0.002), as well as with those at peroneal nerve testing at 2000 Hz (P = 0.01). Conclusion: Autonomic and sensory nerve dysfunctions are frequent in PBC. Twenty-four-hour HRV analysis is more sensitive than standard cardiovascular tests for detecting of both parasympathetic and sympathetic impairments. Our novel data suggest that hyperaesthesia is a characteristic feature of peripheral sensory neuropathy and might contribute to itching in PBC. Autonomic dysfunction is related to the duration and severity of PBC.",
author = "Katalin Keresztes and Ildik{\'o} Istenes and Aniko Folhoffer and P. Lakatos and Andrea Horvath and Timea Csak and Peter Varga and P. Kempler and F. Szalay",
year = "2004",
month = "10",
day = "15",
language = "English",
volume = "10",
pages = "3039--3043",
journal = "World Journal of Gastroenterology",
issn = "1007-9327",
publisher = "WJG Press",
number = "20",

}

TY - JOUR

T1 - Autonomic and sensory nerve dysfunction in primary biliary cirrhosis

AU - Keresztes, Katalin

AU - Istenes, Ildikó

AU - Folhoffer, Aniko

AU - Lakatos, P.

AU - Horvath, Andrea

AU - Csak, Timea

AU - Varga, Peter

AU - Kempler, P.

AU - Szalay, F.

PY - 2004/10/15

Y1 - 2004/10/15

N2 - Aim: Cardiovascular autonomic and peripheral sensory neuropathy is a known complication of chronic alcoholic and non-alcoholic liver diseases. We aimed to assess the prevalence and risk factors for peripheral sensory nerve and autonomic dysfunction using sensitive methods in patients with primary biliary cirrhosis (PBC). Methods: Twenty-four AMA M2 positive female patients with clinical, biochemical and histological evidence of PBC and 20 age matched healthy female subjects were studied. Five standard cardiovascular reflex tests and 24-h heart rate variability (HRV) analysis were performed to define autonomic function. Peripheral sensory nerve function on median and peroneal nerves was characterized by current perception threshold (CPT), measured by a neuroselective diagnostic stimulator (Neurotron, Baltimore, MD). Results: Fourteen of 24 patients (58%) had at least one abnormal cardiovascular reflex test and thirteen (54%) had peripheral sensory neuropathy. Lower heart rate response to deep breathing (P = 0.001), standing (P = 0.03) and Valsalva manoeuvre (P = 0.01), and more profound decrease of blood pressure after standing (P = 0.03) was found in PBC patients than in controls. As a novel finding we proved that both time domain and frequency domain parameters of 24-h HRV were significantly reduced in PBC patients compared to controls. Each patient had at least one abnormal parameter of HRV. Lower CPT values indicated hyperaesthesia as a characteristic feature at peroneal nerve testing at three frequencies (2000 Hz: P = 0.005; 250 Hz: P = 0.002; 5 Hz: P = 0.004) in PBC compared to controls. Correlation of autonomic dysfunction with the severity and duration of the disease was observed. Lower total power of HRV correlated with lower CPT values at median nerve testing at 250 Hz (P = 0.0001) and at 5 Hz (P = 0.002), as well as with those at peroneal nerve testing at 2000 Hz (P = 0.01). Conclusion: Autonomic and sensory nerve dysfunctions are frequent in PBC. Twenty-four-hour HRV analysis is more sensitive than standard cardiovascular tests for detecting of both parasympathetic and sympathetic impairments. Our novel data suggest that hyperaesthesia is a characteristic feature of peripheral sensory neuropathy and might contribute to itching in PBC. Autonomic dysfunction is related to the duration and severity of PBC.

AB - Aim: Cardiovascular autonomic and peripheral sensory neuropathy is a known complication of chronic alcoholic and non-alcoholic liver diseases. We aimed to assess the prevalence and risk factors for peripheral sensory nerve and autonomic dysfunction using sensitive methods in patients with primary biliary cirrhosis (PBC). Methods: Twenty-four AMA M2 positive female patients with clinical, biochemical and histological evidence of PBC and 20 age matched healthy female subjects were studied. Five standard cardiovascular reflex tests and 24-h heart rate variability (HRV) analysis were performed to define autonomic function. Peripheral sensory nerve function on median and peroneal nerves was characterized by current perception threshold (CPT), measured by a neuroselective diagnostic stimulator (Neurotron, Baltimore, MD). Results: Fourteen of 24 patients (58%) had at least one abnormal cardiovascular reflex test and thirteen (54%) had peripheral sensory neuropathy. Lower heart rate response to deep breathing (P = 0.001), standing (P = 0.03) and Valsalva manoeuvre (P = 0.01), and more profound decrease of blood pressure after standing (P = 0.03) was found in PBC patients than in controls. As a novel finding we proved that both time domain and frequency domain parameters of 24-h HRV were significantly reduced in PBC patients compared to controls. Each patient had at least one abnormal parameter of HRV. Lower CPT values indicated hyperaesthesia as a characteristic feature at peroneal nerve testing at three frequencies (2000 Hz: P = 0.005; 250 Hz: P = 0.002; 5 Hz: P = 0.004) in PBC compared to controls. Correlation of autonomic dysfunction with the severity and duration of the disease was observed. Lower total power of HRV correlated with lower CPT values at median nerve testing at 250 Hz (P = 0.0001) and at 5 Hz (P = 0.002), as well as with those at peroneal nerve testing at 2000 Hz (P = 0.01). Conclusion: Autonomic and sensory nerve dysfunctions are frequent in PBC. Twenty-four-hour HRV analysis is more sensitive than standard cardiovascular tests for detecting of both parasympathetic and sympathetic impairments. Our novel data suggest that hyperaesthesia is a characteristic feature of peripheral sensory neuropathy and might contribute to itching in PBC. Autonomic dysfunction is related to the duration and severity of PBC.

UR - http://www.scopus.com/inward/record.url?scp=4644359653&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=4644359653&partnerID=8YFLogxK

M3 - Article

C2 - 15378789

AN - SCOPUS:4644359653

VL - 10

SP - 3039

EP - 3043

JO - World Journal of Gastroenterology

JF - World Journal of Gastroenterology

SN - 1007-9327

IS - 20

ER -