En el episodio de hoy, tenemos delante un tema muy desconocido en neurorrehabilitación aunque muy relevante como es el sistema nervioso autónomo. Todos los profesionales de la salud y especialmente los que nos dedicamos a los pacientes neurológicos, tenemos una cierta base teórica sobre el sistema nervioso autónomo, si bien peca mucho de lo periférico, cuando existe una representación central (la red autónoma central) que ejerce control sobre el sistema autónomo y tiene implicaciones en patología neurológica, incluso en el tratamiento. Hablamos de variabilidad de frecuencia cardíaca como variable autónoma fundamental y de algunos modelos vagales cardíacos que explican la conexión cerebro-corazón. Referencias del episodio: 1. Sposato, L. A., Hilz, M. J., Aspberg, S., Murthy, S. B., Bahit, M. C., Hsieh, C. Y., Sheppard, M. N., Scheitz, J. F., & World Stroke Organisation Brain & Heart Task Force (2020). Post-Stroke Cardiovascular Complications and Neurogenic Cardiac Injury: JACC State-of-the-Art Review. Journal of the American College of Cardiology, 76(23), 2768–2785. https://doi.org/10.1016/j.jacc.2020.10.009 (https://pubmed.ncbi.nlm.nih.gov/33272372/). 2. Porges S. W. (2009). The polyvagal theory: new insights into adaptive reactions of the autonomic nervous system. Cleveland Clinic journal of medicine, 76 Suppl 2(Suppl 2), S86–S90. https://doi.org/10.3949/ccjm.76.s2.17 (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3108032/). 3. Sletten, D. M., Suarez, G. A., Low, P. A., Mandrekar, J., & Singer, W. (2012). COMPASS 31: a refined and abbreviated Composite Autonomic Symptom Score. Mayo Clinic proceedings, 87(12), 1196–1201. https://doi.org/10.1016/j.mayocp.2012.10.013 (https://pubmed.ncbi.nlm.nih.gov/23218087/). 4. Nikolin, S., Boonstra, T. W., Loo, C. K., & Martin, D. (2017). Combined effect of prefrontal transcranial direct current stimulation and a working memory task on heart rate variability. PloS one, 12(8), e0181833. https://doi.org/10.1371/journal.pone.0181833 (https://pubmed.ncbi.nlm.nih.gov/28771509/). 5. Vistisen, S. T., Jensen, J., Fleischer, J., & Nielsen, J. F. (2015). Association between the sensory-motor nervous system and the autonomic nervous system in neurorehabilitation patients with severe acquired brain injury. Brain injury, 29(3), 374–379. https://doi.org/10.3109/02699052.2014.969312 (https://pubmed.ncbi.nlm.nih.gov/25356639/). 6. Vistisen, S. T., Hansen, T. K., Jensen, J., Nielsen, J. F., & Fleischer, J. (2014). Heart rate variability in neurorehabilitation patients with severe acquired brain injury. Brain injury, 28(2), 196–202. https://doi.org/10.3109/02699052.2013.860477 (https://pubmed.ncbi.nlm.nih.gov/24295072/). 7. Scheitz, J. F., Sposato, L. A., Schulz-Menger, J., Nolte, C. H., Backs, J., & Endres, M. (2022). Stroke-Heart Syndrome: Recent Advances and Challenges. Journal of the American Heart Association, 11(17), e026528. https://doi.org/10.1161/JAHA.122.026528 (https://pubmed.ncbi.nlm.nih.gov/36056731/). 8. Lee, Y., Walsh, R. J., Fong, M. W. M., Sykora, M., Doering, M. M., & Wong, A. W. K. (2021). Heart rate variability as a biomarker of functional outcomes in persons with acquired brain injury: Systematic review and meta-analysis. Neuroscience and biobehavioral reviews, 131, 737–754. https://doi.org/10.1016/j.neubiorev.2021.10.004 (https://pubmed.ncbi.nlm.nih.gov/34626686/). 9. Arakaki, X., Arechavala, R. J., Choy, E. H., Bautista, J., Bliss, B., Molloy, C., Wu, D. A., Shimojo, S., Jiang, Y., Kleinman, M. T., & Kloner, R. A. (2023). The connection between heart rate variability (HRV), neurological health, and cognition: A literature review. Frontiers in neuroscience, 17, 1055445. https://doi.org/10.3389/fnins.2023.1055445 (https://pubmed.ncbi.nlm.nih.gov/36937689/). 10. Agorastos, A., Mansueto, A. C., Hager, T., Pappi, E., Gardikioti, A., & Stiedl, O. (2023). Heart Rate Variability as a Translational Dynamic Biomarker of Altered Autonomic Function in Health and Psychiatric Disease. Biomedicines, 11(6), 1591. https://doi.org/10.3390/biomedicines11061591 (https://pubmed.ncbi.nlm.nih.gov/37371686/). 11. Buitrago-Ricaurte, N., Cintra, F., & Silva, G. S. (2020). Heart rate variability as an autonomic biomarker in ischemic stroke. Arquivos de neuro-psiquiatria, 78(11), 724–732. https://doi.org/10.1590/0004-282X20200087 (https://pubmed.ncbi.nlm.nih.gov/33331466/). 12. Dawson, J., Liu, C. Y., Francisco, G. E., Cramer, S. C., Wolf, S. L., Dixit, A., Alexander, J., Ali, R., Brown, B. L., Feng, W., DeMark, L., Hochberg, L. R., Kautz, S. A., Majid, A., O'Dell, M. W., Pierce, D., Prudente, C. N., Redgrave, J., Turner, D. L., Engineer, N. D., … Kimberley, T. J. (2021). Vagus nerve stimulation paired with rehabilitation for upper limb motor function after ischaemic stroke (VNS-REHAB): a randomised, blinded, pivotal, device trial. Lancet (London, England), 397(10284), 1545–1553. https://doi.org/10.1016/S0140-6736(21)00475-X (https://pubmed.ncbi.nlm.nih.gov...
