title: Increased vagal modulation in atopic dermatitis.
abstract: BACKGROUND
  Atopic dermatitis has been shown to be associated with neurogenic and psychosocial factors. In related atopic diseases such as rhinitis or asthma, a shift in autonomic balance towards a parasympathetic modulation has been described. On the other hand, the psychiatric symptoms known for atopic dermatitis are often associated with decreased vagal modulation. Furthermore, an increased parasympathetic activity has been shown to exhibit anti-inflammatory effects, thus rather alleviating dermatitis symptoms.
  
  
  OBJECTIVE
  In order to address these intriguing discrepancies, we aimed to assess the autonomic state in patients suffering from atopic dermatitis.
  
  
  METHODS
  Heart rate variability assessment was performed in 30 patients and data were compared to those obtained from matched controls. Furthermore, questionnaires for disease activity and psychosocial stressors were employed.
  
  
  RESULTS
  Patients showed higher values for parasympathetic modulation than controls. This was mainly reflected by an increase in the root mean square of successive differences (RMSSD). This parameter further correlated with dermatological symptoms and the time since the last severe exacerbation of the disease. In addition, subgroups of patients with dyshidrosis or photophobia showed significant differences in autonomic modulation under deep respiration. Moreover, cardiac autonomic modulation was hardly altered upon postural change, indicating that autonomic reactivity is only mildly influenced in these patients.
  
  
  CONCLUSIONS
  Patients with atopic dermatitis showed an autonomic dysbalance which is comparable to other diseases related to atopy or allergy. Our findings point to the question whether these alterations are disease-inherent or counter-regulatory, which should be addressed in future studies.
authors.affiliation: Department of Psychiatry and Psychotherapy, University Hospital, Jena, Germany.
authors.forename: Michael Karl
authors.initials: MK
authors.lastname: Boettger
authors.forename: Karl-Jürgen
authors.initials: KJ
authors.lastname: Bär
authors.forename: Anne
authors.initials: A
authors.lastname: Dohrmann
authors.forename: Helge
authors.initials: H
authors.lastname: Müller
authors.forename: Lutz
authors.initials: L
authors.lastname: Mertins
authors.forename: Norbert Hironimus
authors.initials: NH
authors.lastname: Brockmeyer
authors.forename: Marcus Willy
authors.initials: MW
authors.lastname: Agelink
mesh_terms: D000328:Adult; D001341:Autonomic Nervous System / Q000503:physiopathology; D016022:Case-Control Studies; D003876:Dermatitis, Atopic / Q000503:physiopathology*; D005260:Female; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010275:Parasympathetic Nervous System / Q000503:physiopathology; D011584:Psychology; D012720:Severity of Illness Index; D014630:Vagus Nerve / Q000503:physiopathology*