title: Evaluating the autonomic nervous system in patients with laryngopharyngeal reflux.
abstract: OBJECTIVE
  The pathogenesis of laryngopharyngeal reﬂux (LPR) remains unclear. It is linked to but distinct from gastroesophageal reflux disease (GERD), which has been shown to be related to disturbed autonomic regulation. The aim of this study is to investigate whether autonomic dysfunction also plays a role in the pathogenesis of LPR.
  
  
  METHODS
  Case-control study.
  
  
  METHODS
  Tertiary care center.
  
  
  METHODS
  Seventeen patients with LPR and 19 healthy controls, aged between 19 and 50 years, were enrolled in the study. The patients were diagnosed with LPR if they had a reflux symptom index (RSI) ≥ 13 and a reflux finding score (RFS) ≥ 7. Spectral analysis of heart rate variability (HRV) analysis was used to assess autonomic function. Anxiety and depression levels measured by the Beck Anxiety Inventory (BAI) and Beck Depression Inventory II (BDI-II) were also conducted.
  
  
  RESULTS
  In HRV analysis, high frequency (HF) represents the parasympathetic activity of the autonomic nervous system, whereas low frequency (LF) represents the total autonomic activity. There were no significant differences in the LF power and HF power between the 2 groups. However, significantly lower HF% (P = .003) and a higher LF/HF ratio (P = .012) were found in patients with LPR, who demonstrated poor autonomic modulation and higher sympathetic activity. Anxiety was also frequently observed in the patient group.
  
  
  CONCLUSIONS
  The study suggests that autonomic dysfunction seems to be involved in the pathogenesis of LPR. The potential beneficial effect of autonomic nervous system modulation as a therapeutic modality for LPR merits further investigation.
authors.affiliation: Department of Otolaryngology, Taipei Veterans General Hospital, Taipei, Taiwan.
authors.forename: Wan-Ju
authors.initials: WJ
authors.lastname: Huang
authors.forename: Chih-Hung
authors.initials: CH
authors.lastname: Shu
authors.forename: Kun-Ta
authors.initials: KT
authors.lastname: Chou
authors.forename: Yi-Fen
authors.initials: YF
authors.lastname: Wang
authors.forename: Yen-Bin
authors.initials: YB
authors.lastname: Hsu
authors.forename: Ching-Yin
authors.initials: CY
authors.lastname: Ho
authors.forename: Ming-Ying
authors.initials: MY
authors.lastname: Lan
mesh_terms: D000328:Adult; D001007:Anxiety / Q000453:epidemiology / Q000503:physiopathology; D001145:Arrhythmias, Cardiac / Q000453:epidemiology / Q000503:physiopathology; D001342:Autonomic Nervous System Diseases / Q000453:epidemiology* / Q000503:physiopathology*; D016022:Case-Control Studies; D015897:Comorbidity; D003866:Depressive Disorder / Q000453:epidemiology / Q000503:physiopathology; D005260:Female; D006801:Humans; D015994:Incidence; D057045:Laryngopharyngeal Reflux / Q000453:epidemiology* / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D012016:Reference Values; D018570:Risk Assessment; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D055815:Young Adult
keywords: autonomic dysfunction; autonomic nervous system; gastroesophageal reflux; heart rate variability; laryngopharyngeal reflux