title: Baroreflex mechanisms in Irritable Bowel Syndrome: Part I. Traditional indices.
abstract: OBJECTIVE
  This study was conducted to present evidence of differences in autonomic regulation of cardiovascular activity and its role in the severity of specific (disease-related) and non-specific (negative affect and chronic pain-related) symptoms in individuals with Irritable Bowel Syndrome (IBS).
  
  
  METHODS
  Seventy-eight female patients with IBS and 27 healthy women age 18-62 years were assessed for IBS symptoms, negative affect, and baroreceptor sensitivity (BRS), blood pressure (BP), heart rate, and heart rate variability (HRV) at rest. Direct and indirect regression effects were examined with application of the bootstrap procedure to validate findings.
  
  
  RESULTS
  IBS was reliably related to lower resting BRS, higher BP, and higher negative affect compared to healthy controls. Longer disease duration (chronicity) was related to BRS decrease coupled with systolic BP increase (95% CIs=-0.14 to -0.01). Three autonomic mechanisms associated with BRS decrease were found to further regulate severity of IBS symptoms. Lower BRS was related to higher IBS severity in general if the effect was transferred through the decrease of low frequency power of HRV (e.g., 95% CIs=-0.039 to -0.001 for abdominal pain severity). However, lower BRS was related to lower IBS severity in general if the effect was transferred through diastolic BP increase (95% CIs=0.01-0.11 for abdominal pain severity). Lower BRS was related to higher abdominal pain severity coupled with high negative affect if the effect was transferred through the decrease of higher frequency power of HRV (95% CIs=-0.026 to -0.003).
  
  
  CONCLUSIONS
  These findings indicate that different cardiovascular mechanisms are associated with IBS development and the increase and decrease of severity of IBS symptoms. Their assessment suggests ways to personalize treatment of IBS.
authors.affiliation: Laboratory of Neuroimmunopathology, Institute of General Pathology and Pathophysiology, Russian Academy of Medical Sciences, 8 Baltiyskaia ul., Moscow 125315, Russia. Electronic address: d.m.davydov@gmail.com.
authors.forename: Dmitry M
authors.initials: DM
authors.lastname: Davydov
authors.affiliation: Department of Medicine, David Geffen School of Medicine at UCLA, 10833 Le Conte Avenue, Los Angeles, CA 90095, United States; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, 760 Westwood Plaza, Los Angeles, CA 90095, United States. Electronic address: naliboff@ucla.edu.
authors.forename: Bruce
authors.initials: B
authors.lastname: Naliboff
authors.affiliation: Department of Medicine, David Geffen School of Medicine at UCLA, 10833 Le Conte Avenue, Los Angeles, CA 90095, United States. Electronic address: drleilashahabi@gmail.com.
authors.forename: Leila
authors.initials: L
authors.lastname: Shahabi
authors.affiliation: Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, 760 Westwood Plaza, Los Angeles, CA 90095, United States. Electronic address: dshapiro@mednet.ucla.edu.
authors.forename: David
authors.initials: D
authors.lastname: Shapiro
mesh_terms: D000293:Adolescent; D000328:Adult; D017704:Baroreflex / Q000502:physiology*; D001794:Blood Pressure / Q000502:physiology; D004562:Electrocardiography; D005260:Female; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D043183:Irritable Bowel Syndrome / Q000150:complications* / Q000523:psychology; D008875:Middle Aged; D019964:Mood Disorders / Q000209:etiology*; D011569:Psychiatric Status Rating Scales; D012720:Severity of Illness Index; D013223:Statistics as Topic; D055815:Young Adult
keywords: Baroreceptor sensitivity; Chronic pain severity; Diastolic blood pressure; Heart rate variability; Irritable Bowel Syndrome; Negative affect; Systolic blood pressure
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