• Korean Journal of Psychosomatic Medicine
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• v.30 no.1
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• pp.7-15
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• 2022

Objectives : The purpose of this study is to identify the effect of office workers' stress level and stress vulnerability on heart rate variability (HRV), confirm the significance of objective stress indicators obtained through subjective stress and heart rate variability devices, and examine their effectiveness as an integrated stress measurement tool in community mental health projects. Methods : From June to July in 2020, 929 workers participated in the stress management and mental health promotion project carried out by K hospital, and their recorded database was used for study analysis with their agreements. Multiple linear regression analysis was performed to find out the effects of general stress level, and stress vulnerability on heart rate variability. Results : All general characteristics were found to have a significant effect on SDNN (ln), RMSSD (ln), LF (ln), and HF (ln), but work experience did not significantly affect RMSSD (ln). Stress level and stress vulnerability did not significantly affect heart rate variability, but stress perception, a sub-factor of stress level, was found to have a significant effect on RMSSD (ln) (β=0.118, p=0.023). Conclusions : In this study, stress perception, a sub-factor of stress level, was found to be a factor affecting RMSSD (ln). This indicates an association with the activity of parasympathetic nerves in stressful situations, and more follow-up studies are needed to use it as a direct indicator of chronic stress and integrated stress in the community mental health field.

• Korean Journal of Psychosomatic Medicine
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• v.28 no.1
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• pp.81-88
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• 2020

Objectives : This study aimed to compare autonomic nervous system (ANS) dysregulation and differential relationships with clinical severities between anxiety disorder, depressive disorder, and trauma·stressor related disorder using heart rate variability (HRV) parameters. Methods : We conducted a retrospective chart review of outpatients from 2017 to 2018 in Stress Clinic of National Center for Mental Health. Total 473 patients were included; 166 anxiety disorder; 184 depressive disorder ; 123 trauma·stressor related disorder. Parameters of 5-min analysis of HRV were compared in three groups. Additionally, we investigated the differential association of each parameters with Clinical Global Impression-Severity Scale (CGI-S) across each group. Results : No significant differences were found in all HRV parameters between the three groups. However, significant group interactions by CGI-S were found in standard deviation of all RR intervals (SDNN) and the square root of the mean squared differences of successive normal-to-normal intervals (RMSSD) (SDNN, p=0.017 ; RMSSD, p=0.034). A negative relationship between CGI-S and SDNN, RMSSD has been found in anxiety disorder and depressive disorder. However, a positive relationship between CGI-S and SDNN, RMSSD has been found in trauma·stressor related disorder. Conclusions : Despite of no significant differences of each HRV parameter, our findings suggested the differential associations of HRV parameters with clinical severity among anxiety disorder, depressive disorder and trauma·stressor related disorder. In trauma·stressor related disorder, the clinical severity and degree of ANS dysregulation may differ, so more aggressive treatment is suggested.

• Journal of Oriental Neuropsychiatry
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• v.13 no.1
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• pp.19-37
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• 2002

Objectives : This study sought to define autonomic functional difference on heart rate variability between headache patients and normal subjects Methods : We determined, heart rate variability of 52 headache patients and 30 normal subjects by means of three time domain measures: Mean PR(mean pulse rate), SDNN(standard deviation of all normal R-R intervals), RMSSD(the square root of the mean of sum of the squares of differences between adjacent normal R-R intervals), and five frequency domain measures: TP(total power), VLF(very low frequency), LF(low frequency), HF(high frequency). Results : 1) RMSSD, TP, HF, HF Norm of HRV decreased with aging and LF Norm, LF/HF increased with aging in headache patients. 2) There was no significant differences between migraine and tention headache in any standard index of HRV, whereas, HRV of total headache patients were smaller than those of normal subjects. 3) In the gender comparison, SDNN, RMSSD, HF of tention headache patients were the smallest and then migraine patients, normal subjects in order with man, whereas, LF Norm, LF/HF of normal subjects were the smallest with man. RMSSD of migraine patients were the smallest and then tention headache patients, normal subjects in order with women. 4) In the term of history of headache patients, SDNN, RMSSD were getting lower as long term. 5) There was no significant differences of HRV in physical symptom of headache patients. Conclusions : All of these results show that standard index of HRV of headache patients were significantly different with normal subjects.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.18 no.3
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• pp.66-74
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• 2005

Objective: Stress is one of the most important etiological factors in our lives. Human body makes effort to keep his homeostasis from stress by using autonomic nerve system. So we need markers which can evaluate autonomic nerve system easily. HRV represents such markers. Sympathetic and Parasympathetic nerve system are part of autonomic nerve system, related with cur body and diseases in ENT, Dermatology, Ophthalmology are also deeply related with stress, Sympathetic and Parasympathetic nerve system. So we can expect that it can help understanding patients to evaluate autonomic nerve system with HRV Research Methods and Procedures: Forty one patients who have seif-recognized stress in Dept. of Oph & Otolaryngo & Dermatology were selected. SDNN. RMSSD, LF, HF, norm-LF, norm-HF, LF/HF ratio, LnLF, LnHF were checked. Results: Men showed lower SDNN, HF, and LnHF than women(p<0.05). Age over-forty group showed significant lower SDNN, LF, HF, LnLF, LnH(p<0.01), and lower RMSSD(p<0.05) than age under-forty group. There's no big differences for age at norm-LF, norm-HF, and LF/HF ratio. Skin disease group showed higher SDNN, RMSSD, LF, HF, LnLF, LNHF than the others, facial palsy group showed higher norm-HF. LF/HF ratio, and mouth-throat group showed higher norm-LF, but there's no statically significant difference. Comparing skin disease group with the others, the others showed statically significant low SDNN(P<0.01), RMSSD, LF, HF, LnLF and LnHF(P<0.05).

• Journal of the Korean Applied Science and Technology
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• v.35 no.2
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• pp.445-453
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• 2018

The purpose of this study was to analyze the effect of acute respiratory training feedback upon a change on HRV-Autonomic nervous system in middle-aged women. The research subjects were totally 24 middle-aged women(40-60 years old), were randomly allocated 12 people to the respiratory training group and 12 people to the control group, and then were carried out the acute respiratory training. The feedback exercise in the respiratory training group was conducted for totally 15 minutes. Following the 10-minute breath awareness training according to the expert's guidance, the 5-minute autonomous breathing exercise was implemented. The data analysis was carried out Repeated Measures ANOVA with SPSS WIN 20.0. The conclusions that were obtained through this are as follows. The middle-aged women got significantly higher in SDNN, RMSSD, LF, HF after the acute respiratory training. Compared to the control group. the respiratory training group was indicated to have gotten higher significantly in SDNN, RMSSD, LF, HF. Mean HR and LF/HF were not shown a significant difference in both the main effect of group & period and the interaction effect of group & period. Above of a result the acute respiratory training feedback is effective for SDNN, RMSSD, sympathetic activity, parasympathetic activity in the middle-aged women. Thereby, the respiratory training program improves autonomic nervous system, being considered to be possibly expected the effective value of exercise intervention available for relieving stress and recovering autonomic dysfunction in the middle-aged women.

• Science of Emotion and Sensibility
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• v.21 no.1
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• pp.71-82
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• 2018

Stress involves changes in behavior, autonomic function and the secretion of hormones. Autonomic nervous system (ANS) contributes to physiological adaptive process in short durations. In particular, heart rate variability (HRV) analysis is commonly used as a quantitative marker depicting the ANS activity related to mental stress. The aim of this study is to investigate correlations between psychological responses to stress and HRV indices induced by the cognitive stressor. Thirty-three participants rated their mental and physical symptoms occurred during the past two weeks on Stress Response Inventory (SRI), which is composed of seven stress factors that may influence the status of mental stress levels. Then, they underwent the psychophysiological procedures, which are collected electrocardiogram (ECG) signals during a cognitive stress task. HRV indices, the standard deviation of R-R interval (SDNN), root mean square of successive R-R interval difference (RMSSD) and low frequency (LF)/high frequency (HF) ratio were extracted from ECG signals. Physiological responses were calculated stress responses by subtracting mean of the baseline from the mean of recovery. Stress factors such as tension, aggression, depression, fatigue, and frustration were positively correlated to HRV indices. In particular, aggression had significant positive correlations to SDNN, RMSSD and LF/HF ratio. Increased aggressive responses to stress correlated with the increases of all HRV indices. This means the increased autonomic coactivation. Additionally, tension, depression, fatigue, and frustration were positively associated with RMSSD reflecting increases in parasympathetic activation. The autonomic coactivation may represent an integrated response to specific cognitive reactions such as the orienting response.

• Journal of Electrical Engineering and Technology
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• v.12 no.1
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• pp.346-355
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• 2017

Atrial fibrillation (AF) and Congestive heart failure (CHF) are increasingly widespread, costly, deadly diseases and are associated with significant morbidity and mortality. In this study, we analyzed three statistical methods for automatic detection of AF and CHF based on the randomness, variability and complexity of the heart beat interval, which is RRI time series. Specifically, we used short RRI time series with 16 beats and employed the normalized root mean square of successive RR differences (RMSSD), the sample entropy and the Shannon entropy. The detection performance was analyzed using four large well documented databases, namely the MIT-BIH Atrial fibrillation (n=23), the MIT-BIH Normal Sinus Rhythm (n=18), the BIDMC Congestive Heart Failure (n=13) and the Congestive Heart Failure RRI databases (n=25). Using thresholds by Receiver Operating Characteristic (ROC) curves, we found that the normalized RMSSD provided the highest accuracy. The overall sensitivity, specificity and accuracy for AF and CHF were 0.8649, 0.9331 and 0.9104, respectively. Regarding CHF detection, the detection rate of CHF (NYHA III-IV) was 0.9113 while CHF (NYHA I-II) was 0.7312, which shows that the detection rate of CHF with higher severity is higher than that of CHF with lower severity. For the clinical 24 hour data (n=42), the overall sensitivity, specificity and accuracy for AF and CHF were 0.8809, 0.9406 and 0.9108, respectively, using normalized RMSSD.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.21 no.2
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• pp.142-153
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• 2008

Objective : Etiologically, stress is a important factor to immune system and skin disease. Human body is controled to keep his homeostasis from stress by autonomic nerve system. So we investigated autonomic nerve balance and stress level of patients with skin disease by heart rate variability(HRV) test. Research Methods and Procedures : Fifty two patient(from 15 years old to 35 years old) who visited Dept. of Oriental medical Dermatology, Kyunghee university at first and had an examination by HRV test, were selected as the subject of our study. We checked items of HRV test(such as SDNN, RMSSD, VLF, LF, HF, TP, norm-LF, norm-HF, LF/HF ratio, LnHF and LnHF), and analyzed time and frequency domain by sex, age, onset, color on end of patient's tongue, sweating and sleep condition. Results and Conclusion : Men showed significant higher SDNN, RMSSD, LF, norm-LF, norm-HF, LF/HF ratio, LnLF and LnHF than women(p <0.05). Patients who were attacked by skin disease within 6 months, showed significant higher TP and VLF than over 6 months(p <0.05). Patients with normal color on the end of their tongue showed significant higher TP and VLF than with flare color. We analyzed correlation to color on the end of tongue and RMSSD. Prevalence risk(RMSSD <20ms) in the case of normal color on the end of tongue was 5 times as high as in the case of flare color(p <0.1). And we analyzed correlation to age and LF/HF ratio. Prevalence risk(LF/HF ratio <1) of patients from 15 years old to 25 years old was 1.467 times as high as from 26 years old to 35 years old(p <0.1).

• Journal of the Korean Society of Physical Medicine
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• v.10 no.1
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• pp.37-43
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• 2015

PURPOSE: The purpose of this study is to investigate the effect of the physical therapy treatment room environment using microwave diathermy on the autonomic nervous system of human body. METHODS: Participants were 24 healthy adults. Standard deviation of all normal R-R intervals(SDNN), root mean square of successive differences(RMSSD), low frequency(LF), high frequency(HF), LF/HF ratio were compared in microwave irradiation and non-irradiation group. Data were analyzed in Wilcoxon's signed-ranks test and Mann-Whitney U test. RESULTS: Standard deviation of all normal R-R intervals (SDNN), root mean square of successive differences (RMSSD), low frequency(LF), high frequency(HF), LF/HF ratio were not significantly different in microwave irradiation group. Standard deviation of all normal R-R intervals(SDNN), root mean square of successive differences (RMSSD), low frequency(LF), high frequency(HF), LF/HF ratio were not significantly different in microwave non-irradiation group. Standard deviation of all normal R-R intervals(SDNN), root mean square of successive differences (RMSSD), low frequency(LF), high frequency(HF), LF/HF ratio were not significantly different between two groups. CONCLUSION: There was no significant change in the sympathetic nervous system and parasympathetic nervous system regardless of the presence of microwave irradiation. There was no significant change in the autonomic nervous system adaptability regardless of the presence of microwave irradiation.According to this study, microwave diathermy does not have significant effect on the autonomic nervous system.Future study is necessary to investigate the long term effect of the physical therapy treatment room environment using microwave diathermy on the autonomic nervous system of the human body.

• Journal of Korean Medicine Rehabilitation
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• v.31 no.2
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• pp.81-97
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• 2021

Objectives This study was designed to identify the changes of autonomic nervous system (ANS) which was induced by acupuncture at the field of the auricular branch of the vagus nerve. Methods 30 healthy adults were selected and classified into two groups; experimental group, control group. After providing mental stress, acupuncture was applied at external ear in experimental group and no treatment executed in control group. The evaluation of ANS function was measured by heart rate variability (HRV). We statically analyzed the difference of HRV parameters which include mean heart rate (MHRT), standard deviation of all N-N intervals (SDNN), square root of the mean of the sum of the squares of differences between adjacent N-N intervals (RMSSD), total power (TP), low frequency power (LF), high frequency power (HF), LF/HF ratio. Results All subjects showed significant increase in SDNN, LF after stress stimulation (p<0.05). Immediately after intervention, MHRT was significantly decreased (p<0.001) and RMSSD, HF were significantly increased in experimental group (p<0.05). After the end of intervention, SDNN, HF, RMSSD, TP, LF were significantly increased in experimental group (p<0.01, p<0.05). And when comparing baseline HRV, SDNN, LF were significantly increased in control group (p<0.01) and SDNN, RMSSD, TP, LF were significantly increased in experimental group (p<0.05). In the subgroup analysis, normal balance of ANS group showed significant increase in TP, LF, SDNN, HF (p<0.01, p<0.05). Conclusions We suggested that acupuncture at external ear, region of the vagus nerve distribution could increase parasympathetic activity and cause changes and reregulation of the ANS.