Heart rate variability in infants with central coordination disturbance

Bjelakovic, Bojko; Ilic, Stevan; Dimitrijevic, Lidija; Milovanovic, Branislav; Kostic, Gordana; Bjelakovic, Ljiljana; Lukic, Stevo

doi:10.1016/j.earlhumdev.2010.01.022

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Volume 86, Issue 2 , Pages 77-81, February 2010

Heart rate variability in infants with central coordination disturbance

Bojko Bjelakovic
- Clinic of Pediatrics, Clinical Center, Nis, Serbia
- Corresponding author. Clinic of Pediatrics, Clinical Center, Nis, Zorana Djindjica 48 Boulevard, 18000 Nis, Serbia. Tel.: +381 18534579; fax: +381 18238770.
Stevan Ilic
- Clinic for Cardiovascular Diseases, Institute for Treatment and Rehabilitation, Niska Banja, Serbia
Lidija Dimitrijevic
- Clinic of Physical Medicine and Rehabilitation, Pediatric Department, Clinical Center Nis, Serbia
Branislav Milovanovic
- Clinical Hospital Center, Bezanijska Kosa, Belgrade, Serbia
Gordana Kostic
- Clinic of Pediatrics, Clinical Center, Nis, Serbia
Ljiljana Bjelakovic
- Clinic of Pediatrics, Clinical Center, Nis, Serbia
Stevo Lukic
- Clinic of Neurology, Clinical Center, Nis, Serbia

Received 24 November 2009; received in revised form 11 January 2010; accepted 19 January 2010.

Abstract

Despite a remarkable medical progress in the field of Developmental Medicine and Child Neurology, early identification of infants at risk for permanent motor disabilities still presents challenge for both clinicians and researchers.

As an indicator of cardiac autonomic control, it was shown that heart rate variability (HRV) might reflect not only sympathetic or parasympathetic activity but also functional integrity of the central nervous system (CNS). Furthermore a pattern of HRV was demonstrated to correlate with motor developmental outcome in high risk infants.

The purpose of this study was to analyze the clinical usefulness as well as predictive value of time-domain HRV parameters in infants with central coordination disturbance.

The study included 35 infants with central coordination disturbance and 37 healthy age and sex-matched controls. Time-domain HRV indices were analyzed from 24-h electrocardiography recordings.

We found significantly lower values of SDNN, SDANN and RMSSD parameters in infants with central coordination disturbance compared to controls. Additionally, logistic regression analyses demonstrated independent predictive value of parameters SDNN and SDANN in infants who subsequently developed cerebral palsy (CP). By performing receiver operating characteristic (ROC) analyses, the optimal cut-off value of SDNN<=48ms predicted CP with a sensitivity of 68.7% (95% CI 41.4–88.9) and specificity of 84.2% (95 CI 60.4–96.4) while the optimal cut-off value of SDANN<=41ms predicted CP with a sensitivity of 87.5% (95% CI 61.6–98.1) and specificity of 57.9% (95 CI 33.5–79.7).

We are in opinion that time domain HRV analysis could be helpful clinically as well as a prognostic tool in infants with central coordination disturbance.

Abbreviations: HRV, heart rate variability, NN interval, the length between two successive heart beats, SDNN, standard deviation of all NN intervals, SDANN, standard deviation of the averages of NN intervals in all five-minute segments, RMSSD, square root of the mean of the sum of the squares of the differences between adjacent NN intervals, PR, postural responses, CP, cerebral palsy