Blood pressure variability and closed-loop baroreflex assessment in adolescent chronic fatigue syndrome during supine rest and orthostatic stress

Hemodynamic abnormalities have been documented in the chronic fatigue syndrome (CFS), indicating functional disturbances of the autonomic nervous system responsible for cardiovascular regulation. The aim of this study was to explore blood pressure variability and closed-loop baroreflex function at rest and during mild orthostatic stress in adolescents with CFS. We included a consecutive sample of 14 adolescents 12–18 years old with CFS diagnosed according to a thorough and standardized set of investigations and 56 healthy control subjects of equal sex and age distribution. Heart rate and blood pressure were recorded continuously and non-invasively during supine rest and during lower body negative pressure (LBNP) of –20 mmHg to simulate mild orthostatic stress. Indices of blood pressure variability and baroreflex function (α-gain) were computed from monovariate and bivariate spectra in the low-frequency (LF) band (0.04–0.15 Hz) and the high–frequency (HF) band (0.15–0.50 Hz), using an autoregressive algorithm. Variability of systolic blood pressure in the HF range was lower among CFS patients as compared to controls both at rest and during LBNP. During LBNP, compared to controls, α-gain HF decreased more, and α-gain LF and the ratio of α-gain LF/α-gain HF increased more in CFS patients, all suggesting greater shift from parasympathetic to sympathetic baroreflex control. CFS in adolescents is characterized by reduced systolic blood pressure variability and a sympathetic predominance of baroreflex heart rate control during orthostatic stress. These findings may have implications for the pathophysiology of CFS in adolescents.     

Peculiarities of autonomic regulation assessed by variability of hemodynamic parameters in rats with different stress resistance

Analysis of contribution of sympathetic and parasympathetic systems into heart rate variability carried out using atenolol and atropine showed that August rats are characterized by enhanced tone of the sympathetic system and reduced tone of the parasympathetic system compared to Wistar rats. Reduced tone of the parasympathetic system is also confirmed by lower sensitivity of the baroreflex. Blockade of NO synthesis with N^ω-nitro-L-arginine more markedly increased blood pressure variability in August rats compared to Wistar rats. The data attest to a certain rigidity of the autonomic cardiovascular regulation in August rats. __________ Translated from Byulleten’ Eksperimental’noi Biologii i Meditsiny, Vol. 142, No. 10, pp. 376–381, October, 2006     

Cluster Analysis of Extracardiac Control of the Heart Rate in Random-Bred Albino Rats at Rest

Heart rate variability was examined in random-bred albino rats at rest. The rats were clusterized according to activity of autonomic contour of heart rate control. Combination of factor and cluster analyses enhanced informative value of spectrum parameters of the heart rate variability in nonlinear rats grouped by initial neurovegetative status. The contours of central and autonomic regulation describe the most general features of the control influences that realize modulating influences at the heart level via sympathetic and parasympathetic control pathways. Their activity is comprehensively assessed by the normalized power spectrum of variations in the heart rate. Translated from Byulleten’ Eksperimental’noi Biologii i Meditsiny, Vol. 147, No. 1, pp. 16–19, January, 2009     

Low-frequency power of heart rate variability is not a measure of cardiac sympathetic tone but may be a measure of modulation of cardiac autonomic outflows by baroreflexes

Power spectral analysis of heart rate variability has often been used to assess cardiac autonomic function; however, the relationship of low-frequency (LF) power of heart rate variability to cardiac sympathetic tone has been unclear. With or without adjustment for high-frequency (HF) power, total power or respiration, LF power seems to provide an index not of cardiac sympathetic tone but of baroreflex function. Manipulations and drugs that change LF power or LF:HF may do so not by affecting cardiac autonomic outflows directly but by affecting modulation of those outflows by baroreflexes.     

Spectral analysis of heart rate fluctuations and optimum thermal management for low birth weight infants

Spectral analysis of heart rate variability is studied in 10 healthy growing premature infants to investigate the changes in autonomic balance achieved as a function of changes in skin temperature. Heart rate is obtained from ECG recordings and the power spectrum of beat-to-beat heart rate fluctuations is computed. The infants maintain mean rectal temperature within 36.3–37.2°C, while skin temperature changes. The respiratory rate does not change at the different servocontrol set points. Heart rate is found to increase slightly, but consistently. The low-frequency band (0.02–0.2 Hz), reflecting the interplay of the sympathetic and parasympathetic tone and known to be maximum at the thermoneutral zone, is maximum at 35.5 and 36°C and decreases gradually to a lower level at a servocontrol temperature of 36.5–37°C. The high-frequency band (0.2–2.0 Hz), coinciding with the respiratory peak and reflecting parasympathetic activity, is significantly elevated at 36°C (p<0.01). The minimum low: high ratio, indicating the minimum sympathetic-parasympathetic balance and possibly reflecting the most comfortable conditions, occurs at 36°C, although the differences are not statistically significant. Servocontrol skin temperature may thus be adapted, and possibly selected at 36°C for growing premature infants in an attempt to achieve thermal comfort and more balanced autonomic activity.     

The Association of Heart Rate Variability with Parkinsonian Motor Symptom Duration

Purpose

Impaired cardiovascular autonomic regulation is a non-motor symptom of Parkinson''s disease (PD) and may increase long-term morbidity. This study applied frequency-domain analysis of heart rate variability (HRV) to understand the progression of sympathetic and parasympathetic cardiac regulation in patients with PD.

Materials and Methods

In this cross-sectional study, 21 male and 11 female Taiwanese patients with advanced PD and 32 healthy gender- and age-matched subjects were enrolled. To minimize artifacts due to subject motion, daytime electrocardiograms for 5 minutes were recorded in awake patients during levodopa-on periods and controls. Using fast Fourier transformation, heart rate variables were quantified into a high-frequency power component [0.15-0.45 Hz, considered to reflect vagal (parasympathetic) regulation], low-frequency power component (0.04-0.15 Hz, reflecting mixed sympathetic and parasympathetic regulation), and low-frequency power in normalized units (reflecting sympathetic regulation). The significance of between-group differences was analyzed using the paired t-test. Pearson correlation analysis and stepwise regression analysis were applied to assess the correlation of patient age, PD duration, and disease severity (represented by the Unified Parkinson''s Disease Rating Scale) with each heart rate variables.

Results

Impaired HRV is significantly correlated with the duration of PD, but not with disease severity and patient age. Meanwhile, parasympathetic heart rate variable is more likely than sympathetic heart rate variable to be affected by PD.

Conclusion

PD is more likely to affect cardiac parasympathetic regulation than sympathetic regulation by time and the heart rate variables have the association with Parkinsonian motor symptom duration.     

Effect of relaxation training on cardiac parasympathetic tone

To examine the hypothesis that the relaxation response is associated with an increase in cardiac parasympathetic tone, the frequency components of heart rate variability during relaxation training were investigated in 16 college students. Electrocardiograms and pneumograms were recorded during a 5-min baseline period followed by three successive 5-min sessions of the autogenic training (relaxation) or by the same periods of quiet rest (control), while subjects breathed synchronously with a visual pacemaker (0.25 Hz). Although neither the magnitude nor the frequeney of respiration showed a significant difference between relaxation and control, the amplitude of the high-frequency component of heart rate variability increased only during relaxation (p= .008). There was no significant difference in the ratio of the low-frequency (0.04–0.15 Hz) to the high-frequency amplitudes. The increased high-frequency amplitude without changes in the respiratory parameters indicates enhanced cardiac parasympathetic tone. Thus, our results support the initial hypothesis of this study. Enhanced cardiac parasympathetic tone may explain an important mechanism underlying the beneficial effect of the relaxation response.     

Assessment of autonomic nervous system with analysis of heart rate variability in children with spastic cerebral palsy

The purpose of this study was to investigate the function of the autonomic nervous system in children with spastic cerebral palsy (CP) through an analysis of heart rate variability (HRV) occurring with orthostatic stress. Twelve children with spastic CP and twelve normal children participated in this study. The echocardiogram (ECG) signals were recorded for 3 minutes in both the supine and 70 degrees C head-up tilt positions, and then the HRV signals underwent power spectrum analysis at each position. Two components were measured; a low- frequency (LF) component (0.05 - 0.15 Hz) primarily reflecting sympathetic activity during orthostatic stress and a high-frequency (HF) component (0.15 - 0.4 Hz) reflecting parasympathetic activity. In the supine position, there was no significant difference between any of the HRV components of the two groups. In the head-up tilt position, absolute and normalized LF were significantly increased and absolute HF was significantly decreased in the normal children (p < 0.05), but not in the children with spastic CP. The results of this study suggest that cardiac autonomic functions, such as vagal withdrawal and sympathetic activation which occur during head-up tilt position, are not sufficient to overcome the orthostatic stress arising in spastic CP children.     

Model-based assessment of autonomic control in obstructive sleep apnea syndrome

STUDY OBJECTIVES: To quantitatively assess autonomic cardiovascular control in patients with obstructive sleep apnea syndrome (OSAS) using a mathematical model that relates changes in R-R interval (RRI) to respiration and changes in systolic blood pressure (SBP), and to compare the results obtained with conventional techniques. DESIGN: Respiration, RRI, and arterial blood pressure were monitored noninvasively in awake subjects in the supine and standing postures. A mathematical model was used to partition the fluctuations in RRI into a component ("RSA") correlated with respiration and a component ("baroreflex") correlated with fluctuations in SBP. SETTING: Sleep disorders laboratory in a hospital setting. PATIENTS OR PARTICIPANTS: 11 middle-aged male patients with untreated OSAS (apnea-hypopnea index = 75.9 +/- 11.1 (SE) events h-1) and 11 age-matched normal controls (10 males + 1 female). INTERVENTIONS: The subjects were monitored while breathing spontaneously in both supine and standing postures. Each subject also had to perform a battery of 5 standard autonomic stress tests (AST). MEASUREMENTS AND RESULTS: Four of the 5 ASTs did not indicate any difference between controls and OSAS subjects. There were also no differences in the indices derived from power spectral analysis of RRI and blood pressure variability; however, these spectral indices were sensitive to postural changes (orthostatic stress). Both RSA and baroreflex gains estimated from the model were substantially depressed in OSAS (P < 0.02) Changes in posture affected RSA gain but not baroreflex gain. The time-courses of the dynamics of these model components were not significantly different between subject groups. CONCLUSIONS: OSAS leads to abnormal parasympathetic and sympathetic control of heart rate, as reflected in depressed RSA and baroreflex gains. Model-based assessment was more sensitive in detecting abnormal autonomic function, compared to standard autonomic testing and power spectral analysis. The model-based approach represents a relatively simple and nonintrusive means of quantifying the key aspects of autonomic control in spontaneously breathing OSAS patients during wakefulness.     

Autonomic modulation of arterial pressure and heart rate variability in hypertensive diabetic rats

OBJECTIVE: The aim of the present study was to evaluate the autonomic modulation of the cardiovascular system in streptozotocin (STZ)-induced diabetic spontaneously hypertensive rats (SHR), evaluating baroreflex sensitivity and arterial pressure and heart rate variability. METHODS: Male SHR were divided in control (SHR) and diabetic (SHR+DM, 5 days after STZ) groups. Arterial pressure (AP) and baroreflex sensitivity (evaluated by tachycardic and bradycardic responses to changes in AP) were monitored. Autoregressive spectral estimation was performed for systolic AP (SAP) and pulse interval (PI) with oscillatory components quantified as low (LF:0.2-0.6Hz) and high (HF:0.6-3.0Hz) frequency ranges. RESULTS: Mean AP and heart rate in SHR+DM (131+/-3 mmHg and 276+/-6 bpm) were lower than in SHR (160+/-7 mmHg and 330+/-8 bpm). Baroreflex bradycardia was lower in SHR+DM as compared to SHR (0.55+/-0.1 vs. 0.97+/-0.1 bpm/mmHg). Overall SAP variability in the time domain (standard deviation of beat-by-beat time series of SAP) was lower in SHR+DM (3.1+/-0.2 mmHg) than in SHR (5.7+/-0.6 mmHg). The standard deviation of the PI was similar between groups. Diabetes reduced the LF of SAP (3.3+/-0.8 vs. 28.7+/-7.6 mmHg2 in SHR), while HF of SAP were unchanged. The power of oscillatory components of PI did not differ between groups. CONCLUSIONS: These results show that the association of hypertension and diabetes causes an impairment of the peripheral cardiovascular sympathetic modulation that could be, at least in part, responsible for the reduction in AP levels. Moreover, this study demonstrates that diabetes might actually impair the reduced buffer function of the baroreceptors while reducing blood pressure.     

The effect of change in sympatho-vagal balance on heart rate and blood pressure variability in the foetal lamb

Cardiac and vascular function is mainly under autonomic nervous control within seconds to minutes, although the control is not mature at birth. We studied sympatho-vagal control of heart rate and blood pressure in chronically catheterized foetal lambs in the last trimester of gestation. Power spectral analysis was used to quantitate the frequency-specific heart rate variability (HRV) and blood pressure variability. We performed 15 experiments in seven foetal lambs. These preliminary studies showed that parasympathetic blockade by atropine (eight experiments) had no significant effect on the distribution of HRV to different frequencies. Beta-sympathetic blockade by propranolol (seven experiments) decreased the ratio of low and mid to high frequency (0.025-0.13 to 0.13-1.00 Hz) HRV (P= 0.02). The increased high frequency HRV in the absence of a similar increase in blood pressure variability and tracheal pressure variability suggests enhanced baroreflex responsiveness after propranolol administration. The frequency-specific sympathetic control of HRV in foetal lambs, the change in ratio of low and mid to high frequency HRV, might have clinical implications in estimating the level of foetal sympathetic activation in the follow-up of high-risk pregnancies.     

Autonomic cardiac control. III. Psychological stress and cardiac response in autonomic space as revealed by pharmacological blockades

Behavioral contexts can evoke a variety of autonomic modes of response, characterized by reciprocal, coactive, or independent changes in the autonomic divisions. In the present study, we investigated the reactive autonomic control of the heart in response to psychological stressors, using quantitative methods for analyzing single and double autonomic blockades, and through the use of noninvasive indices based on heart period variability and systolic time intervals. Analysis of the effects of pharmacological blockades revealed an overall pattern of increased sympathetic and decreased parasympathetic control of the heart during speech stress, mental arithmetic, and a reaction-time task. Unlike the classical reciprocal sympathetic-parasympathetic response to orthostatic challenge, however, the responses of the autonomic branches to stress were uncorrelated. This reflected notable individual differences in the mode of autonomic response to stress, which had considerable stability across stress tasks. The putative noninvasive indices of sympathetic (preejection period) and parasympathetic (respiratory sinus arrhythmia) control changed in accord with the results of pharmacological blockades. Together, these results emphasize the substantial individual differences in the mode of autonomic response to stress, the advantages of a quantitative approach to analyzing blockade data, and the importance of validity estimates of blockade data.     

Model-Based Assessment of Cardiovascular Autonomic Control in Children with Obstructive Sleep Apnea

Study Objectives:

To quantitatively assess daytime autonomic cardiovascular control in pediatric subjects with and without obstructive sleep apnea syndrome (OSAS).

Design:

Respiration, R-R intervals, and noninvasive continuous blood pressure were monitored in awake subjects in the supine and standing postures, as well as during cold face stimulation.

Setting:

Sleep disorders laboratory in a hospital setting.

Participants:

Ten pediatric patients (age 11.4 ± 3.6 years) with moderate to severe OSAS (obstructive apnea-hypopnea index = 21.0 ± 6.6/ h) before treatment and 10 age-matched normal control subjects (age 11.5 ± 3.7 years).

Measurements and Results:

Spectral analysis of heart rate variability revealed that high-frequency power was similar and the ratio of low- to high-frequency power was lower in subjects with OSAS vs control subjects. The closed-loop minimal model allowed heart rate variability to be partitioned into a component mediated by respiratory-cardiac coupling and a baroreflex component, whereas blood pressure variability was assumed to result from the direct effects of respiration and fluctuations in cardiac output. Baroreflex gain was lower in subjects with OSAS vs control subjects. Under orthostatic stress, respiratory-cardiac coupling gain decreased in both subject groups, but baroreflex gain decreased only in controls. The model was extended to incorporate time-varying parameter changes for analysis of the data collected during cold face stimulation: cardiac output gain increased in controls but remained unchanged in OSAS.

Conclusions:

Our findings suggest that vagal modulation of the heart remains relatively normal in pediatric subjects with OSAS. However, baseline cardiovascular sympathetic activity is elevated, and reactivity to autonomic challenges is impaired.

Citation:

Chaicharn J; Lin Z; Chen ML; Ward SLD; Keens T; Khoo MCK. Model-based assessment of cardiovascular autonomic control in children with obstructive sleep apnea. SLEEP 2009;32(7):927-938.     

Impact of chronic obstructive pulmonary disease on linear and nonlinear dynamics of heart rate variability in patients with heart failure

The objective of this study was to investigate the impact of chronic obstructive pulmonary disease (COPD)-heart failure (HF) coexistence on linear and nonlinear dynamics of heart rate variability (HRV). Forty-one patients (14 with COPD-HF and 27 HF) were enrolled and underwent pulmonary function and echocardiography evaluation to confirm the clinical diagnosis. Heart rate (HR) and R-R intervals (iRR) were collected during active postural maneuver (APM) [supine (10 min) to orthostasis (10 min)], respiratory sinus arrhythmia maneuver (RSA-M) (4 min), and analysis of frequency domain, time domain, and nonlinear HRV. We found expected autonomic response during orthostatic changes with reduction of mean iRR, root mean square of successive differences between heart beats (RMSSD), RR tri index, and high-frequency [HF (nu)] and an increased mean HR, low-frequency [LF (nu)], and LF/HF (nu) compared with supine only in HF patients (P<0.05). Patients with COPD-HF coexistence did not respond to postural change. In addition, in the orthostatic position, higher HF nu and lower LF nu and LF/HF (nu) were observed in COPD-HF compared with HF patients. HF patients showed an opposite response during RSA-M, with increased sympathetic modulation (LF nu) and reduced parasympathetic modulation (HF nu) (P<0.05) compared with COPD-HF patients. COPD-HF directly influenced cardiac autonomic modulation during active postural change and controlled breathing, demonstrating an autonomic imbalance during sympathetic and parasympathetic maneuvers compared with isolated HF.     

Features of autonomic cardiovascular control during cognition in major depressive disorder

Previous research has suggested reduced parasympathetic cardiac regulation during cognitive activity in major depressive disorder (MDD). However, little is known about possible abnormalities in sympathetic control and cardiovascular reactivity. This study aimed to provide a comprehensive analysis of autonomic cardiovascular control in the context of executive functions in MDD. Thirty six MDD patients and 39 healthy controls participated. Parameters of sympathetic (pre‐ejection period, PEP) and parasympathetic control (high and low frequency heart rate variability, HF HRV, LF HRV; and baroreflex sensitivity, BRS) as well as RR interval were obtained at rest and during performance of executive function tasks (number‐letter task, n‐back task, continuous performance test, and Stroop task). Patients, as compared to controls, exhibited lower HF HRV and LF HRV during task execution and smaller shortenings in PEP and RR interval between baseline and tasks. They displayed longer reaction times during all conditions of the tasks and more omission errors and false alarms on the continuous performance test. In the total sample, on‐task HF HRV, LF HRV and BRS, and reactivity in HF HRV, LF HRV, and PEP, were positively associated with task performance. As performance reduction arose independent of executive function load of the tasks, the behavioral results reflect impairments in attention and processing speed rather than executive dysfunctions in MDD. Abnormalities in cardiovascular control during cognition in MDD appear to involve both divisions of the autonomic nervous system. Low tonic parasympathetic control and blunted sympathetic reactivity imply reduced physiological adjustment resources and, by extension, provide suboptimal conditions for cognitive performance.     

Changes in autonomic function and EEG power during mental arithmetic task and their mutual relationship

Meditation is a specific consciousness state in which deep relaxation and increased internalized attention coexist. Autonomic nervous activity during meditation was reported to be characterized by decreased sympathetic activity and increased parasympathetic activity. And concerning EEG power, slow alpha power and fast theta power increased during meditation. On the other hand, mental arithmetic (MA) tasks have been reported to induce an increase in blood pressure and heart rate with enhanced sympathetic activity. However, changes in autonomic nervous activity and EEG power during MA tasks and their mutual relationship have not been adequately studied. In the present study, we quantitatively analyzed the changes in autonomic nervous activity using heart rate variability (HRV) and EEG power during MA task in 30 healthy volunteers. MA task induced significant increases in normalized LF, LF/HF ratio (as a sympathetic index), and a decrease in normalized HF (as a parasympathetic index). On the other hand, significant decrease in EEG power (slow theta: 4-6 Hz and fast alpha: 10-13 Hz in the posterior region and fast theta: 6-8 Hz and slow alpha: 8-10 Hz in all the regions) were induced by MA task. Further evaluation of these changes showed a negative correlation between the change rates (with the control resting condition as the baseline) in fast alpha power and that in LF/HF. These results suggest that specific correlated relationships exist between the change in autonomic nervous activity and EEG power depending on the difference in mental task (i.e., meditation or MA).     

Oxytocin increases autonomic cardiac control: moderation by loneliness

The current study examined the role of perceived social isolation in moderating the effects of oxytocin on cardiac autonomic control in humans. Intranasal administration of 20 IU oxytocin resulted in a significant increase in autonomic (parasympathetic and sympathetic) cardiac control. Specifically, oxytocin increased high frequency heart rate variability, a relatively pure measure of parasympathetic cardiac control, and decreased pre-ejection period, a well-validated marker of enhanced sympathetic cardiac control. Derived metrics of autonomic co-activity and reciprocity revealed that oxytocin significantly increased overall autonomic cardiac control. Furthermore, the effects of oxytocin on cardiac autonomic control were significantly associated with loneliness ratings. Higher levels of loneliness were associated with diminished parasympathetic cardiac reactivity to intranasal oxytocin. The effects of OT on autonomic cardiac control were independent of any effects on circulating pro-inflammatory cytokine or stress hormone levels. Thus, lonely individuals may be less responsive to the salubrious effects of oxytocin on cardiovascular responsivity.     

心血管变异性的一个简单的数学模型

目的：建立心血管变异性的数学模型,探讨变异性频谱的主要频率成分机理。方法：建立了包含血流动力学和自主神经系统,尤其考虑了心血管中枢整合的闭环控制数学模型。结果：成功地模拟了心血管变异性频谱中的三个主要频率峰。高频峰的频率是呼吸频率与心率之比,低频和极低频可能与交感和副交感神经调节心率的非可加性有关。     

Volitional control of the heart rate

The heart rate is largely under control of the autonomic nervous system. The aim of the present study is to investigate the interactions between the brain and heart underlying volitional control of the heart and to explore the effectiveness of volition as a strategy to control the heart rate without biofeedback. Twenty seven healthy male subjects voluntarily participated in the study and were instructed to decrease and increase their heart beats according to rhythmic, computer generated sound either 10% faster or slower than the subjects' measured heart rate. Sympathetic and parasympathetic activities were estimated with the heart rate variability (HRV) obtained by power spectral analysis of RR intervals. Functional coupling patterns of cerebral cortex with the heart were determined by Partial directed coherence (PDC). In HR_slow task; HR and sympathetic activity significantly decreased. However parasympathetic activity and power spectral density of EEG in low Alpha (8–10.5 Hz) band significantly increased. Moreover information flow from parietal area (P3 and P4) to RR interval significantly increased. During HR_quick task; HR, sympathetic activity and power spectral density of EEG in low Beta (14–24 Hz) band significantly increased. Parasympathetic activity significantly decreased. Information flow from FT8, CZ and T8 electrodes to RR interval significantly increased. Our findings suggested that the heart beat can be controlled by volition and is related to some special areas in the cortex.     

Cardiovascular effects of morning nutrition in preadolescents

The cardiovascular response to eating has been extensively investigated in adults, but comparable data in children are lacking. In this investigation, heart-rate and heart-rate variability were evaluated in preadolescents during resting periods in the morning initially while participants maintained overnight fasting, and again after the participants either ate a standardized breakfast or continued fasting. Relative to the initial fasting period, heart rate (HR) increased slightly in fed participants and decreased significantly in those who continued to fast. These effects were associated with significant increases in low- (LF: 0.04-0.15 Hz; primarily sympathetic influences) and high-frequency (HF:0.15-0.5 Hz; parasympathetic influences) spectral components in fasting participants and with nonsignificant decreases in both components in fed participants. Although these HF changes are consistent with the observed heart-rate variations (i.e., increases and decreases in parasympathetic influence associated with decreased and increased HR, respectively), the LF increase with the slowing, and decrease with the acceleration of HR run counter to expected sympathetic effects on HR. The net effect of these modulations was unchanged sympathovagal balance (LF/HF) for fasting participants but a significant decrease for fed participants across recording periods. The results indicate that the continuation of overnight fasting is associated with a significant increase in parasympathetic activity that is attenuated by eating breakfast. Furthermore, the findings suggest that the parasympathetic contribution to the LF spectral component is significantly enhanced in preadolescents, and, consequently, the LF/HF ratio-generally considered to reflect sympathovagal balance-does not segregate sympathetic and parasympathetic influences in children.