Using the head-up tilt test as measured by EMG to assess autonomic nervous system involvement in people with leprosy
Remzi Yigiter, Hizir Ulvi
Med Sci Tech 2011; 52(1-2): RA41-44
Backgound: Heart rate variability (HRV) is reduced in people with leprosy. However, the relationships among HRV and positions (lying down and standing) in people with leprosy are unknown. The aim of this study was to assess the relationships among HRV and positions (lying down and standing) in people affected by leprosy and to verify the correlation of HRV measured in changing position with disease severity and functional disability.
Material/Methods: We studied 16 people with leprosy (mean age: 33, 9 females and 7 males) and 53 age-matched healthy subjects (mean age: 34, 28 females and 25 males). Non-invasive head-up tilt test (orthostatic test) and nerve conduction parameters were studied in all subjects.
Results: The mean values of the ‘’30/15’’ head-up tilt test (in patients, 0.92±0.43 vs. controls, 1.12±0.30% [p<0.05]) was significantly lower compared with the controls. The mean difference of systolic and diastolic blood pressure between supine rest and during standing in leprosy patients were higher compared with the controls (mean systolic pressure in patients, 7.3±6.2 mmHg vs. controls, 6.4±8.5 mmHg [p>0.05] and mean diastolic pressure in patients, 3.2±3.1 mmHg vs. controls, 3±2 mmHg [p>0.05]), but they did not reach statistical significance. These data indicate that leprosy patients have functional abnormalities of the autonomic nervous system (ANS).
Conclusions: We conclude that the head-up tilt test, which can be easily and rapidly performed in an EMG (electromyogram) laboratory using standard equipment, can provide useful, objective information in assessing ANS function, specially orthostatic functional abnormalities, in peripheral neuropathy in leprosy patients.
Keywords: Leprosy, autonomic nervoussystem, head-up tilt test, heart rate variability