ANS ANALYSIS - ANALYSIS OF THE AUTONOMIC NERVOUS SYSTEM

The patient view explained

In the patient view, the resting pulse rate (HR, purple), the sympathetic activity (SI, red) and the parasympathetic activity (RMSSD, blue) are displayed. The color red symbolizes tension and the color blue symbolizes relaxation.

The traffic light colors in the background make it easier for the therapist to evaluate the measurement results. At a glance, the ANS Analysis shows, for example, “Everything is in the green zone” or sympathetic activity is much too high and the parasympathetic nervous system is almost no longer active. The visual display, which is understandable even for laypersons, saves time and greatly increases patient acceptance.

The therapist view explained

The therapist view can be added with a tap of the finger and is used with additional parameters for an even more detailed evaluation of the measurement results.

HR (purple) shows the average heart rate over the measured period.

Alpha 1 (green) shows the interaction of the individual autonomic control circuits and thus the quality of regulation. The alpha 1 value is used as an additive risk parameter for the patient’s prognosis.

The SDNN (standard deviation normal to normal, orange) indicates an average value of the variability and consists of sympathetic and parasympathetic components. The SDNN therefore indicates the overall variability and is also referred to as total power.

The SI (stress index according to Baevsky, red) shows the sympathetic activity.

The RMSSD (Root Mean Square of Successive Differences, blue) shows the parasympathetic activity.

The rhythmogram, histogram and scatter diagram explained

In the rhythmogram, the heart rate variability (HRV) is recorded in milliseconds. The more irregular (jagged) the rhythmogram is, the better the HRV. The flatter the rhythmogram, the worse the HRV.

The histogram is a percentage distribution curve of the measured heartbeats. A broad normal distribution according to Gaus reflects a good HRV. Few bars in the histogram indicate a limited HRV.

In the scatterplot, a point in the coordinate system results from two neighboring RR intervals. The first value is plotted on the X-axis and the second on the Y-axis. The larger the scatter cloud, the better the HRV. The denser the cloud, the more limited the HRV.

Added value through the alpha 1 value

The alpha1 value is a so-called non-linear HRV parameter and, unlike the other parameters, reflects the quality rather than the quantity of HRV. It describes the degree of correlation or similarity of the HRV data and characterizes the systemic interaction, the interplay of the individual control systems. It should be included as an additional parameter in the assessment of the overall autonomic regulatory capacity. At rest, low values (< 0.75) in particular indicate a poor prognosis and suggest that an additional diagnostic risk assessment (e.g. cardiological, oncological) is advisable. High alpha 1 values (> 1.70) indicate compensatory processes in the organism, the development of which should be monitored and observed by regular ANS Analyses. The alpha 1 value is also used as a meaningful risk parameter in intensive care units in order to be able to recognize potential risks more quickly (e.g. sepsis, MODS).

A system is a whole consisting of several individual parts. For a system to function smoothly and successfully, the individual parts must be connected, cooperate and communicate with each other.

The practical significance of the alpha 1 value can be explained very well using the example of football. In this system (team) there are players in attack and in defense. The attack (sympathetic nervous system) and the defense (vagus) must not only master their actual task (scoring goals – preventing goals), but they must also know each other, they must know what the characteristics and peculiarities of the other players are, which connections exist for the quick switch from defense via the midfield to attack. Communication and mutual understanding must be guaranteed if this team (system) is to be successful. It’s not just the statistics – the quantity (number of shots on goal, shots blocked, percentage of ball possession, etc.) that are decisive for victory or defeat. The quality of the team play is also largely responsible for success. Even a world selection with the best players is no guarantee of success against a well-coordinated team.

If a system, such as the autonomic nervous system, works very well together in its complexity, you have an ideal alpha 1 value of around 1.0. The sympathetic and parasympathetic nervous systems thus work together in the best possible way for physiological regulation of the entire organism.

Influence of breathing on autonomic regulation

Respiratory sinus arrhythmia (RSA) describes the breathing-dependent fluctuations in heart rate (frequency increase during inspiration, frequency slowdown during expiration). When the cardiovascular system is rhythmically stimulated by timed breathing with a frequency of six breathing cycles per minute, there is a significant increase in heart rate fluctuation and an improvement in autonomic regulation. This controlled breathing is also known as cardiorespiratory or cardiovagal biofeedback. This method can be used to determine within a few minutes whether autonomic regulation can be improved immediately by existing parasympathetic reserves or whether there is a more lasting regulatory disorder that requires further diagnostics and therapy.

The cardiovagal biofeedback function integrated into the ANS Analysis can be used both diagnostically and therapeutically. If the first measurement shows a regulatory disorder (increased sympathetic nervous system, decreased parasympathetic nervous system), a second measurement with timed breathing should be carried out immediately afterwards in order to visualize the parasympathetic reserves and the degree of regulatory ability. The ANS Analysis provides the patient with the inhalation and exhalation phase via a visual and/or acoustic signal (Fig. above and below).

After completion of the second measurement under breathing instructions, this is compared with the first (Fig. below). The first measurement shows an increased sympathetic nervous system and a decreased parasympathetic nervous system. The second measurement was carried out while the patient was breathing and shows a clear improvement in autonomic regulation.

Through simple visualization, the patient understands why breathing training is important and what effects can be achieved with it. In this case, it is advisable to start breathing training with the Vagusvit© breathing trainer app in order to train the autonomic regulation ability and stress resilience in the long term.

Stress is the greatest health risk of the 21st century, according to the World Health Organization. However, stress is not only an issue for adults, but is now increasingly affecting children and young people. Stress factors such as exam nerves, poor grades, the high performance demands at school, the daily pressure of deadlines, but also conflicts within the family, arguments with friends or the pursuit of social recognition have a negative impact on the body and lead to complex clinical pictures and increasing visits to therapeutic practices.

As the autonomic regulation of children and adolescents differs considerably from that of adults, the use of autonomic functional diagnostics in children was previously only possible to a limited extent.

The ANS Analysis is the world’s first system to integrate study-based pediatric reference values after a research phase lasting several years. The new update supplements the existing standard values of 20 – 80 years with the age of 10 – 19 years and now makes it possible to assess the autonomic nervous system in children and adolescents, to record their stress resilience and regenerative capacity and to prevent the stress cycle in good time, which sooner or later leads to illness.

To illustrate the importance of correct standard values for children and adults, the graphs below show the measurement of a 14-year-old girl. The first figure (left) shows the measurement with the adjusted standard values for 10 – 19 year olds and the second figure (right) with the previous standard values for adults, which the 14 year old girl assessed as false positive. The adjusted standard values for children clearly show the urgent need for action.