ArticlePain practice : the official journal of World Institute of Pain2018
The Relationship Between Heart Rate Variability, Psychological Flexibility, and Pain in Neurofibromatosis Type 1.
Article in Pain practice : the official journal of World Institute of Pain, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.
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Who cites it
15 citing papers in PubMed, 1 synthesis or guideline pooled it, 29 citations in OpenAlex.
- Which outcome variables are associated with psychological inflexibility/flexibility for chronic pain patients? A three level meta-analysis.Frontiers in psychology · 2022Pooled it
- From Subjective to Objective: The Bedside Value of HRV in AssessingChronic Pain Complicated by Emotionaland Sleep Issues.Applied psychophysiology and biofeedback · 2026Article
- Digital Health Monitoring and Intervention Suite for Stress in Frontline Nurses: Prospective Cohort Trial.JMIR formative research · 2026Article
- Article
- Gritty Heart: Improved Heart Rate Variability Markers of Adaptive Physiological Response in Grit.Psychophysiology · 2025Article
- Comparison of the autonomic nervous system dysfunction between different chronic spine disorders: neck pain versus low back pain.Revista da Associacao Medica Brasileira (1992) · 2022Article
- Do catastrophizing and autonomic-reduced flexibility mediate pain outcomes in chronic headache?Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2022Article
- Innovation in the treatment of persistent pain in adults with Neurofibromatosis Type 1 (NF1): Implementation of the iCanCope mobile application.Contemporary clinical trials communications · 2022Article
- Heart rate and heart rate variability in patients with chronic inflammatory joint disease: the role of pain duration and the insular cortex.BMC musculoskeletal disorders · 2022Article
- Regulatory Emotional Self-Efficacy Buffers the Effect of Heart Rate Variability on Functional Capacity in Older Adults With Chronic Low Back Pain.Frontiers in pain research (Lausanne, Switzerland) · 2022Article
- Depression explains the association between pain intensity and pain interference among adults with neurofibromatosis.Journal of neuro-oncology · 2021Article
- Predicting personal protective equipment use, trauma symptoms, and physical symptoms in the USA during the early weeks of the COVID-19 lockdown (April 9-18, 2020).Journal of contextual behavioral science · 2021Article
- Review
- Chinese Version of the Psychological Inflexibility in Pain Scale for Cancer Patients Reporting Chronic Pain.Cancer nursingArticle
- Disease burden and unmet needs in adults with neurofibromatosis type 1 and plexiform neurofibromas: A systematic literature review.Neuro-oncology advancesReview
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Authors and funding
7 authors at 2 institutions in 1 country.
Funding
Abstract
Individuals with neurofibromatosis type 1 (NF1) and plexiform neurofibromas (PNs) can experience chronic pain. Previous research has examined the relationship between heart rate variability (HRV) and persistent pain. HRV is an index of autonomic nervous system functioning, and reflects the variability in time elapsed between heartbeats. Patients with chronic pain tend to exhibit lower HRV, which has been associated with poor adaptability, or psychological flexibility, to stress. The aim of the current study was to examine relationships between HRV, psychological flexibility, and pain in a sample of adolescents and young adults (AYAs) with NF1 and PNs. AYA participants (n = 40) 16 to 34 years of age with NF1 completed baseline measures of pain and psychological functioning, and underwent a 5-minute electrocardiogram (ECG). A subset of 20 participants completed follow-up questionnaires and a second ECG 8 weeks later. Spectral analyses of ECGs yielded a measure of high-frequency heart rate variability (HF-HRV). Baseline correlations revealed that lower HF-HRV is related to greater inflexibility and more pain interference, but not pain intensity. Moreover, psychological inflexibility significantly mediated the relationship between HF-HRV and pain interference. Finally, regression models indicated that baseline psychological inflexibility is a significant predictor of HF-HRV at follow-up and, separately, that baseline HF-HRV significantly predicted pain intensity at follow-up. These findings suggest complex mind-body processes in the experience of pain in NF1, which have not been studied previously. Implications for pain-related interventions and future research are discussed.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.