ArticleJournal of translational medicine2024
Osteoarthritis patients exhibit an autonomic dysfunction with indirect sympathetic dominance.
Article in Journal of translational medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed.
- The effect of preemptive intravenous paracetamol-mannitol on postoperative analgesia and quality of recovery in elderly patients undergoing total hip arthroplasty.BMC anesthesiology · 2026Trial
- Pain informed movement compared to neuromuscular exercise and standard education in people with knee osteoarthritis: A pilot and feasibility randomized controlled trial.Osteoarthritis and cartilage open · 2025Trial
- Improvement in pain by using lidocaine combined with esketamine in elderly patients receiving local anaesthesia for percutaneous kyphoplasty: a randomized controlled study.BMC anesthesiology · 2024Trial
- Relationship between cerebral white matter hyperintensities and autonomic function in older individuals with cerebral small vessel disease.Clinical autonomic research : official journal of the Clinical Autonomic Research Society · 2026Article
- Radon balneotherapy in rheumatologic diseases: potential mechanisms and implications for cardiovascular autonomic control and inflammation.Clinical rheumatology · 2026Review
- Sensor-Based Monitoring of Knee Osteoarthritis Symptoms in Free-Living Settings: Scoping Review.Journal of medical Internet research · 2026Article
- Emerging concepts in osteoarthritis and musculoskeletal diseases: Insights from the University of Debrecen Musculoskeletal Symposium 2025.Osteoarthritis and cartilage open · 2026Article
- Psychological stress and gut microbiota regulation of osteoarthritis progression: mechanisms and therapeutic strategies.Frontiers in microbiology · 2026Review
- Molecular mechanisms and therapeutic implications of the sympathetic nervous system in bone-related disorders: a brain-bone axis perspective.Bone research · 2025Review
- Oxytocin Receptor Expression and Activation in Parasympathetic Brainstem Cardiac Vagal Neurons.eNeuro · 2025Article
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Authors and funding
9 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundOsteoarthritis (OA) is a chronic degenerative joint disease causing limited mobility and pain, with no curative treatment available. Recent in vivo studies suggested autonomic alterations during OA progression in patients, yet clinical evidence is scarce. Therefore, autonomic tone was analyzed in OA patients via heart rate variability (HRV) measurements.
methodsTime-domain (SDRR, RMSSD, pRR50) and frequency-domain (LF, HF, LF/HF) HRV indices were determined to quantify sympathetic and parasympathetic activities. In addition, perceived stress, WOMAC pain as well as serum catecholamines, cortisol and dehydroepiandrosterone-sulphate (DHEA-S) were analyzed. The impact of the grade of disease (GoD) was evaluated by linear regression analysis and correlations with clinical data were performed.
resultsGoD significantly impacted the autonomic tone in OA patients. All time-domain parameters reflected slightly decreased HRV in early OA patients and significantly reduced HRV in late OA patients. Moreover, frequency-domain analysis revealed decreased HF and LF power in all OA patients, reflecting diminished parasympathetic and sympathetic activities. However, LF/HF ratio was significantly higher in early OA patients compared to late OA patients and implied a clear sympathetic dominance. Furthermore, OA patients perceived significantly higher chronic stress and WOMAC pain levels compared to healthy controls. Serum cortisol and cortisol/DHEA-S ratio significantly increased with GoD and positively correlated with WOMAC pain. In contrast, serum catecholamines only trended to increase with GoD and pain level.
conclusionsThis prospective study provides compelling evidence of an autonomic dysfunction with indirect sympathetic dominance in early and late knee OA patients for the first time based on HRV analyses and further confirmed by serum stress hormone measurements. Increased sympathetic activity and chronic low-grade inflammation in OA as well as in its major comorbidities reinforce each other and might therefore create a vicious cycle. The observed autonomic alterations coupled with increased stress and pain levels highlight the potential of HRV as a prognostic marker. In addition, modulation of autonomic activity represents an attractive future therapeutic option.
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