Increased Heart Rate Variability Response Among Infants with Reported Rhinorrhea and Watery Eyes: A Pilot Study

Abstract

Laura A Conrad,1 Natalie Buchinsky,2 Luis M Acosta,2 J David Nugent,3 Khalil W Savary,4 Rachel L Miller,5 Nurdant Emanet,6 Julie Herbstman,2 Beatrice Beebe,6 Michael M Myers,3 William P Fifer,3 Matthew S Perzanowski2 1Division of Respiratory and Sleep Medicine, Albert Einstein College of Medicine, New York, NY, USA; 2Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA; 3Division of Developmental Neuroscience, Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, NY, USA; 4Department of Pediatrics, Rutgers University, Newark, NJ, USA; 5Division of Clinical Immunology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA; 6Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, NY, USACorrespondence: Matthew S PerzanowskiDepartment of Environmental Health Sciences, Mailman School of Public Health, Columbia University, 722 West 168th St, 11th Floor, New York, NY, 10032, USATel [phone]Fax [phone]Email [email protected]: Previously, we found that reported infant rhinorrhea and watery eyes without a cold (RWWC) predicted school age exercise-induced wheeze, emergency department visits, and hospitalizations. These findings were independent of allergic sensitization, and we theorized that increased parasympathetic tone underlay the association. We also reported that increased heart-rate variability (HRV) in infants predicted wheeze in 2– 3 year-olds. In a convenience sample of children participating in a birth cohort study, we tested the hypothesis that infants with RWWC would have elevated HRV, indicating increased parasympathetic tone.Methods: RWWC symptoms since birth were queried for 3-month-old children. At 4-months, HRV was assessed (root mean square of successive differences [RMSSD]) during a standardized infant–mother still-face paradigm, which included 2 minutes of mother/child play immediately followed by 2 minutes of the mother maintaining a still-face.Results: Among participants (n=38), RWWC was common for girls (32%) and boys (21%). The children with the greatest decrease in RMSSD between play and still-face challenge (lowest tertile) had a higher prevalence of RWWC as compared with children in the higher tertiles (50% vs 16%, P=0.045). In a logistic regression model controlling for sex, age and time between HRV and RWWC assessment, children with greater decrease in HRV between play and still-face (lowest tertile) had greater odds of having RWWC (odds ratio=6.0, P=0.029).Conclusion: In this relatively small study, we demonstrated greater decreases in HRV in response to a stressor among children with reported RWWC, suggesting that these children might have increased parasympathetic tone and/or overall greater vagal reactivity.Keywords: watery eyes, still-face challenge, rhinitis, exercise-induced asthma, autonomic nervous system, heart rate variability

Keywords

• watery eyes
• still-face challenge
• rhinitis
• exercise-induced asthma
• autonomic nervous system
• heart rate variability