Observational Study
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World J Cardiol. Jun 26, 2014; 6(6): 502-506
Published online Jun 26, 2014. doi: 10.4330/wjc.v6.i6.502
Respiratory modulation of cardiac vagal tone in Lyme disease
Basant K Puri, Mussadiq Shah, Jean A Monro, Michele C Kingston, Peter OO Julu
Basant K Puri, Department of Medicine, Imperial College London, Hammersmith Hospital, London W12 0HS, United Kingdom
Basant K Puri, Imaging Directorate, Imperial College London, Hammersmith Hospital, London W12 0HS, United Kingdom
Mussadiq Shah, Jean A Monro, Michele C Kingston, Peter OO Julu, Department of Neuroscience, Breakspear Medical Group, Hertfordshire House, Hemel Hempstead, Hertfordshire HP2 4FD, United Kingdom
Peter OO Julu, Department of Medicine, Imperial College London, London SW7 2AZ, United Kingdom
Peter OO Julu, National Rett Center, SE-832 23 Frösön, Sweden
Author contributions: Puri BK designed the study, analyzed the data, and drafted the article; Shah M, Monro JA, Kingston MC and Julu POO contributed to the conception of the study, acquired the data, and critically reviewed the article.
Correspondence to: Basant K Puri, MA, PhD, MB, BChir, BSc (Hons) MathSci, DipStat, MMath, FRCPsych, FSB, Professor, Imaging Directorate, Imperial College London, Hammersmith Hospital, Du Cane Road, London W12 0HS, United Kingdom. basant.puri@imperial.ac.uk
Telephone: +44-1442-261333 Fax: +44-1442-266388
Received: December 24, 2013
Revised: April 11, 2014
Accepted: May 16, 2014
Published online: June 26, 2014
Processing time: 183 Days and 17.6 Hours
Core Tip

Core tip: Given that immune dysfunction, postural orthostatic tachycardia syndrome, fatigue, cognitive dysfunction, orthostatic palpitations, syncope, and stress, which may occur in Lyme disease, are associated with parasympathetic activity and reduced modulation of cardiac vagal tone, we hypothesized that modulation of cardiac vagal tone is impaired in this disease. This was confirmed in our study of 18 patients and 18 matched controls. Cardiac vagal tone is reflexly generated through arterial baroreceptor stimulation, by the afferents of the latter facilitating cardiac vagal motoneuron discharge relaying through interneurons in the nucleus tractus solitarius, implying that Lyme disease may directly affect the vagus or brainstem.