Document 6bp32rkxGb18DLEVJ3jpkow73

00*101- BIO-MEDICAL.RESEARCH DOCUMENT DESCRIPTION FORM 63 Duplicate in all cards:--> 68 69 76 14 0000126 year as-1961- File number [Right justify [Numeric only] Author(s), as Last Name FS (No Punctuation) and coden for journal as JAMA preceeded by one blank space 1 20 21 // ,t s' i /:, .c iA '" 40 41 W/ , , s /. 77 78 Sub-Index Code 60 61 62 11 12 13 Title of Report; end with space-hyphen-hyphen-space. Follow with Index Terms, separated from each other with comma-space. Avoid other punctuation; do not abbreviate. ^2 . 61 o2 <7- /' ----------i l /f 4- - , / / '- ' / L l 41 s) / 'Ll; < 4"/ A f*- : ^ ,A /(_s_ C. & 1 ' f. /V " sTc "r . " : -A ^ r-- , , 4f, / >' _ \s -- - *r>- y -* 'A J ;- ~-t:t A a-.j ,/ 1 / c y- y ' s 21 22 23 24 Source (Journal, Vol., Number, Pages, Date ) 12 vt,, --,-/ i- //-^ /; '' ~T7-6 ''W ' T 1 61 62 31 1 /C ' i /"- ' ^ r 1/ 1 / v ^ 'f / '< ' 32 Brief Summary 12 10 SUMMARY: 61 62 61 62 63 64 R&S 107401 * 1 Vfafy&r ' , 0000126 Gigiena Truda i Professional' nye Gabolevaniia 1980, No. 5, 39-^2 :YSL COURSE CF THE HEART HATE AND GALVANIC SKIN REFLEX during night sleep in patients with chronic occupational INTOXICATION BY VINYL CHLORIDE E. A. Gnesina and A. I. Fshenitsyna During various stages of sleep the heart rate (HR) and galvanic skin reflex (13R), like other vegetative functions, undergo a number of regular changes (A. M. Vein). Thus, in the superficial stages of slow-wave sleep (S3) the HR, v;hen compared with this index during the v. a king stage, decreases and disordered GSR appear; in the deep stages cf SS the HP. increases and the GSR reach their maximum expression (L. 7, Latash and coworkers; Coccagna and coworkers). With the start of fr.st-wave sleep (FS) the pulse becomes more frequent and arrhythmic and extrasvstcles arise. Here a variable rhythm is more characteristic for tne F3 than an increase in the HR; the GSR are usually absent in FS. It is usually assumed that the HR and GSR reflect the state of the emotional sphere (Bloch). From this standpoint the lability of the HR and FS correlates v/ith experiencing emotionally colored dreams in this stage, but the greatest expression of the GSR in the deep stages of SS, or specifically delta sleep (DS) , in the absence of dreams, represents a certain paradox. A study of the dynamics of the CSR during sleep disclosed that the maximum number of GSP. is observed in the second and third cycles of IS, decreasing toward the end of the night, where the emotional nature of the dreams usually increases (V. F. Danilin d and L. ?, Latash; V. S* Rotenberg and coworkers). These data enabled L. P. Latash to express the theory that DS, and the GSR accompanying It, has a damping role as regards the frequency and emotional nature of the dreams in subsequent episodes of FS. From the standpoint of the information theories (Gaardner), sleep represents a process that is characterized by continuous psychic activity, which proceeds either consciously, as dreams in FS, or unconsciously, as dreams in SS. In the opinion of L. P. Latash, the GSP are the stigma of the unconscious activity in SS. L. ?. Latash explains the practical absence of GSR in FS by the vegetative blockade mechanism, by analogy with the decrease in the muscle tone in this stage. Despite the fact that the presented data require further experimental and clinical confirmation, they can serve as a starting point when studying vegetative regulation in patients with sleep disturbances. \'te studied the HR and GSR during the night sleep of patients with insomnia, v.hicn accompanies chronic occupational intoxication by vinyl chloride (VC), a volatile narcotic that is widely used at the present time by the chemical industry in the production of synthetic polymers (S. A. Gnesina and V. A. Antonyuzhenko). Clinically, the intoxication is distinguished as two stages: the early stage, which proceeds with functionally dynamic shifts in the nervous system, and the later stage, where organic symptoms of damage to the trunk sections of the brain and trunk-hypothalamic paroxysms appear (V. A. Antonyuzhenko). V.'o studied a total of 20 patients (9 in the early stage of intoxication, and 11 m the later stage), ranging in age from pO to 50 years, and healthy persons of the same age (control). The overall clinical study included a continuous polygraphic recording of night sleep by R&S 107402 vn 2 R&S 107403 p 1C P. 40 the standard Eechtschaffen - Kales method, with recording of the EKG and GSE from a palmar surface by the I. E. Tarkhanov method. The stages of sleep were determined visually using the classification of the same authors. The HP in the episodes of the separate stages were calculated from the average indices of the number of E--S intervals on the EKG in three 20-second sections taken from the portions of the recording without motive artifacts. The difference between the maximum and minimum values of the HE in this stage was taken as the lability index in the FS. The absolute number and frequency of the GSE per minute in all of the episodes of the various stages of sleep were calculated during the entire polygraphic recording. The obtained data vere processed statistically using the V.'ilc exon - Mann - Vihitney nonparameoric criterion (E. V. Gubler and A. A. Genkin). The dynamics of the G3E ar.d HE were compared with the answers of the patients regarding dreams during the time of the experimental night. The absolute number of G3R varied widely for the persons in the control group, and on the average was 1578. The frequency of the GSE in the first cycle predominated in the superficial stages of the SS (I, II), decreased toward the end of t.ne cycle in the DS, and even more so in the SS; on the whole, the frequency of the GSE in the first cycle was lower than in the subsequent 3 "4 cycles (Fig. l). Beginning with -.he second cycle, a definite regularity appeared in the distribution cf the GSR: the lowest indices were observed in the superficial stages cf the S3 of all of the cycles, the highest were observed in 33, while the transition from 13 to F3 was accompanied by a sharp drop in the frequency of the 33?.. 1 he frequency of the GSE in 33 continued to R&S 107404 \ 40 - ic t: tc tc tc * * X /O & ro * >1 1 -1; ---------- -- -- - i - --i -- ,, -4 Fig. 1. Distribution of GSR during night sleep. Ordinate) frequency (number per minute) of GSR; abscissa) stage of slew-wave sleep (SS); FS) phase of fast sleep; A) line connecting average indices of GSR frequency in S (I, II, III, and IV stages) and FS for persons in control group; 5) the sane for the patients in the early stare of chronic occupational intoxication by vinyl chloride; C) in the later stage of intoxication. FS FS FS FS IS FS Fig. i. Dynamics of HR during night sleep. Crdinate) }(R (number of R~R intervals on EHG per minute ; abscissa) the same as in Fig. 1; A) line connecting average indices cf }G? in SS (I, II, III, and IV stares) and FS for pernors ir. control group; 3) the same for patients in early stage of chronic occupational intoxication by vinyl chloride; D) ir. t: e later stage of intoxication. R&S 107405 . kO increase from the second to the fourth cycle, and then it decreased, although the character of the distribution of the GSR was retained in the pth and oth cycles (see Fig. 1). The R3 for the awake persons in the control group immediately before placing the electrodes was 68 per minute. The transition to sleep was accompanied by a decrease in the HE. In the first cycle the lowest HR (59) v;as observed in the superficial stages (I and II) of IS, -while in the deep stages of 3S and FS the HR increased somewhat. Like the GSR, the dynamics of the HR in the first cycle differed from the dynamics of the HR in the subsequent cycles (Fig. 2). Beginning with the second cycle a high HR was observed in stage I of SS; the HR was lower in stages II- IV of SS. The frequency of the rhythm of one heart contractions increased again on going to FS, while extrasystoles appeared in the individual persons. The lability in FS increased toward the end cf night up to 10.5 number/sec, and on the average reaching : r.umbcr/sec. The range in the fluctuations of the HR, the difference between the extremes during the time of recording all of the HR values, "as 12,0. After waking, when compared with being awake before sleep, the HR. was observed tc drop to 10.5 number/sec. The results obtained in studying the healthy persons testified -.o the complex multistep re or ganizat ion of the vegetative regulation curing sleep, with a variable coupling of the vagal (decrease in HR sr.d GSR) and sympathicotonic (increase in HR and GSR) effects, and deriding the reciprocal relationship that exists between the OS and GSR '.hen night starts and the ccr.smsntly increasing decrease in the frequency and emotional nature of the dreams in the zrtmcrning cycles. o For the patients in the early stage of intoxication the total number cf G3R was 1076, which is somewhat lower than for the persons in the control group, but the differences in the distribution of the GSR aid not reach the confidence level (P > 0.05). The GSR distribution by cycles was similar to the distribution in the control group: minimum values in FS, and maximum values in DS. The highest GSR frequency was reached in the DS of the fourth cycle. The difference in the GSR distribution from the control group was related to the structure characteristics of sleep, by a reduction in its duration and a decrease is the number o: cycles down to 4, and less frequently to 5- Judging by the GSR distribution (see Fig. 1), cycles were absent in which a decrease in the frequency of the GSR in DS and the arising of FS, accompanied by remembered emotional dreamy could be expected. For the patients in the early stage of intoxication the HR prior no sleep was hig.-.er (70) than for the persons in the control group. The same as in the control group, a retardation of the HR was observed on going to sleep, but it began more gradually (see Fig. 2). In contrast to the control group, a tendency for reduction in the HR in the 4th and 5th cycles was not observed. `..hen compared with the control group, the lability in FS (4.2 number/sec) was lower (P <0.C5). The differences between the HR before and after sleep (5*0 number/sec; F < 0.01) and the range in the fluctuations of the HR (S number/sec; P <0.01) were smaller than for the healthy persons. Dreams v.ere mentioned by 6 of the 9 patients in the early stare cf intoxication. however, 5 of them after waiting could not remember t.oe contents of the dreams. The description of the dreams was fragmentary, included details of the scene, but not the entire nieture. From the R&S 107406 / . 41 R&S 107407 --r.djeir.t cf the cleanups and remembrance of the dreams ae a recir.rcal function of OS saturation the GSR is high, while the depiction of the GSR in S3, which did not decrease up to the end of sleep, correlated with some impoverishment of the dream activity for the patients in the early stage of intoxication. It is obvious that a more uniform distribution cf the HR, and a decrease in the lability of the HR in FS when compared with the control group, both reflected a decrease in the emotional nature of the dreams experienced by these patients during sleep. For the patients in the later stage of intoxication the absolute number of "SR in the polygrams was lower than for the control group ar.d fer the patients in the early stage, and on the average was 459*5 (F < 0.05). A definite distribution of the GSR by stages within the cycles was absent', when compared with the control group the GSR frequency in S was lower (? <0.01), and higher in S3 (P <0.05)i a tendency to establish a GSR maximum in the OS of the third and fourth cycles, like for the patients in the early stage, was not observed (see Fig. 1). The starting HR prior to sleep for the patients in the later stage cf intoxication was reduced to 38. when compared with the control group, a reliable decrease was observed in the range of the HR fluctuations (5*3 r.u.mber/sec; ? <0.05) and the lability of the HR in FS (3 nunber/sec; F < 0.01). Here the HR, after an initial retardation in the first cycle, tended to show a steady increase in subsequent cycles. To sum up, the IF after awaking exceeded the HR before sleep by 7.2 number/sec (P < O.Cl). The dream activity for the patients in the later stage of intoxication characterised by a ,, c a n t i e s n , and the area ms vtre rare (for 4 of patients) and simple in content. It must be assumed that ir. the er sts-e cf ir.toxica ticn cne of the factors, present in the general C R&S 107408 41 P. ^2 pathcgenetic chain with an impoverishment of the dream activity, can be the low and monotonic, not differentiated by stages and cycles, depiction of the HR and GSR. As a result, an analysis of the distribution of the GSR and HR during sleep for patients with chronic occupational intoxication by VC disclosed characteristic differences in the distribution of the vegetative indices in different stages of intoxication. cased on our previously obtained data, the insomnia syndrome, arising during chronic occupational intoxication by VC, is related to an enhancement of the physical activation shifts in the early stage of intoxication and a predominance of the tonic activation in the later stare (E. A. Gnesina and V. A. Antonyuzhenko). This gives reason to believe that the change in dream activity and the picture of the vegetative ornamentation of sleep for the patients studied by us reflects a ncr.optinum course of the information processes and disturbance of the vegetative regulation on a background of the activation shifts. The results of our studies permit an approach to understanding the pathogenesis of the emotional and vegetative disturbances that accompany the insomnia syndrome during intoxication by VC, and also by other narcotic poisons, and, in addition, they give basis for solving the problem of the path cge.ne tically based therapy cf these disturbances, SU.T'ARY 1. A change in the number and distribution of the HR and R -r.g p is observed in the insomnia syndro -.e that acccmra: les ic c c o upaticr.al intoxication by VC. : tne early stage o: intoxication ihe differences in depicting *2 ir.e 3SH in the DS episodes during the night are counterbalanced; the lability cf the HP and FS is reduced. 3. In the later stage of intoxication the nunber of GSR decreases and a definite distribution of the GSR by phases and cycles disappears; tr.e lability of the HR in FS is low, and the differences in the HR in SS and FS are smoothed out. LITERATURE CITED R&s 107409 /!/ ^ntonyuzhenko, V. A., 2h. Nevropatol. i Psikhiatr. f 1973, No. 3, 377 - 3S2. /2/ Vein, A. M., disturbances of Sleep and While Awake /in Russian/, Moscow (1974). /3/ Gnesina, E. A., and Antonyuzhenko, V. A., in the book: All-Union Symposium on the Clinics, Diagnosis, and Curing Ailments of Chemical Etiology, Abstracts of Papers /in Russian/, Hiev (1577), ?p 65 - 67. /4/ Gubler, E. V., and Genkin, A. A., Application of Criteria of Nonparametric Statistics to Evaluate the Differences of Two Groups of Observations in .Medicobiological Studies /in Russian/, Moscow (1969). /5/ Danilin, V. P., and Latash, L, 362 - 366. , Fiziol. Zh. SSSR, 1975, No. 3, /6/ Latash, L. ?., in the book: Physiology of Man and Animals /in Fussian/, Mcscow (1975), pp. 9*+- 152. /?/ F.otenberg, V. 2., Kochubei, B. I,'., and Shakh.narcv ich, V. M. , Zh. Vyssh. Kc-rvn. Seyat. , 1975, Nc. 4, 58 - 86l. // Bloch, V., Ann. Psychol., 52_, 97 (1952). /9/ Coccarna, G. , Moscheu, R. , Vela, A., et al. , F.ev. l.'evral. , 17, ^91 - 506 (1977). /10/ Gaarcr.er, H. , Arch. Gen. Psychict. , r4, 253 - 261 (1966). /II/ 7-ecr.tschaf f c-r., ar.d Vales, A., A Manual of Standardized Ter..:ir.clo Techniques and Scoring System for Sleep Stages of Human Subjects, I&thesda (l?o5). Trar.s lated bv: John Livak