Autonomic arousal and heart rate variability in functional somatic disorder - a cross-sectional population-based study 2025 Gormsen, Fink et al

[Andy]

Highlights​

• The BDS checklist score was negatively associated with autonomic arousal.
• Individuals with FSD, especially multi-organ, had faster heart rates, independent of sex, age, smoking, and activity.
• An increased sympathetic neural and neurohormonal activity in patients with FSD may be present.

Abstract​

Objective​

The bodily distress syndrome (BDS) checklist has proven to be useful diagnostic aid and as screening tool for functional somatic disorder (FSD). It has been hypotheses that the symptoms clusters of the checklist represent autonomic activity. This study aims to investigate associations between autonomic activity (Heart rate variability, HRV) and somatic symptoms profiles measured by the BDS checklist and diagnoses of FSD based on interviews.

Methods​

This cross-sectional population-based study included 6891 men and women aged 18–72 years. Somatic symptom profiles were measured by the 25-item BDS checklist, and five short-term HRV measures (MeanRR, RMSSD, LF, HF, and LF/HF) were obtained. In a stratified subsample (n = 1590), diagnoses of FSD was established by diagnostic interviews, performed by trained family physicians. Associations were tested with regression models. Measures of associations were mean difference with 95 % confidence intervals (CIs) for Mean RR and median ratio and 95 % CI for RMSS, LF, HF, and LF/HF.

Results​

Overall, higher BDS checklist scores were associated with lower HRV, particularly reduced mean RR intervals (−0.86, 95 % CI: −0,24;-0,49 for the total sum score). The strongest associations were seen for the cardiopulmonary symptom cluster (−3.58, 95 % CI: −0,05;-2.10). Clinically diagnosed FSD cases also showed lower mean RR compared to non-cases (−23.12, 95 % CI: −41.17;-5.07), especially the multi-organ type (−39.44, 95 % CI: −75.49;-3.39).

Conclusions​

The study indicate that the symptom clusters of the BDS checklist are associated with autonomic arousal as measured by HRV. Further that individuals with FSD, especially the multi-organ type, had an increased sympathetic neural and neurohormonal activity, suggesting this may be an important physiological mechanism in FSD.

Open access

 

[SNT Gatchaman]

Probably some useful data, but the usual poor attention to detail and logic in the write up. That abstract could have benefited from even a single read through.

But apart from the grammar, how does the conclusion in the paper —

This suggests heightened sympathetic neural and neurohormonal activity.

which follows this discussion —

This arousal could involve the sympathetic neurohormonal system as there were no marked changes in cardiac neural HRV indexes of either vagal or cardiac sympathetic activity (LF). However, we did not measure blood levels of neurohormones to support this hypothesis.

lead to this conclusion in the abstract?

Further that individuals with FSD, especially the multi-organ type, had an increased sympathetic neural and neurohormonal activity, suggesting this may be an important physiological mechanism in FSD.

 

[Utsikt]

five short-term HRV measures (MeanRR, RMSSD, LF, HF, and LF/HF) were obtained.

Is this just one measurement at the GP’s office?

Edit; should have kept reading a bit further:

The health examinations were conducted by trained project nurses and took place at the Research Centre for Prevention and Health, Glostrup, Denmark, (now: Center for Clinical Research and Prevention, Bispebjerg/Frederiksberg Hospital, Capital Region).

All examinations were performed between 8 am and 3 pm. Participants met after at least six hours fasting (including intake of coffee) and were asked to abstain from smoking at least one hour prior to the examination. Participants were resting in supine position for at least five minutes before measurement of continuous interbeat intervals (RR intervals) between successive sinus node derived heart beats, which was performed using the “E-motion” heart rate monitor device (eMotion HRV, Bittium, Kuopio, Finland). In concordance with current guidelines [13] measurements were performed during the last five minutes of at least 10 min supine rest with free breathing and a sampling rate of 250 Hz was chosen. Both staff and subjects were instructed to refrain from talking apart from necessary commands.

 

[Utsikt]

Most of the lines are almost horisontal.
And have they done any corrections for multiple comparisons?

————

Generally, and increase in heart rate (i.e., shortening of the RR intervals) and a reduction in both vagal indices (RMSSD and HF) as well as LF power were found by increasing total BDS sum score (Fig. 1).

Fig. 1. Association between heart rate variability measures and the total sum score on the Bodily Distress Syndrome (BDS) Checklist.

Associations between the HRV measures and diagnoses of FSD are displayed in Fig. 2.

Fig. 2. Figure legend: Association between heart rate variability measures and the total sum score on the Bodily Distress Syndrome Checklist across diagnoses of functional somatic disorder.

 

[rvallee]

Yes, what lots of people have been reporting for decades, is what's happening. You spend decades ignoring what people report, and you will fail to notice what they have reported. But it's completely silly to come along, decades later, and pretend to start noticing those things. This is all stuff that would normally fall under the dysautonomia umbrella, which remains completely misunderstood because of decades of clowning around with fake labels and doing fake research with zero depth.

But Dr Magoo's entire shtick is to not even know where he is at any moment, even less where he's going. So there is zero mention of dysautonomia, even though of course they know very well this is the term that has been used for a long time to refer to this. No mention of orthostatic, intolerance or otherwise, either, because these people can pretend to have been born yesterday and suffer zero loss of credibility.

Although, of course, the correlation with their BDS BS is weak, and that's because it's completely generic and useless. But they take the opportunity to stroke their ego, which is frankly ridiculous:

The bodily distress syndrome (BDS) checklist has proven to be useful diagnostic aid and as screening tool for functional somatic disorder (FSD).

It has not. Quit lying. Ridiculous people.

Plus, holy crap, they took a single measurement. Not even amateur, this is so much worse than what any random group of amateurs can achieve.