Influence of violations of autonomic regulation on the development of occupational polyneuropathy of the upper extremities in Kuzbass miners

Introduction. Active coal mining in Kuzbass, with its unfavorable climatic and environmental conditions, necessitates the study of occupational diseases of workers in this industry. One of the most common occupationally caused diseases of miners is polyneuropathy of the upper extremities.

The aim of the study is to assess the effect of autonomic disorders on the course of occupational upper limb polyneuropathy in workers of the Kuzbass coal industry using various methods of analyzing heart rate variability.

Materials and methods. 52 employees of coal enterprises aged from 43 to 64 years with the established diagnosis of “polyneuropathy of the upper extremities” were examined. The control group consisted of 16 healthy volunteers of the same age, engaged mainly in mental or light physical labor. Electroneuromyography was performed to assess the degree of damage to peripheral nerve fibers. Spectral and nonlinear parameters of heart rate variability were used to determine the state of autonomic regulation. The Mann-Whitney criterion was used to assess the statistical significance of differences between the study groups.

Results. 3 groups of patients with polyneuropathy were identified according to the severity of violations of impulse conduction in the peripheral nerves. In subjects with mild, initial disturbances of pulse conduction (n=8, 15.4%), a decrease in parasympathetic influence is determined, which is manifested by a statistically significant decrease in the power of high frequency oscillations of the heart rate variability spectrum. With moderate signs of polyneuropathy (28 cases, 53.9%), there is a shift in the autonomic balance towards sympathetic activation; a statistically significant increase in very low-frequency fluctuations in heart rate variability indicates an increase in the influence of suprasegmental autonomic centers. In subjects with gross violations of the peripheral nerve impulses (n=16, 30.7%), there is a decrease in the power of oscillations in all frequency ranges of heart rate variability.

Conclusions. The obtained data confirm the influence of autonomic regulation on the course of occupational polyneuropathy.

The authors declare no conflict of interests.

1. Filimonov S.N., Panev N.I., Korotenko O.Yu., Evseeva N.A., Danilov I.P., Zatsepina O.V. Prevalence of somatic pathology in coal mine workers with occupational respiratory diseases. Med. truda i prom. ekol. 2019; (6): 381–4. DOI: 10.31089/1026-9428-2019-59- 6-381-384 (in Russian).

2. Mukhin N.A., Kosarev B.B., Babanov S.A., Fomin V.V. Occupational diseases. Moscow: GEOTAR-Media; 2016 (in Russian).

3. Yan’shina E.N., Lyubchenko P.N., Yan’shin N.P., Kasatkina L.F., Samoylov M.I. Multiple local involvement of peripheral nerves in workers suffering from occupational hands disorders. Med. truda i prom. ekol. 2009; (2): 24–8. (in Russian).

4. Yamshchikova A.V., Fleishman A.N., Gidayatova M.O. Сomorbid conditions in the vibration disease patients. Gigiena i sanitariya. 2019; (7): 718–22 ( in Russian).

5. Vorob’eva E.V., Babanov S.A. Features of neurological manifestations in vibration disease from the action of local and wholebody vibration. Novye meditsinskie tekhnologii. 2010; (7): 43–9 (in Russian).

6. Kochetova O.A., Mal’kova N.Yu. Study of working conditions in patients with occupational polyneuropathy of upper extremities. Gigiena i sanitariya. 2017; (7): 636–41 (in Russian).

7. Rusanova D.V., Katamanova E.V., Lakhman O.L., eds. The use of electro-neuromyography in the clinic of occupational diseases: A training manual.. Irkutsk: RIO IGMAPO; 2018 (in Russian).

8. Rusanova D.V., Lakhman O.L. Efficiency of using electroneuromyography in diagnostics of occupational diseases. Byulleten’ VSNTS SO RA MN. 2013; (3): 34–9 (in Russian).

9. Poteryaeva E.L., Loseva M.I., Bekeneva T.I., Taranov T.I. Violation of hormonal regulation in the pathogenesis of vibration disease. Med. truda i prom. ekol. 2001; (9): 10–2 (in Russian).

10. Amanbekov U.A., Battakova Sh.B., Otarbaeva M.B., Fazylova D.A., Abdikulova A.A. The state of the autonomic nervous system in vibration disease in miners. Med. truda i prom. ekol. 2006; (4): 8–10 (in Russian).

11. Martynov I.D., Fleishman A.N. Disturbances of vegetative regulation and compensator opportunities for ortostatic loads in patients with neurogenic functions (based on spectral analysis of variability of heart rhythm). Vestnik nauki Sibiri. 2015; (S1(15)): 303–13 (in Russian).

12. Veyn A.M. Autonomic disorders: clinical picture, diagnostics, treatment. Moscow: Meditsinskoe informatsionnoe agentstvo; 2003 (in Russian).

13. Fleishman A.N., Korablina T.V., Haliulin I.G., Petrovskiy S.A., Neretin A.A. Sex differences in VLF 100 and VLF 50 spectrum of heart rate variability in healthy young and older persons with vascular pathology in seven-test, hyperventilation and orthostasis. Meditsina v Kuzbasse. 2017; 16(4): 23–33 (in Russian).

14. Aleynikova T.V. Heart rate variability (literature review). Problemy zdorov’ya i ekologii. 2012; (1): 17–23 (in Russian).

15. Fleishman A.N. Heart rate variability and slow hemodynamic oscillations: nonlinear phenomena in clinical practice. 2nd ed. Novosibirsk; 2009 (in Russian).

16. Gerus A.Ju., Fleishman A.N. Features of heart rate variability in patients with type 2 diabetes mellitus. Vestnik NGU. Serija: Biologija, klinicheskaja medicina. 2010; 8(1): 96–100 (in Russian).

17. Malik R.A., Veves A., Tesfaye S., Smith G., Cameron N., Zochodne D. et al. Small fibre neuropathy: role in the diagnosis of diabetic sensorimotor polyneuropathy. Diabetes Metab Res Rev. 2011; 27(7): 678–84. DOI: 10.1002/dmrr. 1222.

18. Serra J., Collado A., Sola R ., Antonelli F., Torres X., Salqueiro M. et al. Hyperexcitable C nociceptors in fibromyalgia. Ann Neurol. 2014; 75(2): 196–208 DOI: 10.1002/ana.24065.

19. Van Acker N., Rage M., Slyudts E., Knaapen M.W., De Bie M., Timmers M. et al. Automated PGP9.5 immunofluorescence staining: a valuable tool in the assessment of small fiber neuropathy? BMC Res Notes. 2016; 9: 280 DOI: 10.1186/s13104-016- 2085-4.

20. Suponeva N.A., Belova N.V., Zaitseva N.I., Yusupova D.G., Lagoda D.Yu., Korepina O.S. Small fiber neuropathy. Annals of Clinical and Experimental Neurology. 2017; 11(1): 73–9 (in Russian).

21. Bokeriya L.A., Bokeriya O.L., Volkovskaya I.V. Heart rate variability: measurement methods, interpretation, clinical use. Annaly aritmologii. 2009; 6(4): 21–32 (in Russian).

22. Chekeeva N.T., Shleyfer S.G., Bebinov E.M. Indicators of heart rate variability in patients with cerebrovascular pathology in the conditions of low mountains. Neyrokhirurgiya i nevrologiya Kazakhstana. 2018; (2): 51 (in Russian).

23. Yamshchikova A.V., Fleishman A.N., Gidayatova M.O., Kungurova A.A. Indicators of the relationship between heart rate variability and levels of glycemia and cholesterol in vibration pathology. Med. truda i prom. ekol. 2019; 59 (6): 359–63. DOI: 10.31089/1026-9428-2019-59-6-359-363 (in Russian).