Introduction

The autonomous system has three main divisions. These divisions include, the Sympathetic
Division, the Parasympathetic Division, and the Enteric Nervous system. The Enteric Nervous
system plays an active role in the gastrointestinal tract. In particularly, it controls digestion. The
Enteric Nervous system has neural circuits that do coincide with the autonomous nervous
system; however it also has other neural circuits, allowing it to work independently. AS a result,
the Enteric Nervous system is not a useful system for looking at Autonomic activity. Instead the
Parasympathetic and Sympathetic divisions are looked at.
The sympathetic division is associated with the fight of flight response. The fight or flight
response is associated with activating the body from a state a rest. This is achieved through
different mechanisms such as increasing heart rate, and increasing respiration rate. The
sympathetic nervous system has neural circuits which extend from the thoracic section of the
spinal cord to the lumbar section. (Contares et al. 1980)
The Parasympathetic nervous system has a role somewhat opposite of the role of the sympathetic
nervous system. It is associated with the idea of rest and digest. That is it brings the body from
an excited state back down to a calm state. For example, when the sympathetic nervous system
increases heart rate the Parasympathetic nervous system decrease the heart rate to calm the
person down. The Parasympathetic division has neurons that extend from the brain to the
beginning of the Lumbar section.

Since the Parasympathetic and Sympathetic Nervous systems can increase/decrease your heart
rate Heart Rate Variability (HRV) is often looked at in order to determine
Parasympathetic/Sympathetic activity. (Malik et al. 2005) Heart Rate Variability is a measure
that is calculated from Electrocardiograph (ECG) data. In order to look at the Heart Rate
Variability measure, ECG data has to be filtered of artifacts and interpolated to get a smooth
function. The HRV itself can only show ANS activity. In order to determine Parasympathetic and
Sympathetic Activity time frequency analysis has to be done. Usually a Fourier Transformation
is applied; however other form of Frequency Domain Analysis may be used. (Saul et al. 1990)
When the analysis is done the High Frequencies (HF) and the Low Frequencies (LF) may be
separated. The HF is an indicator of Sympathetic activity while the Low Frequencies are an
indicator of Parasympathetic activities. Normalization of the HF and LF also looked at so that an
idea of the balance between the Parasympathetic and Sympathetic activities can be looked at.
Traumatic Brain Injury (TBI) is injury that occurs to the brain as a result of an external force.
TBI may occur as a result of many different things. One such cause could be an object
penetrating the skull and scathing the brain. Another may be the result of a sudden deceleration
or acceleration causing the brain to hit along the skull. In turn TBI can have many different
severities. Those who suffer from TBI tend to have injury to their ANS and specifically the
Parasympathetic and Sympathetic division.

Purpose
The purpose of this study is to examine how TBI impacts HRV.
Methods
A. In this study 30 subjects are to be enrolled.
a. These subjects all have mild to medium TBI.
b. There severity is to be measured according to the Glasgov Coma Scale
c. The subjects are also tested if they suffer from any Axis 1 disorders such as
schizophrenia. If so they would not be able to partake in the study.
B. Afterwards baseline electrocardiograph data is be taken as the subjects relax for 30 seconds.
C. For this study, emotion will be elicited through the use of movie clips.
a. The movie clips will last from two to three minutes.
b. Each movie clip will elicit an emotion:
i. Neutral
ii. Fear
iii. Amusement
iv. Sexual Amusement
v. Sadness
vi. Disgust (more than one clip)
c. The subjects were not aware of clips they were going to watch. Furthermore, the
emotions were balanced out such that the subjects would not be overwhelmed by one
emotion.
d. Between each clip the subject would view an image of a white cross on a black
background for 10 seconds.
D. While the subjects viewed each clip they would be given a question in which they had to
write what emotions they felt when they viewed the clip.
E. During the period which the subjects watched the clips ECG data was also taken.
a. LFA and RFA data was taken during the interval of interest (IOI) or the 30 seconds
where the most emotion was evoked.
b. The study also looked at the coefficients of variability for LFA and RFA (cvLFA and
cvRFA).
i. These measures how much the LFA and RFA fluctuate from the average LFA
and RFA for each subject.
F. The subjects watched multiple clips so that their ability to suppress emption could be
determined.
a. The subjects would view three clips that elicited disgust.
b. They would watch the first clip normally
c. While watching the second clips the subjects will be asked to suppress their emotion
d. When watching the last clip subjects will try to amplify the elicited disgust.