{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T11:03:50Z","timestamp":1781089430365,"version":"3.54.1"},"reference-count":45,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2025,4,21]],"date-time":"2025-04-21T00:00:00Z","timestamp":1745193600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"European Union","award":["PE00000006"],"award-info":[{"award-number":["PE00000006"]}]},{"name":"European Union","award":["CUP H93C22000660006"],"award-info":[{"award-number":["CUP H93C22000660006"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Sensors"],"abstract":"<jats:p>Background: Heart rate variability (HRV) provides both linear and nonlinear autonomic proxies that can be informative of health status in fibromyalgia (FM), where sympatho-vagal abnormalities are common. This retrospective observational study aims to: 1. detect differences in correlation dimension (D2) between FM patients and healthy controls (HCs); 2. correlate D2 with standard HRV parameters; 3. correlate the degree of HRV changes using a global composite parameter called HRV grade, derived from three linear indices (SDNN = intervals between normal sinus beats; RMSSD = mean square of successive differences; total power), with FM clinical outcomes; 4. correlate all linear and nonlinear HRV parameters with clinical variables in patients. Methods: N = 85 patients were considered for the analysis and compared to 35 healthy subjects. According to standard diagnostic protocol, they underwent a systematic HRV protocol with a 5-min paced breathing task. Disease duration, pain intensity, mood, sleep, fatigue, and quality of life were assessed. Non-parametric tests for independent samples and pairwise correlations were performed using JMP (all p &lt; 0.001). Results: Mann-Whitney U found a significant difference in D2 values between FM patients and HCs (p &lt; 0.001). In patients, D2 was associated with all HRV standard indices (all p &lt; 0.001) and FM impairment (FIQ = \u22120.4567; p &lt; 0.001). HRV grade was also associated with FM impairment (FIQ = 0.5058; p &lt; 0.001). Conclusion: Combining different HRV measurements may help understand the correlates of autonomic dysregulation in FM. Specifically, clinical protocols could benefit from the inclusion and validation of D2 and HRV parameters to target FM severity and related dysautonomia.<\/jats:p>","DOI":"10.3390\/s25082618","type":"journal-article","created":{"date-parts":[[2025,4,21]],"date-time":"2025-04-21T03:34:36Z","timestamp":1745206476000},"page":"2618","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Combined Proxies for Heart Rate Variability as a Global Tool to Assess and Monitor Autonomic Dysregulation in Fibromyalgia and Disease-Related Impairments"],"prefix":"10.3390","volume":"25","author":[{"given":"Emanuella","family":"Ladisa","sequence":"first","affiliation":[{"name":"Neurophysiopathology Unit, Department of Translational Biomedicine and Neuroscience (DiBraiN), University of Bari Aldo Moro (IT), 70124 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiara","family":"Abbatantuono","sequence":"additional","affiliation":[{"name":"Neurophysiopathology Unit, Department of Translational Biomedicine and Neuroscience (DiBraiN), University of Bari Aldo Moro (IT), 70124 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Ammendola","sequence":"additional","affiliation":[{"name":"Neurophysiopathology Unit, Department of Translational Biomedicine and Neuroscience (DiBraiN), University of Bari Aldo Moro (IT), 70124 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giusy","family":"Tancredi","sequence":"additional","affiliation":[{"name":"Neurophysiopathology Unit, Department of Translational Biomedicine and Neuroscience (DiBraiN), University of Bari Aldo Moro (IT), 70124 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5888-3024","authenticated-orcid":false,"given":"Marianna","family":"Delussi","sequence":"additional","affiliation":[{"name":"Department of Education, Psychology, Communication (For.Psi.Com.), University of Bari Aldo Moro (IT), 70124 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulia","family":"Paparella","sequence":"additional","affiliation":[{"name":"Neurophysiopathology Unit, Department of Translational Biomedicine and Neuroscience (DiBraiN), University of Bari Aldo Moro (IT), 70124 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5463-0460","authenticated-orcid":false,"given":"Livio","family":"Clemente","sequence":"additional","affiliation":[{"name":"Neurophysiopathology Unit, Department of Translational Biomedicine and Neuroscience (DiBraiN), University of Bari Aldo Moro (IT), 70124 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annalisa","family":"Dio","sequence":"additional","affiliation":[{"name":"Neurophysiopathology Unit, Department of Translational Biomedicine and Neuroscience (DiBraiN), University of Bari Aldo Moro (IT), 70124 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Federici","sequence":"additional","affiliation":[{"name":"School of Medicine, Biomedical Sciences and Human Oncology, University of Bari Aldo Moro (IT), 70124 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6567-5373","authenticated-orcid":false,"given":"Marina","family":"de Tommaso","sequence":"additional","affiliation":[{"name":"Neurophysiopathology Unit, Department of Translational Biomedicine and Neuroscience (DiBraiN), University of Bari Aldo Moro (IT), 70124 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,4,21]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Karemaker, J.M. 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