Increased heart rate variability response among infants with reported rhinorrhea and watery eyes: A pilot study

Laura A. Conrad, Natalie Buchinsky, Luis M. Acosta, J. David Nugent, Khalil W. Savary, Rachel L. Miller, Nurdant Emanet, Julie Herbstman, Beatrice Beebe, Michael M. Myers, William P. Fifer, Matthew S. Perzanowski

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


Introduction: Previously, we found that reported infant rhinorrhea and watery eyes without a cold (RWWC) predicted school age exercise-induced wheeze, emergency department visits, and hospitalizations. These findings were independent of allergic sensitization, and we theorized that increased parasympathetic tone underlay the association. We also reported that increased heart-rate variability (HRV) in infants predicted wheeze in 2–3 year-olds. In a convenience sample of children participating in a birth cohort study, we tested the hypothesis that infants with RWWC would have elevated HRV, indicating increased para-sympathetic tone. Methods: RWWC symptoms since birth were queried for 3-month-old children. At 4-months, HRV was assessed (root mean square of successive differences [RMSSD]) during a standardized infant–mother still-face paradigm, which included 2 minutes of mother/child play immediately followed by 2 minutes of the mother maintaining a still-face. Results: Among participants (n=38), RWWC was common for girls (32%) and boys (21%). The children with the greatest decrease in RMSSD between play and still-face challenge (lowest tertile) had a higher prevalence of RWWC as compared with children in the higher tertiles (50% vs 16%, P=0.045). In a logistic regression model controlling for sex, age and time between HRV and RWWC assessment, children with greater decrease in HRV between play and still-face (lowest tertile) had greater odds of having RWWC (odds ratio=6.0, P=0.029). Conclusion: In this relatively small study, we demonstrated greater decreases in HRV in response to a stressor among children with reported RWWC, suggesting that these children might have increased parasympathetic tone and/or overall greater vagal reactivity.

Original languageEnglish
Pages (from-to)1349-1354
Number of pages6
JournalJournal of Asthma and Allergy
StatePublished - 2021


  • Autonomic nervous system
  • Exercise-induced asthma
  • Heart rate variability
  • Rhinitis
  • Still-face challenge
  • Watery eyes


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