Jasmine inhalation reduces sympathetic and enhances parasympathetic activity in patients after moderate and severe traumatic brain injury

Background: Traumatic brain injury (TBI) increases long-term mortality rates. Central autonomic dysfunction may cause late fatalities. Jasmine-stimulation improves cardiovascular autonomic modulation in patients with a history of mild TBI (Hilz MJ, Neurology, 2010) and might have similar effects in patients after more severe TBI. Objective: To assess Jasmine effects on autonomic cardiovascular modulation in moderate and severe post-TBI-patients. Patients and methods: In 19 moderate post-TBI-patients (GCS 9-12; age 34 ± 11 years; 36-311 weeks after TBI; 4 women), 17 severe post-TBI-patients (GCS ≤8; age 31 ± 10 years; 74-314 weeks after TBI; 4 women) and 18 healthy controls (age 29 ± 11 years; 8 women), we recorded RR-intervals (RRI), systolic and diastolic blood pressure (BPsys, BPdia), respiration (RESP) at rest and upon 27 Jasmine stimuli (1 second stimulation; 3 seconds interval). We determined RRI-RMSSDs, spectral powers and normalized units of mainly sympathetic low frequency (LF: 0.04-0.15Hz) and parasympathetic high frequency (HF: 0.15-0.50Hz) RRI-oscillations, RRI-LF/HF-ratios, sympathetic BP-LF-powers. ANOVA with post-hoc analysis compared parameters between groups at rest and during Jasmine-stimulation (significance: p < 0.05). Results: Between groups, resting values and values upon Jasmine-stimulation were similar. Jasmine-stimulation significantly increased RRI-HF-powers in controls (1396.90 ± 1493.408 vs. 1212.56 ± 1620.824 ms2) and moderate post-TBI-patients (1202.64 ± 1125.693 vs. 932.09 ± 971.017 ms2), and increased normalized RRI-HF-powers in moderate (0.48 ± 0.20 vs. 0.36 ± 0.18) and severe post-TBI-patients (0.44 ± 0.19 vs. 0.31 ± 0.20). Jasmine-stimulation significantly reduced normalized RRI-LF-powers in moderate (0.52 ± 0.20 vs. 0.64 ± 0.18) and severe post-TBI-patients (0.56 ± 0.19 vs. 0.69 ± 0.20), and reduced RRI-LF/HF-ratio in severe post-TBI-patients only (2.88 ± 3.19 vs. 5.39 ± 7.54). Conclusion: Jasmine-stimulation lowers sympathetic and increases parasympathetic cardiovascular modulation in moderate and severe post-TBI-patients.