Factors influencing the role of cardiac autonomic regulation in the service of cognitive control

The moderating effect of resting heart rate variability on the relationship between pain catastrophizing and depressed mood: an empirical study

Previous research indicated that pain catastrophizing-a negative emotional and cognitive response toward actual or anticipated pain-could contribute to pain intensity and could be associated with depressive symptoms not just in chronic pain patients but in healthy population as well. Accumulated evidence suggests that resting heart rate variability (HRV) as a putative proxy of emotion regulation could moderate the association of self-reported pain catastrophizing and depressed mood. In the present cross-sectional study, we investigated these associations in a healthy young adult sample controlling for the effect of trait rumination. Seventy-two participants (58 females, mean age = 22.2 ± 1.79 years ranging from 19 to 28 years old) completed the Pain Catastrophizing Scale, the Zung Self-Rating Depression Scale and the Ruminative Response Scale. Resting HRV was measured by time domain metric of HRV, the root mean square of successive differences (RMSSD). The results showed that the relationship between pain catastrophizing and depressive symptoms is significantly moderated by resting HRV (indexed by lnRMSSD). Specifically, in participants with higher resting HRV there was no significant relationship between the two investigated variables, while in participants with relatively low or medium HRV pain catastrophizing and depressed mood showed significant positive association. The relationship remained significant after controlling for sex, age and trait rumination. These results might indicate that measuring pain catastrophizing and depressive symptoms is warranted in non-clinical samples as well and higher resting HRV could have a buffer or protective role against depressive symptoms.

How Does Surgeons' Autonomic Physiology Vary Intraoperatively?: A Real-time Study of Cardiac Reactivity

OBJECTIVE

To measure the physiological responses of surgical team members under varying levels of intraoperative risk.

BACKGROUND

Measurement of intraoperative physiological responses provides insight into how operation complexity, phase of surgery, and surgeon seniority impact stress.

METHODS

Autonomic nervous system responses (interbeat intervals, IBIs) were measured continuously during different surgical operations of various complexity. The study investigated whether professional role (eg attending surgeon), operative risk (high vs. low), and type of primary operator (attending surgeon vs. resident) impacted IBI reactivity. Physiological synchrony captured the degree of correspondence between individuals' physiological responses at any given time point.

RESULTS

A total of 10,005 observations of IBI reactivity were recorded in 26 participants during 16 high-risk (renal transplant and laparoscopic donor nephrectomy) and low-risk (arteriovenous fistula formation) operations. Attending surgeons showed greater IBI reactivity (faster heart rate) than residents and nurses during high-risk operations and while actively operating (Ps<0.001). Residents showed lower reactivity during high-risk (relative to low-risk) operations (P<0.001) and similar reactivity regardless of whether they or the attending surgeon was operating (P=0.10). Nurses responded similarly during low-risk and high-risk operations (P=0.102) but were more reactive when the resident was operating compared to when the attending surgeon was the primary operator (P<0.001). In high-risk operations, attending surgeons had negative physiological covariation with residents and nurses (P<0.001). In low-risk operations, only attending surgeons and nurses were synchronized (P<0.001).

CONCLUSION

Attending surgeons' physiological responses were well-calibrated to operative demands. Residents' and nurses' responses were not callibrated to the same extent. This suggests that risk sensitivity is an adaptive response to stress that surgeons acquire.

Maternal age differences in cognitive regulation: examination of associations and interactions between RSA and EEG frontoparietal alpha power coherence

Strong cognitive regulation is advantageous for flexible, responsive parenting. Optimal cognitive regulation is reliant on associations between physiological mechanisms of central and peripheral nervous system functioning. Across middle adulthood there may be shifts in how cognitive regulation functions, reflecting changes in the associations and interactions between these physiological mechanisms. Two physiological indicators of cognitive regulation are autonomic regulation of the heart (e.g., respiratory sinus arrhythmia, RSA) and activity of the brain's frontoparietal network (e.g., frontoparietal EEG alpha power coherence, FPc). In the current study we examined maternal age differences (N = 90, age M = 32.35 years, SD = 5.86 years) in correlations and interactions between RSA and FPc in the statistical prediction of cognitive regulation [i.e., executive function (EF), effortful control (EC), cognitive reappraisal (CR)]. Age-related patterns involving interaction between RSA and FPc were found, pointing to a potential shift from optimization to compensation for changes with aging or alternately, the effects of age-based decrements in functioning. Findings are discussed in the context of adult developmental changes in maternal caregiving.

Abnormal physiological responses toward sensory stimulus are related to the attention deficits in children with sluggish cognitive tempo

Previous studies have found that sluggish cognitive tempo (SCT) is often associated with difficulties in real-life functioning, such as social problems, emotional difficulties, and academic learning difficulties. However, the underlying mechanisms contributing to the SCT symptoms and its associated real-life difficulties have still not been clearly understood. A previous study has found that SCT symptoms were associated with hypoarousal and hyperarousal toward the sensory stimulus. However, it is still unclear whether such abnormal arousal regulation is related to sustained attention difficulties that have been found to be related to social difficulties and withdrawn behavior in children with SCT. In this study, arousal regulation deficit in SCT is examined by the physiological responses quantified by HRV and EEG in the sensory challenge paradigm. This study aimed to establish a linkage between arousal regulation reflected by HRV and EEG and attention difficulties in children with SCT. The results of this study showed that higher theta power in the auditory stimulation condition than in the resting condition was associated with higher omission errors in sustained attention tasks in the SCT group. It was also found that higher parasympathetic activities during sensory stimulation conditions were associated with higher commission errors in the SCT group. These results reflected that hypersensitivity toward stressful sensitivity toward a stressful sensory stimulus is associated with attention difficulties in children with SCT. This further supported the notion that SCT should be conceptualized as a condition characterized by multiple deficits in different biological systems, such as the cognitive system, the negative valence system, and the arousal regulatory system.

The interplay of self-critical rumination and resting heart rate variability on subjective well-being and somatic symptom distress: A prospective study

OBJECTIVE

The aim of this prospective study was to investigate the association of self-critical rumination, autonomic function (indexed by a time domain metric of resting heart rate variability-RMSSD), subjective well-being and somatic symptom distress.

METHOD

84 healthy participants (73 females; mean age = 23.56, SD = 3.35 years) completed the Somatic Symptom Severity Scale of the Patient Health Questionnaire and Mental Health Continuum Short Form at two timepoints (at baseline and six months later). Resting heart rate variability (HRV) was assessed at baseline, along with content specific rumination using the Self-Critical Rumination Scale. Four moderation analyses were performed to test these associations.

RESULTS

The interaction between resting HRV and self-critical rumination significantly explained somatic symptom distress at baseline. For those participants who had high resting HRV, somatic symptom distress was basically independent from the level of self-critical rumination. At the same time, lower resting HRV was associated with higher somatic symptom distress, especially in the presence of more ruminative thoughts. Prospectively, however, the interaction between rumination and resting HRV was not a significant predictor of somatic symptom distress. The association between resting HRV and self-critical rumination did not explain the variance on subjective well-being, but subjective well-being was negatively related to self-critical rumination.

CONCLUSION

Our findings potentially indicate that self-critical rumination could have a long-term negative impact on psychological functioning, even in a non-clinical sample, and highlight that a lower level of parasympathetic activation, assessed with RMSSD, might be an important factor in the relationship of self-critical rumination and somatic symptom distress.

Perceiving utilitarian gradients: Heart rate variability and self-regulatory effort in the moral dilemma task

It is not yet clear which response behavior requires self-regulatory effort in the moral dilemma task. Previous research has proposed that utilitarian responses require cognitive control, but subsequent studies have found inconsistencies with the empirical predictions of that hypothesis. In this paper, we treat participants’ sensitivity to utilitarian gradients as a measure of performance. We confronted participants (N = 82) with a set of five dilemmas evoking a gradient of mean utilitarian responses in a 4-point scale and collected data on heart rate variability and utilitarian responses. We found positive correlations between tonic and phasic HRV and sensitivity to the utilitarian gradient in the high tonic group, but not in the low tonic group. Moreover, the low tonic group misplaced a scenario with a selfish incentive at the high end of the gradient. Results suggest that performance is represented by sensitivity correlated with HRV and accompanied with a reasonable placement of individual scenarios within the gradient.

A Neurovisceral Integrative Study on Cognition, Heart Rate Variability, and Fitness in the Elderly

The association between physical fitness and cognitive performance has been widely investigated in the literature. However, the neurophysiological mechanisms underlying this relationship are not yet clear. Here, we aim to evaluate the interactions between executive function measures, heart rate variability (HRV), and physical fitness in the context of the neurovisceral integration (NVI) theory. Twenty-eight healthy elderly subjects (>60 years) were submitted to evaluation of executive performance with three computerized tests: the N-back test measured working memory capacity, the Stroop Color test evaluated inhibitory control and selective attention, and the Wisconsin Card Sorting Test (WCST) evaluated abstract reasoning and cognitive flexibility. We also used the Physical Testing Battery for the Elderly to measure aerobic capacity, dynamic balance, upper body flexibility, and handgrip strength. Our results confirm the relationship between executive function and physical fitness, particularly between working memory, cardiorespiratory fitness, and dynamic balance. We also demonstrate an association between executive performance and HRV in older people, corroborating previous results from other groups obtained in young adults. However, our regression models did not indicate that HRV mediates the relationship between cognition and physical fitness in the elderly, suggesting that age-related degeneration of autonomic control can affect aspects of NVI in this population.

Neuro-physiological correlates of sluggish cognitive tempo (SCT) symptoms in school-aged children

This study was the first to examine the relationship between neurophysiological abnormalities and symptoms of sluggish cognitive tempo (SCT) in children. Thirty children aged 6-12 years were recruited. Their heart rate variability (HRV) was measured under resting and warning signal conditions. At rest, the children's SCT symptoms were found to be positively associated with their HRV (indicated by the standard deviation of the Poincaré plot along the line of identity in normalized units, SD2 nu). SCT symptoms were also positively associated with a change in SD2 nu between the resting and warning signal conditions. When controlling for symptoms of attention deficit hyperactivity disorder, the children's SCT symptoms were significantly predicted by their resting SD2 nu and by changes in SD2 nu and the percentage of successive RR intervals that differ by more than 50 ms (pNN50) between the resting and warning signal conditions. These findings suggest that the readiness and regulation of the autonomic nervous system may contribute to symptoms of SCT. Specifically, disturbances in the internal neurophysiological system may explain the difficulties experienced by children when exposed to environmental stimulation. These initial data support the hypothesis that SCT results from deficiencies in arousal.

Cortical and affective regulation of autonomic coordination

Although anatomical research clearly demonstrates the ability of the sympathetic and parasympathetic branches of the autonomic nervous system to independently influence cardiac function, little research has examined whether coordinated activation is typical or whether the extent of autonomic coordination is situationally dependent. This study examines the extent of coordination between sympathetic (cardiac pre-ejection period: PEP) and parasympathetic (respiratory sinus arrhythmia: RSA) influences on the cardiac function to determine whether coordination is a trait-like between-person characteristic or a state-varying within-person phenomenon, and if so, whether variability in autonomic coordination is modulated by cognitive (P3b amplitude) or affective state. Kindergarten-aged children (n = 257) completed a go/no-go task administered in blocks designed to induce affective states through the delivery of reward (Blocks 1 and 3) and frustration (Block 2). Results from multilevel models that allowed for the simultaneous examination of between-person and within-person associations in the repeated measures data suggested that (a) children with higher overall RSA also tended to have higher overall PEP; (b) at within-person level, RSA and PEP tended to be reciprocally coordinated; but that (c) when frustration invokes cognitive disengagement, coordination between parasympathetic and sympathetic systems demonstrate compensatory coordination. These findings highlight the extent to which the coordination of autonomic systems is a dynamic state-like phenomenon rather than a trait-like individual differences characteristic.

A psychophysiological investigation of the interplay between orienting and executive control during stimulus conflict: A heart rate variability study

BACKGROUND

It has been hypothesized that resting state cardiac vagal activity (CVA) - an indicator of parasympathetic nervous system activity - is a specific psychophysiological marker of executive control function. Here, we propose an alternative hypothesis - that CVA is associated with early stage attention orientation, promoting the flexible uptake of new information, on which the later operation of such executive control functions depends. We therefore predicted that CVA would predict the interaction between orienting and executive control. This was tested using the revised version of the Attention Network Test (ANT-R) that was developed to distinguish between orienting and executive attention during a stimulus conflict task.

METHODS

Healthy adults (N = 48) performed the ANT-R and their resting CVA was measured over a 5 min period using ECG recordings.

RESULTS

Multiple regression analyses indicated that, when other factors were controlled for, CVA was more strongly associated with the interaction between the orienting and executive control terms than with either factor individually.

CONCLUSION

Higher levels of CVA are specifically implicated in the modulation of executive control by intrinsic orientation operating at early stages of conflict detection. These initial findings of higher CVA on orienting attention in conflict detection need to be replicated in larger samples.

Heart Rate Variability and Cognitive Function: A Systematic Review

Background: Autonomic dysfunctions may precede the development of cognitive impairment, but the connection between these dimensions is unclear. This systematic review aims to analyze the relationship between heart rate variability (HRV) and cognitive functions.

Methods: The review process was conducted according to the PRISMA-Statement. Restrictions were made, selecting the studies in English and published in peer-review journals, including at least one cognitive measure and presenting the measurement of HRV. Studies that included participants with medical conditions, dementia, psychiatric disorders, strokes, and traumatic brain injury were excluded. Twenty studies were selected, with a total of 19,431 participants. The results were divided into different cognitive domains determined a priori: global cognitive functioning, attention, processing speed, executive functions, memory, language and visuospatial skills.

Results: Both increased sympathetic activity and decreased parasympathetic activity seem to be associated with a worse performance in the cognitive domains considered, in the absence of dementia and severe cardiovascular diseases or other medical and psychiatric diseases.

Conclusion: The results highlight the influence of the autonomic nervous system (ANS) in cognitive functioning. However, the marked interest facing toward a specific domain, i.e., the executive functions, and the relatively small number of the studies on this topic do not allow understanding better this relationship. Despite these limits, HRV could be considered a promising early biomarker of cognitive impairment in populations without dementia or stroke. This index should be evaluated within a preventative perspective to minimize the risk of developing cognitive impairment.

The age-dependent relationship between resting heart rate variability and functional brain connectivity

Resting heart rate variability (HRV), an index of parasympathetic cardioregulation and an individual trait marker related to mental and physical health, decreases with age. Previous studies have associated resting HRV with structural and functional properties of the brain - mainly in cortical midline and limbic structures. We hypothesized that aging affects the relationship between resting HRV and brain structure and function. In 388 healthy subjects of three age groups (140 younger: 26.0 ± 4.2 years, 119 middle-aged: 46.3 ± 6.2 years, 129 older: 66.9 ± 4.7 years), gray matter volume (GMV, voxel-based morphometry) and resting state functional connectivity (eigenvector centrality mapping and exploratory seed-based functional connectivity) were related to resting HRV, measured as the root mean square of successive differences (RMSSD). Confirming previous findings, resting HRV decreased with age. For HRV-related GMV, there were no statistically significant differences between the age groups, nor similarities across all age groups. In whole-brain functional connectivity analyses, we found an age-dependent association between resting HRV and eigenvector centrality in the bilateral ventromedial prefrontal cortex (vmPFC), driven by the younger adults. Across all age groups, HRV was positively correlated with network centrality in the bilateral posterior cingulate cortex. Seed-based functional connectivity analysis using the vmPFC cluster revealed an HRV-related cortico-cerebellar network in younger but not in middle-aged or older adults. Our results indicate that the decrease of HRV with age is accompanied by changes in functional connectivity along the cortical midline. This extends our knowledge of brain-body interactions and their changes over the lifespan.

Breath of Life: The Respiratory Vagal Stimulation Model of Contemplative Activity

Contemplative practices, such as meditation and yoga, are increasingly popular among the general public and as topics of research. Beneficial effects associated with these practices have been found on physical health, mental health and cognitive performance. However, studies and theories that clarify the underlying mechanisms are lacking or scarce. This theoretical review aims to address and compensate this scarcity. We will show that various contemplative activities have in common that breathing is regulated or attentively guided. This respiratory discipline in turn could parsimoniously explain the physical and mental benefits of contemplative activities through changes in autonomic balance. We propose a neurophysiological model that explains how these specific respiration styles could operate, by phasically and tonically stimulating the vagal nerve: respiratory vagal nerve stimulation (rVNS). The vagal nerve, as a proponent of the parasympathetic nervous system (PNS), is the prime candidate in explaining the effects of contemplative practices on health, mental health and cognition. We will discuss implications and limitations of our model.

Parasympathetic and sympathetic activity are associated with individual differences in neural indices of selective attention in adults

Multiple theoretical frameworks posit that interactions between the autonomic nervous system and higher-order neural networks are crucial for cognitive and emotion regulation. However, few studies have directly examined the relationship between measures of autonomic physiology and brain activity during cognitive tasks, and fewer studies have examined both the parasympathetic and sympathetic autonomic branches when doing so. Here, 93 adults completed an ERP auditory selective attention task concurrently with measures of parasympathetic activity (high-frequency heart rate variability; HF-HRV) and sympathetic activity (preejection period; PEP). We focus on the well-studied N1 ERP component to test for associations with baseline values of HF-HRV and PEP. Individuals with higher resting HF-HRV and shorter resting PEP showed larger effects of selective attention on their ERPs. Follow-up regression models demonstrated that HF-HRV and PEP accounted for unique variance in selective attention effects on N1 mean amplitude. These results are consistent with the neurovisceral integration model, such that greater parasympathetic activity is a marker of increased selective attention, as well as other theoretical models that emphasize the role of heightened sympathetic activity in more efficient attention-related processing. The present findings highlight the importance of autonomic physiology in the study of individual differences in neurocognitive function and, given the foundational role of selective attention across cognitive domains, suggest that both parasympathetic and sympathetic activity may be key to understanding variability in brain function across a variety of cognitive tasks.

Resting sympathetic arousal moderates the association between parasympathetic reactivity and working memory performance in adults reporting high levels of life stress

The neurovisceral integration model stipulates that autonomic function plays a critical role in the regulation of higher-order cognitive processes, yet most work to date has examined parasympathetic function in isolation from sympathetic function. Furthermore, the majority of work has been conducted on normative samples, which typically demonstrate parasympathetic withdrawal to increase arousal needed to complete cognitive tasks. Little is known about how autonomic regulation supports cognitive function in populations exposed to high levels of stress, which is critical given that chronic stress exposure alters autonomic function. To address this, we sought to characterize how parasympathetic (high-frequency heart rate variability, HF-HRV) and sympathetic (preejection period, PEP) measures of cardiac function contribute to individual differences in working memory (WM) capacity in a sample of high-risk women. HF-HRV and PEP were measured at rest and during a visual change detection measure of WM. Multilevel modeling was used to examine within-person fluctuations in WM performance throughout the task concurrently with HF-HRV and PEP, as well as between-person differences as a function of resting HF-HRV and PEP levels. Results indicate that resting PEP moderated the association between HF-HRV reactivity and WM capacity. Increases in WM capacity across the task were associated with increases in parasympathetic activity, but only among individuals with longer resting PEP (lower sympathetic arousal). Follow-up analyses showed that shorter resting PEP was associated with greater cumulative risk exposure. These results support the autonomic space framework, in that the relationship between behavior and parasympathetic function appears dependent on resting sympathetic activation.

Heart rate variability indices as bio-markers of top-down self-regulatory mechanisms: A meta-analytic review

Theoretical perspectives posit that heart-rate variability (HRV) reflects self-regulatory capacity and therefore can be employed as a bio-marker of top-down self-regulation (the ability to regulate behavioral, cognitive, and emotional processes). However, existing findings of relations between self-regulation and HRV indices are mixed. To clarify the nature of such relations, we conducted a meta-analysis of 123 studies (N=14,347) reporting relations between HRV indices and aspects of top-down self-regulation (e.g., executive functioning, emotion regulation, effortful control). A significant, albeit small, effect was observed (r=0.09) such that greater HRV was related to better top-down self-regulation. Differences in relations were negligible across aspects of self-regulation, self-regulation measurement methods, HRV computational techniques, at-risk compared with healthy samples, and the context of HRV measurement. Stronger relations were observed in older relative to younger samples and in published compared to unpublished studies. These findings generally support the notion that HRV indices can tentatively be employed as bio-markers of top-down self-regulation. Conceptual and theoretical implications, and critical gaps in current knowledge to be addressed by future work, are discussed.

Resting high frequency heart rate variability selectively predicts cooperative behavior

This study explores whether the vagal connection between the heart and the brain is involved in prosocial behaviors. The Polyvagal Theory postulates that vagal activity underlies prosocial tendencies. Even if several results suggest that vagal activity is associated with prosocial behaviors, none of them used behavioral measures of prosociality to establish this relationship. We recorded the resting state vagal activity (reflected by High Frequency Heart Rate Variability, HF-HRV) of 48 (42 suitale for analysis) healthy human adults and measured their level of cooperation during a hawk-dove game. We also manipulated the consequence of mutual defection in the hawk-dove game (severe vs. moderate). Results show that HF-HRV is positively and linearly related to cooperation level, but only when the consequence of mutual defection is severe (compared to moderate). This supports that i) prosocial behaviors are likely to be underpinned by vagal functioning ii) physiological disposition to cooperate interacts with environmental context. We discuss these results within the theoretical framework of the Polyvagal Theory.