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Razza LB, De Smet S, Cornelis X, Nikolin S, Pulopulos MM, De Raedt R, Brunoni AR, Vanderhasselt MA. Dose-dependent response of prefrontal transcranial direct current stimulation on the heart rate variability: An electric field modeling study. Psychophysiology 2024; 61:e14556. [PMID: 38459778 DOI: 10.1111/psyp.14556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 02/01/2024] [Accepted: 02/20/2024] [Indexed: 03/10/2024]
Abstract
Transcranial direct current stimulation (tDCS) of the prefrontal cortex (PFC) modulates the autonomic nervous system by activating deeper brain areas via top-down pathway. However, effects on the nervous system are heterogeneous and may depend on the amount of current that penetrates. Therefore, we aimed to investigate the variable effects of tDCS on heart rate variability (HRV), a measure of the functional state of the autonomic nervous system. Using three prefrontal tDCS protocols (1.5, 3 mA and sham), we associated the simulated individual electric field (E-field) magnitude in brain regions of interest with the HRV effects. This was a randomized, double-blinded, sham-controlled and within-subject trial, in which healthy young-adult participants received tDCS sessions separated by 2 weeks. The brain regions of interest were the dorsolateral PFC (DLPFC), anterior cingulate cortex, insula and amygdala. Overall, 37 participants were investigated, corresponding to a total of 111 tDCS sessions. The findings suggested that HRV, measured by root mean squared of successive differences (RMSSD) and high-frequency HRV (HF-HRV), were significantly increased by the 3.0 mA tDCS when compared to sham and 1.5 mA. No difference was found between sham and 1.5 mA. E-field analysis showed that all brain regions of interest were associated with the HRV outcomes. However, this significance was associated with the protocol intensity, rather than inter-individual brain structural variability. To conclude, our results suggest a dose-dependent effect of tDCS for HRV. Therefore, further research is warranted to investigate the optimal current dose to modulate HRV.
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Affiliation(s)
- Laís B Razza
- Department of Head and Skin, Psychiatry and Medical Psychology, Ghent University Hospital, Ghent University, Ghent, Belgium
- Ghent Experimental Psychiatry (GHEP) Lab, Ghent University, Ghent, Belgium
| | - Stefanie De Smet
- Department of Head and Skin, Psychiatry and Medical Psychology, Ghent University Hospital, Ghent University, Ghent, Belgium
- Ghent Experimental Psychiatry (GHEP) Lab, Ghent University, Ghent, Belgium
| | - Xander Cornelis
- Ghent Experimental Psychiatry (GHEP) Lab, Ghent University, Ghent, Belgium
| | - Stevan Nikolin
- School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia
- Black Dog Institute, Sydney, New South Wales, Australia
| | - Matias M Pulopulos
- Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Rudi De Raedt
- Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Andre R Brunoni
- Departamento de Clínica Médica, Faculdade de Medicina da Universidade de São Paulo & Hospital Universitário, Universidade de São Paulo, São Paulo, Brazil
- Hospital Universitário, Universidade de São Paulo, São Paulo, Brazil
- Serviço Interdisciplinar de Neuromodulação, Laboratório de Neurociências (LIM-27), Departamento e Instituto de Psiquiatria, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Marie-Anne Vanderhasselt
- Department of Head and Skin, Psychiatry and Medical Psychology, Ghent University Hospital, Ghent University, Ghent, Belgium
- Ghent Experimental Psychiatry (GHEP) Lab, Ghent University, Ghent, Belgium
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Quigley KS, Gianaros PJ, Norman GJ, Jennings JR, Berntson GG, de Geus EJC. Publication guidelines for human heart rate and heart rate variability studies in psychophysiology-Part 1: Physiological underpinnings and foundations of measurement. Psychophysiology 2024:e14604. [PMID: 38873876 DOI: 10.1111/psyp.14604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 12/22/2023] [Accepted: 04/04/2024] [Indexed: 06/15/2024]
Abstract
This Committee Report provides methodological, interpretive, and reporting guidance for researchers who use measures of heart rate (HR) and heart rate variability (HRV) in psychophysiological research. We provide brief summaries of best practices in measuring HR and HRV via electrocardiographic and photoplethysmographic signals in laboratory, field (ambulatory), and brain-imaging contexts to address research questions incorporating measures of HR and HRV. The Report emphasizes evidence for the strengths and weaknesses of different recording and derivation methods for measures of HR and HRV. Along with this guidance, the Report reviews what is known about the origin of the heartbeat and its neural control, including factors that produce and influence HRV metrics. The Report concludes with checklists to guide authors in study design and analysis considerations, as well as guidance on the reporting of key methodological details and characteristics of the samples under study. It is expected that rigorous and transparent recording and reporting of HR and HRV measures will strengthen inferences across the many applications of these metrics in psychophysiology. The prior Committee Reports on HR and HRV are several decades old. Since their appearance, technologies for human cardiac and vascular monitoring in laboratory and daily life (i.e., ambulatory) contexts have greatly expanded. This Committee Report was prepared for the Society for Psychophysiological Research to provide updated methodological and interpretive guidance, as well as to summarize best practices for reporting HR and HRV studies in humans.
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Affiliation(s)
- Karen S Quigley
- Department of Psychology, Northeastern University, Boston, Massachusetts, USA
| | - Peter J Gianaros
- Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Greg J Norman
- Department of Psychology, The University of Chicago, Chicago, Illinois, USA
| | - J Richard Jennings
- Department of Psychiatry & Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Gary G Berntson
- Department of Psychology & Psychiatry, The Ohio State University, Columbus, Ohio, USA
| | - Eco J C de Geus
- Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
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Frasier RM, Starski PA, de Oliveira Sergio T, Grippo AJ, Hopf FW. Sex differences in heart rate variability measures that predict alcohol drinking in rats. Addict Biol 2024; 29:e13387. [PMID: 38502109 PMCID: PMC11061848 DOI: 10.1111/adb.13387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 01/23/2024] [Accepted: 02/13/2024] [Indexed: 03/20/2024]
Abstract
Problem alcohol drinking continues to be a substantial cost and burden. In addition, alcohol consumption in women has increased in recent decades, and women can have greater alcohol problems and comorbidities. Thus, there is a significant need for novel therapeutics to enhance sex-specific, individualized treatment. Heart rate (HR) and HR variability (HRV) are of broad interest because they may be both biomarkers for and drivers of pathological states. HRV reflects the dynamic balance between sympathetic (SNS, 'fight or flight') and parasympathetic (PNS, 'rest and digest') systems. Evidence from human studies suggest PNS predominance in women and SNS in men during autonomic regulation, indicating the possibility of sex differences in risk factors and physiological drivers of problem drinking. To better understand the association between HRV sex differences and alcohol drinking, we examined whether alcohol consumption levels correlated with time domain HRV measures (SDNN and rMSSD) at baseline, at alcohol drinking onset, and across 10 min of drinking, in adult female and male Wistar rats. In particular, we compared both HRV and HR measures under alcohol-only and compulsion-like conditions (alcohol + 10 mg/L quinine), because compulsion can often be a significant barrier to treatment of alcohol misuse. Importantly, previous work supports the possibility that different HRV measures could be interpreted to reflect PNS versus SNS influences. Here, we show that females with higher putative PNS indicators at baseline and at drinking onset had greater alcohol consumption. In contrast, male intake levels related to increased potential SNS measures at drinking onset. Once alcohol was consumed, HR predicted intake level in females, perhaps a pharmacological effect of alcohol. However, HRV changes were greater during compulsion-like intake versus alcohol-only, suggesting HRV changes (reduced SNS in females, reduced PNS and increased HR in males) specifically related to aversion-resistant intake. We find novel and likely clinically relevant autonomic differences associated with biological sex and alcohol drinking, suggesting that different autonomic mechanisms may promote differing aspects of female and male alcohol consumption.
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Affiliation(s)
- Raizel M. Frasier
- Department of PsychiatryIndiana University School of MedicineIndianapolisIndianaUSA
- Medical Scientist Training ProgramIndiana University School of MedicineIndianapolisIndianaUSA
| | - Phillip A. Starski
- Department of PsychiatryIndiana University School of MedicineIndianapolisIndianaUSA
| | | | - Angela J. Grippo
- Department of PsychologyNorthern Illinois UniversityDeKalbIllinoisUSA
| | - F. Woodward Hopf
- Department of PsychiatryIndiana University School of MedicineIndianapolisIndianaUSA
- Stark Neurosciences Research InstituteIndiana UniversityIndianapolisIndianaUSA
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Radimecká M, Látalová A, Lamoš M, Jáni M, Bartys P, Damborská A, Theiner P, Linhartová P. Facial emotion processing in patients with borderline personality disorder as compared with healthy controls: an fMRI and ECG study. Borderline Personal Disord Emot Dysregul 2024; 11:4. [PMID: 38360712 PMCID: PMC10870473 DOI: 10.1186/s40479-024-00245-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 01/08/2024] [Indexed: 02/17/2024] Open
Abstract
BACKGROUND Maladaptive behaviors and interpersonal difficulties in patients with borderline personality disorder (BPD) seem connected to biased facial emotion processing. This bias is often accompanied by heightened amygdala activity in patients with BPD as compared to healthy controls. However, functional magnetic resonance imaging (fMRI) studies exploring differences between patients and healthy controls in facial emotion processing have produced divergent results. The current study explored fMRI and heart rate variability (HRV) correlates of negative facial emotion processing in patients with BPD and healthy controls. METHODS The study included 30 patients with BPD (29 females; age: M = 24.22, SD = 5.22) and 30 healthy controls (29 females; M = 24.66, SD = 5.28). All participants underwent the "faces" task, an emotional face perception task, in an fMRI session simultaneously with ECG. In this task, participants are presented with emotional expressions of disgust, sadness, and fear (as a negative condition) and with the same pictures in a scrambled version (as a neutral condition). RESULTS We found no differences in brain activity between patients with BPD and healthy controls when processing negative facial expressions as compared to neutral condition. We observed activation in large-scale brain areas in both groups when presented with negative facial expressions as compared to neutral condition. Patients with BPD displayed lower HRV than healthy controls in both conditions. However, there were no significant associations between HRV and amygdala activity and BPD symptoms. CONCLUSION The results of this study indicate no abnormal brain activity during emotional facial processing in patients with BPD. This result contrasts with previous studies and more studies are needed to clarify the relationship between facial emotion processing and brain activity in patients with BPD. Possible reasons for the absence of brain activity differences are discussed in the study. Consistent with previous findings, patients showed lower HRV than healthy controls. However, HRV was not associated with amygdala activity and BPD symptoms.
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Affiliation(s)
- Monika Radimecká
- Department of Psychiatry, University Hospital Brno and Faculty of Medicine, Masaryk University, Jihlavská 340/20, Brno, 625 00, Czech Republic.
| | - Adéla Látalová
- Department of Psychiatry, University Hospital Brno and Faculty of Medicine, Masaryk University, Jihlavská 340/20, Brno, 625 00, Czech Republic
| | - Martin Lamoš
- Brain and Mind Research Program, Central European Institute of Technology, Masaryk University, Brno, Czech Republic
| | - Martin Jáni
- Department of Psychiatry, University Hospital Brno and Faculty of Medicine, Masaryk University, Jihlavská 340/20, Brno, 625 00, Czech Republic
| | - Patrik Bartys
- Department of Psychiatry, University Hospital Brno and Faculty of Medicine, Masaryk University, Jihlavská 340/20, Brno, 625 00, Czech Republic
| | - Alena Damborská
- Department of Psychiatry, University Hospital Brno and Faculty of Medicine, Masaryk University, Jihlavská 340/20, Brno, 625 00, Czech Republic
| | - Pavel Theiner
- Department of Psychiatry, University Hospital Brno and Faculty of Medicine, Masaryk University, Jihlavská 340/20, Brno, 625 00, Czech Republic
| | - Pavla Linhartová
- Department of Psychiatry, University Hospital Brno and Faculty of Medicine, Masaryk University, Jihlavská 340/20, Brno, 625 00, Czech Republic
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Fricker F, Barbotte MV, Pallot G, Radoua N, Sorci G, Heitz M, Brison G, Sales-Vuillemin E, Connat JL. Positive psychological effects of seated acupressure massage are associated with a rise in plasma oxytocin without affecting CGRP levels or circulating IL-6. COMPREHENSIVE PSYCHONEUROENDOCRINOLOGY 2024; 17:100220. [PMID: 38318420 PMCID: PMC10839771 DOI: 10.1016/j.cpnec.2023.100220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 12/04/2023] [Indexed: 02/07/2024] Open
Abstract
Work-related stress is a major public health issue. Given the relationship between acute stress responses and health, finding strategies to deal with the unpleasant symptoms brought on by stress is essential. Massage therapy is a popular stress-reduction technique, but its effectiveness has yet to be shown. In that matter, this study investigates the effects of a 17-minute session of seated Amma massage on young healthy people. Subjective stress perception, anxiety and self-confidence were assessed before and after the massage using the Spielberger State Anxiety Scale (STAI-Y, Spielberger et al., 1983) and the Competitive State Anxiety Inventory (EEAC, Cury et al., 1999), together with cardiovascular parameters. Cortisol, CGRP, IL-6, and oxytocin plasma levels were measured before and after the massage to investigate its possible mode of action. This study enrolled 59 people: 33 receiving the massage, and 26 controls only seated on the massage chair. Interaction Time x Group demonstrates significant differences for all psychological measurements (STAI, EEAC) before and after the Amma massage, showing a beneficial effect of this treatment, in particular on perceived anxiety and self-confidence. No evidence was found of any correlation between cortisol plasma levels and psychological outcomes. No relationship was shown between the decrease of perceived stress and measured CGRP or IL-6 release, but the data demonstrated that heart frequency could be slightly decreased. The oxytocin plasma levels were significantly increased by the massage and could be responsible for the recovery of psychological outcomes. We conclude that seated acupressure Amma massage could be a useful tool to ameliorate quality of life at work.
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Affiliation(s)
- Florentine Fricker
- Université de Bourgogne, UFR Sciences Humaines, Cedex, Erasme, 21078, Dijon, France
| | | | - Gaétan Pallot
- Université de Bourgogne, LNC Research Center U1231—Team LipSTIC, 7 Bvd Jeanne d’Arc, 21000, Dijon, France
- Université de Bourgogne, UFR SVTE, Biogéosciences, CNRS UMR 6282, 6 Bvd Gabriel, 21000, Dijon, France
| | - Nouhaila Radoua
- Université de Bourgogne, UFR SVTE, 6 Bvd Gabriel, 21000, Dijon, France
| | - Gabriele Sorci
- Université de Bourgogne, Biogéosciences / UMR 6282, 6 Bvd Gabriel, 21000 Dijon, France
| | - Marie Heitz
- Université de Bourgogne, UFR Sciences Humaines, Cedex, Erasme, 21078, Dijon, France
| | - Grégory Brison
- Université de Bourgogne, Psychologie Sociale et Psychologie du travail, Psy-DREPI (EA-7458), 21000 Dijon, France
- Psychologue Education Nationale, CIO Dijon, 21000, Dijon, France
| | - Edith Sales-Vuillemin
- Université de Bourgogne, Psychologie Sociale et Psychologie du travail, Psy-DREPI (EA-7458), 21000 Dijon, France
| | - Jean-Louis Connat
- Université de Bourgogne, INSERM TCM Research Center U1231—Therapies, Immune Response and Cancers Team, Animal Cell and Molecular Biology, 6 Bvd Gabriel, 21000, Dijon, France
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Citrenbaum C, Corlier J, Ngo D, Vince-Cruz N, Wilson A, Wilke SA, Krantz D, Tadayonnejad R, Ginder N, Levitt J, Lee JH, Leuchter MK, Strouse TB, Corse A, Vyas P, Leuchter AF. Pretreatment pupillary reactivity is associated with differential early response to 10 Hz and intermittent theta-burst repetitive transcranial magnetic stimulation (rTMS) treatment of major depressive disorder (MDD). Brain Stimul 2023; 16:1566-1571. [PMID: 37863389 DOI: 10.1016/j.brs.2023.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 10/04/2023] [Accepted: 10/08/2023] [Indexed: 10/22/2023] Open
Abstract
BACKGROUND Repetitive Transcranial Magnetic Stimulation (rTMS) is an effective treatment for Major Depressive Disorder (MDD). Two common rTMS protocols, 10 Hz and intermittent theta burst stimulation (iTBS), have comparable rates of efficacy in groups of patients. Recent evidence suggests that some individuals may be more likely to benefit from one form of stimulation than the other. The pretreatment pupillary light reflex (PLR) is significantly associated with response to a full course of rTMS using heterogeneous stimulation protocols. OBJECTIVE To test whether the relationship between pretreatment PLR and early symptom improvement differed between subjects treated with iTBS or 10 Hz stimulation. METHODS PLR was measured in 52 subjects who received solely 10 Hz (n = 35) or iTBS (n = 17) to left dorsolateral prefrontal cortex (DLPFC) for the first ten sessions of their treatment course. Primary outcome measure was the percent change of Inventory of Depressive Symptomatology - Self Report (IDS-SR) from session 1 to session 10. RESULTS There was a positive association between normalized maximum constriction velocity (nMCV) and early improvement in subjects receiving 10 Hz stimulation (R = 0.48, p = 0.004) and a negative association in subjects receiving iTBS (R = -0.52, p = 0.03). ANOVA revealed a significant interaction between nMCV and the type of initial stimulation (p = 0.001). Among subjects with low nMCV, those initially treated with iTBS showed 2.6 times greater improvement after 10 sessions (p = 0.01) than subjects initially receiving 10 Hz stimulation. CONCLUSION nMCV may detect physiologic differences between those likely to benefit from 10 Hz or iTBS treatment. Future studies should examine whether PLR could guide prospective treatment selection.
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Affiliation(s)
- Cole Citrenbaum
- TMS Clinical and Research Program, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, CA, USA; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, 90024, USA
| | - Juliana Corlier
- TMS Clinical and Research Program, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, CA, USA; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, 90024, USA
| | - Doan Ngo
- TMS Clinical and Research Program, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, CA, USA; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, 90024, USA
| | - Nikita Vince-Cruz
- TMS Clinical and Research Program, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, CA, USA; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, 90024, USA
| | - Andrew Wilson
- Cooperative Institute for Research in Environmental Sciences (CIRES), University of Colorado Boulder, Boulder, CO, USA; NOAA National Centers for Environmental Information (NCEI), Boulder, CO, USA
| | - Scott A Wilke
- TMS Clinical and Research Program, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, CA, USA; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, 90024, USA
| | - David Krantz
- TMS Clinical and Research Program, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, CA, USA; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, 90024, USA
| | - Reza Tadayonnejad
- TMS Clinical and Research Program, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, CA, USA; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, 90024, USA; Division of the Humanities and Social Sciences, California Institute of Technology, Pasadena, CA, USA
| | - Nathaniel Ginder
- TMS Clinical and Research Program, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, CA, USA; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, 90024, USA
| | - Jennifer Levitt
- TMS Clinical and Research Program, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, CA, USA; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, 90024, USA
| | - John H Lee
- TMS Clinical and Research Program, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, CA, USA; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, 90024, USA
| | - Michael K Leuchter
- TMS Clinical and Research Program, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, CA, USA; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, 90024, USA
| | - Thomas B Strouse
- TMS Clinical and Research Program, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, CA, USA; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, 90024, USA
| | - Andrew Corse
- TMS Clinical and Research Program, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, CA, USA; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, 90024, USA
| | - Pooja Vyas
- Department of Psychiatry, University of California San Diego, San Diego, CA, USA
| | - Andrew F Leuchter
- TMS Clinical and Research Program, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, CA, USA; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, 90024, USA.
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Singh Solorzano C, Grano C. Predicting postpartum depressive symptoms by evaluating self-report autonomic nervous system reactivity during pregnancy. J Psychosom Res 2023; 174:111484. [PMID: 37690332 DOI: 10.1016/j.jpsychores.2023.111484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 02/11/2023] [Accepted: 09/04/2023] [Indexed: 09/12/2023]
Abstract
OBJECTIVE Altered self-reported autonomic reactivity is associated with worse mental health in the general population. Although dysfunctional changes in ANS during pregnancy have been investigated in relation to depressive symptoms, no studies addressed the relationship between self-report autonomic reactivity during pregnancy and depressive symptoms after the delivery. The present study aimed to assess the impact of prepartum self-reported autonomic reactivity on the development of postpartum depressive symptoms. METHODS In this longitudinal study, 170 women were assessed during pregnancy (i.e., second or third trimester) and after childbirth (i.e., one month after the delivery). Self-reported autonomic reactivity was assessed through the Body Perception Questionnaire - Short Form that evaluates the autonomic functions related to organs above (i.e., supradiaphragmatic reactivity) and below (i.e., subdiaphragmatic reactivity) the diaphragm. In addition, prepartum and postpartum depressive symptoms were evaluated using the Patient Health Questionnaire - 9. RESULTS Findings showed that higher prepartum supradiaphragmatic reactivity predicted higher depressive symptoms in the postpartum period (β = 0.112, p = 0.009) after controlling for prepartum depressive symptomatology and other potential covariates. CONCLUSIONS Evaluation of self-reported autonomic activity may be a useful tool to identify antenatally women at risk of postpartum depressive symptoms. Future studies are needed to evaluate the effectiveness of interventions aimed at reducing the threat-responsive autonomic reactivity at rest and improving adaptive autonomic regulation to prevent postpartum depression.
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Affiliation(s)
| | - Caterina Grano
- Department of Psychology, Sapienza University, Rome, Italy.
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Bachman SL, Cole S, Yoo HJ, Nashiro K, Min J, Mercer N, Nasseri P, Thayer JF, Lehrer P, Mather M. Daily heart rate variability biofeedback training decreases locus coeruleus MRI contrast in younger adults in a randomized clinical trial. Int J Psychophysiol 2023; 193:112241. [PMID: 37647944 PMCID: PMC10591988 DOI: 10.1016/j.ijpsycho.2023.08.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 08/10/2023] [Accepted: 08/25/2023] [Indexed: 09/01/2023]
Abstract
As an arousal hub region in the brain, the locus coeruleus (LC) has bidirectional connections with the autonomic nervous system. Magnetic resonance imaging (MRI)-based measures of LC structural integrity have been linked to cognition and arousal, but less is known about factors that influence LC structure and function across time. Here, we tested the effects of heart rate variability (HRV) biofeedback, an intervention targeting the autonomic nervous system, on LC MRI contrast and sympathetic activity. Younger and older participants completed daily HRV biofeedback training for five weeks. Those assigned to an experimental condition performed biofeedback involving slow, paced breathing designed to increase heart rate oscillations, whereas those assigned to a control condition performed biofeedback to decrease heart rate oscillations. At the pre- and post-training timepoints, LC contrast was assessed using turbo spin echo MRI scans, and RNA sequencing was used to assess cAMP-responsive element binding protein (CREB)-regulated gene expression in circulating blood cells, an index of sympathetic nervous system signaling. We found that left LC contrast decreased in younger participants in the experimental group, and across younger participants, decreases in left LC contrast were related to the extent to which participants increased their heart rate oscillations during training. Furthermore, decreases in left LC contrast were associated with decreased expression of CREB-associated gene transcripts. On the contrary, there were no effects of biofeedback on LC contrast among older participants in the experimental group. These findings provide novel evidence that in younger adults, HRV biofeedback involving slow, paced breathing can decrease both LC contrast and sympathetic nervous system signaling.
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Affiliation(s)
- Shelby L Bachman
- University of Southern California, Los Angeles, CA 90089, United States of America
| | - Steve Cole
- University of California Los Angeles, Los Angeles, CA 90095, United States of America
| | - Hyun Joo Yoo
- University of Southern California, Los Angeles, CA 90089, United States of America
| | - Kaoru Nashiro
- University of Southern California, Los Angeles, CA 90089, United States of America
| | - Jungwon Min
- University of Southern California, Los Angeles, CA 90089, United States of America
| | - Noah Mercer
- University of Southern California, Los Angeles, CA 90089, United States of America
| | - Padideh Nasseri
- University of Southern California, Los Angeles, CA 90089, United States of America
| | - Julian F Thayer
- University of California Irvine, Irvine, CA 92697, United States of America
| | - Paul Lehrer
- Rutgers University, Piscataway, NJ 08852, United States of America
| | - Mara Mather
- University of Southern California, Los Angeles, CA 90089, United States of America.
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Frasier RM, De Oliveira Sergio T, Starski PA, Grippo AJ, Hopf FW. Heart rate variability measures indicating sex differences in autonomic regulation during anxiety-like behavior in rats. Front Psychiatry 2023; 14:1244389. [PMID: 38025424 PMCID: PMC10644002 DOI: 10.3389/fpsyt.2023.1244389] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 10/11/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction Mental health conditions remain a substantial and costly challenge to society, especially in women since they have nearly twice the prevalence of anxiety disorders. However, critical mechanisms underlying sex differences remain incompletely understood. Measures of cardiac function, including heart rate (HR) and HR variability (HRV), reflect balance between sympathetic (SNS) and parasympathetic (PNS) systems and are potential biomarkers for pathological states. Methods To better understand sex differences in anxiety-related autonomic mechanisms, we examined HR/HRV telemetry in food-restricted adult rats during novelty suppression of feeding (NSF), with conflict between food under bright light in the arena center. To assess HRV, we calculated the SDNN (reflective of both SNS and PNS contribution) and rMSSD (reflective of PNS contribution) and compared these metrics to behaviors within the anxiety task. Results Females had greater HR and lower SNS indicators at baseline, as in humans. Further, females (but not males) with higher basal HR carried this state into NSF, delaying first approach to center. In contrast, males with lower SNS measures approached and spent more time in the brightly-lit center. Further, females with lower SNS indicators consumed significantly more food. In males, a high-SNS subpopulation consumed no food. Among consumers, males with greater SNS ate more food. Discussion Together, these are congruent with human findings suggesting women engage PNS more, and men SNS more. Our previous behavior-only work also observed female differences from males during initial movement and food intake. Thus, high basal SNS in females reduced behavior early in NSF, while subsequent reduced SNS allowed greater food intake. In males, lower SNS increased engagement with arena center, but greater SNS predicted higher consumption. Our findings show novel and likely clinically relevant sex differences in HRV-behavior relationships.
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Affiliation(s)
- Raizel M. Frasier
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, United States
- Medical Scientist Training Program, Indiana University School of Medicine, Indianapolis, IN, United States
| | | | - Phillip A. Starski
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Angela J. Grippo
- Department of Psychology, Northern Illinois University, DeKalb, IL, United States
| | - F. Woodward Hopf
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, United States
- Stark Neurosciences Research Institute, Indiana University, Indianapolis, IN, United States
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10
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Citrenbaum C, Corlier J, Ngo D, Vince-Cruz N, Wilson A, Wilke S, Krantz D, Tadayonnejad R, Ginder N, Levitt J, Lee JH, Strouse T, Corse A, Vyas P, Leuchter AF. Pretreatment pupillary reactivity is associated with outcome of Repetitive Transcranial Magnetic Stimulation (rTMS) treatment of Major Depressive Disorder (MDD). J Affect Disord 2023; 339:412-417. [PMID: 37437737 DOI: 10.1016/j.jad.2023.07.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 06/02/2023] [Accepted: 07/08/2023] [Indexed: 07/14/2023]
Abstract
BACKGROUND Pre-treatment biomarkers for outcome of repetitive Transcranial Magnetic Stimulation (rTMS) treatment of Major Depressive Disorder (MDD) have proven elusive. One promising family of biomarkers involves the autonomic nervous system (ANS), which is dysregulated in individuals with MDD. METHODS We examined the relationship between the pre-treatment pupillary light reflex (PLR) and rTMS outcome in 51 MDD patients. Outcome was measured as the percent change in the 30-item Inventory of Depressive Symptomatology Self Rated (IDS-SR) score from baseline to treatment 30. RESULTS Patients showed significant improvement with rTMS treatment. There was a significant correlation between baseline pupillary Constriction Amplitude (CA) and clinical improvement over the treatment course (R = 0.41, p = 0.003). LIMITATIONS We examined a limited number of subjects who received heterogeneous treatment protocols. Almost all patients in the study received psychotropic medications concomitant with rTMS treatment. CONCLUSION PLR measured before treatment may be a predictive biomarker for clinical improvement from rTMS in subjects with MDD.
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Affiliation(s)
- Cole Citrenbaum
- TMS Clinical and Research Program, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, CA, USA; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA 90024, USA
| | - Juliana Corlier
- TMS Clinical and Research Program, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, CA, USA; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA 90024, USA
| | - Doan Ngo
- TMS Clinical and Research Program, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, CA, USA; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA 90024, USA
| | - Nikita Vince-Cruz
- TMS Clinical and Research Program, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, CA, USA; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA 90024, USA
| | - Andrew Wilson
- TMS Clinical and Research Program, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, CA, USA; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA 90024, USA
| | - Scott Wilke
- TMS Clinical and Research Program, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, CA, USA; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA 90024, USA
| | - David Krantz
- TMS Clinical and Research Program, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, CA, USA; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA 90024, USA
| | - Reza Tadayonnejad
- TMS Clinical and Research Program, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, CA, USA; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA 90024, USA; Division of the Humanities and Social Sciences, California Institute of Technology, Pasadena, CA, USA
| | - Nathaniel Ginder
- TMS Clinical and Research Program, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, CA, USA; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA 90024, USA
| | - Jennifer Levitt
- TMS Clinical and Research Program, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, CA, USA; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA 90024, USA
| | - John H Lee
- TMS Clinical and Research Program, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, CA, USA; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA 90024, USA
| | - Thomas Strouse
- TMS Clinical and Research Program, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, CA, USA; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA 90024, USA
| | - Andrew Corse
- TMS Clinical and Research Program, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, CA, USA; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA 90024, USA
| | | | - Andrew F Leuchter
- TMS Clinical and Research Program, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, CA, USA; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA 90024, USA.
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11
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Liu KY, Whitsel EA, Heiss G, Palta P, Reeves S, Lin FV, Mather M, Roiser JP, Howard R. Heart rate variability and risk of agitation in Alzheimer's disease: the Atherosclerosis Risk in Communities Study. Brain Commun 2023; 5:fcad269. [PMID: 37946792 PMCID: PMC10631859 DOI: 10.1093/braincomms/fcad269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 07/24/2023] [Accepted: 10/11/2023] [Indexed: 11/12/2023] Open
Abstract
Agitation in Alzheimer's disease is common and may be related to impaired emotion regulation capacity. Heart rate variability, a proposed index of autonomic and emotion regulation neural network integrity, could be associated with agitation propensity in Alzheimer's disease. We used the Atherosclerosis Risk in Communities Study cohort data, collected over seven visits spanning over two decades, to investigate whether heart rate variability (change) was associated with agitation risk in individuals clinically diagnosed with dementia due to Alzheimer's disease. Agitation (absence/presence) at Visit 5, the primary outcome, was based on the Neuropsychiatric Inventory agitation/aggression subscale, or a composite score comprising the total number of agitation/aggression, irritability, disinhibition and aberrant motor behaviour subscales present. Visit 1-5 heart rate variability measures were the log-transformed root mean square of successive differences in R-R intervals and standard deviation of normal-to-normal R-R intervals obtained from resting, supine, standard 12-lead ECGs. To aid interpretability, heart rate variability data were scaled such that model outputs were expressed for each 0.05 log-unit change in heart rate variability (which approximated to the observed difference in heart rate variability with every 5 years of age). Among 456 participants who had dementia, 120 were clinically classified to have dementia solely attributable to Alzheimer's disease. This group showed a positive relationship between heart rate variability and agitation risk in regression models, which was strongest for measures of (potentially vagally mediated) heart rate variability change over the preceding two decades. Here, a 0.05 log-unit of heart rate variability change was associated with an up to 10-fold increase in the odds of agitation and around a half-unit increase in the composite agitation score. Associations persisted after controlling for participants' cognitive status, heart rate (change), sociodemographic factors, co-morbidities and medications with autonomic effects. Further confirmatory studies, incorporating measures of emotion regulation, are needed to support heart rate variability indices as potential agitation propensity markers in Alzheimer's disease and to explore underlying mechanisms as targets for treatment development.
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Affiliation(s)
- Kathy Y Liu
- Division of Psychiatry, University College London, London W1T 7NF, UK
| | - Eric A Whitsel
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
- Department of Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Gerardo Heiss
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Priya Palta
- Department of Medicine, Columbia University Irving Medical Center, New York, NY 10032, USA
- Department of Epidemiology, Columbia University Irving Medical Center, New York, NY 10032, USA
| | - Suzanne Reeves
- Division of Psychiatry, University College London, London W1T 7NF, UK
| | - Feng V Lin
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA 94305, USA
| | - Mara Mather
- Davis School of Gerontology, University of Southern California, Los Angeles, CA 90089, USA
| | - Jonathan P Roiser
- Institute of Cognitive Neuroscience, University College London, London WC1N 3AZ, UK
| | - Robert Howard
- Division of Psychiatry, University College London, London W1T 7NF, UK
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12
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Gullett N, Zajkowska Z, Walsh A, Harper R, Mondelli V. Heart rate variability (HRV) as a way to understand associations between the autonomic nervous system (ANS) and affective states: A critical review of the literature. Int J Psychophysiol 2023; 192:35-42. [PMID: 37543289 DOI: 10.1016/j.ijpsycho.2023.08.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 07/31/2023] [Accepted: 08/02/2023] [Indexed: 08/07/2023]
Abstract
Evidence suggests affective disorders such as depression and bipolar disorder are characterised by dysregulated autonomic nervous system (ANS) activity. These findings suggest ANS dysregulation may be involved in the pathogenesis of affective disorders. Different affective states are characterised by different ANS activity patterns (i.e., an increase or decrease in sympathetic or parasympathetic activity). To understand how ANS abnormalities are involved in the development of affective disorders, it is important to understand how affective states correlate with ANS activity before their onset. Using heart rate variability (HRV) as a tool to measure ANS activity, this review aimed to look at associations between affective states and HRV in non-clinical populations (i.e., in those without medical and psychiatric disorders). Searches on PubMed and Google Scholar were completed using the following search terms: heart rate variability, autonomic nervous system, sympathetic nervous system, parasympathetic nervous system, affective state, mood and emotion in all possible combinations. All but one of the studies examined (N = 13), demonstrated significant associations between affect and HRV. Findings suggest negative affect, encompassing both diffused longer-term experiences (i.e., mood) as well as more focused short-term experiences (i.e., emotions), may be associated with a reduction in parasympathetic activity as measured through HRV parameters known to quantify parasympathetic activity (e.g., high frequency (HF)-HRV). HRV measures typically linked to reduction in parasympathetic activity appear to be linked to negative affective states in non-clinical populations. However, given the complex and possibly non-linear relationship between HRV and parasympathetic activity, further studies need to clarify specificity of these findings. Future studies should investigate the potential utility of HRV measures as biomarkers for monitoring changes in affective states and for early detection of onset and relapse of depression in patients with affective disorders.
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Affiliation(s)
- Nancy Gullett
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, Department of Psychological Medicine, London, UK.
| | - Zuzanna Zajkowska
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, Department of Psychological Medicine, London, UK
| | - Annabel Walsh
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, Department of Psychological Medicine, London, UK
| | - Ross Harper
- Limbic, Kemp House, 160 City Road, London EC1V 2NX, UK
| | - Valeria Mondelli
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, Department of Psychological Medicine, London, UK; National Institute for Health Research Mental Health Biomedical Research Centre, South London and Maudsley NHS Foundation Trust and King's College London, London, UK
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13
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Gavelin HM, Neely AS, Aronsson I, Josefsson M, Andersson L. Mental fatigue, cognitive performance and autonomic response following sustained mental activity in clinical burnout. Biol Psychol 2023; 183:108661. [PMID: 37598882 DOI: 10.1016/j.biopsycho.2023.108661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 08/15/2023] [Accepted: 08/16/2023] [Indexed: 08/22/2023]
Abstract
OBJECTIVE To investigate the effects of sustained mental activity on perceptions of mental fatigue, cognitive performance, and autonomic response in patients with clinical burnout as compared to a healthy control group. METHODS Patients with clinical burnout (n = 30) and healthy control participants (n = 30) completed a 3-hour test session, in which they were administered a set of cognitive tests before and after an effortful cognitive task with concurrent sound exposure. Perceptions of mental fatigue and task demands (mental effort and concentration difficulties) were assessed repeatedly over the course of the test session. Heart rate variability was recorded to index autonomic response. RESULTS In comparison with controls, perceived mental fatigue increased earlier in the session for the clinical burnout group and did not recover following a short rest period. Throughout the session, patients rated the tasks as more demanding and showed less improvement on measures of attention and processing speed, inhibition and working memory. While autonomic responses were initially comparable, there was a unique decrease in high-frequency heart rate variability in the clinical burnout group after extended testing and exposure. CONCLUSION Patients with clinical burnout are affected differently than healthy controls by sustained mental activity, as reflected by ratings of perceived mental fatigue, aspects of cognitive performance and autonomic response. Further investigation into the role of autonomic regulation in relation to cognitive symptoms in clinical burnout is warranted.
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Affiliation(s)
| | - Anna Stigsdotter Neely
- Department of Social Sciences, Technology and Arts; Department of Health, Education and Technology, Luleå University of Technology, Sweden; Department of Social and Psychological studies, Karlstad University, Sweden
| | | | - Maria Josefsson
- Department of Statistics, Umeå School of Business, Economics and Statistics, Umeå University, Sweden
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14
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Hu L, He H, Roberts N, Chen J, Yan G, Pu L, Song X, Luo C. Insular dysfunction of interoception in major depressive disorder: from the perspective of neuroimaging. Front Psychiatry 2023; 14:1273439. [PMID: 37840807 PMCID: PMC10568471 DOI: 10.3389/fpsyt.2023.1273439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Accepted: 09/14/2023] [Indexed: 10/17/2023] Open
Abstract
Interoception plays a crucial role in maintaining bodily homeostasis and promoting survival, and is considered the basis of human emotion, cognition, and self-formation. A malfunction of interoception is increasingly suggested to be a fundamental component of different mental health conditions, and depressive disorders have been especially closely associated. Interoceptive signaling and processing depends on a system called the "interoceptive pathway," with the insula, located in the deep part of the lateral fissure, being the most important brain structure in this pathway. Neuroimaging studies have revealed alterations in the structure and function of the insula in a large number of individuals with depression, yet the precise relationship between these alterations and interoceptive dysfunction remains unclear. The goal of this review is to examine the evidence that exists for dysfunction of interoception in people with Major Depressive Disorder (MDD), and to determine the associated specific alterations in the structure and function of the insula revealed by neuroimaging. Overall, three aspects of the potential relationship between interoceptive dysfunction and alterations in insular function in people with depression have been assessed, namely clinical symptoms, quantitative measures of interoceptive function and ability, and interoceptive modulation. To conclude, several specific limitations of the published studies and important lines of enquiry for future research are offered.
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Affiliation(s)
- Lan Hu
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China
- The Fourth People’s Hospital of Chengdu, Chengdu, China
| | - Hui He
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China
- The Fourth People’s Hospital of Chengdu, Chengdu, China
| | - Neil Roberts
- Centre for Reproductive Health (CRH), School of Clinical Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | - Jiajia Chen
- The Fourth People’s Hospital of Chengdu, Chengdu, China
| | - Guojian Yan
- The Fourth People’s Hospital of Chengdu, Chengdu, China
| | - Li Pu
- The Fourth People’s Hospital of Chengdu, Chengdu, China
| | - Xufeng Song
- The Fourth People’s Hospital of Chengdu, Chengdu, China
| | - Cheng Luo
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China
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15
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Lin FV, Heffner KL. Autonomic nervous system flexibility for understanding brain aging. Ageing Res Rev 2023; 90:102016. [PMID: 37459967 PMCID: PMC10530154 DOI: 10.1016/j.arr.2023.102016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 07/07/2023] [Accepted: 07/13/2023] [Indexed: 07/20/2023]
Abstract
A recent call was made for autonomic nervous system (ANS) measures as digital health markers for early detection of Alzheimer's disease and related dementia (AD/ADRD). Nevertheless, contradictory or inconclusive findings exist. To help advance understanding of ANS' role in dementia, we draw upon aging and dementia-related literature, and propose a framework that centers on the role of ANS flexibility to guide future work on application of ANS function to differentiating the degree and type of dementia-related brain pathologies. We first provide a brief review of literature within the past 10 years on ANS and dementia-related brain pathologies. Next, we present an ANS flexibility model, describing how the model can be applied to understand these brain pathologies, as well as differentiate or even be leveraged to modify typical brain aging and dementia. Lastly, we briefly discuss the implication of the model for understanding resilience and vulnerability to dementia-related outcomes.
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Affiliation(s)
- Feng V Lin
- Department of Psychiatry and Behavioral Sciences, Stanford University, USA; Wu Tsai Neurosciences Institute, Stanford University, USA.
| | - Kathi L Heffner
- School of Nursing, University of Rochester, USA; Department of Psychiatry, School of Medicine and Dentistry, University of Rochester, USA; Department of Medicine, School of Medicine and Dentistry, University of Rochester, USA
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16
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Mishra B, Tarai S, Ratre V, Bit A. Processing of attentional and emotional stimuli depends on retrospective response of foot pressure: Conceptualizing neuron-cognitive distribution in human brain. Comput Biol Med 2023; 164:107186. [PMID: 37480678 DOI: 10.1016/j.compbiomed.2023.107186] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 06/08/2023] [Accepted: 06/13/2023] [Indexed: 07/24/2023]
Abstract
Cognitive function of human brain requires temporal execution of emotional or attentional tasks, or their inter-dependence influences. Smooth execution of such tasks requires spontaneous distribution of cognitive load at specific regions of brain based on its classification. A strong connectivity between peripheral sensors and central nervous system is thought to assist the cognitive load distribution effectively. Novelty of current study evaluates the modulation of foot pressure and its mapping with distributed cognitive load while executing attentional biased emotional tasks. Emotional stimulus in form of happy and sad faces with attentional paradigm drawn on them were used in the study. Behavioral results were measured with respect to the analysis of response time (RT) and response accuracy (%). Neurological signals were acquired using 10-channel EEG data acquisition system, whereas, another 6 channels were used to measure foot pressure in the left and right feet at three different locations of foot. Acquired signals were further analyzed in time and frequency domains to interpret the cognitive load distribution, and the influence of foot pressure on distribution of cognitive loads. We found that the foot pressure accelerated the response accuracy rate in attending the local scope of attention, which was not in the case of global scope of attention. This means that the global attention does not require any pressure from peripheral sensory neurons. Our event related potential (ERP) results revealed that the early sensory negative N100 characterized the processing of global scope of attention coupled with high-foot pressure. However, the late positive peak of P300 and P600 associated with local scope of attention along with high-foot pressure. The global scope of attention with low-foot pressure modulates delta and theta oscillations. These results largely contribute to the literature on cognitive neuroscience of attention and it corelation with the peripheral sensory foot pressure.
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Affiliation(s)
- Bharti Mishra
- Department of Biomedical Engineering, National Institute of Technology, Raipur, India
| | - Shashikanta Tarai
- Department of Humanities and Social Sciences, National Institute of Technology, Raipur, India
| | - Vinod Ratre
- Department of Biomedical Engineering, National Institute of Technology, Raipur, India
| | - Arindam Bit
- Department of Biomedical Engineering, National Institute of Technology, Raipur, India.
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17
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Lee SH, Hwang HH, Kim S, Hwang J, Park J, Park S. Clinical Implication of Maumgyeol Basic Service-the 2 Channel Electroencephalography and a Photoplethysmogram-based Mental Health Evaluation Software. CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE : THE OFFICIAL SCIENTIFIC JOURNAL OF THE KOREAN COLLEGE OF NEUROPSYCHOPHARMACOLOGY 2023; 21:583-593. [PMID: 37424425 PMCID: PMC10335898 DOI: 10.9758/cpn.23.1062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 03/24/2023] [Accepted: 03/29/2023] [Indexed: 07/11/2023]
Abstract
Objective Maumgyeol Basic service is a mental health evaluation and grade scoring software using the 2 channels EEG and photoplethysmogram (PPG). This service is supposed to assess potential at-risk groups with mental illness more easily, rapidly, and reliably. This study aimed to evaluate the clinical implication of the Maumgyeol Basic service. Methods One hundred one healthy controls and 103 patients with a psychiatric disorder were recruited. Psychological evaluation (Mental Health Screening for Depressive Disorders [MHS-D], Mental Health Screening for Anxiety Disorders [MHS-A], cognitive stress response scale [CSRS], 12-item General Health Questionnaire [GHQ-12], Clinical Global Impression [CGI]) and digit symbol substitution test (DSST) were applied to all participants. Maumgyeol brain health score and Maumgyeol mind health score were calculated from 2 channel frontal EEG and PPG, respectively. Results Participants were divided into three groups: Maumgyeol Risky, Maumgyeol Good, and Maumgyeol Usual. The Maumgyeol mind health scores, but not brain health scores, were significantly lower in the patients group compared to healthy controls. Maumgyeol Risky group showed significantly lower psychological and cognitive ability evaluation scores than Maumgyeol Usual and Good groups. Maumgyel brain health score showed significant correlations with CSRS and DSST. Maumgyeol mind health score showed significant correlations with CGI and DSST. About 20.6% of individuals were classified as the No Insight group, who had mental health problems but were unaware of their illnesses. Conclusion This study suggests that the Maumgyeol Basic service can provide important clinical information about mental health and be used as a meaningful digital mental healthcare monitoring solution to prevent symptom aggravation.
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Affiliation(s)
- Seung-Hwan Lee
- Bwave Inc., Goyang, Korea
- Department of Psychiatry, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea
- Clinical Emotion and Cognition Research Laboratory, Department of Psychiatry, Inje University, Goyang, Korea
| | - Hyeon-Ho Hwang
- Clinical Emotion and Cognition Research Laboratory, Department of Psychiatry, Inje University, Goyang, Korea
- Department of Human-Computer Interaction, Hanyang University, Ansan, Korea
| | - Sungkean Kim
- Department of Human-Computer Interaction, Hanyang University, Ansan, Korea
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18
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Otsuka K, Cornelissen G, Kubo Y, Shibata K, Mizuno K, Aiba T, Furukawa S, Ohshima H, Mukai C. Methods for assessing change in brain plasticity at night and psychological resilience during daytime between repeated long-duration space missions. Sci Rep 2023; 13:10909. [PMID: 37407662 DOI: 10.1038/s41598-023-36389-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 06/02/2023] [Indexed: 07/07/2023] Open
Abstract
This study was designed to examine the feasibility of analyzing heart rate variability (HRV) data from repeat-flier astronauts at matching days on two separate missions to assess any effect of repeated missions on brain plasticity and psychological resilience, as conjectured by Demertzi. As an example, on the second mission of a healthy astronaut studied about 20 days after launch, sleep duration lengthened, sleep quality improved, and spectral power (ms2) co-varying with activity of the salience network (SN) increased at night. HF-component (0.15-0.50 Hz) increased by 61.55%, and HF-band (0.30-0.40 Hz) by 92.60%. Spectral power of HRV indices during daytime, which correlate negatively with psychological resilience, decreased, HF-component by 22.18% and HF-band by 37.26%. LF-component and LF-band, reflecting activity of the default mode network, did not change significantly. During the second mission, 24-h acrophases of HRV endpoints did not change but the 12-h acrophase of TF-HRV did (P < 0.0001), perhaps consolidating the circadian system to help adapt to space by taking advantage of brain plasticity at night and psychological resilience during daytime. While this N-of-1 study prevents drawing definitive conclusions, the methodology used herein to monitor markers of brain plasticity could pave the way for further studies that could add to the present results.
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Affiliation(s)
- Kuniaki Otsuka
- Space Biomedical Research Group, Japan Aerospace Exploration Agency, Ibaraki, Japan.
- Halberg Chronobiology Center, University of Minnesota, Minneapolis, MN, USA.
- Tokyo Women's Medical University, Tokyo, Japan.
| | | | - Yutaka Kubo
- Tokyo Women's Medical University, Tokyo, Japan
| | | | - Koh Mizuno
- Space Biomedical Research Group, Japan Aerospace Exploration Agency, Ibaraki, Japan
- Faculty of Education, Tohoku Fukushi University, Miyagi, Japan
| | - Tatsuya Aiba
- Space Biomedical Research Group, Japan Aerospace Exploration Agency, Ibaraki, Japan
| | - Satoshi Furukawa
- Space Biomedical Research Group, Japan Aerospace Exploration Agency, Ibaraki, Japan
| | - Hiroshi Ohshima
- Space Biomedical Research Group, Japan Aerospace Exploration Agency, Ibaraki, Japan
| | - Chiaki Mukai
- Space Biomedical Research Group, Japan Aerospace Exploration Agency, Ibaraki, Japan
- Tokyo University of Science, Tokyo, Japan
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19
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Kong SDX, Gordon CJ, Hoyos CM, Wassing R, D’Rozario A, Mowszowski L, Ireland C, Palmer JR, Grunstein RR, Shine JM, McKinnon AC, Naismith SL. Heart rate variability during slow wave sleep is linked to functional connectivity in the central autonomic network. Brain Commun 2023; 5:fcad129. [PMID: 37234683 PMCID: PMC10208252 DOI: 10.1093/braincomms/fcad129] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 02/20/2023] [Accepted: 05/18/2023] [Indexed: 05/28/2023] Open
Abstract
Reduced heart rate variability can be an early sign of autonomic dysfunction in neurodegenerative diseases and may be related to brain dysfunction in the central autonomic network. As yet, such autonomic dysfunction has not been examined during sleep-which is an ideal physiological state to study brain-heart interaction as both the central and peripheral nervous systems behave differently compared to during wakefulness. Therefore, the primary aim of the current study was to examine whether heart rate variability during nocturnal sleep, specifically slow wave (deep) sleep, is associated with central autonomic network functional connectivity in older adults 'at-risk' of dementia. Older adults (n = 78; age range = 50-88 years; 64% female) attending a memory clinic for cognitive concerns underwent resting-state functional magnetic resonance imaging and an overnight polysomnography. From these, central autonomic network functional connectivity strength and heart rate variability data during sleep were derived, respectively. High-frequency heart rate variability was extracted to index parasympathetic activity during distinct periods of sleep, including slow wave sleep as well as secondary outcomes of non-rapid eye movement sleep, wake after sleep onset, and rapid eye movement sleep. General linear models were used to examine associations between central autonomic network functional connectivity and high-frequency heart rate variability. Analyses revealed that increased high-frequency heart rate variability during slow wave sleep was associated with stronger functional connectivity (F = 3.98, P = 0.022) in two core brain regions within the central autonomic network, the right anterior insular and posterior midcingulate cortex, as well as stronger functional connectivity (F = 6.21, P = 0.005) between broader central autonomic network brain regions-the right amygdala with three sub-nuclei of the thalamus. There were no significant associations between high-frequency heart rate variability and central autonomic network connectivity during wake after sleep onset or rapid eye movement sleep. These findings show that in older adults 'at-risk' of dementia, parasympathetic regulation during slow wave sleep is uniquely linked to differential functional connectivity within both core and broader central autonomic network brain regions. It is possible that dysfunctional brain-heart interactions manifest primarily during this specific period of sleep known for its role in memory and metabolic clearance. Further studies elucidating the pathophysiology and directionality of this relationship should be conducted to determine if heart rate variability drives neurodegeneration, or if brain degeneration within the central autonomic network promotes aberrant heart rate variability.
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Affiliation(s)
- Shawn D X Kong
- Correspondence to: Shawn Dexiao KongHealthy Brain Ageing ProgramBrain and Mind Centre, University of Sydney100 Mallett St, Camperdown, NSW 2050, Australia E-mail:
| | - Christopher J Gordon
- CIRUS, Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, University of Sydney, Glebe, NSW 2037, Australia
- Faculty of Medicine and Health, University of Sydney, Camperdown, NSW 2050, Australia
| | - Camilla M Hoyos
- Healthy Brain Ageing Program, Brain and Mind Centre, University of Sydney, Camperdown, NSW 2050, Australia
- Charles Perkins Centre, University of Sydney, Camperdown, NSW 2050, Australia
- School of Psychology, Faculty of Science, University of Sydney, Camperdown, NSW 2050, Australia
- CIRUS, Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, University of Sydney, Glebe, NSW 2037, Australia
| | - Rick Wassing
- CIRUS, Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, University of Sydney, Glebe, NSW 2037, Australia
| | - Angela D’Rozario
- Healthy Brain Ageing Program, Brain and Mind Centre, University of Sydney, Camperdown, NSW 2050, Australia
- School of Psychology, Faculty of Science, University of Sydney, Camperdown, NSW 2050, Australia
- CIRUS, Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, University of Sydney, Glebe, NSW 2037, Australia
| | - Loren Mowszowski
- Healthy Brain Ageing Program, Brain and Mind Centre, University of Sydney, Camperdown, NSW 2050, Australia
- Charles Perkins Centre, University of Sydney, Camperdown, NSW 2050, Australia
- School of Psychology, Faculty of Science, University of Sydney, Camperdown, NSW 2050, Australia
| | - Catriona Ireland
- Healthy Brain Ageing Program, Brain and Mind Centre, University of Sydney, Camperdown, NSW 2050, Australia
| | - Jake R Palmer
- Healthy Brain Ageing Program, Brain and Mind Centre, University of Sydney, Camperdown, NSW 2050, Australia
| | - Ronald R Grunstein
- CIRUS, Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, University of Sydney, Glebe, NSW 2037, Australia
- Faculty of Medicine and Health, University of Sydney, Camperdown, NSW 2050, Australia
- Royal Prince Alfred Hospital, University of Sydney, Camperdown, NSW 2050, Australia
| | - James M Shine
- Royal Prince Alfred Hospital, University of Sydney, Camperdown, NSW 2050, Australia
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20
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Kassinopoulos M, Rolandi N, Alphan L, Harper RM, Oliveira J, Scott C, Kozák LR, Guye M, Lemieux L, Diehl B. Brain Connectivity Correlates of Breathing and Cardiac Irregularities in SUDEP: A Resting-State fMRI Study. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.05.19.541412. [PMID: 37293113 PMCID: PMC10245782 DOI: 10.1101/2023.05.19.541412] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Sudden unexpected death in epilepsy (SUDEP) is the leading cause of premature mortality among people with epilepsy. Evidence from witnessed and monitored SUDEP cases indicate seizure-induced cardiovascular and respiratory failures; yet, the underlying mechanisms remain obscure. SUDEP occurs often during the night and early morning hours, suggesting that sleep or circadian rhythm-induced changes in physiology contribute to the fatal event. Resting-state fMRI studies have found altered functional connectivity between brain structures involved in cardiorespiratory regulation in later SUDEP cases and in individuals at high-risk of SUDEP. However, those connectivity findings have not been related to changes in cardiovascular or respiratory patterns. Here, we compared fMRI patterns of brain connectivity associated with regular and irregular cardiorespiratory rhythms in SUDEP cases with those of living epilepsy patients of varying SUDEP risk, and healthy controls. We analysed resting-state fMRI data from 98 patients with epilepsy (9 who subsequently succumbed to SUDEP, 43 categorized as low SUDEP risk (no tonic-clonic seizures (TCS) in the year preceding the fMRI scan), and 46 as high SUDEP risk (>3 TCS in the year preceding the scan)) and 25 healthy controls. The global signal amplitude (GSA), defined as the moving standard deviation of the fMRI global signal, was used to identify periods with regular ('low state') and irregular ('high state') cardiorespiratory rhythms. Correlation maps were derived from seeds in twelve regions with a key role in autonomic or respiratory regulation, for the low and high states. Following principal component analysis, component weights were compared between the groups. We found widespread alterations in connectivity of precuneus/posterior cingulate cortex in epilepsy compared to controls, in the low state (regular cardiorespiratory activity). In the low state, and to a lesser degree in the high state, reduced anterior insula connectivity (mainly with anterior and posterior cingulate cortex) in epilepsy appeared, relative to healthy controls. For SUDEP cases, the insula connectivity differences were inversely related to the interval between the fMRI scan and death. The findings suggest that anterior insula connectivity measures may provide a biomarker of SUDEP risk. The neural correlates of autonomic brain structures associated with different cardiorespiratory rhythms may shed light on the mechanisms underlying terminal apnea observed in SUDEP.
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Affiliation(s)
- Michalis Kassinopoulos
- UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
- Epilepsy Society, Chalfont St. Peter, Buckinghamshire, United Kingdom
| | - Nicolo Rolandi
- UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
- Epilepsy Society, Chalfont St. Peter, Buckinghamshire, United Kingdom
| | - Laren Alphan
- UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
| | - Ronald M. Harper
- UCLA Brain Research Institute, Los Angeles, CA, United States
- Department of Neurobiology, David Geffen School of Medicine at UCLA, Los Angeles, CA, United States
| | - Joana Oliveira
- UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
- Department of Clinical Neurophysiology, National Hospital for Neurology and Neurosurgery, UCLH, London, United Kingdom
| | - Catherine Scott
- UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
- Department of Clinical Neurophysiology, National Hospital for Neurology and Neurosurgery, UCLH, London, United Kingdom
| | - Lajos R. Kozák
- UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
- Department of Neuroradiology, Medical Imaging Centre, Semmelweis University, Budapest, Hungary
| | - Maxime Guye
- Aix Marseille Univ, CNRS, CRMBM UMR 7339, Marseille, France
- APHM, Hôpital de la Timone, CEMEREM, Marseille, France
| | - Louis Lemieux
- UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
- Epilepsy Society, Chalfont St. Peter, Buckinghamshire, United Kingdom
| | - Beate Diehl
- UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
- Epilepsy Society, Chalfont St. Peter, Buckinghamshire, United Kingdom
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21
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Krause E, Vollmer M, Wittfeld K, Weihs A, Frenzel S, Dörr M, Kaderali L, Felix SB, Stubbe B, Ewert R, Völzke H, Grabe HJ. Evaluating heart rate variability with 10 second multichannel electrocardiograms in a large population-based sample. Front Cardiovasc Med 2023; 10:1144191. [PMID: 37252117 PMCID: PMC10213655 DOI: 10.3389/fcvm.2023.1144191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 03/27/2023] [Indexed: 05/31/2023] Open
Abstract
Introduction Heart rate variability (HRV), defined as the variability of consecutive heart beats, is an important biomarker for dysregulations of the autonomic nervous system (ANS) and is associated with the development, course, and outcome of a variety of mental and physical health problems. While guidelines recommend using 5 min electrocardiograms (ECG), recent studies showed that 10 s might be sufficient for deriving vagal-mediated HRV. However, the validity and applicability of this approach for risk prediction in epidemiological studies is currently unclear to be used. Methods This study evaluates vagal-mediated HRV with ultra-short HRV (usHRV) based on 10 s multichannel ECG recordings of N = 4,245 and N = 2,392 participants of the Study of Health in Pomerania (SHIP) from two waves of the SHIP-TREND cohort, additionally divided into a healthy and health-impaired subgroup. Association of usHRV with HRV derived from long-term ECG recordings (polysomnography: 5 min before falling asleep [N = 1,041]; orthostatic testing: 5 min of rest before probing an orthostatic reaction [N = 1,676]) and their validity with respect to demographic variables and depressive symptoms were investigated. Results High correlations (r = .52-.75) were revealed between usHRV and HRV. While controlling for covariates, usHRV was the strongest predictor for HRV. Furthermore, the associations of usHRV and HRV with age, sex, obesity, and depressive symptoms were similar. Conclusion This study provides evidence that usHRV derived from 10 s ECG might function as a proxy of vagal-mediated HRV with similar characteristics. This allows the investigation of ANS dysregulation with ECGs that are routinely performed in epidemiological studies to identify protective and risk factors for various mental and physical health problems.
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Affiliation(s)
- Elischa Krause
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - Marcus Vollmer
- Institute of Bioinformatics, University Medicine Greifswald, Greifswald, Germany
- German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, Greifswald, Germany
| | - Katharina Wittfeld
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
- German Centre for Neurodegenerative Diseases (DZNE), Partner Site Rostock/Greifswald, Greifswald, Germany
| | - Antoine Weihs
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - Stefan Frenzel
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - Marcus Dörr
- German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, Greifswald, Germany
- Department of Internal Medicine B, University Medicine Greifswald, Greifswald, Germany
| | - Lars Kaderali
- Institute of Bioinformatics, University Medicine Greifswald, Greifswald, Germany
- German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, Greifswald, Germany
| | - Stephan B. Felix
- German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, Greifswald, Germany
- Department of Internal Medicine B, University Medicine Greifswald, Greifswald, Germany
| | - Beate Stubbe
- Department of Internal Medicine B, University Medicine Greifswald, Greifswald, Germany
| | - Ralf Ewert
- Department of Internal Medicine B, University Medicine Greifswald, Greifswald, Germany
| | - Henry Völzke
- Department of Internal Medicine B, University Medicine Greifswald, Greifswald, Germany
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Hans J. Grabe
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
- German Centre for Neurodegenerative Diseases (DZNE), Partner Site Rostock/Greifswald, Greifswald, Germany
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22
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The physiology of intraoperative error: using electrokardiograms to understand operator performance during robot-assisted surgery simulations. Surg Endosc 2023:10.1007/s00464-023-09957-0. [PMID: 36862171 DOI: 10.1007/s00464-023-09957-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 02/12/2023] [Indexed: 03/03/2023]
Abstract
BACKGROUND No platform for objective, synchronous and on-line evaluation of both intraoperative error and surgeon physiology yet exists. Electrokardiogram (EKG) metrics have been associated with cognitive and affective features that are known to impact surgical performance but have not yet been analyzed in conjunction with real-time error signals using objective, real-time methods. METHODS EKGs and operating console point-of-views (POVs) for fifteen general surgery residents and five non-medically trained participants were captured during three simulated robotic-assisted surgery (RAS) procedures. Time and frequency-domain EKG statistics were extracted from recorded EKGs. Intraoperative errors were detected from operating console POV videos. EKG statistics were synchronized with intraoperative error signals. RESULTS Relative to personalized baselines, IBI, SDNN and RMSSD decreased 0.15% (S.E. 3.603e-04; P = 3.25e-05), 3.08% (S.E. 1.603e-03; P < 2e-16) and 1.19% (S.E. 2.631e-03; P = 5.66e-06), respectively, during error. Relative LF RMS power decreased 1.44% (S.E. 2.337e-03; P = 8.38e-10), and relative HF RMS power increased 5.51% (S.E. 1.945e-03; P < 2e-16). CONCLUSIONS Use of a novel, on-line biometric and operating room data capture and analysis platform enabled detection of distinct operator physiological changes during intraoperative errors. Monitoring operator EKG metrics during surgery may help improve patient outcomes through real-time assessments of intraoperative surgical proficiency and perceived difficulty as well as inform personalized surgical skills development.
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23
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Critchley HD, Sherrill SP, Ewing DL, van Praag CG, Habash-Bailey H, Quadt L, Eccles JA, Meeten F, Jones AM, Garfinkel SN. Cardiac interoception in patients accessing secondary mental health services: A transdiagnostic study. Auton Neurosci 2023; 245:103072. [PMID: 36709619 DOI: 10.1016/j.autneu.2023.103072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 12/19/2022] [Accepted: 01/08/2023] [Indexed: 01/15/2023]
Abstract
BACKGROUND Abnormalities in the regulation of physiological arousal and interoceptive processing are implicated in the expression and maintenance of specific psychiatric conditions and symptoms. We undertook a cross-sectional characterisation of patients accessing secondary mental health services, recording measures relating to cardiac physiology and interoception, to understand how physiological state and interoceptive ability relate transdiagnostically to affective symptoms. METHODS Participants were patients (n = 258) and a non-clinical comparison group (n = 67). Clinical diagnoses spanned affective disorders, complex personality presentations and psychoses. We first tested for differences between patient and non-clinical participants in terms of cardiac physiology and interoceptive ability, considering interoceptive tasks and a self-report measure. We then tested for correlations between cardiac and interoceptive measures and affective symptoms. Lastly, we explored group differences across recorded clinical diagnoses. RESULTS Patients exhibited lower performance accuracy and confidence in heartbeat discrimination and lower heartbeat tracking confidence relative to comparisons. In patients, greater anxiety and depression predicted greater self-reported interoceptive sensibility and a greater mismatch between performance accuracy and sensibility. This effect was not observed in comparison participants. Significant differences between patient groups were observed for heart rate variability (HRV) although post hoc differences were not significant after correction for multiple comparisons. Finally, accuracy in heartbeat tracking was significantly lower in schizophrenia compared to other diagnostic groups. CONCLUSIONS The multilevel characterisation presented here identified certain physiological and interoceptive differences associated with psychiatric symptoms and diagnoses. The clinical stratification and therapeutic targeting of interoceptive mechanisms is therefore of potential value in treating certain psychiatric conditions.
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Affiliation(s)
- Hugo D Critchley
- Department of Neuroscience, Brighton and Sussex Medical School, United Kingdom of Great Britain and Northern Ireland; Sussex Partnership NHS Foundation Trust, United Kingdom of Great Britain and Northern Ireland; Sussex Neuroscience, University of Sussex, United Kingdom of Great Britain and Northern Ireland.
| | - Samantha P Sherrill
- Department of Neuroscience, Brighton and Sussex Medical School, United Kingdom of Great Britain and Northern Ireland; Sussex Neuroscience, University of Sussex, United Kingdom of Great Britain and Northern Ireland
| | - Donna L Ewing
- Department of Neuroscience, Brighton and Sussex Medical School, United Kingdom of Great Britain and Northern Ireland; School of Humanities and Social Science, University of Brighton, United Kingdom of Great Britain and Northern Ireland
| | - Cassandra Gould van Praag
- Department of Neuroscience, Brighton and Sussex Medical School, United Kingdom of Great Britain and Northern Ireland; Department of Psychiatry, University of Oxford, United Kingdom of Great Britain and Northern Ireland
| | - Haniah Habash-Bailey
- Department of Neuroscience, Brighton and Sussex Medical School, United Kingdom of Great Britain and Northern Ireland; School of Psychology, University of Sussex, United Kingdom of Great Britain and Northern Ireland
| | - Lisa Quadt
- Department of Neuroscience, Brighton and Sussex Medical School, United Kingdom of Great Britain and Northern Ireland; Sussex Neuroscience, University of Sussex, United Kingdom of Great Britain and Northern Ireland
| | - Jessica A Eccles
- Department of Neuroscience, Brighton and Sussex Medical School, United Kingdom of Great Britain and Northern Ireland; Sussex Partnership NHS Foundation Trust, United Kingdom of Great Britain and Northern Ireland; Sussex Neuroscience, University of Sussex, United Kingdom of Great Britain and Northern Ireland
| | - Fran Meeten
- Department of Neuroscience, Brighton and Sussex Medical School, United Kingdom of Great Britain and Northern Ireland; School of Psychology, University of Sussex, United Kingdom of Great Britain and Northern Ireland
| | - Anna-Marie Jones
- Sussex Partnership NHS Foundation Trust, United Kingdom of Great Britain and Northern Ireland
| | - Sarah N Garfinkel
- Institute of Cognitive Neuroscience, University College London, United Kingdom of Great Britain and Northern Ireland
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24
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Peralta-Malváez L, Turnbull A, Anthony M, Adeli E, Lin FV. CCA identifies a neurophysiological marker of adaptation capacity that is reliably linked to internal locus of control of cognition in amnestic MCI. GeroScience 2023:10.1007/s11357-023-00730-8. [PMID: 36697886 PMCID: PMC10400522 DOI: 10.1007/s11357-023-00730-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 01/09/2023] [Indexed: 01/27/2023] Open
Abstract
Locus of control (LOC) describes whether an individual thinks that they themselves (internal LOC) or external factors (external LOC) have more influence on their lives. LOC varies by domain, and a person's LOC for their intellectual capacities (LOC-Cognition) may be a marker of resilience in older adults at risk for dementia, with internal LOC-Cognition relating to better outcomes and improved treatment adherence. Vagal control, a key component of parasympathetic autonomic nervous system (ANS) regulation, may reflect a neurophysiological biomarker of internal LOC-Cognition. We used canonical correlation analysis (CCA) to identify a shared neurophysiological marker of ANS regulation from electrocardiogram (during auditory working memory) and functional connectivity (FC) data. A canonical variable from root mean square of successive differences (RMSSD) time series and between-network FC was significantly related to internal LOC-Cognition (β = 0.266, SE = 0.971, CI = [0.190, 4.073], p = 0.031) in 65 participants (mean age = 74.7, 32 female) with amnestic mild cognitive impairment (aMCI). Follow-up data from 55 of these individuals (mean age = 73.6, 22 females) was used to show reliability of this relationship (β = 0.271, SE = 0.971, CI = [0.033, 2.630], p = 0.047), and a second sample (40 participants with aMCI/healthy cognition, mean age = 72.7, 24 females) showed that the canonical vector biomarker generalized to visual working memory (β = 0.36, SE = 0.136, CI = [0.023, 0.574], p = 0.037), but not inhibition task RMSSD data (β = 0.08, SE = 1.486, CI = [- 0.354, 0.657], p = 0.685). This canonical vector may represent a biomarker of autonomic regulation that explains how some older adults maintain internal LOC-Cognition as dementia progresses. Future work should further test the causality of this relationship and the modifiability of this biomarker.
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Affiliation(s)
- Lizbeth Peralta-Malváez
- CogT Lab, Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, 94305, USA
| | - Adam Turnbull
- CogT Lab, Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, 94305, USA. .,Department of Brain and Cognitive Sciences, University of Rochester, Rochester, NY, 14627, USA.
| | - Mia Anthony
- CogT Lab, Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, 94305, USA.,Department of Brain and Cognitive Sciences, University of Rochester, Rochester, NY, 14627, USA
| | - Ehsan Adeli
- CogT Lab, Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, 94305, USA
| | - F Vankee Lin
- CogT Lab, Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, 94305, USA
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25
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Singh Solorzano C, Violani C, Grano C. Pre-partum HRV as a predictor of postpartum depression: The potential use of a smartphone application for physiological recordings. J Affect Disord 2022; 319:172-180. [PMID: 36162652 DOI: 10.1016/j.jad.2022.09.056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 08/05/2022] [Accepted: 09/20/2022] [Indexed: 11/17/2022]
Abstract
BACKGROUND This study aimed to investigate the role of a time-domain Heart Rate Variability index (the root mean square of successive difference between NN intervals, rMSSD) as a predictor of the onset of postpartum depression. HRV has been related to an increased risk of depression in the general population. However, its role in pregnant women is not clear, and the potential use of smartphone applications to evaluate HRV in this population has not been investigated. METHODS In study 1, simultaneous electrocardiogram and smartphone photoplethysmography were collected. The rMSSD was determined from each recording to evaluate the accuracy of a smartphone application in the measurement of HRV. In study 2, 135 pregnant women provided rMSSD values measured through a smartphone application in the prepartum (second or third trimester) and filled in the Edinburgh Postnatal Depression Scale in the postpartum (one month after the childbirth). RESULTS Study 1 showed the excellent accuracy of the smartphone application in the measurement of rMSSD. Study 2 indicated that lower prepartum rMSSD predicted higher depressive symptoms in the postpartum (β = -0.217, p = 0.010) after controlling for prepartum depressive symptoms and other potential covariates. LIMITATIONS Artefacts (e.g., hand movements) might have corrupted the physiological signal registered. CONCLUSION This study showed that a reduced vagal tone, indexed by lower rMSSD, during pregnancy was a predictor of depressive symptoms one month after childbirth. The prepartum period may offer an important timeframe to implement preventive intervention on vagal modulation in order to prevent depressive symptoms in the postpartum.
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Affiliation(s)
| | | | - Caterina Grano
- Department of Psychology, Sapienza University, Rome, Italy.
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26
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Dell’Acqua C, Mura F, Messerotti Benvenuti S, Patron E, Palomba D. Reduced heart rate variability and expressive suppression interact to prospectively predict COVID-19 pandemic-related post-traumatic stress symptoms. Sci Rep 2022; 12:21311. [PMID: 36494439 PMCID: PMC9734110 DOI: 10.1038/s41598-022-25915-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 12/07/2022] [Indexed: 12/13/2022] Open
Abstract
The COVID-19 pandemic is a unique period of stress that, in some cases, led to post-traumatic stress symptoms (PTSSs). Emotion regulation strategies are known to modulate the emotional response to stressful events. Expressive suppression (ES) is a maladaptive strategy related to the exacerbation of the physiological stress response. Heart rate variability (HRV), an index of cardiac autonomic balance strictly related to ES, was also shown to predict PTSSs. This was the first study to investigate whether the pre-pandemic ES use and resting-state HRV predicted pandemic-related PTSSs. Before the pandemic, 83 (58 females) university students completed the Emotion Regulation Questionnaire (ERQ), self-report measures of anxiety and depressive symptoms, and a three-minute resting-state electrocardiogram recording. After 12 months, 61 (45 females) participants completed a self-report measure of pandemic-related PTSSs and repeated the self-report psychological measures. Pre-pandemic anxiety symptoms prospectively predicted greater PTSSs. Moreover, a significant interaction between HRV and ES in predicting PTSSs emerged, whereby those who had higher levels of ES and reduced HRV showed higher PTSSs. These findings suggest that an integrated assessment of HRV and ES might be useful for identifying individuals who are more vulnerable to the development of PTSSs during crises.
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Affiliation(s)
- Carola Dell’Acqua
- grid.5608.b0000 0004 1757 3470Department of General Psychology, University of Padua, Via Venezia, 8, 35131 Padua, Italy ,grid.5608.b0000 0004 1757 3470Padova Neuroscience Center (PNC), University of Padua, Padua, Italy
| | - Francesca Mura
- grid.5608.b0000 0004 1757 3470Department of General Psychology, University of Padua, Via Venezia, 8, 35131 Padua, Italy ,grid.5608.b0000 0004 1757 3470Padova Neuroscience Center (PNC), University of Padua, Padua, Italy
| | - Simone Messerotti Benvenuti
- grid.5608.b0000 0004 1757 3470Department of General Psychology, University of Padua, Via Venezia, 8, 35131 Padua, Italy ,grid.5608.b0000 0004 1757 3470Padova Neuroscience Center (PNC), University of Padua, Padua, Italy ,grid.411474.30000 0004 1760 2630Hospital Psychology Unit, Padua University Hospital, Padua, Italy
| | - Elisabetta Patron
- grid.5608.b0000 0004 1757 3470Department of General Psychology, University of Padua, Via Venezia, 8, 35131 Padua, Italy
| | - Daniela Palomba
- grid.5608.b0000 0004 1757 3470Department of General Psychology, University of Padua, Via Venezia, 8, 35131 Padua, Italy ,grid.5608.b0000 0004 1757 3470Padova Neuroscience Center (PNC), University of Padua, Padua, Italy
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27
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Perez TM, Glue P, Adhia DB, Navid MS, Zeng J, Dillingham P, Smith M, Niazi IK, Young CK, De Ridder D. Infraslow closed-loop brain training for anxiety and depression (ISAD): a protocol for a randomized, double-blind, sham-controlled pilot trial in adult females with internalizing disorders. Trials 2022; 23:949. [DOI: 10.1186/s13063-022-06863-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 10/22/2022] [Indexed: 11/18/2022] Open
Abstract
Abstract
Background
The core intrinsic connectivity networks (core-ICNs), encompassing the default-mode network (DMN), salience network (SN) and central executive network (CEN), have been shown to be dysfunctional in individuals with internalizing disorders (IDs, e.g. major depressive disorder, MDD; generalized anxiety disorder, GAD; social anxiety disorder, SOC). As such, source-localized, closed-loop brain training of electrophysiological signals, also known as standardized low-resolution electromagnetic tomography (sLORETA) neurofeedback (NFB), targeting key cortical nodes within these networks has the potential to reduce symptoms associated with IDs and restore normal core ICN function. We intend to conduct a randomized, double-blind (participant and assessor), sham-controlled, parallel-group (3-arm) trial of sLORETA infraslow (<0.1 Hz) fluctuation neurofeedback (sLORETA ISF-NFB) 3 times per week over 4 weeks in participants (n=60) with IDs. Our primary objectives will be to examine patient-reported outcomes (PROs) and neurophysiological measures to (1) compare the potential effects of sham ISF-NFB to either genuine 1-region ISF-NFB or genuine 2-region ISF-NFB, and (2) assess for potential associations between changes in PRO scores and modifications of electroencephalographic (EEG) activity/connectivity within/between the trained regions of interest (ROIs). As part of an exploratory analysis, we will investigate the effects of additional training sessions and the potential for the potentiation of the effects over time.
Methods
We will randomly assign participants who meet the criteria for MDD, GAD, and/or SOC per the MINI (Mini International Neuropsychiatric Interview for DSM-5) to one of three groups: (1) 12 sessions of posterior cingulate cortex (PCC) ISF-NFB up-training (n=15), (2) 12 sessions of concurrent PCC ISF up-training and dorsal anterior cingulate cortex (dACC) ISF-NFB down-training (n=15), or (3) 6 sessions of yoked-sham training followed by 6 sessions genuine ISF-NFB (n=30). Transdiagnostic PROs (Hospital Anxiety and Depression Scale, HADS; Inventory of Depression and Anxiety Symptoms – Second Version, IDAS-II; Multidimensional Emotional Disorder Inventory, MEDI; Intolerance of Uncertainty Scale – Short Form, IUS-12; Repetitive Thinking Questionnaire, RTQ-10) as well as resting-state neurophysiological measures (full-band EEG and ECG) will be collected from all subjects during two baseline sessions (approximately 1 week apart) then at post 6 sessions, post 12 sessions, and follow-up (1 month later). We will employ Bayesian methods in R and advanced source-localisation software (i.e. exact low-resolution brain electromagnetic tomography; eLORETA) in our analysis.
Discussion
This protocol will outline the rationale and research methodology for a clinical pilot trial of sLORETA ISF-NFB targeting key nodes within the core-ICNs in a female ID population with the primary aims being to assess its potential efficacy via transdiagnostic PROs and relevant neurophysiological measures.
Trial registration
Our study was prospectively registered with the Australia New Zealand Clinical Trials Registry (ANZCTR; Trial ID: ACTRN12619001428156). Registered on October 15, 2019.
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Woodward SH. Autonomic regulation during sleep in PTSD. Neurobiol Stress 2022; 21:100483. [DOI: 10.1016/j.ynstr.2022.100483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Revised: 08/01/2022] [Accepted: 08/25/2022] [Indexed: 10/31/2022] Open
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Fan J, Wang L, Yang X, Zhang X, Song Z, Wu S, Zou L, Li X, Zhao X, Li C, Pan Y, Tie Y, Wang Y, Luo Z, Sun X. Night shifts in interns: Effects of daytime napping on autonomic activity and cognitive function. Front Public Health 2022; 10:922716. [PMID: 36299766 PMCID: PMC9589154 DOI: 10.3389/fpubh.2022.922716] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Accepted: 08/29/2022] [Indexed: 01/22/2023] Open
Abstract
Objective Night shifts have adverse cognitive outcomes that might be attenuated by daytime napping. The neurovisceral integration model suggests that resting vagally mediated heart rate variability (vmHRV) is linked with cognitive function. This study investigated the relationship between resting vmHRV and cognitive function after different nap durations in interns after shift work. Methods A total of 105 interns were randomly allocated to one of three groups (non-nap, n = 35; 15-min nap, n = 35; 45-min nap, n = 35) to perform cognitive tests and resting vmHRV at 12:00, 15:00 and 18:00. Information processing (digit symbol substitution test; DSST), motor speed (finger tapping test; FTT), response selection (choice reaction time; CRT), and attention shifts (shifting attention test; SAT) were assessed. Resting vmHRV was assessed at baseline and during each cognitive task across groups. Results Compared with the non-nap control, the 15-min and 45-min naps improved all outcome measures (including subjective sleepiness and cognitive performance) at 15:00, with some benefits maintained at 18:00. The 15-min nap produced significantly greater benefits on the FTT at 15:00 after napping than did the 45-min nap. Resting vmHRV was significantly correlated with DSST and SAT performance. In addition, FTT performance was the only significant predictor of DSST performance across different nap durations. Conclusion Our results demonstrate links between daytime napping (in particular, a 15-min nap) and improved cognitive control in relation to autonomic activity after shift work in interns. These results indicated that autonomic activity when awake plays a crucial role in DSST and SAT performance and facilitated the understanding of differences in neurocognitive mechanisms underlying information processing after different nap durations.
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Affiliation(s)
- Jieyi Fan
- Department of Aerospace Medicine, Air Force Medical University, Xi'an, China
| | - Liang Wang
- Department of Medical Genetics and Developmental Biology, Air Force Medical University, Xi'an, China
| | - Xiaotian Yang
- Department of Medical Genetics and Developmental Biology, Air Force Medical University, Xi'an, China
| | - Xiangbo Zhang
- Department of Aerospace Medicine, Air Force Medical University, Xi'an, China
| | - Ziyao Song
- Department of Medical Genetics and Developmental Biology, Air Force Medical University, Xi'an, China
| | - Sifan Wu
- Department of Medical Genetics and Developmental Biology, Air Force Medical University, Xi'an, China
| | - Linru Zou
- Department of Medical Genetics and Developmental Biology, Air Force Medical University, Xi'an, China
| | - Xi Li
- Department of Aerospace Medicine, Air Force Medical University, Xi'an, China
| | - Xingcheng Zhao
- Department of Aerospace Medicine, Air Force Medical University, Xi'an, China
| | - Chenfei Li
- Department of Aerospace Medicine, Air Force Medical University, Xi'an, China
| | - Yikai Pan
- Department of Aerospace Medicine, Air Force Medical University, Xi'an, China
| | - Yateng Tie
- Department of Aerospace Medicine, Air Force Medical University, Xi'an, China
| | - Yongchun Wang
- Department of Aerospace Medicine, Air Force Medical University, Xi'an, China,Yongchun Wang
| | - Zhengxue Luo
- General Hospital of PLA Air Force, Beijing, China,Zhengxue Luo
| | - Xiqing Sun
- Department of Aerospace Medicine, Air Force Medical University, Xi'an, China,*Correspondence: Xiqing Sun
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Schumann A, Helbing N, Rieger K, Suttkus S, Bär KJ. Depressive rumination and heart rate variability: A pilot study on the effect of biofeedback on rumination and its physiological concomitants. Front Psychiatry 2022; 13:961294. [PMID: 36090366 PMCID: PMC9452722 DOI: 10.3389/fpsyt.2022.961294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Accepted: 07/22/2022] [Indexed: 11/13/2022] Open
Abstract
Objective Recent studies suggest that lower resting heart rate variability (HRV) is associated with elevated vulnerability to depressive rumination. In this study, we tested whether increases in HRV after HRV-biofeedback training are accompanied by reductions in rumination levels. Materials and methods Sixteen patients suffering from depression completed a 6-week HRV-biofeedback training and fourteen patients completed a control condition in which there was no intervention (waitlist). The training included five sessions per week at home using a smartphone application and an ECG belt. Depressive symptoms and autonomic function at rest and during induced rumination were assessed before and after each of the two conditions. We used a well-established rumination induction task to provoke a state of pervasive rumination while recording various physiological signals simultaneously. Changes in HRV, respiration rate, skin conductance, and pupil diameter were compared between conditions and time points. Results A significant correlation was found between resting HRV and rumination levels, both assessed at the first laboratory session (r = -0.43, p < 0.05). Induction of rumination led to an acceleration of heart rate and skin conductance increases. After biofeedback training, resting vagal HRV was increased (p < 0.01) and self-ratings of state anxiety (p < 0.05), rumination (p < 0.05), perceived stress (p < 0.05), and depressive symptoms (QIDS, BDI; both p < 0.05) were decreased. In the control condition, there were no changes in autonomic indices or depressive symptomatology. A significant interaction effect group x time on HRV was observed. Conclusion Our results indicate that a smartphone-based HRV-biofeedback intervention can be applied to improve cardiovagal function and to reduce depressive symptoms including self-rated rumination tendencies.
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Affiliation(s)
- Andy Schumann
- Lab for Autonomic Neuroscience, Imaging and Cognition (LANIC), Department of Psychosomatic Medicine and Psychotherapy, Jena University Hospital, Jena, Germany
- Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Nadin Helbing
- Lab for Autonomic Neuroscience, Imaging and Cognition (LANIC), Department of Psychosomatic Medicine and Psychotherapy, Jena University Hospital, Jena, Germany
| | - Katrin Rieger
- Lab for Autonomic Neuroscience, Imaging and Cognition (LANIC), Department of Psychosomatic Medicine and Psychotherapy, Jena University Hospital, Jena, Germany
| | - Stefanie Suttkus
- Lab for Autonomic Neuroscience, Imaging and Cognition (LANIC), Department of Psychosomatic Medicine and Psychotherapy, Jena University Hospital, Jena, Germany
| | - Karl-Jürgen Bär
- Lab for Autonomic Neuroscience, Imaging and Cognition (LANIC), Department of Psychosomatic Medicine and Psychotherapy, Jena University Hospital, Jena, Germany
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Williamson S, Daniel-Watanabe L, Finnemann J, Powell C, Teed A, Allen M, Paulus M, Khalsa SS, Fletcher PC. The Hybrid Excess and Decay (HED) model: an automated approach to characterising changes in the photoplethysmography pulse waveform. Wellcome Open Res 2022. [DOI: 10.12688/wellcomeopenres.17855.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Photoplethysmography offers a widely used, convenient and non-invasive approach to monitoring basic indices of cardiovascular function, such as heart rate and blood oxygenation. Systematic analysis of the shape of the waveform generated by photoplethysmography might be useful to extract estimates of several physiological and psychological factors influencing the waveform. Here, we developed a robust and automated method for such a systematic analysis across individuals and across different physiological and psychological contexts. We describe a psychophysiologically-relevant model, the Hybrid Excess and Decay (HED) model, which characterises pulse wave morphology in terms of three underlying pressure waves and a decay function. We present the theoretical and practical basis for the model and demonstrate its performance when applied to a pharmacological dataset of 105 participants receiving intravenous administrations of the sympathomimetic drug isoproterenol (isoprenaline). We show that these parameters capture photoplethysmography data with a high degree of precision and, moreover, are sensitive to experimentally-induced changes in interoceptive arousal within individuals. We conclude by discussing the possible value in using the HED model as a complement to standard measures of photoplethysmography signals.
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Effect of a 16-Session Qigong Program in Non-Hodgkin Lymphoma Survivors: A Randomized Clinical Trial. J Clin Med 2022; 11:jcm11123421. [PMID: 35743490 PMCID: PMC9225257 DOI: 10.3390/jcm11123421] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 05/30/2022] [Accepted: 06/10/2022] [Indexed: 12/04/2022] Open
Abstract
Background: The treatment associated with non-Hodgkin lymphoma patients may cause adverse effects on their physical and psychological condition. The aim of this study is to detect the response to an eight-week, 16-session, 60-min presential Qigong program in anxiety, depression and vagal nerve activity alongside a control group. Methods: A randomized controlled clinical trial was managed. Randomization was carried out by generating a numerical sequence of three cycles through the software EPIDAT 4.1. Numbers were placed in sealed opaque envelopes for assignment to the different groups. Results: Anxiety levels were substantially decreased in the experimental group, with a large effect size (F = 30.38, p < 0.00). Depression levels had an improvement in the experimental group in contrast to the control group, reaching statistical significance (F = 19.19, p < 0.00). Heart Rate Variability unveiled significant results in terms of between-group differences, with a large effect size in the HRV Index (F = 15.80, p < 0.00), SDNN (F = 8.82, p < 0.00), and RMSSD (F = 6.72, p < 0.01) in the time domain, and a medium effect size in the HF (F = 9.78, p < 0.003), LF (F = 9.78, p < 0.00), and LF/HF Ratio (F = 18.44, p < 0.00) in the frequency domain, which were all bettered in the experimental group, after the Qigong program. Conclusions: Qigong therapy can be an effective therapeutic activity in consonance with traditional medicine to improve psychological health and autonomic nervous system balance in non-Hodgkin lymphoma survivors.
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Asbrand J, Vögele C, Heinrichs N, Nitschke K, Tuschen-Caffier B. Autonomic Dysregulation in Child Social Anxiety Disorder: An Experimental Design Using CBT Treatment. Appl Psychophysiol Biofeedback 2022; 47:199-212. [PMID: 35641719 PMCID: PMC9296402 DOI: 10.1007/s10484-022-09548-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/04/2022] [Indexed: 11/26/2022]
Abstract
Models of social anxiety disorder (SAD) stress the relevance of physiological arousal. So far, limited research has been conducted in children with SAD in experimental stress designs. Thus, examining autonomic arousal, children with and without SAD completed a standardized social stressor (Trier Social Stress Test for Children-C; TSST-C). Pre-existing differences to healthy controls (HC) were expected to decrease after receiving cognitive behavior therapy (CBT). Children with SAD (n = 64) and HC children (n = 55) completed a TSST-C. Children with SAD participated in a second TSST-C after either cognitive-behavioral treatment or a waitlist-control period (WLC). As expected, children with SAD showed blunted heart rate reactivity compared to HC children. Further, children with SAD had elevated levels of tonic sympathetic arousal as indexed by skin conductance level compared to HC. Children with SAD showed lower parasympathetic arousal during the baseline compared to HC. Children receiving treatment did not differ from children in the WLC condition in a repeated social stress test. Psychophysiological differences between children with SAD and HC children could be confirmed as indicated by previous research. The lack of physiological effects of the intervention as an experimental manipulation might be related to slower changes in physiology compared to e.g. cognition.
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Affiliation(s)
- Julia Asbrand
- Department of Psychology, Albert-Ludwigs-University of Freiburg, Freiburg im Breisgau, Germany.
- Department of Psychology, Humboldt-Universität Zu Berlin, Berlin, Germany.
| | - Claus Vögele
- Clinical Psychophysiology Laboratory (CLIPSLAB), Institute for Health and Behaviour, University of Luxembourg, Esch-sur-Alzette, Luxembourg
| | - Nina Heinrichs
- Department of Psychology, University of Bremen, Bremen, Germany
| | - Kai Nitschke
- Department of Psychology, Albert-Ludwigs-University of Freiburg, Freiburg im Breisgau, Germany
| | - Brunna Tuschen-Caffier
- Department of Psychology, Albert-Ludwigs-University of Freiburg, Freiburg im Breisgau, Germany
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Faust O, Hong W, Loh HW, Xu S, Tan RS, Chakraborty S, Barua PD, Molinari F, Acharya UR. Heart rate variability for medical decision support systems: A review. Comput Biol Med 2022; 145:105407. [DOI: 10.1016/j.compbiomed.2022.105407] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 03/09/2022] [Accepted: 03/12/2022] [Indexed: 12/22/2022]
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Schmaußer M, Hoffmann S, Raab M, Laborde S. The effects of noninvasive brain stimulation on heart rate and heart rate variability: A systematic review and meta-analysis. J Neurosci Res 2022; 100:1664-1694. [PMID: 35582757 DOI: 10.1002/jnr.25062] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 04/25/2022] [Accepted: 04/30/2022] [Indexed: 12/30/2022]
Abstract
Noninvasive brain stimulation (NIBS) techniques such as transcranial magnetic stimulation and transcranial direct current stimulation are widely used to test the involvement of specific cortical regions in various domains such as cognition and emotion. Despite the capability of stimulation techniques to test causal directions, this approach has been only sparsely used to examine the cortical regulation of autonomic nervous system (ANS) functions such as heart rate (HR) and heart rate variability (HRV) and to test current models in this regard. In this preregistered (PROSPERO) systematic review and meta-analysis, we aimed to investigate, based on meta-regression, whether NIBS represents an effective method for modulating HR and HRV measures, and to evaluate whether the ANS is modulated by cortical mechanisms affected by NIBS. Here we have adhered to the PRISMA guidelines. In a series of four meta-analyses, a total of 131 effect sizes from 35 sham-controlled trials were analyzed using robust variance estimation random-effects meta-regression technique. NIBS was found to effectively modulate HR and HRV with small to medium effect sizes. Moderator analyses yielded significant differences in effects between stimulation of distinct cortical areas. Our results show that NIBS is a promising tool to investigate the cortical regulation of ANS, which may add to the existing brain imaging and animal study literature. Future research is needed to identify further factors modulating the size of effects. As many of the studies reviewed were found to be at high risk of bias, we recommend that methods to reduce potential risk of bias be used in the design and conduct of future studies.
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Affiliation(s)
| | - Sven Hoffmann
- Institute of Psychology, University of Hagen, Hagen, Germany
| | - Markus Raab
- Institute of Psychology, German Sport University, Cologne, Germany.,School of Applied Sciences, London South Bank University, London, UK
| | - Sylvain Laborde
- Institute of Psychology, German Sport University, Cologne, Germany.,UFR STAPS, EA 4260, Université de Caen Normandie, Caen, France
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The role of the autonomic nervous system in cerebral blood flow regulation in dementia: A review. Auton Neurosci 2022; 240:102985. [DOI: 10.1016/j.autneu.2022.102985] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 02/28/2022] [Accepted: 04/28/2022] [Indexed: 11/19/2022]
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Kirk PA, Davidson Bryan A, Garfinkel SN, Robinson OJ. RapidHRV: an open-source toolbox for extracting heart rate and heart rate variability. PeerJ 2022; 10:e13147. [PMID: 35345583 PMCID: PMC8957280 DOI: 10.7717/peerj.13147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 03/01/2022] [Indexed: 01/12/2023] Open
Abstract
Heart rate and heart rate variability have enabled insight into a myriad of psychophysiological phenomena. There is now an influx of research attempting using these metrics within both laboratory settings (typically derived through electrocardiography or pulse oximetry) and ecologically-rich contexts (via wearable photoplethysmography, i.e., smartwatches). However, these signals can be prone to artifacts and a low signal to noise ratio, which traditionally are detected and removed through visual inspection. Here, we developed an open-source Python package, RapidHRV, dedicated to the preprocessing, analysis, and visualization of heart rate and heart rate variability. Each of these modules can be executed with one line of code and includes automated cleaning. In simulated data, RapidHRV demonstrated excellent recovery of heart rate across most levels of noise (>=10 dB) and moderate-to-excellent recovery of heart rate variability even at relatively low signal to noise ratios (>=20 dB) and sampling rates (>=20 Hz). Validation in real datasets shows good-to-excellent recovery of heart rate and heart rate variability in electrocardiography and finger photoplethysmography recordings. Validation in wrist photoplethysmography demonstrated RapidHRV estimations were sensitive to heart rate and its variability under low motion conditions, but estimates were less stable under higher movement settings.
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Affiliation(s)
- Peter A. Kirk
- Institute of Cognitive Neuroscience, University College London, University of London, London, United Kingdom,Experimental Psychology, University College London, University of London, London, United Kingdom
| | | | - Sarah N. Garfinkel
- Institute of Cognitive Neuroscience, University College London, University of London, London, United Kingdom
| | - Oliver J. Robinson
- Institute of Cognitive Neuroscience, University College London, University of London, London, United Kingdom,Clinical, Educational and Health Psychology, University College London, University of London, London, United Kingdom
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Quadt L, Critchley H, Nagai Y. Cognition, emotion, and the central autonomic network. Auton Neurosci 2022; 238:102948. [PMID: 35149372 DOI: 10.1016/j.autneu.2022.102948] [Citation(s) in RCA: 34] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 12/05/2021] [Accepted: 01/16/2022] [Indexed: 10/19/2022]
Abstract
The demands of both mental and physical activity are integrated with the dynamic control of internal bodily states. The set of neural interactions that supports autonomic regulation extends beyond afferent-efferent homeostatic reflexes (interoceptive feedback, autonomic action) to encompass allostatic policies reflecting more abstract and predictive mental representations, often accessed as conscious thoughts and feelings. Historically and heuristically, reason is contrasted with passion, cognition with emotion, and 'cold' with 'hot' cognition. These categories are themselves arbitrary and blurred. Investigations of psychological processes have been generally pursued during states of musculoskeletal quiescence and are thus relatively insensitive to autonomic interaction with attentional, perceptual, mnemonic and decision-making processes. Autonomic psychophysiology has nevertheless highlighted the bidirectional coupling of distinct cognitive domains to the internal states of bodily arousal. More powerfully perhaps, in the context of emotion, autonomically mediated changes in inner bodily physiological states are viewed as intrinsic constituents of the expression of emotions, while their feedback representation is proposed to underpin emotional and motivational feelings. Here, we review the brain systems, encapsulated by the notion of central autonomic network, that provide the interface between cognitive, emotional and autonomic state. These systems span the neuraxis, overlap with the more general governance of behaviour, and represent district levels of proximity to survival-related imperatives. We touch upon the conceptual relevance of prediction and surprise to understanding the integration of cognition and emotion with autonomic control.
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Affiliation(s)
- Lisa Quadt
- BSMS Department of Neuroscience, University of Brighton and University of Sussex, UK; Sussex Neuroscience, University of Sussex, UK
| | - Hugo Critchley
- BSMS Department of Neuroscience, University of Brighton and University of Sussex, UK; Sussex Neuroscience, University of Sussex, UK; Sackler Centre for Consciousness Science, University of Sussex, UK; Sussex Partnership NHS Foundation Trust, UK.
| | - Yoko Nagai
- BSMS Department of Neuroscience, University of Brighton and University of Sussex, UK; Sussex Neuroscience, University of Sussex, UK
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Whitehurst LN, Subramoniam A, Krystal A, Prather AA. Links between the brain and body during sleep: implications for memory processing. Trends Neurosci 2022; 45:212-223. [PMID: 35074220 DOI: 10.1016/j.tins.2021.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 11/30/2021] [Accepted: 12/21/2021] [Indexed: 10/19/2022]
Abstract
Sleep is intimately related to memory processes. The established view is that the transformation of experiences into long-term memories is linked to sleep-related CNS function. However, there is increasing evidence that the autonomic nervous system (ANS), long recognized to modulate cognition during waking, can impact memory processing during sleep. Here, we review human research that examines the role of autonomic activity and sleep in memory formation. We argue that autonomic activity during sleep may set the stage for the CNS dynamics associated with sleep and memory stability and integration. Further, we consider how the link between ANS activity and polysomnographic markers of sleep may help elucidate both healthy and pathological cognitive aging in humans.
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Affiliation(s)
| | | | - Andrew Krystal
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, USA
| | - Aric A Prather
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, USA
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Trull TJ, Hepp J, Wycoff AM, Vebares TJ, Fleming MN, Hua JPY, Yeung EW, Kerns JG. Relations between lab indices of emotion dysregulation and negative affect reactivity in daily life in two independent studies. J Affect Disord 2022; 297:217-224. [PMID: 34695499 PMCID: PMC8629845 DOI: 10.1016/j.jad.2021.10.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 09/22/2021] [Accepted: 10/20/2021] [Indexed: 01/17/2023]
Abstract
BACKGROUND We investigated the extent to which physiological/biological measures of emotion dysregulation collected in the lab, resting respiratory sinus arrhythmia (RSA) in Study 1 and amygdala activation in response to negative stimuli in Study 2, combined with daily measures of interpersonal stressors predicted negative emotional states in outpatients better than the stressors alone. METHODS Participants were adult outpatients with emotional distress disorders (N=30 individuals in Study 1, and N=26 women in Study 2). After completing a laboratory session that collected physiological/biological measures of emotion dysregulation, participants then completed 1-3 weeks of ambulatory assessment during which they reported on interpersonal stressors and negative affective states several times per day. RESULTS Laboratory measures of emotion dysregulation were largely unrelated to either momentary or mean levels of daily-life hostility, sadness, and fear in both studies. However, resting RSA significantly moderated the association between day-level interpersonal stressors and momentary fear such that low resting RSA strengthened this association. Similarly, amygdala activation tended to moderate this relationship in the predicted direction. LIMITATIONS Both samples were relatively small and focused on only a limited set of diagnoses associated with emotion dysregulation. Only two possible physiological/biological markers of emotion dysregulation were examined. CONCLUSIONS The current studies support the collection of physiological/biological data on emotion dysregulation when indexing daily-life emotion dysregulation as the degree of emotional reactivity to stressors in daily life among outpatients with emotional distress disorders.
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Affiliation(s)
| | - Johanna Hepp
- Department of Psychosomatic Medicine, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
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Liu KY, Elliott T, Knowles M, Howard R. Heart rate variability in relation to cognition and behavior in neurodegenerative diseases: A systematic review and meta-analysis. Ageing Res Rev 2022; 73:101539. [PMID: 34883203 PMCID: PMC8783051 DOI: 10.1016/j.arr.2021.101539] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 11/05/2021] [Accepted: 12/03/2021] [Indexed: 12/24/2022]
Abstract
Neurodegenerative diseases, which frequently present with neuropsychiatric symptoms related to prefrontal cortical dysfunction, can alter the integrity of the neural networks involved in central autonomic nervous system regulation, which is proposed to be indexed by heart rate variability (HRV). We systematically reviewed the characteristics, methodology and outcomes of 27 studies of HRV in relation to measures of cognition and behavior in neurodegenerative conditions, and assessed the strength of this relationship, cross-sectionally, across 18 studies. A significant, moderate effect was observed (r = 0.25), such that higher HRV was related to better cognitive and behavioral scores, which was not influenced by mean age or cognitive status. There was no evidence of small-study effects but we could not rule out publication bias, and other factors may have contributed to heterogeneity between studies. Our findings support the proposal that HRV may be a marker of self-regulatory processes in neurodegenerative conditions, and further research on this association is needed in relation to neuropsychiatric symptoms and alongside neuroimaging methods. Heart rate variability is proposed to be influenced by a neural network involved in autonomic regulation. Neurodegenerative processes alter the integrity of the central autonomic network. We reviewed studies of HRV and cognition/behavior in neurodegenerative diseases. We found a moderate correlation between HRV and measures of cognition/behavior.
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Estimating Resting HRV during fMRI: A Comparison between Laboratory and Scanner Environment. SENSORS 2021; 21:s21227663. [PMID: 34833744 PMCID: PMC8619981 DOI: 10.3390/s21227663] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 11/02/2021] [Accepted: 11/15/2021] [Indexed: 12/31/2022]
Abstract
Heart rate variability (HRV) is regularly assessed in neuroimaging studies as an indicator of autonomic, emotional or cognitive processes. In this study, we investigated the influence of a loud and cramped environment during magnetic resonance imaging (MRI) on resting HRV measures. We compared recordings during functional MRI sessions with recordings in our autonomic laboratory (LAB) in 101 healthy subjects. In the LAB, we recorded an electrocardiogram (ECG) and a photoplethysmogram (PPG) over 15 min. During resting state functional MRI, we acquired a PPG for 15 min. We assessed anxiety levels before the scanning in each subject. In 27 participants, we performed follow-up sessions to investigate a possible effect of habituation. We found a high intra-class correlation ranging between 0.775 and 0.996, indicating high consistency across conditions. We observed no systematic influence of the MRI environment on any HRV index when PPG signals were analyzed. However, SDNN and RMSSD were significantly higher when extracted from the PPG compared to the ECG. Although we found a significant correlation of anxiety and the decrease in HRV from LAB to MRI, a familiarization session did not change the HRV outcome. Our results suggest that psychological factors are less influential on the HRV outcome during MRI than the methodological choice of the cardiac signal to analyze.
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Kassinopoulos M, Mitsis GD. A multi-measure approach for assessing the performance of fMRI preprocessing strategies in resting-state functional connectivity. Magn Reson Imaging 2021; 85:228-250. [PMID: 34715292 DOI: 10.1016/j.mri.2021.10.028] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 09/17/2021] [Accepted: 10/17/2021] [Indexed: 12/17/2022]
Abstract
It is well established that head motion and physiological processes (e.g. cardiac and breathing activity) should be taken into consideration when analyzing and interpreting results in fMRI studies. However, even though recent studies aimed to evaluate the performance of different preprocessing pipelines there is still no consensus on the optimal strategy. This is partly due to the fact that the quality control (QC) metrics used to evaluate differences in performance across pipelines have often yielded contradictory results. Furthermore, preprocessing techniques based on physiological recordings or data decomposition techniques (e.g. aCompCor) have not been comprehensively examined. Here, to address the aforementioned issues, we propose a framework that summarizes the scores from eight previously proposed and novel QC metrics to a reduced set of two QC metrics that reflect the signal-to-noise ratio and the reduction in motion artifacts and biases in the preprocessed fMRI data. Using this framework, we evaluate the performance of three commonly used practices on the quality of data: 1) Removal of nuisance regressors from fMRI data, 2) discarding motion-contaminated volumes (i.e., scrubbing) before regression, and 3) low-pass filtering the data and the nuisance regressors before their removal. Using resting-state fMRI data from the Human Connectome Project, we show that the scores of the examined QC metrics improve the most when the global signal (GS) and about 17% of principal components from white matter (WM) are removed from the data. Finally, we observe a small further improvement with low-pass filtering at 0.20 Hz and milder variants of WM denoising, but not with scrubbing.
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Affiliation(s)
- Michalis Kassinopoulos
- Graduate Program in Biological and Biomedical Engineering, McGill University, Montreal, QC, Canada.
| | - Georgios D Mitsis
- Department of Bioengineering, McGill University, Montreal, QC, Canada
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Online Left-Hemispheric In-Phase Frontoparietal Theta tACS for the Treatment of Negative Symptoms of Schizophrenia. J Pers Med 2021; 11:jpm11111114. [PMID: 34834466 PMCID: PMC8625275 DOI: 10.3390/jpm11111114] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Revised: 10/24/2021] [Accepted: 10/28/2021] [Indexed: 11/17/2022] Open
Abstract
Negative symptoms represent an unmet need for schizophrenia treatment. The effect of theta frequency transcranial alternating current stimulation (theta-tACS) applied during working memory (WM) tasks on negative symptoms has not been demonstrated as of yet. We conducted a randomized, double-blind, sham-controlled trial of 36 stabilized schizophrenia patients, randomized to receive either twice daily, 6 Hz 2 mA, 20 min sessions of in-phase frontoparietal tACS or sham for five consecutive weekdays. Participants were concurrently engaged in WM tasks during stimulation. The primary outcome measure was the change over time in the Positive and Negative Syndrome Scale (PANSS) negative subscale score measured from baseline through to the 1-month follow-up. Secondary outcome measures were other symptom clusters, neurocognitive performance, and relevant outcomes. The intention-to-treat analysis demonstrated greater reductions in PANSS negative subscale scores at the end of stimulation in the active (−13.84%) than the sham (−3.78%) condition, with a large effect size (Cohen’s d = 0.96, p = 0.006). The positive effect endured for at least one month. Theta-tACS also showed efficacies for cognitive symptoms, WM capacity, and psychosocial functions. Online theta-tACS offers a novel approach to modulate frontoparietal networks to treat negative symptoms of schizophrenia. The promising results require large-scale replication studies in patients with predominantly negative symptoms.
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Rosati A, Belcari I, Santarcangelo EL, Sebastiani L. Interoceptive Accuracy as a Function of Hypnotizability. Int J Clin Exp Hypn 2021; 69:441-452. [PMID: 34313546 DOI: 10.1080/00207144.2021.1954859] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
This study aimed to measure the interoceptive accuracy (IA) of individuals with high (highs), medium (mediums), and low hypnotizability (lows) through the heartbeat-counting task during 3 relaxation trials. Participants completed the Multidimensional Assessment of Interoceptive Awareness (MAIA), ECG and skin conductance (SC) were monitored, and the experienced difficulty in counting was reported. Results showed similar counting difficulty and number of actual heartbeats in highs, mediums, and lows. SC decreased in highs during all trials, in mediums and lows only in the third trial. IA measured as [1 - (ǀrecorded heartbeats-counted heartbeatsǀ)/recorded heartbeats] was negatively correlated with hypnotizability and not correlated with interoceptive sensitivity (IS) measured by MAIA scales. Among mediums, IA was higher in males than in females.
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Affiliation(s)
- Anna Rosati
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Italy
| | - Iacopo Belcari
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Italy
| | - Enrica L Santarcangelo
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Italy
| | - Laura Sebastiani
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Italy
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Vargas-Román K, Cortés-Martín J, Sánchez-García JC, Rodríguez-Blanque R, De La Fuente-Solana EI, Díaz-Rodríguez L. Autonomic Imbalance in Lymphoma Survivors. J Clin Med 2021; 10:jcm10194391. [PMID: 34640409 PMCID: PMC8509196 DOI: 10.3390/jcm10194391] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Revised: 08/18/2021] [Accepted: 09/22/2021] [Indexed: 12/16/2022] Open
Abstract
Among the types of blood cancers, non-Hodgkin lymphoma is the most common. The usual treatments for this type of cancer can cause heart failure. A descriptive observational study was conducted that included 16 non-Hodgkin lymphoma survivors and 16 healthy controls matched by age and sex. Vagal tone was evaluated in the short term with a three-channel Holter device, and the time and frequency domains were analyzed following a previously accepted methodology to evaluate cardiac autonomic balance. The results of the analysis revealed that the standard deviation of the NN interval (F = 6.25, p = 0.021) and the square root of the mean of the sum of the differences between NN intervals (F = 9.74, p = 0.004) were significantly higher in healthy subjects than in lymphoma survivors. In the heart rate variability (HRV) index, there were no significant differences between the groups (F = 0.03, p = 0.85), nor in the parameters of the frequency domains LF (F = 1.94, p = 0.17), HF (F = 0.35, p = 0.55), and the ratio LF/HF (F = 3.07, p = 0.09). HRV values were lower in non-Hodgkin lymphoma survivors in the first year after treatment, resulting in autonomic imbalance compared to healthy paired subjects.
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Affiliation(s)
- Keyla Vargas-Román
- Research Group CTS1068, Andalusia Research Plan, Junta de Andalucía, 18014 Granada, Spain; (J.C.-M.); (J.C.S.-G.); (R.R.-B.); (L.D.-R.)
- Spanish Education Ministry Program FPU16/01437, Methodology of Behavioral Sciences Department, Faculty of Psychology, University of Granada, 18071 Granada, Spain
- Correspondence:
| | - Jonathan Cortés-Martín
- Research Group CTS1068, Andalusia Research Plan, Junta de Andalucía, 18014 Granada, Spain; (J.C.-M.); (J.C.S.-G.); (R.R.-B.); (L.D.-R.)
| | - Juan Carlos Sánchez-García
- Research Group CTS1068, Andalusia Research Plan, Junta de Andalucía, 18014 Granada, Spain; (J.C.-M.); (J.C.S.-G.); (R.R.-B.); (L.D.-R.)
- Department of Nursing, School of Health Sciences, University of Granada, 18016 Granada, Spain
| | - Raquel Rodríguez-Blanque
- Research Group CTS1068, Andalusia Research Plan, Junta de Andalucía, 18014 Granada, Spain; (J.C.-M.); (J.C.S.-G.); (R.R.-B.); (L.D.-R.)
- Health Technology Park, San Cecilio University Hospital, 18016 Granada, Spain
| | | | - Lourdes Díaz-Rodríguez
- Research Group CTS1068, Andalusia Research Plan, Junta de Andalucía, 18014 Granada, Spain; (J.C.-M.); (J.C.S.-G.); (R.R.-B.); (L.D.-R.)
- Department of Nursing, School of Health Sciences, University of Granada, 18016 Granada, Spain
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Lugao RDS, Barbosa RRB, Coelho PDF, Liberato FMG, Vidal PR, Carvalho RBCOD, Melotti RDCNC, Donadio MVF. Association of sleep disorders with heart rate variability in children and adolescents with cystic fibrosis. ACTA ACUST UNITED AC 2021; 40:e2020295. [PMID: 34495277 PMCID: PMC8432146 DOI: 10.1590/1984-0462/2022/40/2020295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 01/17/2021] [Indexed: 11/25/2022]
Abstract
Objective: To assess the association of sleep disorders with the findings of heart rate variability (HRV) in children and adolescents with cystic fibrosis (CF). Methods: Cross-sectional study including children and adolescents aged six to 18 years with a clinical diagnosis of CF. Sociodemographic and clinical data were collected. Sleep disorders were evaluated using baseline nocturnal polysomnography. The autonomic nervous system (ANS) was evaluated through resting HRV. Results: A total of 30 individuals (11.2 years) with a mean forced expiratory volume in the first second (FEV1) of 62.7% were included. The respiratory disturbance index presented a median of 2.6 and obstructive sleep apnea syndrome (OSAS) was identified in 30%. In the HRV analysis, a mean standard deviation of all inter-beat (RR) intervals (SDNN) of 60.8±45.9ms was found. There was a significant correlation between the HRV low-frequency/high-frequency (LF/HF) global modulation index and the minimum SpO2 during sleep in patients with FEV1<60% (r=0.71; p=0.02). The prevalence of sleep disorders and HRV abnormalities was higher in individuals with lesser pulmonary function (FEV1<60%). Conclusions: The results indicate a weak correlation of sleep disorders (minimum SpO2) with HRV parameters (LH/HF) in children and adolescents with CF. When pulmonary function was reduced, a stronger correlation was found, highlighting the influence of disease severity. A high prevalence of ANS disorders, nocturnal hypoxemia, and presence of OSAS was also found.
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Affiliation(s)
| | | | | | | | - Pâmela Reis Vidal
- School of Sciences, Santa Casa de Misericórdia de Vitória, Vitória, ES, Brazil
| | | | | | - Márcio Vinícius Fagundes Donadio
- Laboratory of Pediatric Physical Activity, Centro Infant, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil
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Yousef Yengej DN, Ferando I, Kechechyan G, Nwaobi SE, Raman S, Charles A, Faas GC. Continuous long-term recording and triggering of brain neurovascular activity and behaviour in freely moving rodents. J Physiol 2021; 599:4545-4559. [PMID: 34438476 DOI: 10.1113/jp281514] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Accepted: 08/23/2021] [Indexed: 11/08/2022] Open
Abstract
A minimally invasive, microchip-based approach enables continuous long-term recording of brain neurovascular activity, heart rate, and head movement in freely behaving rodents. This approach can also be used for transcranial optical triggering of cortical activity in mice expressing channelrhodopsin. The system uses optical intrinsic signal recording to measure cerebral blood volume, which under baseline conditions is correlated with spontaneous neuronal activity. The arterial pulse and breathing can be quantified as a component of the optical intrinsic signal. Multi-directional head movement is measured simultaneously with a movement sensor. A separate movement tracking element through a camera enables precise mapping of overall movement within an enclosure. Data is processed by a dedicated single board computer, and streamed from multiple enclosures to a central server, enabling simultaneous remote monitoring and triggering in many subjects. One application of this system described here is the characterization of changes in of cerebral blood volume, heart rate and behaviour that occur with the sleep-wake cycle over weeks. Another application is optical triggering and recording of cortical spreading depression (CSD), the slowly propagated wave of neurovascular activity that occurs in the setting of brain injury and migraine aura. The neurovascular features of CSD are remarkably different in the awake vs. anaesthetized state in the same mouse. With its capacity to continuously and synchronously record multiple types of physiological and behavioural data over extended time periods in combination with intermittent triggering of brain activity, this inexpensive method has the potential for widespread practical application in rodent research. KEY POINTS: Recording and triggering of brain activity in mice and rats has typically required breaching the skull, and experiments are often performed under anaesthesia A minimally invasive microchip system enables continuous recording and triggering of neurovascular activity, and analysis of heart rate and behaviour in freely behaving rodents over weeks This system can be used to characterize physiological and behavioural changes associated with the sleep-wake cycle over extended time periods This approach can also be used with mice expressing channelrhodopsin to trigger and record cortical spreading depression (CSD) in freely behaving subjects. The neurovascular responses to CSD are remarkably different under anaesthesia compared with the awake state. The method is inexpensive and straightforward to employ at a relatively large scale. It enables translational investigation of a wide range of physiological and pathological conditions in rodent models of neurological and systemic diseases.
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Affiliation(s)
- Dmitri N Yousef Yengej
- Department of Neurology, The David Geffen School of Medicine at UCLA, 635 Charles Young Drive South, Los Angeles, CA, 90095-733522, USA
| | - Isabella Ferando
- Department of Neurology, The David Geffen School of Medicine at UCLA, 635 Charles Young Drive South, Los Angeles, CA, 90095-733522, USA.,Department of Neurology, Miller School of Medicine at the University of Miami, 1150 NW 14th street, Miami, FL, 33136, USA
| | - Gayane Kechechyan
- Department of Neurology, The David Geffen School of Medicine at UCLA, 635 Charles Young Drive South, Los Angeles, CA, 90095-733522, USA.,University of California, San Diego, Skaggs School of Pharmacy and Pharmaceutical Sciences, 9500 Gilman Drive, MC 0657, La Jolla, CA, 92093-0657, USA
| | - Sinifunanya E Nwaobi
- Department of Neurology, The David Geffen School of Medicine at UCLA, 635 Charles Young Drive South, Los Angeles, CA, 90095-733522, USA
| | - Shrayes Raman
- School of Letters and Sciences, UCLA, 1309 Murphy Hall Box 951413, Los Angeles, CA, 90095-1413, USA
| | - Andrew Charles
- Department of Neurology, The David Geffen School of Medicine at UCLA, 635 Charles Young Drive South, Los Angeles, CA, 90095-733522, USA
| | - Guido C Faas
- Department of Neurology, The David Geffen School of Medicine at UCLA, 635 Charles Young Drive South, Los Angeles, CA, 90095-733522, USA
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Abstract
Emotions can be defined as states elicited by rewards or punishments, and indeed the neurology of emotional disorders can be understood in terms of this foundation. The orbitofrontal cortex in humans and other primates is a critical area in emotion processing, determining the value of stimuli and whether they are rewarding or nonrewarding. The cortical processing that occurs before the orbitofrontal cortex primarily involves defining the identity of stimuli, i.e., "what" is present and not reward value. There is evidence that this holds true for taste, visual, somatosensory, and olfactory stimuli. The human medial orbitofrontal cortex is important in processing many different types of reward, and the lateral orbitofrontal cortex in processing nonreward and punishment. Humans with damage to the orbitofrontal cortex have an impaired ability to identify facial and voice expressions of emotions, and impaired subjective experience of emotion. They can have an altered personality and be impulsive because they are impaired at processing failures to receive expected rewards and at processing punishments. In humans, the role of the amygdala in the processing of emotions is reduced because of the great evolutionary development of the orbitofrontal cortex: amygdala damage has much less effect on emotion than does orbitofrontal cortex damage. The orbitofrontal cortex projects reward value information to the anterior cingulate cortex, which is involved in learning those actions required to obtain rewards and avoid punishments. The cingulate cortex thus provides an output route for emotional behavior. In depression, the medial orbitofrontal cortex has decreased connectivity and sensitivity to reward, and the lateral orbitofrontal cortex has increased connectivity and sensitivity to nonreward. The orbitofrontal cortex has major projections to the anterior cingulate cortex, including its subcommissural region, and the anterior cingulate cortex is also implicated in depression.
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Affiliation(s)
- Edmund T Rolls
- Oxford Centre for Computational Neuroscience, Oxford, United Kingdom; Department of Computer Science, University of Warwick, Coventry, United Kingdom.
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Kassinopoulos M, Mitsis GD. Physiological noise modeling in fMRI based on the pulsatile component of photoplethysmograph. Neuroimage 2021; 242:118467. [PMID: 34390877 DOI: 10.1016/j.neuroimage.2021.118467] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 07/21/2021] [Accepted: 08/10/2021] [Indexed: 02/06/2023] Open
Abstract
The blood oxygenation level-dependent (BOLD) contrast mechanism allows the noninvasive monitoring of changes in deoxyhemoglobin content. As such, it is commonly used in functional magnetic resonance imaging (fMRI) to study brain activity since levels of deoxyhemoglobin are indirectly related to local neuronal activity through neurovascular coupling mechanisms. However, the BOLD signal is severely affected by physiological processes as well as motion. Due to this, several noise correction techniques have been developed to correct for the associated confounds. The present study focuses on cardiac pulsatility fMRI confounds, aiming to refine model-based techniques that utilize the photoplethysmograph (PPG) signal. Specifically, we propose a new technique based on convolution filtering, termed cardiac pulsatility model (CPM) and compare its performance with the cardiac-related RETROICOR (Card-RETROICOR), which is a technique commonly used to model fMRI fluctuations due to cardiac pulsatility. Further, we investigate whether variations in the amplitude of the PPG pulses (PPG-Amp) covary with variations in amplitude of pulse-related fMRI fluctuations, as well as with the systemic low frequency oscillations (SLFOs) component of the fMRI global signal (GS - defined as the mean signal across all gray matter voxels). Capitalizing on 3T fMRI data from the Human Connectome Project, CPM was found to explain a significantly larger fraction of the fMRI signal variance compared to Card-RETROICOR, particularly for subjects with larger heart rate variability during the scan. The amplitude of the fMRI pulse-related fluctuations did not covary with PPG-Amp; however, PPG-Amp explained significant variance in the GS that was not attributed to variations in heart rate or breathing patterns. Our results suggest that the proposed approach can model high-frequency fluctuations due to pulsation as well as low-frequency physiological fluctuations more accurately compared to model-based techniques commonly employed in fMRI studies.
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Affiliation(s)
- Michalis Kassinopoulos
- Graduate Program in Biological and Biomedical Engineering, McGill University, Montreal, QC, Canada.
| | - Georgios D Mitsis
- Department of Bioengineering, McGill University, Montreal, QC, Canada
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