An evaluation of the ensemble averaged impedance cardiogram

Planning, conducting, and analyzing a psychophysiological experiment on challenge and threat: A comprehensive tutorial

The biopsychosocial model of challenge and threat (BPS-CT) is a powerful framework linking psychological processes to reliable patterns of cardiovascular responses during motivated performance situations. Specifically, the BPS-CT poses challenge and threat as two motivational states that can emerge in response to a demanding, self-relevant task, where greater challenge arises when perceived resources are higher than demands, and greater threat arises when perceived resources are lower than demands. By identifying unique patterns of physiological responses associated with challenge and threat, respectively, the BPS-CT affords insight into subjective appraisals of resources and demands, and their determinants, during motivated performance situations. Despite its broad utility, lack of familiarity with physiological concepts and difficulty with identifying clear guidelines in the literature are barriers to wider uptake of this approach by behavioral researchers. Our goal is to remove these barriers by providing a comprehensive, step-by-step tutorial on conducting an experiment using the challenge and threat model, offering concrete recommendations for those who are new to the method, and serving as a centralized collection of resources for those looking to deepen their understanding. The tutorial spans five parts, covering theoretical introduction, lab setup, data collection, data analysis, and appendices offering additional details about data analysis and equipment. With this, we aim to make challenge and threat research, and the insights it offers, more accessible to researchers throughout the behavioral sciences.

Effortful listening: Sympathetic activity varies as a function of listening demand but parasympathetic activity does not

Research on listening effort has used various physiological measures to examine the biological correlates of listening effort but a systematic examination of the impact of listening demand on cardiac autonomic nervous system activity is still lacking. The presented study aimed to close this gap by assessing cardiac sympathetic and parasympathetic responses to variations in listening demand. For this purpose, 45 participants performed four speech-in-noise tasks differing in listening demand-manipulated as signal-to-noise ratio varying between +23 dB and -16 dB-while their pre-ejection period and respiratory sinus arrythmia responses were assessed. Cardiac responses showed the expected effect of listening demand on sympathetic activity, but failed to provide evidence for the expected listening demand impact on parasympathetic activity: Pre-ejection period reactivity increased with increasing listening demand across the three possible listening conditions and was low in the very high (impossible) demand condition, whereas respiratory sinus arrythmia did not show this pattern. These findings have two main implications. First, cardiac sympathetic responses seem to be the more sensitive correlate of the impact of task demand on listening effort compared to cardiac parasympathetic responses. Second, very high listening demand may lead to disengagement and correspondingly low effort and reduced cardiac sympathetic response.

Explicit achievement motive strength determines effort-related myocardial beta-adrenergic activity if task difficulty is unclear but not if task difficulty is clear

Work on physiological and other behavioral correlates of motives often assumes that motives exert a direct effect on behavior once activated. Motivational intensity theory, however, suggests that this does not always apply. In the context of task engagement, motive strength should exert a direct effect on myocardial beta-adrenergic activity if task difficulty is unclear, but not if task difficulty is known. The presented study tested this prediction for the impact of the explicit achievement motive on myocardial beta-adrenergic activity-assessed as pre-ejection period (PEP) reactivity during task performance. Seventy-eight participants performed one of two versions of a mental arithmetic task. After having completed the achievement motive scale of the Personality Research Form, participants were either informed about the difficulty of the task or not before working on it. Participants' PEP reactivity during task performance provided evidence for the predicted moderating impact of clarity of task difficulty: PEP reactivity increased with increasing achievement motive strength if task difficulty was unclear, but not if it was clear. These findings demonstrate that the explicit achievement motive impact on myocardial beta-adrenergic activity is moderated by clarity of task difficulty and suggest that motive strength does not always translate into direct effects on physiology and behavior.

Impact of pain on mental effort assessed as cardiovascular reactivity

Introduction

Pain typically impairs task performance, increases fatigue, and is associated with behavioral disengagement. Together, this suggests that pain impacts effort, defined as the mobilization of resources to carry out behavior. However, empirical evidence on this issue is lacking.

Objectives

Drawing on motivational intensity theory, this study investigated the impact of pain on effort mobilization during cognitive task performance.

Methods

We administered individually adjusted painful thermal stimulations during an easy memory task during which we measured effort as cardiovascular reactivity-a valid and objective measure. Control conditions included painful stimulations alone, the memory task alone, and the memory task with nonpainful heat stimulations. We expected pain to increase subjective difficulty due to additional demand on cognitive functioning, and in turn effort according to motivational intensity theory. Effort-related cardiovascular reactivity was predicted to increase along these conditions: pain-alone, task-alone, task with nonpainful stimulations, and the strongest effort when painful stimulations were administered during the task.

Results

Overall, the findings offered support to our hypotheses. As predicted, results showed that pain increased subjective task difficulty (P = 0.020). Moreover, most of the effort-related cardiovascular measures showed the expected pattern with the strongest reactivity when painful stimulations were administered during the task compared with the other conditions (p < 0.02).

Conclusion

These results are first evidence that pain impacts mental effort assessed as cardiovascular reactivity. We discuss how such extra effort might be related to the persistent feeling of fatigue and behavioral disengagement frequently observed in patients with chronic pain.

RZ Interval as an Impedance Cardiography Indicator of Effort-Related Cardiac Sympathetic Activity

Research on effort and motivation commonly assesses how the sympathetic branch of the autonomic nervous system affects the cardiovascular system. The cardiac pre-ejection period (PEP), assessed via impedance cardiography, is a common outcome, but assessing PEP requires identifying subtle points on cardiac waveforms. The present research examined the psychometric value of the RZ interval (RZ), which has recently been proposed as an indicator of sympathetic activity, for effort research. Also known as the initial systolic time interval (ISTI), RZ is the time (in ms) between the ECG R peak and the dZ/dt Z peak. Unlike PEP, RZ involves salient waveform points that are easily and reliably identified. Data from two experiments evaluated the suitability of RZ for effort paradigms and compared it to a popular automated PEP method. In Studies 1 (n = 89) and 2 (n = 71), participants completed a standard appetitive task in which each correct response earned a small amount of cash. As expected, incentives significantly affected PEP and RZ in both experiments. PEP and RZ were highly correlated (all rs ≥ 0.89), and RZ consistently yielded a larger effect size than PEP. In Study 3, a quantitative synthesis of the experiments indicated that the effect size of RZ's response to incentives (Hedges's g = 0.432 [0.310, 0.554]) was roughly 15% larger than PEP's effect size (g = 0.376 [0.256, 0.496]). RZ thus appears promising for future research on sympathetic aspects of effort-related cardiac activity.

Biological sensitivity to context: A test of the hypothesized U-shaped relation between early adversity and stress responsivity

We conducted signal detection analyses to test for curvilinear, U-shaped relations between early experiences of adversity and heightened physiological responses to challenge, as proposed by biological sensitivity to context theory. Based on analysis of an ethnically diverse sample of 338 kindergarten children (4-6 years old) and their families, we identified levels and types of adversity that, singly and interactively, predicted high (top 25%) and low (bottom 25%) rates of stress reactivity. The results offered support for the hypothesized U-shaped curve and conceptually replicated and extended the work of Ellis, Essex, and Boyce (2005). Across both sympathetic and adrenocortical systems, a disproportionate number of children growing up under conditions characterized by either low or high adversity (as indexed by restrictive parenting, family stress, and family economic condition) displayed heightened stress reactivity, compared with peers growing up under conditions of moderate adversity. Finally, as hypothesized by the adaptive calibration model, a disproportionate number of children who experienced exceptionally stressful family conditions displayed blunted cortisol reactivity to stress.

Cardiac sympathetic activity during recovery as an indicator of sympathetic activity during task performance

The goals of this research were to analyze cardiac sympathetic recovery patterns and evaluate whether sympathetic cardiac responses to a task challenge can be predicted using residual cardiac activity measured directly after the task (that is, during the recovery period). In two studies (total N = 181), we measured cardiac sympathetic activity, quantified as pre-ejection period and RB interval, during both task performance and the 2-min recovery period following the task. Additional analyses examined effects on the RZ interval. We found that sympathetic recovery from a task was rather quick: Cardiovascular recovery occurred within the first 30 s of the recovery period. Nevertheless, residual cardiac activity during the recovery period had predictive power for task-related cardiac activity. This suggests that sympathetic cardiac activity during recovery may serve as a useful indicator of task-related cardiac sympathetic activity. We discuss the implications of these findings for practical applications and the design of future studies.

Is satisficing really satisfying? Satisficers exhibit greater threat than maximizers during choice overload

When selecting from too many options (i.e., choice overload), maximizers (people who search exhaustively to make decisions that are optimal) report more negative post-decisional evaluations of their choices than do satisficers (people who search minimally to make decisions that are sufficient). Although ample evidence exists for differences in responses after-the-fact, little is known about possible divergences in maximizers' and satisficers' experiences during choice overload. Thus, using the biopsychosocial model of challenge/threat, we examined 128 participants' cardiovascular responses as they actively made a selection from many options. Specifically, we focused on cardiovascular responses assessing the degree to which individuals (a) viewed their decisions as valuable/important and (b) viewed themselves as capable (vs. incapable) of making a good choice. Although we found no differences in terms of the value individuals placed on their decisions (i.e., cardiovascular responses of task engagement), satisficers-compared to maximizers-exhibited cardiovascular responses consistent with feeling less capable of making their choice (i.e., greater relative threat). The current work provides a novel investigation of the nature of differences in maximizers'/satisficers' momentary choice overload experiences, suggesting insight into why they engage in such distinct search behaviors.

An open-source automated algorithm for removal of noisy beats for accurate impedance cardiogram analysis

OBJECTIVE

The impedance cardiogram (ICG) is a non-invasive sensing modality for assessing the mechanical aspects of cardiac function, but is sensitive to artifacts from respiration, speaking, motion, and electrode displacement. Electrocardiogram (ECG)-synchronized ensemble averaging of ICG (conventional ensemble averaging method) partially mitigates these disturbances, as artifacts from intra-subject variability (ISVar) of ICG morphology and event latency remain. This paper describes an automated algorithm for removing noisy beats for improved artifact suppression in ensemble-averaged (EA) ICG beats.

APPROACH

Synchronized ECG and ICG signals from 144 male subjects at rest in different psychological conditions were recorded. A 'three-stage EA ICG beat' was formed by passing 60-seconds non-overlapping ECG-synchronized ICG signals through three filtering stages. The amplitude filtering stage removed spikes/noisy beats with amplitudes outside of normal physiological ranges. Cross-correlation was applied to remove noisy beats in coarse and fine filtering stages. The accuracy of the algorithm-detected artifacts was measured with expert-identified artifacts. Agreement between the expert and the algorithm was assessed using intraclass correlation coefficients (ICC) and Bland-Altman plots. The ISVar of the cardiac parameters was evaluated to quantify improvement in these estimates provided by the proposed method.

MAIN RESULTS

The proposed algorithm yielded an accuracy of 96.3% and high inter-rater reliability (ICC > 0.997). Bland-Altman plots showed consistently accurate results across values. The ISVar of the cardiac parameters derived using the proposed method was significantly lower than those derived via conventional ensemble averaging method (p < 0.0001). Enhancement in resolution of fiducial points and smoothing of higher-order time derivatives of the EA ICG beats were observed.

SIGNIFICANCE

The proposed algorithm provides a robust framework for removal of noisy beats and accurate estimation of ICG-based parameters. Importantly, the methodology reduced the ISVar of cardiac parameters. An open-source toolbox has been provided to enable other researchers to readily reproduce and improve upon this work.

The effect of increased parasympathetic activity on perceived duration

Theories of human temporal perception suggest that changes in physiological arousal distort the perceived duration of events. Behavioural manipulations of sympathetic nervous system (SNS) activity support this suggestion, however the effects of behavioural manipulations of parasympathetic (PSNS) activity on time perception are unclear. The current study examined the effect of a paced respiration exercise known to increase PSNS activity on sub-second duration estimates. Participants estimated the duration of negatively and neutrally valenced images following a period of normal and paced breathing. PSNS and SNS activity were indexed by high-frequency heart-rate variability and pre-ejection period respectively. Paced breathing increased PSNS activity and reduced the perceived duration of the negative and neutrally valenced stimuli relative to normal breathing. The results show that manipulations of PSNS activity can distort time in the absence of a change in SNS activity. They also suggest that activities which increase PSNS activity may be effective in reducing the perceived duration of short events.

Multiple Ion Transition Summation of Isotopologues for Improved Mass Spectrometric Detection of N-Acetyl-S-(1,2-dichlorovinyl)-L-cysteine

Multiple ion transition summation of isotopologues (MITSI) is an adaptable and easy-to-implement methodology for improving analytical sensitivity, especially for halogenated compounds and otherwise abundant isotopologues. This novel application of signal summing was applied to measure and quantitate the two most abundant ion transitions of two isotopologues of N-acetyl-S-(1,2-dichlorovinyl)-L-cysteine (1DCV), a urinary metabolite of trichloroethylene (TCE). Because 1DCV is dichlorinated, only approximately half of the total potential signal is quantifiable when the monoisotopic ion transition (i.e., m/z 256 → 127 for ³⁵Cl₂) is monitored. By summing the intensity of a separate and high-abundance 1DCV isotopologue ion transition (i.e., m/z 258 → 129 to include ³⁵Cl and ³⁷Cl), overall signal intensity increased by over 70%. This summation technique improved the analytical sensitivity and limit of detection (LOD) by factors of 2.3 and 2.9, respectively, compared to monitoring the two transitions separately, without summation. Separation and detection were performed using liquid chromatography-tandem mass spectrometry (LC-MS/MS) in negative-ion mode with scheduled selected reaction monitoring. This approach was verified for accuracy and precision using two quality control materials. In addition, we derived a modified signal summation equation to calculate predicted signal enhancements specific to the MITSI approach. Graphical Abstract .

Automatic analysis of pre-ejection period during sleep using impedance cardiogram

The pre-ejection period (PEP) is a valid index of myocardial contractility and beta-adrenergic sympathetic control of the heart defined as the time between electrical systole (ECG Q wave) to the initial opening of the aortic valve, estimated as the B point on the impedance cardiogram (ICG). B-point detection accuracy can be severely impacted if ICG cardiac cycles corrupted by motion artifact, noise, or electrode displacement are included in the analyses. Here, we developed new algorithms to detect and exclude corrupted ICG cycles by analyzing their level of activity. PEP was then estimated and analyzed on ensemble-averaged clean ICG cycles using an automatic algorithm previously developed by the authors for the detection of B point in awake individuals. We investigated the algorithms' performance relative to expert visual scoring on long-duration data collected from 20 participants during overnight recordings, where the quality of ICG could be highly affected by movement artifacts and electrode displacements and the signal could also vary according to sleep stage and time of night. The artifact rejection algorithm achieved a high accuracy of 87% in detection of expert-identified corrupted ICG cycles, including those with normal amplitude as well as out-of-range values, and was robust to different types and levels of artifact. Intraclass correlations for concurrent validity of the B-point detection algorithm in different sleep stages and in-bed wakefulness exceeded 0.98, indicating excellent agreement with the expert. The algorithms show promise toward sleep applications requiring accurate and reliable automatic measurement of cardiac hemodynamic parameters.

Time distortion under threat: Sympathetic arousal predicts time distortion only in the context of negative, highly arousing stimuli

Theoretical models of time perception suggest a simple bottom-up relationship between physiological arousal and perceived duration. Increases in physiological arousal lengthen the perceived duration of events whereas decreases in physiological arousal reduce them. Whilst this relationship has been demonstrated for highly arousing negatively valenced stimuli, it has not been demonstrated for other classes of distorting stimuli (e.g. positively valenced or low arousal stimuli). The current study tested the effect of valence (positive and negative) and arousal level (high and low) on the relationship between physiological arousal and perceived duration. Sympathetic nervous system (SNS) and parasympathetic nervous system (PSNS) activity was measured during a verbal estimation task in which participants judged the duration of high and low arousal, positive, negative and neutrally valenced IAPS images. SNS and PSNS activity were indexed by measuring Pre-Ejection Period (PEP) and High Frequency Heart-rate Variability (HF-HRV) respectively. SNS reactivity was predicative of perceived duration, but only for high arousal negatively valenced stimuli, with decreases in PEP being associated with longer duration estimates. SNS and PSNS activity was not predictive of perceived duration for the low arousal negative stimuli or the low and high arousal positive stimuli. We therefore propose a new model suggesting that emotional distortions to time result from a combination of bottom-up (physiological arousal) and top-down (threat detection) factors.

Simultaneous Recording of ICG and ECG Using Z-RPI Device with Minimum Number of Electrodes

Impedance cardiography (ICG) is a noninvasive method for monitoring mechanical function of the heart with the use of electrical bioimpedance measurements. This paper presents the feasibility of recording an ICG signal simultaneously with electrocardiogram signal (ECG) using the same electrodes for both measurements, for a total of five electrodes rather than eight electrodes. The device used is the Z-RPI. The results present good performance and show waveforms presenting high similarity with the different signals reported using different electrodes for acquisition; the heart rate values were calculated and they present accurate evaluation between the ECG and ICG heart rates. The hemodynamics and cardiac parameter results present similitude with the physiological parameters for healthy people reported in the literature. The possibility of reducing number of electrodes used for ICG measurement is an encouraging step to enabling wearable and personal health monitoring solutions.

An Open-Source Feature Extraction Tool for the Analysis of Peripheral Physiological Data

Electrocardiogram, electrodermal activity, electromyogram, continuous blood pressure, and impedance cardiography are among the most commonly used peripheral physiological signals (biosignals) in psychological studies and healthcare applications, including health tracking, sleep quality assessment, disease early-detection/diagnosis, and understanding human emotional and affective phenomena. This paper presents the development of a biosignal-specific processing toolbox (Bio-SP tool) for preprocessing and feature extraction of these physiological signals according to the state-of-the-art studies reported in the scientific literature and feedback received from the field experts. Our open-source Bio-SP tool is intended to assist researchers in affective computing, digital and mobile health, and telemedicine to extract relevant physiological patterns (i.e., features) from these biosignals semi-automatically and reliably. In this paper, we describe the successful algorithms used for signal-specific quality checking, artifact/noise filtering, and segmentation along with introducing features shown to be highly relevant to category discrimination in several healthcare applications (e.g., discriminating patterns associated with disease versus non-disease). Further, the Bio-SP tool is a publicly-available software written in MATLAB with a user-friendly graphical user interface (GUI), enabling future crowd-sourced modification to these tools. The GUI is compatible with MathWorks Classification Learner app for inference model development, such as model training, cross-validation scheme farming, and classification result computation.

Nontraditional Electrocardiogram and Algorithms for Inconspicuous In-Home Monitoring: Comparative Study

BACKGROUND

Wearable and connected in-home medical devices are typically utilized in uncontrolled environments and often measure physiologic signals at suboptimal locations. Motion artifacts and reduced signal-to-noise ratio, compared with clinical grade equipment, results in a highly variable signal quality that can change significantly from moment to moment. The use of signal quality classification algorithms and robust feature delineation algorithms designed to achieve high accuracy on poor quality physiologic signals can prove beneficial in addressing concerns associated with measurement accuracy, confidence, and clinical validity.

OBJECTIVE

The objective of this study was to demonstrate the successful extraction of clinical grade measures using a custom signal quality classification algorithm for the rejection of poor-quality regions and a robust QRS delineation algorithm from a nonstandard electrocardiogram (ECG) integrated into a toilet seat; a device plagued by many of the same challenges as wearable technologies and other Internet of Things-based medical devices.

METHODS

The present algorithms were validated using a study of 25 normative subjects and 29 heart failure (HF) subjects. Measurements captured from a toilet seat-based buttocks electrocardiogram were compared with a simultaneously captured 12-lead clinical grade ECG. The ECG lead with the highest morphological correlation to buttocks electrocardiogram was used to determine the accuracy of the heart rate (HR), heart rate variability (HRV), which used the standard deviation of the normal-to-normal (SDNN) intervals between sinus beats, QRS duration, and the corrected QT interval (QT_c). These algorithms were benchmarked using the MIT-BIH Arrhythmia Database (MITDB) and European ST-T Database (EDB), which are standardized databases commonly used to test QRS detection algorithms.

RESULTS

Clinical grade accuracy was achieved for all buttocks electrocardiogram measures compared with standard Lead II. For the normative cohort, the mean was -0.0 (SD 0.3) bpm (N=141 recordings) for HR accuracy and -1.0 (SD 3.4) ms for HRV (N=135). The QRS duration and the QT_c interval had an accuracy of -0.5 (SD 6.6) ms (N=85) and 14.5 (SD 11.1) ms (N=85), respectively. In the HF cohort, the accuracy for HR, HRV, QRS duration, and QT_c interval was 0.0 (SD 0.3) bpm (N=109), -6.6 (SD 13.2) ms (N=99), 2.9 (SD 11.5) ms (N=59), and 11.2 (SD 19.1) ms (N=58), respectively. When tested on MITDB and EDB, the algorithms presented herein had an overall sensitivity and positive predictive value of over 99.82% (N=900,059 total beats), which is comparable to best in-class algorithms tuned specifically for use with these databases.

CONCLUSIONS

The present algorithmic approach to data analysis of noisy physiologic data was successfully demonstrated using a toilet seat-based ECG remote monitoring system. This approach to the analysis of physiologic data captured from wearable and connected devices has future potential to enable new types of monitoring devices, providing new insights through daily, inconspicuous in-home monitoring.

Toward a better noninvasive assessment of preejection period: A novel automatic algorithm for B-point detection and correction on thoracic impedance cardiogram

Impedance cardiography is the most common clinically validated, noninvasive method for determining the timing of the opening of the aortic valve, an important event used for measuring preejection period, which reflects sympathetic beta-adrenergic influences on the heart. Automatic detection of the exact time of the opening of the aortic valve (B point on the impedance cardiogram) has proven to be challenging as its appearance varies between and within individuals and may manifest as a reversal, inflection, or rapid slope change of the thoracic impedance derivative's (dZ/dt) rapid rise. Here, a novel automatic algorithm is proposed for the detection of the B point by finding the main rapid rise of the dZ/dt signal, which is due to blood ejection. Several conditions based on zero crossings, minima, and maxima of the dZ/dt signal and its derivatives are considered to reject any unwanted noise and artifacts and select the true B-point location. The detected B-point locations are then corrected by modeling the B-point time data using forward and reverse autoregressive models. The proposed algorithm is validated against expert-detected B points and is compared with different conventional methods; it significantly outperforms them by at least 54% in mean error, 30% in mean absolute error, and 27% in standard deviation of error. This algorithm can be adopted in ambulatory studies requiring beat-to-beat evaluation of cardiac hemodynamic parameters over extended time periods where expert scoring is not feasible.

Quantifying rapid changes in cardiovascular state with a moving ensemble average

MEAP, the moving ensemble analysis pipeline, is a new open-source tool designed to perform multisubject preprocessing and analysis of cardiovascular data, including electrocardiogram (ECG), impedance cardiogram (ICG), and continuous blood pressure (BP). In addition to traditional ensemble averaging, MEAP implements a moving ensemble averaging method that allows for the continuous estimation of indices related to cardiovascular state, including cardiac output, preejection period, heart rate variability, and total peripheral resistance, among others. Here, we define the moving ensemble technique mathematically, highlighting its differences from fixed-window ensemble averaging. We describe MEAP's interface and features for signal processing, artifact correction, and cardiovascular-based fMRI analysis. We demonstrate the accuracy of MEAP's novel B point detection algorithm on a large collection of hand-labeled ICG waveforms. As a proof of concept, two subjects completed a series of four physical and cognitive tasks (cold pressor, Valsalva maneuver, video game, random dot kinetogram) on 3 separate days while ECG, ICG, and BP were recorded. Critically, the moving ensemble method reliably captures the rapid cyclical cardiovascular changes related to the baroreflex during the Valsalva maneuver and the classic cold pressor response. Cardiovascular measures were seen to vary considerably within repetitions of the same cognitive task for each individual, suggesting that a carefully designed paradigm could be used to capture fast-acting event-related changes in cardiovascular state.

Impedance cardiography in healthy children and children with congenital heart disease: Improving stroke volume assessment

INTRODUCTION

Stroke volume (SV) and cardiac output are important measures in the clinical evaluation of cardiac patients and are also frequently used in research applications. This study was aimed to improve SV scoring derived from spot-electrode based impedance cardiography (ICG) in a pediatric population of healthy volunteers and patients with a corrected congenital heart defect.

METHODS

128 healthy volunteers and 66 patients participated. First, scoring methods for ambiguous ICG signals were optimized to improve agreement of B- and X-points with aortic valve opening/closure in simultaneously recorded transthoracic echocardiography (TTE). Building on the improved scoring of B- and X-points, the Kubicek equation for SV estimation was optimized by testing the agreement with the simultaneously recorded SV by TTE. Both steps were initially done in a subset of the sample of healthy children and then validated in the remaining subset of healthy children and in a sample of patients.

RESULTS

SV assessment by ICG in healthy children strongly improved (intra class correlation increased from 0.26 to 0.72) after replacing baseline thorax impedance (Z₀) in the Kubicek equation by an equation (7.337-6.208∗dZ/dt_max), where dZ/dt_max is the amplitude of the ICG signal at the C-point. Reliable SV assessment remained more difficult in patients compared to healthy controls.

CONCLUSIONS

After proper adjustment of the Kubicek equation, SV assessed by the use of spot-electrode based ICG is comparable to that obtained from TTE. This approach is highly feasible in a pediatric population and can be used in an ambulatory setting.

Children's Autonomic Nervous System Reactivity Moderates the Relations between Family Adversity and Sleep Problems in Latino 5-Year Olds in the CHAMACOS Study

Sleep problems are common for young children especially if they live in adverse home environments. Some studies investigate if young children may also be at a higher risk of sleep problems if they have a specific biological sensitivity to adversity. This paper addresses the research question, does the relations between children’s exposure to family adversities and their sleep problems differ depending on their autonomic nervous system’s sensitivity to challenges? As part of a larger cohort study of Latino, low-income families, we assessed the cross-sectional relations among family demographics (education, marital status), adversities [routines, major life events (MLE)], and biological sensitivity as measured by autonomic nervous system (ANS) reactivity associated with parent-rated sleep problems when the children were 5 years old. Mothers were interviewed in English or Spanish and completed demographic, family, and child measures. The children completed a 15-min standardized protocol while continuous cardiac measures of the ANS [respiratory sinus arrhythmia (RSA), preejection period (PEP)] were collected during resting and four challenge conditions. Reactivity was defined as the mean of the responses to the four challenge conditions minus the first resting condition. Four ANS profiles, co-activation, co-inhibition, reciprocal low RSA and PEP reactivity, and reciprocal high RSA and PEP reactivity, were created by dichotomizing the reactivity scores as high or low reactivity. Logistic regression models showed there were significant main effects for children living in families with fewer daily routines having more sleep problems than for children living in families with daily routines. There were significant interactions for children with low PEP reactivity and for children with the reciprocal, low reactivity profiles who experienced major family life events in predicting children’s sleep problems. Children who had a reciprocal, low reactivity ANS profile had more sleep problems if they also experienced MLE than children who experienced fewer MLE. These findings suggest that children who experience family adversities have different risks for developing sleep problems depending on their biological sensitivity. Interventions are needed for young Latino children that support family routines and reduce the impact of family adversities to help them develop healthy sleep practices.

Implicit activation of the aging stereotype influences effort-related cardiovascular response: The role of incentive

Based on previous research on implicit effects on effort-related cardiovascular response and evidence that aging is associated with cognitive difficulties, we tested whether the mere activation of the aging stereotype can systematically influence young individuals' effort-mobilization during cognitive performance. Young participants performed an objectively difficult short-term memory task during which they processed elderly vs. youth primes and expected low vs. high incentive for success. When participants processed elderly primes during the task, we expected cardiovascular response to be weak in the low-incentive condition and strong in the high-incentive condition. Unaffected by incentive, effort in the youth-prime condition should fall in between the two elderly-prime cells. Effects on cardiac pre-ejection period (PEP) and heart rate (HR) largely supported these predictions. The present findings show for the first time that the mere activation of the aging stereotype can systematically influence effort mobilization during cognitive performance-even in young adults.

Mathematical detection of aortic valve opening (B point) in impedance cardiography: A comparison of three popular algorithms

The preejection period (PEP) is an index of left ventricle contractility widely used in psychophysiological research. Its computation requires detecting the moment when the aortic valve opens, which coincides with the B point in the first derivative of impedance cardiogram (ICG). Although this operation has been traditionally made via visual inspection, several algorithms based on derivative calculations have been developed to enable an automatic performance of the task. However, despite their popularity, data about their empirical validation are not always available. The present study analyzes the performance in the estimation of the aortic valve opening of three popular algorithms, by comparing their performance with the visual detection of the B point made by two independent scorers. Algorithm 1 is based on the first derivative of the ICG, Algorithm 2 on the second derivative, and Algorithm 3 on the third derivative. Algorithm 3 showed the highest accuracy rate (78.77%), followed by Algorithm 1 (24.57%) and Algorithm 2 (13.82%). In the automatic computation of PEP, Algorithm 2 resulted in significantly more missed cycles (48.57%) than Algorithm 1 (6.3%) and Algorithm 3 (3.5%). Algorithm 2 also estimated a significantly lower average PEP (70 ms), compared with the values obtained by Algorithm 1 (119 ms) and Algorithm 3 (113 ms). Our findings indicate that the algorithm based on the third derivative of the ICG performs significantly better. Nevertheless, a visual inspection of the signal proves indispensable, and this article provides a novel visual guide to facilitate the manual detection of the B point.

Cardiorespiratory Indices of Mental Workload during Simulated Air Traffic Control

27 university student participants (16 female) were trained on the TRACON video game and then practiced for 20 hrs. After practice, participants performed 3 mental workload conditions in a single session. Low, medium, and high mental workload scenarios were created by varying air traffic density: participants were required to handle 5, 10, or 15 aircraft within a scenario while cardiorespiratory, performance, and subjective mental workload data were collected. Heart rate change from baseline was faster during the high than during the low scenario. Pre-ejection period and high frequency heart rate variability indicated that the autonomic modes of control differed across scenarios: high and medium workload elicited significant reciprocally-coupled sympathetic activation and parasympathetic withdrawal, whereas low workload did not elicit significant change from baseline. Respiration rate change from baseline was faster during the high and medium scenarios than during the low scenario. Performance was significantly lower for the high than the low scenario. However, subjective workload increased significantly from the low to the medium to the high scenario.

The Nonconscious Influence of Religious Symbols in Motivated Performance Situations

Anthropological, sociological, and psychological theories suggest that religious symbols should influence motivational processes during performance of goal-relevant tasks. In two experiments, positive and negative religious (Christian) symbols were presented outside of participants’ conscious awareness. These symbols influenced cardiovascular responses consistent with challenge and threat states during a subsequent speech task, particularly when the speech topic concerned participants’ mortality, and only for Christian participants; similar images lacking Christian meaning were not influential. Results suggested that these effects were due to the learned meaning of the symbols and point to the importance of religion as a coping resource.

Preejection period can be calculated using R peak instead of Q

Preejection period (PEP) is a common measure of sympathetic nervous system activation in psychophysiological research, which makes it important to measure reliably for as many participants as possible. PEP is typically calculated as the interval between the onset or peak of the electrocardiogram Q wave and the impedance cardiography B point, but the Q wave can lack clear definition and even its peak is not visible for all participants. We thus investigated the feasibility of using the electrocardiogram R wave peak (Rpeak ) instead of Q because it can be consistently identified with ease and precision. Across four samples (total N = 408), young adult participants completed a variety of minimally metabolically demanding laboratory tasks after a resting baseline. Results consistently supported a close relationship between absolute levels of the Rpeak -B interval and PEP (accounting for approximately 90% of the variance at baseline and 89% during task performance, on average), but for reactivity values, Rpeak -B was practically indistinguishable from PEP (accounting for over 98% of the variance, on average). Given that using Rpeak rather than the onset or peak of Q saves time, eliminates potential subjectivity, and can be applied to more participants (i.e., those without a visible Q wave), findings suggest that Rpeak -B likely provides an adequate estimate of PEP when absolute levels are of interest and clearly does so for within-person changes.

Task difficulty moderates implicit fear and anger effects on effort-related cardiac response

Based on the implicit-affect-primes-effort (IAPE) model (Gendolla, 2012, 2015), the present experiment tested whether objective task difficulty moderates the previously found impact of fear and anger primes on effort-related cardiac response during an arithmetic task. We expected that fear primes would lead to stronger cardiac pre-ejection period (PEP) reactivity than anger primes in an easy task, but that anger primes would lead to a stronger PEP response than fear primes in a difficult task. Results corroborated these predictions. Moreover, there was no evidence that the affect primes induced conscious feelings that could explain the observed cardiac reactivity, suggesting that the primes had the intended implicit effect on effort mobilization. The findings contribute to the accumulating evidence in support of the IAPE model, showing that objective task difficulty is a moderator of implicit affect's influence on effort-related cardiac response.

Children with Autism Show Altered Autonomic Adaptation to Novel and Familiar Social Partners

Social deficits are fundamental to autism spectrum disorder (ASD), and a growing body of research implicates altered functioning of the autonomic nervous system (ANS), including both sympathetic and parasympathetic branches. However, few studies have explored both branches concurrently in ASD, particularly within the context of social interaction. The current study investigates patterns of change in indices of sympathetic (pre-ejection period; PEP) and parasympathetic (respiratory sinus arrhythmia; RSA) cardiac influence as boys (ages 8-11 years) with (N = 18) and without (N = 18) ASD engage in dyadic social interaction with novel and familiar social partners. Groups showed similar patterns of autonomic change during interaction with the novel partner, but differed in heart rate, PEP, and RSA reactivity while interacting with a familiar partner. Boys without ASD evinced decreasing sympathetic and increasing parasympathetic influence, whereas boys with ASD increased in sympathetic influence. Boys without ASD also demonstrated more consistent ANS responses across partners than those with ASD, with parasympathetic responding differentiating familiar and novel interaction partners. Finally, PEP slopes with a familiar partner correlated with boys' social skills. Implications include the importance of considering autonomic state during clinical assessment and treatment, and the potential value of regulation strategies as a complement to intervention programs aiming to support social cognition and behavior. Autism Res 2016, 9: 579-591. © 2015 International Society for Autism Research, Wiley Periodicals, Inc.

Simultaneous acquisition of functional magnetic resonance images and impedance cardiography

While simultaneous acquisition of electrocardiography (ECG) data during MRI is a widely used clinical technique, the effects of the MRI environment on impedance cardiography (ICG) data have not been characterized. We collected echo planar MRI scans while simultaneously recording ECG and thoracic impedance using carbon fiber electrodes and customized amplifiers. Here, we show that the key changes in impedance (dZ/dt) and features of the ECG waveforms are not obstructed during MRI. We present a method for ensemble averaging ICG/ECG signals collected during MRI and show that it performs comparably with signals collected outside the MRI environment. These results indicate that ICG can be used during MRI to measure stroke volume, cardiac output, preejection period, and left ventricular ejection time.

Ambulatory measurement of the ECG T-wave amplitude

Ambulatory recording of the preejection period (PEP) can be used to measure changes in cardiac sympathetic nervous system (SNS) activity under naturalistic conditions. Here, we test the ECG T-wave amplitude (TWA) as an alternative measure, using 24-h ambulatory monitoring of PEP and TWA in a sample of 564 healthy adults. The TWA showed a decrease in response to mental stress and a monotonic decrease from nighttime sleep to daytime sitting and more physically active behaviors. Within-participant changes in TWA were correlated with changes in the PEP across the standardized stressors (r = .42) and the unstandardized naturalistic conditions (mean r = .35). Partialling out changes in heart rate and vagal effects attenuated these correlations, but they remained significant. Ambulatory TWA cannot replace PEP, but simultaneous recording of TWA and PEP provides a more comprehensive picture of changes in cardiac SNS activity in real-life settings.

Mood impact on effort-related cardiovascular reactivity depends on task context: evidence from a task with an unfixed performance standard

Gendolla and colleagues have consistently found that negative mood leads to higher effort-related cardiovascular reactivity than positive mood if performers can choose their own performance standard (Gendolla et al., 2001; Gendolla and Krüsken, 2001a, 2002a,b). However, an integration of motivational intensity theory with the mood literature suggests that the impact of mood on cardiovascular activity should vary with task context. In a 2 (task context: demand vs. reward)×2 (mood valence: negative vs. positive) between-persons design, participants performed a memory task without a fixed performance standard. The results showed the expected interaction. Positive mood led to higher effort mobilization-reflected by increased pre-ejection period and heart rate reactivity-than negative mood if participants had answered questions about task reward before performing the task. If participants had responded to questions about task demand, the pattern was reversed. These results extend and add to preceding research that has demonstrated that mood impact on effort-related cardiovascular activity is not stable but depends on task context.

Sympathetic- and parasympathetic-linked cardiac function and prediction of externalizing behavior, emotion regulation, and prosocial behavior among preschoolers treated for ADHD

OBJECTIVE

To evaluate measures of cardiac activity and reactivity as prospective biomarkers of treatment response to an empirically supported behavioral intervention for attention-deficit/hyperactivity disorder (ADHD).

METHOD

Cardiac preejection period (PEP), an index of sympathetic-linked cardiac activity, and respiratory sinus arrhythmia (RSA), an index of parasympathetic-linked cardiac activity, were assessed among 99 preschool children (ages 4-6 years) with ADHD both at rest and in response to behavioral challenge, before participants and their parents completed 1 of 2 versions of the Incredible Years parent and child interventions.

RESULTS

Main effects of PEP activity and reactivity and of RSA activity and reactivity were found. Although samplewide improvements in behavior were observed at posttreatment, those who exhibited lengthened cardiac PEP at rest and reduced PEP reactivity to incentives scored higher on measures of conduct problems and aggression both before and after treatment. In contrast, children who exhibited lower baseline RSA and greater RSA withdrawal scored lower on prosocial behavior before and after treatment. Finally, children who exhibited greater RSA withdrawal scored lower on emotion regulation before and after treatment.

CONCLUSIONS

We discuss these findings in terms of (a) individual differences in underlying neurobiological systems subserving appetitive (i.e., approach) motivation, emotion regulation, and social affiliation and (b) the need to develop more intensive interventions targeting neurobiologically vulnerable children.

Autonomic and adrenocortical reactivity and buccal cell telomere length in kindergarten children

OBJECTIVE

To examine associations between autonomic nervous system and adrenocortical reactivity to laboratory stressors and buccal cell telomere length (BTL) in children.

METHODS

The study sample comprised 78 children, aged 5 to 6 years, from a longitudinal cohort study of kindergarten social hierarchies, biologic responses to adversity, and child health. Buccal cell samples and reactivity measures were collected in the spring of the kindergarten year. BTL was measured by real-time polymerase chain reaction, as the telomere-to-single-copy gene ratio. Parents provided demographic information; parents and teachers reported children's internalizing and externalizing behavior problems. Components of children's autonomic (heart rate, respiratory sinus arrhythmia [RSA], and preejection period [PEP]) and adrenocortical (salivary cortisol) responses were monitored during standardized laboratory challenges. We examined relationships between reactivity, internalizing and externalizing behaviors, and BTL, adjusted for age, race, and sex.

RESULTS

Heart rate and cortisol reactivity were inversely related to BTL, PEP was positively related to BTL, and RSA was unrelated to BTL. Internalizing behaviors were also inversely related to BTL (standardized β = -0.33, p = .004). Split at the median of reactivity parameters, children with high sympathetic activation (decreasing PEP), and parasympathetic withdrawal (decreasing RSA) did not differ with regard to BTL. However, children with both this profile and high cortisol reactivity (n = 12) had significantly shorter BTL (0.80 versus 1.00; χ² = 7.6, p = .006), compared with other children.

CONCLUSIONS

The combination of autonomic and adrenocortical reactivity was associated with shorter BTL in children. These data suggest that psychophysiological processes may influence, and that BTL may be a useful marker of, early biologic aging.

Differentiating challenge reactivity from psychomotor activity in studies of children's psychophysiology: considerations for theory and measurement

Current methods of assessing children's physiological "stress reactivity" may be confounded by psychomotor activity, biasing estimates of the relation between reactivity and health. We examined the joint and independent contributions of psychomotor activity and challenge reactivity during a protocol for 5- and 6-year-old children (N = 338). Measures of parasympathetic reactivity (respiratory sinus arrhythmia [RSA]) and sympathetic reactivity (preejection period [PEP]) were calculated for social, cognitive, sensory, and emotional challenge tasks. Reactivity was calculated relative to both resting and a paired comparison task that accounted for psychomotor activity effects during each challenge. Results indicated that comparison tasks themselves elicited RSA and PEP responses, and reactivity adjusted for psychomotor activity was incongruent with reactivity calculated using rest. Findings demonstrate the importance of accounting for confounding psychomotor activity effects on physiological reactivity.