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Agorastos A, Mansueto AC, Hager T, Pappi E, Gardikioti A, Stiedl O. Heart Rate Variability as a Translational Dynamic Biomarker of Altered Autonomic Function in Health and Psychiatric Disease. Biomedicines 2023; 11:1591. [PMID: 37371686 DOI: 10.3390/biomedicines11061591] [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: 03/17/2023] [Revised: 04/13/2023] [Accepted: 05/24/2023] [Indexed: 06/29/2023] Open
Abstract
The autonomic nervous system (ANS) is responsible for the precise regulation of tissue functions and organs and, thus, is crucial for optimal stress reactivity, adaptive responses and health in basic and challenged states (survival). The fine-tuning of central ANS activity relies on the internal central autonomic regulation system of the central autonomic network (CAN), while the peripheral activity relies mainly on the two main and interdependent peripheral ANS tracts, the sympathetic nervous system (SNS) and the parasympathetic nervous system (PNS). In disease, autonomic imbalance is associated with decreased dynamic adaptability and increased morbidity and mortality. Acute or prolonged autonomic dysregulation, as observed in stress-related disorders, affects CAN core centers, thereby altering downstream peripheral ANS function. One of the best established and most widely used non-invasive methods for the quantitative assessment of ANS activity is the computerized analysis of heart rate variability (HRV). HRV, which is determined by different methods from those used to determine the fluctuation of instantaneous heart rate (HR), has been used in many studies as a powerful index of autonomic (re)activity and an indicator of cardiac risk and ageing. Psychiatric patients regularly show altered autonomic function with increased HR, reduced HRV and blunted diurnal/circadian changes compared to the healthy state. The aim of this article is to provide basic knowledge on ANS function and (re)activity assessment and, thus, to support a much broader use of HRV as a valid, transdiagnostic and fully translational dynamic biomarker of stress system sensitivity and vulnerability to stress-related disorders in neuroscience research and clinical psychiatric practice. In particular, we review the functional levels of central and peripheral ANS control, the main neurobiophysiologic theoretical models (e.g., polyvagal theory, neurovisceral integration model), the precise autonomic influence on cardiac function and the definition and main aspects of HRV and its different measures (i.e., time, frequency and nonlinear domains). We also provide recommendations for the proper use of electrocardiogram recordings for HRV assessment in clinical and research settings and highlight pathophysiological, clinical and research implications for a better functional understanding of the neural and molecular mechanisms underlying healthy and malfunctioning brain-heart interactions in individual stress reactivity and psychiatric disorders.
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Affiliation(s)
- Agorastos Agorastos
- II. Department of Psychiatry, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 56430 Thessaloniki, Greece
| | - Alessandra C Mansueto
- Center for Neurogenomics and Cognitive Research, Vrije Universiteit (VU) Amsterdam, 1081 HV Amsterdam, The Netherlands
- Centre for Urban Mental Health, University of Amsterdam, 1081 HV Amsterdam, The Netherlands
| | - Torben Hager
- Center for Neurogenomics and Cognitive Research, Vrije Universiteit (VU) Amsterdam, 1081 HV Amsterdam, The Netherlands
| | - Eleni Pappi
- Faculty of Health Sciences, School of Medicine, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Angeliki Gardikioti
- Faculty of Health Sciences, School of Medicine, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Oliver Stiedl
- Center for Neurogenomics and Cognitive Research, Vrije Universiteit (VU) Amsterdam, 1081 HV Amsterdam, The Netherlands
- Department of Health, Safety and Environment, Vrije Universiteit (VU) Amsterdam, 1081 HZ Amsterdam, The Netherlands
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Herrero H, Tarrada A, Haffen E, Mignot T, Sense C, Schwan R, El-Hage W, Maillard L, Hingray C. Skin conductance response and emotional response in women with psychogenic non-epileptic seizures. Seizure 2020; 81:123-131. [PMID: 32795943 DOI: 10.1016/j.seizure.2020.07.028] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 07/26/2020] [Accepted: 07/28/2020] [Indexed: 11/17/2022] Open
Abstract
PURPOSE Recent etiopathogenic models place emotional dysregulation at the core of psychogenic nonepileptic seizure (PNES). Our purpose was to assess physiological, cognitive, and behavioral emotional responses of PNES patients. METHODS This study compared three types of emotional responses to visual emotional stimuli between 34 female PNES group and 34 matched healthy controls: physiological response measured by skin conductance response (SCR) (rate, amplitude and latency) and heart rate deceleration; cognitive response measured by valence and arousal elicited by the images; and behavioural response measured by latency of ratings. The groups were characterized on psychiatric comorbidities, traumatic history, alexithymia, and dissociation. RESULTS Compared to controls, PNES group displayed lower SCR for all images (p = 0.038), shorter amplitude of heart rate deceleration (p = 0.024) and faster arousal rating for all images (p = 0.019), but no difference on cognitive rating of images. Within-groups analyses showed only in PNES subjects increased rate (+19.35%, p = 0.046) SCR for negative stimuli with strong arousal compared to negative with low arousal. PNES physiological response (SCR and heart rate deceleration) was negatively correlated to dissociation tendency (r=-0.48, p = 0.0083) and alexithymia (r=-0.44, p = 0.012)). For cognitive response, no correlation was found. CONCLUSION These results are in favour of a lower physiological emotional response but with an over-reactivity at behavioral level contrasting with similar cognitive assessment. For strong aversive stimuli, PNES might present a trend to overreact at physiological and behavioural levels. Our results suggest that dissociation and difficulty in describing feelings are associated with an altered physiological response in PNES women only.
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Affiliation(s)
- Hugo Herrero
- Groupe Hospitalier Paul Guiraud, 94800 Villejuif, France; Pôle Universitaire du Grand Nancy, Centre Psychothérapique de Nancy, Laxou, France
| | | | - Emmanuel Haffen
- Inserm, EA 481Neurosciences,Department of Clinical Psychiatry, Besançon, France
| | - Thibault Mignot
- Pôle Universitaire du Grand Nancy, Centre Psychothérapique de Nancy, Laxou, France
| | - Charlotte Sense
- Pôle Universitaire du Grand Nancy, Centre Psychothérapique de Nancy, Laxou, France
| | - Raymund Schwan
- Pôle Universitaire du Grand Nancy, Centre Psychothérapique de Nancy, Laxou, France
| | | | - Louis Maillard
- Service de Neurologie, CHRU Nancy Nancy, France; CNRS, CRAN - UMR 7039, Nancy F-54000, France
| | - Coraline Hingray
- Pôle Universitaire du Grand Nancy, Centre Psychothérapique de Nancy, Laxou, France; Service de Neurologie, CHRU Nancy Nancy, France
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Chang HA, Fang WH, Wan FJ, Tzeng NS, Liu YP, Shyu JF, Huang SY, Chang TC, Chang CC. Age-specific associations among functional COMT Val 158Met polymorphism, resting parasympathetic nervous control and generalized anxiety disorder. Psychoneuroendocrinology 2019; 106:57-64. [PMID: 30954919 DOI: 10.1016/j.psyneuen.2019.03.020] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2018] [Revised: 03/21/2019] [Accepted: 03/21/2019] [Indexed: 01/06/2023]
Abstract
The functional Val158Met polymorphism (rs4680) of the Catechol-O-Methyltransferase (COMT) gene has been implicated in generalized anxiety disorder (GAD); however, the underlying neural mechanisms remain unexamined. Recent evidence reveals that low resting parasympathetic (vagal) control is an endophenotypic predictor of anxiety, while the effect of COMT rs4680 differs at different ages. Thus, we examined whether the COMT Val158Met variant could increase the risk of GAD through decreased resting parasympathetic nervous control in an age-specific manner. COMT rs4680 polymorphism was genotyped in 1,655 Han Chinese adults (1,142 healthy subjects and 513 patients with GAD; age: 20-65). High-frequency power (HF) of heart rate variability (HRV) was used to measure resting state parasympathetic nervous regulation. Non-genetic factors, such as gender, smoking status, medication use and comorbidity conditions, were treated as covariates. After adjusting for relevant covariates, there was a significant age x COMT genotype interaction on resting HF of HRV. In younger adults, Met allele carriers had a significantly lower HF index; however, older adults exhibited the opposite pattern, with Val/Val homozygotes exhibiting decreased HF values. Moreover, reduced HF-HRV is associated with increased risk of GAD. Finally, pathway analysis revealed a significant indirect effect of COMT on the risk of GAD via reduced resting HF-HRV, in the aforementioned age-dependent manner. Our findings are the first to demonstrate that COMT Val158Met polymorphism is associated with risk of GAD via reduced resting parasympathetic nervous control, an age-specific risk pathway.
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Affiliation(s)
- Hsin-An Chang
- Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Wen-Hui Fang
- Department of Family and Community Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Fang-Jung Wan
- Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Nian-Sheng Tzeng
- Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Yia-Ping Liu
- Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan; Department of Psychiatry, Cheng Hsin General Hospital, Taipei, Taiwan; Laboratory of Cognitive Neuroscience, Department of Physiology, National Defense Medical Center, Taipei, Taiwan
| | - Jia-Fwu Shyu
- Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan; Department of Biology and Anatomy, National Defense Medical Center, Taipei, Taiwan
| | - San-Yuan Huang
- Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Tieh-Ching Chang
- Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Chuan-Chia Chang
- Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
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Olivera-Toro A, Fossion R, Li L, López-Gómez RE, López-Espinosa E, Jiménez-Estrada I, Quiroz-González S. Changes in Heart Rate Variability in Patients with Spleen-Qi Deficiency Syndrome. J Acupunct Meridian Stud 2019; 12:111-121. [PMID: 31351997 DOI: 10.1016/j.jams.2019.07.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Revised: 05/22/2019] [Accepted: 07/09/2019] [Indexed: 02/07/2023] Open
Abstract
Many functional diseases are related to dysautonomia, and heart rate variability has been used to assess dysautonomia. However, heart rate variability has not been studied in Spleen-Qi deficiency syndrome (SQDS). Healthy volunteers (n = 37) and patients with SQDS (n = 67), recruited from the Clinic of the State University of Ecatepec Valley were included in the study. Outcome measures were average heart rate, standard deviation of the normal-to-normal heartbeat intervals, low frequency (LF), high frequency (HF) power, and the LF/HF ratio. Also, intestinal peristalsis, gastrointestinal symptoms (GSs), fatigue, and level of attention were measured. Standard deviation of the normal-to-normal heartbeat intervals (17 ± 2.3%) and HF (14 ± 3.1%) were lower in SQDS patients (17 ± 1.3%) than in healthy volunteers. SQDS patients had higher heart rate, LF power, LF/HF ratio, and fatigue scores (9.6 ± 1.12%, 16 ± 2.1%, 22 ± 3.8%, and 21 ± 4.1%). The fatigue correlated positively with the LF/HF ratio and negatively with HF power. The SQDS group had lower concentration performance (16.2 ± 1.9%) in the d2 test. The intestinal peristalsis showed a reduction (15 ± 1.3%) as compared with control. GS score and peristalsis correlated negatively with HF. Our results suggest that the pathology of SDQS could be associated with a low vagal tone which causes a decrease in peristalsis, increased fatigue, reduced attention, and appearance of GSs.
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Affiliation(s)
- Agnese Olivera-Toro
- Department of Acupuncture and Rehabilitation, State University of Ecatepec Valley, Ecatepec State of México, Mexico
| | - Rubén Fossion
- Institute for Nuclear Science, National Autonomous University of México, Mexico City, Mexico; Complexity Science Center (C3), National Autonomous University of México, Mexico City, Mexico
| | - Lei Li
- Institute of Basic Medical Sciences of Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China; Beijing Key Laboratory of Pharmacology of Chinese Materia Medica, Beijing, China
| | - Rosa E López-Gómez
- Department of Acupuncture and Rehabilitation, State University of Ecatepec Valley, Ecatepec State of México, Mexico
| | - Emma López-Espinosa
- Department of Acupuncture and Rehabilitation, State University of Ecatepec Valley, Ecatepec State of México, Mexico
| | - Ismael Jiménez-Estrada
- Department of Physiology, Biophysics and Neuroscience, Center for Research and Advanced Studies, National Polytechnic Institute, Mexico City, Mexico
| | - Salvador Quiroz-González
- Department of Acupuncture and Rehabilitation, State University of Ecatepec Valley, Ecatepec State of México, Mexico; Department of Neurophysiological Acupuncture and Psychoneurobiomodulation, Institute of Science and Integrative Medicine, Mexico City, Mexico.
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Huang JH, Chang HA, Fang WH, Ho PS, Liu YP, Wan FJ, Tzeng NS, Shyu JF, Chang CC. Serotonin receptor 1A promoter polymorphism, rs6295, modulates human anxiety levels via altering parasympathetic nervous activity. Acta Psychiatr Scand 2018; 137:263-272. [PMID: 29363117 DOI: 10.1111/acps.12853] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/02/2018] [Indexed: 12/15/2022]
Abstract
OBJECTIVE The G-allele of the -1019C/G (rs6295) promoter polymorphism of the serotonin receptor 1A (HTR1A) gene has been implicated in anxiety; however, the underlying neurophysiological processes are still not fully understood. Recent evidence indicates that low parasympathetic (vagal) tone is predictive of anxiety. We thus conducted a structural equation model (SEM) to examine whether the HTR1A rs6295 variant can affect anxiety by altering parasympathetic nervous activity. METHOD A sample of 1141 drug-free healthy Han Chinese was recruited for HTR1A genotyping. Autonomic nervous function was assessed by short-term spectral analysis of heart rate variability (HRV). Anxiety and stress levels were evaluated by the Beck Anxiety Inventory (BAI) and the Perceived Stress Scale (PSS) respectively. RESULTS The number of the HTR1A G allele was inversely correlated with high-frequency power (HF), a parasympathetic index of HRV. The HF index was negatively associated with BAI scores. Furthermore, the good-fitting SEM, adjusting for confounding variables (e.g., age and PSS levels), revealed a significant pathway linking rs6295 variant to BAI scores via HF index modulation. CONCLUSION These results are the first to show that HTR1A -1019C/G polymorphism influences anxiety levels by modulating parasympathetic tone, providing a neurophysiological insight into the role of HTR1A in human anxiety.
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Affiliation(s)
- J-H Huang
- Department of Psychiatry, Beitou Branch, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - H-A Chang
- Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - W-H Fang
- Department of Family and Community Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - P-S Ho
- Department of Psychiatry, Beitou Branch, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Y-P Liu
- Laboratory of Cognitive Neuroscience, Departments of Physiology and Psychiatry, National Defense Medical Center, Taipei, Taiwan
| | - F-J Wan
- Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - N-S Tzeng
- Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - J-F Shyu
- Department of Biology and Anatomy, National Defense Medical Center, Taipei, Taiwan
| | - C-C Chang
- Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
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Chou CY, La Marca R, Steptoe A, Brewin CR. Cardiovascular and psychological responses to voluntary recall of trauma in posttraumatic stress disorder. Eur J Psychotraumatol 2018; 9:1472988. [PMID: 29887977 PMCID: PMC5990938 DOI: 10.1080/20008198.2018.1472988] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2017] [Accepted: 04/20/2018] [Indexed: 01/16/2023] Open
Abstract
Voluntary recall of trauma is a key element in exposure-based psychotherapies and can trigger spontaneous dissociative responses such as flashbacks, depersonalisation, and derealisation. In order to examine the associations between cardiovascular and psychological responses to voluntary recollection of trauma, individuals with PTSD recalled a traumatic memory. Heart rate and heart rate variability were recorded continuously and the episodes when different forms of dissociation were experienced during the recall were identified. A significant increase in parasympathetic activity was found during trauma recall, with greater parasympathetic dominance being indicative of greater state depersonalisation/derealisation. Whereas overall decreases in heart rate during trauma recall were associated with increased fear and perceived threat, flashbacks were accompanied by short-term increases in heart rate. These findings demonstrate different types of cardiovascular responses associated with different psychological experiences during trauma recall. Future research directions were discussed.
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Affiliation(s)
- Chia-Ying Chou
- Department of Clinical, Educational & Health Psychology, University College London, London, UK
| | - Roberto La Marca
- Department of Psychology, Universität Zürich, Zürich, Switzerland
| | - Andrew Steptoe
- Department of Behavioural Science and Health, University College London, London, UK
| | - Chris R Brewin
- Department of Clinical, Educational & Health Psychology, University College London, London, UK
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Yang XF, Immordino-Yang MH. Culture and cardiac vagal tone independently influence emotional expressiveness. ACTA ACUST UNITED AC 2017. [DOI: 10.1007/s40167-017-0048-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Chang CC, Fang WH, Chang HA, Chang TC, Shyu JF, Huang SY. Serotonin 2A receptor (5-HT2A) gene promoter variant interacts with chronic perceived stress to modulate resting parasympathetic activity in humans. Psychoneuroendocrinology 2017; 76:119-126. [PMID: 27912162 DOI: 10.1016/j.psyneuen.2016.11.015] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2016] [Revised: 10/09/2016] [Accepted: 11/14/2016] [Indexed: 11/18/2022]
Abstract
Decreased resting vagal (parasympathetic) tone is implicated in the development of stress-related disorders, including anxiety and depression. Chronic stress elevates the expression of serotonin 2A receptors (5-HT2A), while activation of 5-HT2A leads to inhibition of parasympathetic synaptic transmission. The T allele of the promoter variant, rs6311 (C>T), of the 5-HT2A gene has been shown to increase the 5-HT2A expression in vitro and to be associated with anxiety and depressive disorders. We thus hypothesized that the 5-HT2A functional polymorphism may influence resting vagal activity among persons with chronically high levels of perceived stress. A total of 1138 well-defined healthy, medication-free Han Chinese were included for 5-HT2A genotyping. The Perceived Stress Scale (PSS) was used to measure the level of perceived stress during the last month and participants were divided into low and high PSS groups. Resting-state heart rate variability (HRV) was used to assess autonomic function. No significant between-genotype difference was found in any HRV variable in the low PSS group (n=610). However, in the high PSS group (n=528), high frequency power and root mean square of successive heartbeat interval differences (both HRV indices of parasympathetic activity) were significantly reduced in T/T genotype carriers compared to C/C homozygotes. Our findings are the first to show that individuals homozygous for the high-expressing 5-HT2A (T) allele exhibit diminished resting vagal tone-an index of stress vulnerability-when experiencing chronically elevated levels of perceived stress. The present results may advance our understanding of the genetic mechanism underlying individual differences in susceptibility to stress.
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Affiliation(s)
- Chuan-Chia Chang
- Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan; Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan.
| | - Wen-Hui Fang
- Department of Family and Community Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Hsin-An Chang
- Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Tieh-Ching Chang
- Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Jia-Fwa Shyu
- Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan; Department of Biology and Anatomy, National Defense Medical Center, Taipei, Taiwan
| | - San-Yuan Huang
- Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan; Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan
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Babel KA, Jambroes T, Oostermeijer S, van de Ven PM, Popma A, Vermeiren RRJM, Doreleijers TAH, Jansen LMC. Do post-trauma symptoms mediate the relation between neurobiological stress parameters and conduct problems in girls? Child Adolesc Psychiatry Ment Health 2016; 10:42. [PMID: 27822302 PMCID: PMC5088655 DOI: 10.1186/s13034-016-0129-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2015] [Accepted: 10/12/2016] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE Attenuated activity of stress-regulating systems has consistently been reported in boys with conduct problems. Results in studies of girls are inconsistent, which may result from the high prevalence of comorbid post-trauma symptoms. Therefore, the aim of the present study is to investigate post-trauma symptoms as a potential mediator in the relation between stress-regulation systems functioning and conduct problems in female adolescents. METHODS The sample consisted of 78 female adolescents (mean age 15.4; SD 1.1) admitted to a closed treatment institution. The diagnosis of disruptive behaviour disorder (DBD) was assessed by a structured interview-the diagnostic interview schedule for children version IV (DISC-IV). To assess post-trauma symptoms and externalizing behaviour problems, self-report questionnaires, youth self report (YSR) and the trauma symptom checklist for Children (TSCC) were used. The cortisol awakenings response (CAR) measured hypothalamic-pituitary-adrenal (HPA) axis activity, whereas autonomous nervous system (ANS) activity was assessed by heart rate (HR), pre-ejection period (PEP) and respiratory sinus arrhythmia (RSA). Independent t-tests were used to compare girls with and without DBD, while path analyses tested for the mediating role of post- trauma symptoms in the relation between stress regulating systems and externalizing behaviour. RESULTS Females with DBD (n = 37) reported significantly higher rates of post-trauma symptoms and externalizing behaviour problems than girls without DBD (n = 39). Path analysis found no relation between CAR and externalizing behaviour problems. With regard to ANS activity, positive direct effects on externalizing behaviour problems were present for HR (standardized β = 0.306, p = 0.020) and PEP (standardized β = -0.323, p = 0.031), though not for RSA. Furthermore, no relation-whether direct or indirect-could be determined from post-trauma symptoms. CONCLUSIONS Present findings demonstrate that the neurobiological characteristics of female externalizing behaviour differ from males, since girls showed heightened instead of attenuated ANS activity. While the prevalence of post-trauma symptoms was high in girls with DBD, it did not mediate the relation between stress parameters and externalizing behaviour. Clinical implications and future directions are discussed.
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Affiliation(s)
- Kimberly A. Babel
- Department of Child and Adolescent Psychiatry, VU University Medical Center, p/a De Bascule, P.O. Box 303, 1115 Duivendrecht, The Netherlands
| | - Tijs Jambroes
- Department of Child and Adolescent Psychiatry, VU University Medical Center, p/a De Bascule, P.O. Box 303, 1115 Duivendrecht, The Netherlands
| | - Sanne Oostermeijer
- Department of Child and Adolescent Psychiatry, VU University Medical Center, p/a De Bascule, P.O. Box 303, 1115 Duivendrecht, The Netherlands
| | - Peter M. van de Ven
- Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands
| | - Arne Popma
- Department of Child and Adolescent Psychiatry, VU University Medical Center, p/a De Bascule, P.O. Box 303, 1115 Duivendrecht, The Netherlands ,Department of Criminal Law and Criminology, Leiden University, Leiden, The Netherlands
| | - Robert R. J. M. Vermeiren
- Department of Child and Adolescent Psychiatry, VU University Medical Center, p/a De Bascule, P.O. Box 303, 1115 Duivendrecht, The Netherlands ,Department of Child and Adolescent Psychiatry, Curium-Leiden University Medical Center, Leiden, The Netherlands
| | - Theo A. H. Doreleijers
- Department of Child and Adolescent Psychiatry, VU University Medical Center, p/a De Bascule, P.O. Box 303, 1115 Duivendrecht, The Netherlands
| | - Lucres M. C. Jansen
- Department of Child and Adolescent Psychiatry, VU University Medical Center, p/a De Bascule, P.O. Box 303, 1115 Duivendrecht, The Netherlands
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Association of neuropeptide Y promoter polymorphism (rs16147) with perceived stress and cardiac vagal outflow in humans. Sci Rep 2016; 6:31683. [PMID: 27527739 PMCID: PMC4985655 DOI: 10.1038/srep31683] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2016] [Accepted: 07/25/2016] [Indexed: 12/20/2022] Open
Abstract
Neuropeptide Y (NPY) is involved in resilience to stress, and higher vagal (parasympathetic) activity has been associated with greater stress resilience. Thus, we examined whether rs16147, a functional promoter polymorphism (C>T) of the NPY gene, could influence vagal tone during chronic high stress levels. NPY genotyping, chronic psychological stress level measurement (using the Perceived Stress Scale [PSS]), cardiac autonomic function assessment (using short-term heart rate variability [HRV]) were performed in 1123 healthy, drug-free Han Chinese participants who were divided into low- and high-PSS groups. In the high-PSS group (n = 522), the root mean square of successive heartbeat interval differences and high frequency power (both HRV indices of parasympathetic activity) were significantly increased in T/T homozygotes compared to C/C homozygotes. However, no significant between-genotype difference was found in any HRV variable in the low-PSS group (n = 601). Our results are the first to demonstrate that functional NPY variation alters chronic stress-related vagal control, suggesting a potential parasympathetic role for NPY gene in stress regulation.
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11
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Gutierrez PM, Davidson CL, Friese AH, Forster JE. Physical Activity, Suicide Risk Factors, and Suicidal Ideation in a Veteran Sample. Suicide Life Threat Behav 2016; 46:284-92. [PMID: 26404757 DOI: 10.1111/sltb.12190] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2015] [Accepted: 07/10/2015] [Indexed: 11/28/2022]
Abstract
The association between current level of suicidal ideation and physical activity was tested in a broad sample of veterans seeking care from the Veterans Health Administration. It was hypothesized that the two variables would be significantly inversely related. It was further hypothesized that the relationship would be mediated by depressive symptoms, disturbed sleep, and a measure of heart rate variability based on existing research regarding physical activity and sleep. Due to the first hypothesis not being supported, the second could not be tested. Post hoc correlation analyses did find associations between physical activity and depressive symptoms, in expected directions, and are discussed. Possible explanations for the negative findings along with recommendations for future research to continue exploring links between suicide risk and physical activity are presented. We conclude by suggesting that physical activity may have promise as a risk reduction intervention and that prospective data are more likely to yield significant results than the cross-sectional methodology employed in the current study.
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Affiliation(s)
- Peter M Gutierrez
- Rocky Mountain Mental Illness Research, Education and Clinical Center (MIRECC), Denver VA Medical Center, Denver, CO, USA.,Department of Psychiatry, University of Colorado School of Medicine, Aurora, CO, USA
| | - Collin L Davidson
- Rocky Mountain Mental Illness Research, Education and Clinical Center (MIRECC), Denver VA Medical Center, Denver, CO, USA
| | - Ariel H Friese
- Rocky Mountain Mental Illness Research, Education and Clinical Center (MIRECC), Denver VA Medical Center, Denver, CO, USA
| | - Jeri E Forster
- Rocky Mountain Mental Illness Research, Education and Clinical Center (MIRECC), Denver VA Medical Center, Denver, CO, USA.,Department of Physical Medicine and Rehabilitation, University of Colorado School of Medicine, Aurora, CO, USA.,Department of Biostatistics and Informatics, Colorado School of Public Health, Aurora, CO, USA
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12
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Wang SM, Lee HK, Kweon YS, Lee CT, Chae JH, Kim JJ, Lee KU. Effect of emotion regulation training in patients with panic disorder: Evidenced by heart rate variability measures. Gen Hosp Psychiatry 2016; 40:68-73. [PMID: 26947254 DOI: 10.1016/j.genhosppsych.2016.01.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2015] [Revised: 01/12/2016] [Accepted: 01/14/2016] [Indexed: 01/08/2023]
Abstract
OBJECTIVE We aimed to examine the effect of emotion regulation training in patients with panic disorder (PD) by measuring heart rate variability (HRV). METHODS Forty-eight patients with PD were randomly divided into emotion regulation group (n=25) and no-regulation group (n=23). Three five-minute ECG recordings were taken in the following states: 1) baseline, 2) while subjects viewed 15 aversive pictures (active stimulus), 3) resting state after aversive pictures (post-stimulus). The emotion regulation group briefly received acceptance technique training for five minutes before performing the experimental task. Spectral analysis measures included a high-frequency (HF; 0.15-0.4 HZ) component, a low-frequency (LF; 0.04-0.15Hz) component, and an LF/HF ratio. RESULTS The mean change in LF/HF ratio from baseline to active stimulus was significantly lower in the emotion regulation group than in the no-regulation group (emotion regulation group, 0.13; no-regulation group, 2.31; t=-2.67; P<.05). CONCLUSION This suggests that brief emotion acceptance training could decrease aversive stimulus-induced sympathetic hyperactivity in patients with PD.
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Affiliation(s)
- Sheng-Min Wang
- International Health Care Center, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea; Deparment of Psychiatry, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Hae-Kook Lee
- Department of Psychiatry, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Yong-Sil Kweon
- Department of Psychiatry, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Chung Tai Lee
- Department of Psychiatry, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Jeong-Ho Chae
- Deparment of Psychiatry, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Jung-Jin Kim
- Deparment of Psychiatry, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
| | - Kyoung-Uk Lee
- Department of Psychiatry, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
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13
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Tanaka S, Uehara N, Tsuchihashi N, Sugimoto K. Emotional relationships between child patients and their mothers during dental treatments. J Dent Sci 2016; 11:287-292. [PMID: 30894986 PMCID: PMC6395250 DOI: 10.1016/j.jds.2016.03.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2015] [Revised: 03/09/2016] [Indexed: 12/04/2022] Open
Abstract
Background/purpose The behavioral control of child patients is an important issue in pediatric dentistry. The emotional states of the mothers of patients may influence the attitudes of their children. The aim of this study was to investigate the emotional states estimated from physiological responses of child patients and the subjective anxieties of their mothers during dental treatments and discuss the emotional relationships between children and their mothers. Materials and methods To assess physiological responses associated with emotional changes induced by dental treatments in child patients aged 3–6 years, activity in the autonomic nervous were analyzed from variations in inter-beat intervals in electrocardiogram. Anxiety levels of accompanying mothers were examined using the State Trait Anxiety Inventory, which was filled out during the treatment of their child. Results Regarding the stress of child patients from the aspect of autonomic nervous activities during dental treatments, comparison between the cooperative and uncooperative patient groups showed that the uncooperative group demonstrated significantly higher sympathetic nervous activity and significantly lower parasympathetic nervous activity relative to the cooperative group, and their accompanying mothers showed significantly higher state anxiety scores relative to the mothers of cooperative children. Moreover, positive correlation between state anxiety scores of mothers and sympathetic nervous activities of their children was observed. Conclusion These results indicated that uncooperative child patients undergo more stress and their mothers feel more anxiety from dental treatments, resulting in an emotional relationship between children and their mothers, which requires dental professionals to make special considerations to calm the anxiety of the mother, as well as the stress of the child patient.
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Affiliation(s)
- Shizuka Tanaka
- Department of Behavioral Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Naoko Uehara
- Department of Pediatric Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Natsumi Tsuchihashi
- Department of Basic Oral Health Engineering, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kumiko Sugimoto
- Department of Basic Oral Health Engineering, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
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14
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Chang CC, Fang WH, Chang HA, Huang SY. Functional Ser205Leu polymorphism of the nerve growth factor receptor (NGFR) gene is associated with vagal autonomic dysregulation in humans. Sci Rep 2015; 5:13136. [PMID: 26278479 PMCID: PMC4538378 DOI: 10.1038/srep13136] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2015] [Accepted: 07/20/2015] [Indexed: 12/19/2022] Open
Abstract
Evidence indicates that reduced cardiac vagal (parasympathetic) tone, a robust cardiovascular risk factor, is a trait vulnerability marker of major depressive disorder (MDD). The Ser205/Ser205 genotype of the functional polymorphism (Ser205Leu) of the nerve growth factor receptor (NGFR), also called p75 neurotrophin receptor (p75NTR), gene is reported to increase the risk of MDD. Here, we hypothesized that the NGFR Ser205Leu polymorphism may have an effect on vagal control. A sample of 810 healthy, drug-free, unrelated Han Chinese (413 males, 397 females; mean age 35.17 ± 8.53 years) was included in the NGFR genotyping. Short-term heart rate variability (HRV) was used to assess vagus-mediated autonomic function. Potential HRV covariates, such as mood/anxiety status and serum metabolic parameters, were assessed. Homozygotes of the Ser205 allele had significantly lower high frequency power and root mean square of successive heartbeat interval differences, both HRV indices of vagal modulation, compared to Leu205 allele carriers. Even after adjusting for relevant confounders, these associations remained significant. Further stratification by sex revealed that the associations were observed only in males. Our results implicate that decreased parasympathetic activity is associated with the NGFR Ser205/Ser205 genotype in a gender-specific manner, suggesting a potential role of NGFR polymorphism in modulating cardiac autonomic function.
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Affiliation(s)
- Chuan-Chia Chang
- 1] Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan [2] Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan
| | - Wen-Hui Fang
- Department of Family and Community Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Hsin-An Chang
- Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - San-Yuan Huang
- 1] Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan [2] Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan
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15
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Kang N, Lim JS, Hwang TG, Joe SH, Lee MS. The Relationship between Type D Personality and Heart Rate Variability in Community Mental Health Center Users. Psychiatry Investig 2015; 12:197-203. [PMID: 25866520 PMCID: PMC4390590 DOI: 10.4306/pi.2015.12.2.197] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2014] [Revised: 06/12/2014] [Accepted: 07/07/2014] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVE Type D personality can be regarded as a promising cardiovascular risk marker that has been repeatedly linked to relevant indicators of mental health, quality of life, morbidity, and mortality in cardiac patients. Heart rate variability (HRV) is a non-invasive technology that can provide information regarding a patient's sympathetic/parasympathetic balance and the control mechanisms of the autonomic systems in the cardiovascular system. As both type D personality and HRV are parameters related to the cardiovascular system, we assumed a relationship between type D personality and HRV. This study set out to identify the relationship between type D and HRV and the differences in HRV variables between type D and non-type D personalities. METHODS Patients who visited Guro Community Mental Health Center from January 2011 to December 2012 were surveyed. They were evaluated using both the Korean version of the Type D Personality-14 for type D personality and HRV. During the survey, those who reported major cardiovascular disease that can affect heart rate variability were excluded from the study. RESULTS Our analysis included 559 participants, 249 of whom were classified as type D personality. No significant differences were found in the HRV variables between the type D group and the non-type D group. There were also no clinically meaningful correlations between HRV variables and type D total/subscale scores when controlled for patient age. CONCLUSION A relationship between HRV and type D personality was not identified using short-term HRV measurements in non-clinical patients with no definitive cardiovascular disease. Further studies using long-term HRV measurements in patients with cardiovascular disease are necessary to conclude an association between HRV and type D personality.
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Affiliation(s)
- Noeul Kang
- Korea University School of Medicine, Seoul, Republic of Korea
| | - Jeung-Suk Lim
- Guro Community Mental Health Center, Seoul, Republic of Korea
| | | | - Sook-Haeng Joe
- Department of Psychiatry, Korea University Medical Center, Seoul, Republic of Korea. ; Korea University Research Institute of Mental Health, Seoul, Republic of Korea
| | - Moon-Soo Lee
- Guro Community Mental Health Center, Seoul, Republic of Korea. ; Department of Psychiatry, Korea University Medical Center, Seoul, Republic of Korea. ; Korea University Research Institute of Mental Health, Seoul, Republic of Korea
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16
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Effects of stellate ganglion block on cardiovascular reaction and heart rate variability in elderly patients during anesthesia induction and endotracheal intubation. J Clin Anesth 2015; 27:140-5. [PMID: 25559299 DOI: 10.1016/j.jclinane.2014.06.012] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2013] [Revised: 05/19/2014] [Accepted: 06/09/2014] [Indexed: 12/25/2022]
Abstract
STUDY OBJECTIVE To investigate the effects of stellate ganglion block (SGB) on cardiovascular response and heart rate (HR) variability in elderly patients during anesthesia induction and endotracheal intubation. DESIGN A randomized, double-blinded, and placebo-controlled study. SETTING University-affiliated teaching hospital. PARTICIPANTS Eighty elderly patients (American Society of Anesthesiologists grades I and II) receiving elective surgery during general anesthesia. INTERVENTIONS Right stellate ganglion injection (SGB) was performed in all patients using 10 mL of 1% lidocaine or normal saline. MEASUREMENTS Systolic blood pressure (BP), diastolic BP, HR, and calculated rate pressure product. HR variability at the following time points: conscious status before induction (T0); immediately before intubation (T1); immediately after intubation (T2); and 1, 3, and 5 minutes postintubation (T3, T4, and T5). MAIN RESULTS No significant differences in BP and HR were observed between the 2 groups. Rate pressure product values significantly increased in the control group compared with baseline and SGB group values. Low-frequency power (LF) and LF/high-frequency power (HF) significantly increased, and HF and normalized units of HF significantly decreased in the control group compared with baseline values. LF, normalized units of LF, and LF/HF in the SGB group significantly decreased compared with those of the control group. CONCLUSION SGB protects the myocardium and effectively suppresses stress responses during anesthesia induction and tracheal intubation in elderly patients.
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17
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Brady RE, Constans JI, Marx BP, Spira JL, Gevirtz R, Kimbrell TA, Kramer TL, Pyne JM. Effect of Symptom Over-Reporting on Heart Rate Variability in Veterans With Posttraumatic Stress Disorder. J Trauma Dissociation 2015; 16:551-62. [PMID: 26011249 DOI: 10.1080/15299732.2015.1021505] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Physiological assessment of posttraumatic stress disorder (PTSD) presents an additional avenue for evaluating the severity of PTSD symptoms. We investigated whether the presence of a high number of uncommon symptoms attenuated the relation between self-reported PTSD symptoms and heart rate variability (HRV). Participants were 115 veterans from Operation Iraqi Freedom and Operation Enduring Freedom with or without PTSD. Symptom over-report was assessed using the Miller Forensic Assessment of Symptoms Test (M-FAST). Participants completed the Clinician-Administered PTSD Scale and M-FAST and underwent physiological assessment to determine HRV. These data were then entered into a hierarchical linear regression equation to test the moderating effect of over-reporting on the relation between PTSD symptom severity and HRV. The result of this analysis failed to demonstrate a significant moderating effect of over-reporting on the PTSD and HRV relation. HRV was a significant predictor of PTSD symptom severity, and this relation did not differ across levels of over-reporting. These findings did not support the hypothesis that over-reporting would attenuate the relation between PTSD and HRV. Clinical and research implications and directions for future investigation are discussed.
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Affiliation(s)
- Robert E Brady
- a Health Services Research & Development , Central Arkansas Veterans Healthcare System , North Little Rock , Arkansas , USA.,b Department of Psychiatry , University of Arkansas for Medical Sciences , Little Rock , Arkansas , USA
| | - Joseph I Constans
- c Southeast Louisiana Veterans Health Care System , New Orleans , Louisiana , USA.,d Department of Psychiatry , Tulane University , New Orleans , Louisiana , USA
| | - Brian P Marx
- e National Center for PTSD , VA Boston Healthcare System , Boston , Massachusetts , USA.,f Boston University School of Medicine , Boston , Massachusetts , USA
| | - James L Spira
- g National Center for PTSD-Pacific Island , Honolulu , Hawaii , USA
| | - Richard Gevirtz
- h Department of Clinical Psychology , Alliant International University , San Diego , California , USA
| | - Timothy A Kimbrell
- a Health Services Research & Development , Central Arkansas Veterans Healthcare System , North Little Rock , Arkansas , USA.,b Department of Psychiatry , University of Arkansas for Medical Sciences , Little Rock , Arkansas , USA
| | - Teresa L Kramer
- b Department of Psychiatry , University of Arkansas for Medical Sciences , Little Rock , Arkansas , USA
| | - Jeffrey M Pyne
- a Health Services Research & Development , Central Arkansas Veterans Healthcare System , North Little Rock , Arkansas , USA.,b Department of Psychiatry , University of Arkansas for Medical Sciences , Little Rock , Arkansas , USA
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18
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Abstract
OBJECTIVE Substantial research has shown that anxiety disorders are associated with decreased cardiac vagal tone, which is a known risk factor for cardiac vulnerability. A functional nerve growth factor (NGF) polymorphism (rs6330, c.104C > T, p.Ala35Val) has been associated with anxiety such that in males but not females, T-allele carriers exhibit higher levels of trait anxiety. Here we investigate whether the nonsynonymous NGF variant has an effect on cardiac autonomic control. METHODS From 705 adults initially screened for medical and psychiatric illnesses, a final cohort of 580 healthy Han Chinese (352 men, 228 women; mean [standard deviation] age = 34.46 [8.45] years) was included in the NGF genotyping (C/C: 428% [73.8%] and T-allele carriers: 152% [26.2%]). Short-term heart rate variability was used to assess cardiac autonomic function. RESULTS There were significant genotype-by-sex interaction effects (p < .05) on high-frequency power (HF) and root mean square of successive heartbeat interval differences (RMSSD), both indices of cardiac vagal control. Even after adjusting for possible confounders, men with any T allele showed lower HF and RMSSD compared with men with the C/C genotype. Women, however, showed an opposite but nonsignificant pattern. CONCLUSIONS The studied NGF polymorphism modulates autonomic outflow to the heart in a sex-dependent manner. The findings support the view that male T-allele carriers are at increased susceptibility for anxiety by association with low vagal activity and suggest a potential sex-specific genetic link between the highly comorbid anxiety disorders and cardiovascular diseases.
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19
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Chang CC, Chang HA, Chen TY, Fang WH, Huang SY. Brain-derived neurotrophic factor (BDNF) Val66Met polymorphism affects sympathetic tone in a gender-specific way. Psychoneuroendocrinology 2014; 47:17-25. [PMID: 25001952 DOI: 10.1016/j.psyneuen.2014.04.019] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2014] [Revised: 04/24/2014] [Accepted: 04/25/2014] [Indexed: 01/19/2023]
Abstract
The Val/Val genotype of the brain-derived neurotrophic factor (BDNF) polymorphism (Val66Met) has been reported to affect human anxiety-related phenotypes. Substantial research has demonstrated that anxiety is associated with sympathetic activation, while sex steroid hormones have been shown to exert differential actions in regulating BDNF expression. Thus, we examined whether the BDNF variant modulates autonomic function in a gender-dependent manner. From 708 adults initially screened for medical and psychiatric illnesses, a final cohort of 583 drug-free healthy Han Chinese (355 males, 228 females; age 34.43±8.42 years) was recruited for BDNF genotyping (Val/Val: 136, 23.3%, Val/Met: 294, 50.4%, and Met/Met: 153, 26.2%). Time- and frequency-domain analyses of heart rate variability (HRV) were used to assess autonomic outflow to the heart. Significant genotype-by-gender interaction effects were found on HRV indices. Even after adjusting for possible confounders, male participants bearing the Val/Val genotype had significant increases in low frequency (LF), LF% and LF/high frequency (HF) ratio, indicating altered sympathovagal balance with increased sympathetic modulation, compared to male Met/Met homozygotes. Females, however, showed an opposite but non-significant pattern. These results suggest that the studied BDNF polymorphism is associated with sympathetic control in a gender-specific way. The findings here support the view that male subjects with the Val/Val genotype have increased risk of anxiety by association with sympathetic activation.
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Affiliation(s)
- Chuan-Chia Chang
- Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan; Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan
| | - Hsin-An Chang
- Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Tien-Yu Chen
- Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Wen-Hui Fang
- Department of Family and Community Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - San-Yuan Huang
- Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan; Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan.
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20
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Zanchettin AM, Bascetta L, Rocco P. Acceptability of robotic manipulators in shared working environments through human-like redundancy resolution. APPLIED ERGONOMICS 2013; 44:982-989. [PMID: 23602091 DOI: 10.1016/j.apergo.2013.03.028] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/11/2012] [Revised: 02/26/2013] [Accepted: 03/21/2013] [Indexed: 06/02/2023]
Abstract
Next generation robotic manipulators are expected to resemble a human-like behavior at kinematic level, in order to reach the same level of dexterity of humans in operations like assembly of small pieces. These manipulators are also expected to share the same working environments with humans without artificial barriers. In this work we conjecture that making robots not only kinematically similar but also able to move and act in the same way as humans do, might facilitate their social acceptance. For this the kinematic redundancy of such new generation manipulators can be exploited. An experimental campaign has been organized to assess the physiological comfort/discomfort perceived by humans working side-by-side with robots. For comparison, a human-like and two alternative redundancy resolution strategies have been implemented. The analysis confirmed the hypothesis that a human-like motion of the robot helps in facilitating social acceptance, by reducing the perceived stress by humans in human-robot coexistence.
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Affiliation(s)
- Andrea Maria Zanchettin
- Politecnico di Milano, Dipartimento di Elettronica, Informazione e Bioingegneria, Piazza Leonardo da Vinci, 32, Milano, Italy.
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21
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Schmitz J, Tuschen-Caffier B, Wilhelm FH, Blechert J. Taking a closer look: autonomic dysregulation in socially anxious children. Eur Child Adolesc Psychiatry 2013; 22:631-40. [PMID: 23549960 DOI: 10.1007/s00787-013-0405-y] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2012] [Accepted: 03/19/2013] [Indexed: 11/26/2022]
Abstract
Previous research on autonomic characteristics of social anxiety in children and adolescents has produced highly inconsistent results which may partially be due to task differences and a limited breadth of autonomic measurement. Here we investigated a sample of high (HSA) and low socially anxious (LSA) children, aged 10-12 years before, during and after a standardized evaluated speech task while acquiring a broad set of autonomic and experiential measures. During baseline, we found evidence for tonically higher sympathetic autonomic activity in HSA children, indicated by higher low frequency heart rate variability (LF) and a trend for higher LF to high frequency heart rate variability ratios (LF/HF). In response to the speech task, HSA children showed blunted cardiac responding evidenced by slower increase and delayed recovery of heart rate and a similar significant trend on LF/HF values. Self-reported anxiety, by contrast, showed enhanced reactivity from baseline to anticipation in the HSA compared to the LSA group. The results suggest a restricted cardiac flexibility in HSA children and illustrate that broad autonomic assessment during a well-structured, naturalistic task may improve our understanding of the autonomic physiology of socially anxious children. The results have implications for current theories of social anxiety.
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Affiliation(s)
- Julian Schmitz
- Department for Clinical Psychology and Psychotherapy, University of Freiburg, Engelbergerstrasse 41, 79106, Freiburg, Germany,
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22
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Novakova B, Harris PR, Ponnusamy A, Reuber M. The role of stress as a trigger for epileptic seizures: a narrative review of evidence from human and animal studies. Epilepsia 2013; 54:1866-76. [PMID: 24117321 DOI: 10.1111/epi.12377] [Citation(s) in RCA: 77] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/14/2013] [Indexed: 12/24/2022]
Abstract
Stress is one of the most frequently self-identified seizure triggers in patients with epilepsy; however, most previous publications on stress and epilepsy have focused on the role of stress in the initial development of epilepsy. This narrative review explores the causal role of stress in triggering seizures in patients with existing epilepsy. Findings from human studies of psychological stress, as well as of physiologic stress responses in humans and animals, and evidence from nonpharmacologic interventions for epilepsy are considered. The evidence from human studies for stress as a trigger of epileptic seizures is inconclusive. Although retrospective self-report studies show that stress is the most common patient-perceived seizure precipitant, prospective studies have yielded mixed results and studies of life events suggest that stressful experiences only trigger seizures in certain individuals. There is limited evidence suggesting that autonomic arousal can precede seizures. Interventions designed to improve coping with stress reduce seizures in some individuals. Studies of physiologic stress using animal epilepsy models provide more convincing evidence. Exposure to exogenous and endogenous stress mediators has been found to increase epileptic activity in the brain and trigger overt seizures, especially after repeated exposure. In conclusion, stress is likely to exacerbate the susceptibility to epileptic seizures in a subgroup of individuals with epilepsy and may play a role in triggering "spontaneous" seizures. However, there is currently no strong evidence for a close link between stress and seizures in the majority of people with epilepsy, although animal research suggests that such links are likely. Further research is needed into the relationship between stress and seizures and into interventions designed to reduce perceived stress and improve quality of life with epilepsy.
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Affiliation(s)
- Barbora Novakova
- Department of Neuroscience, University of Sheffield, Sheffield, United Kingdom
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Wang SM, Yeon B, Hwang S, Lee HK, Kweon YS, Lee CT, Chae JH, Lee KU. Threat-induced autonomic dysregulation in panic disorder evidenced by heart rate variability measures. Gen Hosp Psychiatry 2013; 35:497-501. [PMID: 23845286 DOI: 10.1016/j.genhosppsych.2013.06.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2013] [Revised: 05/22/2013] [Accepted: 06/04/2013] [Indexed: 01/08/2023]
Abstract
OBJECTIVE The objective was to compare autonomic response to threatening stimuli between patients with panic disorder (PD) and healthy volunteers by using 5-min recordings of heart rate variability (HRV). METHODS Twenty-seven patients with PD and 20 healthy controls were recruited. The first 5-min measurement of HRV was conducted at resting state. HRV measurement during threatening stimuli was conducted while participants were viewing 15 threatening pictures. Spectral analyses measures included high-frequency (HF; 0.15-0.4 HZ) component, low-frequency (LF; 0.04-0.15 Hz) component and LF/HF ratio. RESULTS There was no significant HRV difference between the two groups at the resting state. During threatening stimuli, the PD group had significantly higher LF power and LF/HF ratio and significantly lower HF power than the healthy controls (for all, P<.01). A two-way analysis of variance was employed to determine the effect of group (patient and control) and condition (threatening and resting) on all three HRV measures. The analysis showed a significant main effect of group (F=12.21; P<.01), condition (F=14.21; P<.001) and interaction effect between group and condition (F=4.83; P<.05) on LF/HF ratio. CONCLUSIONS The findings from the present study suggest that patients with PD exhibit a sympathetic predominance when faced with threatening stimuli compared with normal control subjects.
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Affiliation(s)
- Sheng-Min Wang
- Department of Psychiatry, Uijeongbu St. Mary's Hospital, The Catholic University of Korea College of Medicine, Uijeongbu 480-130, South Korea
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Chang HA, Chang CC, Tzeng NS, Kuo TBJ, Lu RB, Huang SY. Cardiac autonomic dysregulation in acute schizophrenia. Acta Neuropsychiatr 2013; 25:155-64. [PMID: 25287469 DOI: 10.1111/acn.12014] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
OBJECTIVE Altered cardiac autonomic function has been proposed in schizophrenia, but the results are mixed. Therefore, analyses with larger sample sizes and better methodology are needed. METHODS To examine whether acute schizophrenia is associated with cardiac autonomic dysfunction, 314 unmedicated patients with acute schizophrenia and 409 healthy volunteers, aged 18-65 years, were recruited for a case-control analysis. The severity of schizophrenia symptoms was assessed with the Positive and Negative Syndrome Scale. Cardiac autonomic function was evaluated by measuring heart rate variability (HRV) parameters during the supine-standing-supine test. Frequency-domain indices of HRV were obtained. RESULTS Unmedicated patients with acute schizophrenia consistently exhibited reduced mean RR interval and HRV levels in a supine rest and standing position compared with healthy volunteers. The severity of psychopathology, in particular positive symptoms, was negatively correlated with cardiac vagal control. CONCLUSION These data suggest that acute schizophrenia is accompanied by cardiac autonomic dysregulation. In view of the higher risk for cardiac complications in these patients, one might also consider the antipsychotic treatment in favour of improving cardiac autonomic modulation. Further studies using larger patient groups and controlled therapeutics may better understand the influence of antipsychotic treatment on cardiac autonomic regulation in schizophrenia.
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Affiliation(s)
- Hsin-An Chang
- 1 Department of Psychiatry, Tri-Service General Hospital, Taipei, Taiwan, ROC
| | - Chuan-Chia Chang
- 1 Department of Psychiatry, Tri-Service General Hospital, Taipei, Taiwan, ROC
| | - Nian-Sheng Tzeng
- 1 Department of Psychiatry, Tri-Service General Hospital, Taipei, Taiwan, ROC
| | - Terry B J Kuo
- 2 Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan, ROC
| | - Ru-Band Lu
- 3 Institute of Behavioral Medicine and Department of Psychiatry, College of Medicine, National Cheng Kung University, Tainan, Taiwan, ROC
| | - San-Yuan Huang
- 1 Department of Psychiatry, Tri-Service General Hospital, Taipei, Taiwan, ROC
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Agorastos A, Boel JA, Heppner PS, Hager T, Moeller-Bertram T, Haji U, Motazedi A, Yanagi MA, Baker DG, Stiedl O. Diminished vagal activity and blunted diurnal variation of heart rate dynamics in posttraumatic stress disorder. Stress 2013; 16:300-10. [PMID: 23167763 DOI: 10.3109/10253890.2012.751369] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Affected autonomic heart regulation is implicated in the pathophysiology of cardiovascular diseases and is associated with posttraumatic stress disorder (PTSD). However, although sympathetic hyperactivation has been repeatedly shown in PTSD, research has neglected parasympathetic function. The objective of this study is the long-term assessment of heart rate (HR) dynamics and its diurnal changes as an index of autonomic imbalance in PTSD. Since tonic parasympathetic activity underlies long-range correlation of heartbeat interval fluctuations in the healthy state, we included nonlinear (unifractal) analysis as an important and sensitive readout to assess functional alterations. We conducted electrocardiogram recordings over a 24-h period in 15 deployed male subjects with moderate to high levels of combat exposure (PTSD: n = 7; combat controls: n = 8) in the supine position. HR dynamics were assessed in two 5-h sub-epochs in the time and frequency domains, and by nonlinear analysis based on detrended fluctuation analysis. Psychiatric symptoms were assessed using structured interviews, including the Clinician Administered PTSD Scale. Subjects with PTSD showed significantly higher baseline HR, higher LF/HF ratio in the frequency domain, blunted differences between day and night-time measures, as well as a higher scaling coefficient αfast during the day, indicating diminished tonic parasympathetic activity. Diminished diurnal differences and blunted tonic parasympathetic activity altering HR dynamics suggest central neuroautonomic dysregulation that could represent a possible link to increased cardiovascular disease in PTSD.
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Affiliation(s)
- Agorastos Agorastos
- Veterans Affairs Center of Excellence for Stress and Mental Health, VA San Diego, CA, USA
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Barkay G, Freedman N, Lester H, Louzoun Y, Sapoznikov D, Luckenbaugh D, Shalev AY, Chisin RG, Bonne O. Brain activation and heart rate during script-driven traumatic imagery in PTSD: preliminary findings. Psychiatry Res 2012; 204:155-60. [PMID: 23137802 DOI: 10.1016/j.pscychresns.2012.08.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2011] [Revised: 07/31/2012] [Accepted: 08/16/2012] [Indexed: 12/30/2022]
Abstract
Patients with posttraumatic stress disorder (PTSD) experience psychological and physiological distress. However, imaging research has mostly focused on the psychological aspects of the disorder. Considered an expression of distress, heart rate (HR) in PTSD is often elevated. In the current study, we sought to identify brain regions associated with increased HR in PTSD. Nine patients with PTSD and six healthy trauma survivors were scanned while resting, clenching teeth, and listening to neutral and traumatic scripts. Brain function was evaluated using H2O15 positron emission tomography (PET). HR was monitored by electrocardiogram. Data were analyzed using statistical parametric mapping (SPM). Subjects with PTSD exhibited a significant increase in HR upon exposure to traumatic scripts, while trauma survivors did not. Correlations between regional cerebral blood flow and HR were found only in patients with PTSD, in orbitofrontal, precentral and occipital regions. Neither group showed correlation between rCBF and HR in the amygdala or hippocampus. These preliminary results indicate that "top down" central nervous system regulation of autonomic stress response in PTSD may involve associative, sensory and motor areas in addition to regions commonly implicated in fear conditioning.
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Affiliation(s)
- Gavriel Barkay
- Department of Psychiatry, Tel Aviv Sourasky Medical Center, 6 Weizman Street, Tel Aviv, Israel
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27
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Imeraj L, Sonuga-Barke E, Antrop I, Roeyers H, Wiersema R, Bal S, Deboutte D. Altered circadian profiles in attention-deficit/hyperactivity disorder: An integrative review and theoretical framework for future studies. Neurosci Biobehav Rev 2012; 36:1897-919. [DOI: 10.1016/j.neubiorev.2012.04.007] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2011] [Revised: 04/20/2012] [Accepted: 04/23/2012] [Indexed: 12/26/2022]
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Ponnusamy A, Marques JL, Reuber M. Comparison of heart rate variability parameters during complex partial seizures and psychogenic nonepileptic seizures. Epilepsia 2012; 53:1314-21. [DOI: 10.1111/j.1528-1167.2012.03518.x] [Citation(s) in RCA: 84] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Abstract
Zusammenfassung. Eine Vielzahl psychischer Störungen im DSM-IV und ICD-10 beinhalten Symptome einer maladaptiven Emotionsregulation. Der folgende Beitrag beinhaltet einen Überblick zu Definition und Funktion von Emotionsregulation (ER). Danach werden neurowissenschaftliche Modellvorstellungen der ER und empirische Befunde zu neuronalen Korrelaten von ER-Prozessen vorgestellt. Anschließend dokumentiere ich überblicksartig Studienbefunde zur Bedeutung von ER-Prozessen für internalisierende und externalisierende Störungen. Der Beitrag schließt mit Anregungen bezüglich zukünftiger Forschungsansätze und Integration in die Psychotherapieforschung.
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Ponnusamy A, Marques JLB, Reuber M. Heart rate variability measures as biomarkers in patients with psychogenic nonepileptic seizures: potential and limitations. Epilepsy Behav 2011; 22:685-91. [PMID: 21975299 DOI: 10.1016/j.yebeh.2011.08.020] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2011] [Revised: 08/04/2011] [Accepted: 08/19/2011] [Indexed: 02/01/2023]
Abstract
Heart rate variability (HRV) metrics provide reliable information about the functioning of the autonomic nervous system (ANS) and have been discussed as biomarkers in anxiety and personality disorders. We wanted to explore the potential of various HRV metrics (VLF, LF, HF, SDNN, RMSSD, cardiovagal index, cardiosympathetic index, approximate entropy) as biomarkers in patients with psychogenic nonepileptic seizures (PNES). HRV parameters were extracted from 3-minute resting single-lead ECGs of 129 subjects (52 with PNES, 42 with refractory epilepsy and 35 age-matched healthy controls). Compared with healthy controls, both patient groups had reduced HRV (all measures P<0.03). Binary logistic regression analyses yielded significant models differentiating between healthy controls and patients with PNES or patients with epilepsy (correctly classifying 86.2 and 93.5% of cases, respectively), but not between patients with PNES and those with epilepsy. Interictal resting parasympathetic activity and sympathetic activity differ between healthy controls and patients with PNES or those with epilepsy. However, resting HRV measures do not differentiate between patients with PNES and those with epilepsy.
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Affiliation(s)
- Athi Ponnusamy
- Department of Clinical Neurophysiology, Royal Hallamshire Hospital, Sheffield, UK.
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31
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Henriques G, Keffer S, Abrahamson C, Horst SJ. Exploring the effectiveness of a computer-based heart rate variability biofeedback program in reducing anxiety in college students. Appl Psychophysiol Biofeedback 2011; 36:101-12. [PMID: 21533678 DOI: 10.1007/s10484-011-9151-4] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Given the pervasiveness of stress and anxiety in our culture it is important to develop and implement interventions that can be easily utilized by large numbers of people that are readily available, inexpensive and have minimal side effects. Two studies explored the effectiveness of a computer-based heart rate variability biofeedback program on reducing anxiety and negative mood in college students. A pilot project (n = 9) of highly anxious students revealed sizable decreases in anxiety and negative mood following utilizing the program for 4 weeks. A second study (n = 35) employing an immediate versus delayed treatment design replicated the results, although the magnitude of the impact was not quite as strong. Despite observing decreases in anxiety, the expected changes in psychophysiological coherence were not observed.
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Affiliation(s)
- Gregg Henriques
- Graduate Psychology, James Madison University, Harrisonburg, VA, USA.
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Kamata N, Tanaka K, Morita S, Tagaya H, Kawashima M, Shichiri M, Miyaoka H. Relationship between autonomic nervous system activity during sleep and fasting glucose in Japanese workers. INDUSTRIAL HEALTH 2011; 49:427-433. [PMID: 21697626 DOI: 10.2486/indhealth.ms1257] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Although autonomic nervous system activity is reportedly related to diurnal glucose tolerance impairment, the relationship with glucose tolerance during sleep is unclear. Since work styles have recently diversified, it is important to assess the effect of sleep on workers' health. Elucidation of the relationship between autonomic nervous system activity during sleep and glucose tolerance in workers may facilitate preventive measures against diabetes using non-pharmacological means (e.g., sleep hygiene education, relaxation techniques and stress management). We examined whether autonomic nervous system activity during sleep is related to fasting glucose or glycated hemoglobin (HbA1c) in individuals with either normal or impaired fasting glucose tolerance. The subjects were 77 apparently healthy Japanese workers with normal or impaired fasting glucose. We used high frequency (HF) and the ratio of low frequency to high frequency (LF/HF) obtained by pulse wave analysis to estimate autonomic nervous system activity. The data were analyzed using a generalized estimating equation adjusted for potential confounders (age, gender, engagement in shift work, sleep duration, and body mass index). Fasting glucose was significantly negatively related to HF, the parasympathetic component during sleep. Our results suggest that parasympathetic activity during sleep is associated with fasting glucose in apparently healthy Japanese workers.
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Affiliation(s)
- Naoki Kamata
- Department of Psychiatry, Graduate School of Medical Sciences, Kitasato University, 1–15–1 Kitasato, Minami-ku, Sagamihara, Kanagawa, Japan.
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Radulescu AR, Rubin D, Strey HH, Mujica-Parodi LR. Power spectrum scale invariance identifies prefrontal dysregulation in paranoid schizophrenia. Hum Brain Mapp 2011; 33:1582-93. [PMID: 21567663 DOI: 10.1002/hbm.21309] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2010] [Revised: 01/14/2011] [Accepted: 02/18/2011] [Indexed: 11/08/2022] Open
Abstract
Theory and experimental evidence suggest that complex living systems function close to the boundary of chaos, with erroneous organization to an improper dynamical range (too stiff or chaotic) underlying system-wide dysregulation and disease. We hypothesized that erroneous organization might therefore also characterize paranoid schizophrenia, via optimization abnormalities in the prefrontal-limbic circuit regulating emotion. To test this, we acquired fMRI scans from 35 subjects (N = 9 patients with paranoid schizophrenia and N = 26 healthy controls), while they viewed affect-valent stimuli. To quantify dynamic regulation, we analyzed the power spectrum scale invariance (PSSI) of fMRI time-courses and computed the geometry of time-delay (Poincaré) maps, a measure of variability. Patients and controls showed distinct PSSI in two clusters (k(1) : Z = 4.3215, P = 0.00002 and k(2) : Z = 3.9441, P = 0.00008), localized to the orbitofrontal/medial prefrontal cortex (Brodmann Area 10), represented by β close to white noise in patients (β ≈ 0) and in the pink noise range in controls (β ≈ -1). Interpreting the meaning of PSSI differences, the Poincaré maps indicated less variability in patients than controls (Z = -1.9437, P = 0.05 for k(1) ; Z = -2.5099, P = 0.01 for k(2) ). That the dynamics identified Brodmann Area 10 is consistent with previous schizophrenia research, which implicates this area in deficits of working memory, executive functioning, emotional regulation and underlying biological abnormalities in synaptic (glutamatergic) transmission. Our results additionally cohere with a large body of work finding pink noise to be the normal range of central function at the synaptic, cellular, and small network levels, and suggest that patients show less supple responsivity of this region.
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Affiliation(s)
- Anca R Radulescu
- Department of Biomedical Engineering, Stony Brook University School of Medicine, Stony Brook, New York 11794-5281, USA
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Cardiac vagal control in nonmedicated depressed women and nondepressed controls: impact of depression status, lifetime trauma history, and respiratory factors. Psychosom Med 2011; 73:336-43. [PMID: 21364194 PMCID: PMC3090496 DOI: 10.1097/psy.0b013e318213925d] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To evaluate the impact of acute stress and relationship-focused imagery on cardiac vagal control, as indicated by levels of respiratory sinus arrhythmia (RSA), in depressed and nondepressed women. Impairment in cardiac parasympathetic (vagal) control may confer risk for cardiac mortality in depressed populations. METHODS Electrocardiogram and respiratory rate were evaluated in 15 nonmedicated depressed women and 15 matched controls during two laboratory conditions: 1) a relationship-focused imagery designed to elicit vagal activation; and 2) a speech stressor designed to evoke vagal withdrawal. RESULTS As expected, the relationship-focused imagery increased RSA (F(3,66) = 3.79, p = .02) and the speech stressor decreased RSA (F(3,66) = 4.36, p = .02) across women. Depressed women exhibited lower RSA during the relationship-focused imagery, and this effect remained after control for respiratory rate and trauma history (F(1,21) = 5.65, p = .027). Depressed women with a trauma history exhibited the lowest RSA during the stress condition (F(1,22) = 9.61, p = .05). However, after controlling for respiratory rate, Trauma History × Task Order (p = .02) but not Trauma History × Depression Group (p = .12) accounted for RSA variation during the stress condition. CONCLUSION Depression in women is associated with lower RSA, particularly when women reflect on a close love relationship, a context expected to elicit vagal activation and hence increase RSA. In contrast, depression-related variation in stressor-evoked vagal activity seems to covary with women's trauma history. Associations between vagal activity and depression are complex and should be considered in view of the experimental conditions under which vagal control is assessed, as well as physiological and behavioral factors that may affect vagal function.
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Romanowicz M, Schmidt JE, Bostwick JM, Mrazek DA, Karpyak VM. Changes in heart rate variability associated with acute alcohol consumption: current knowledge and implications for practice and research. Alcohol Clin Exp Res 2011; 35:1092-105. [PMID: 21332532 DOI: 10.1111/j.1530-0277.2011.01442.x] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Alcohol consumption is associated with a broad array of physiologic and behavioral effects including changes in heart rate. However, the physiologic mechanisms of alcohol effects and the reasons for individual differences in the cardiac response remain unknown. Measuring changes in resting heart rate (measured as beats/min) has not been found to be as sensitive to alcohol's effects as changes in heart rate variability (HRV). HRV is defined as fluctuations in interbeat interval length which reflect the heart's response to extracardiac factors that affect heart rate. HRV allows simultaneous assessment of both sympathetic and parasympathetic activity and the interplay between them. Increased HRV has been associated with exercise and aerobic fitness, while decreased HRV has been associated with aging, chronic stress, and a wide variety of medical and psychiatric disorders. Decreased HRV has predictive value for mortality in general population samples and patients with myocardial infarction and used as an indicator of altered autonomic function. A significant inverse correlation was found between HRV and both the severity of depression and the duration of the depressive episode. HRV analysis provides insights into mechanisms of autonomic regulation and is extensively used to clarify relationships between depression and cardiovascular disease. This article will review the methodology of HRV measurements and contemporary knowledge about effects of acute alcohol consumption on HRV. Potential implications of this research include HRV response to alcohol that could serve as a marker for susceptibility to alcoholism. At present however there is almost no research data supporting this hypothesis.
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Affiliation(s)
- Magdalena Romanowicz
- Department of Psychiatry and Psychology, Mayo Clinic College of Medicine, 200 First Street SW, Rochester, MN 55905, USA
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36
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Fairchild KD, O'Shea TM. Heart rate characteristics: physiomarkers for detection of late-onset neonatal sepsis. Clin Perinatol 2010; 37:581-98. [PMID: 20813272 PMCID: PMC2933427 DOI: 10.1016/j.clp.2010.06.002] [Citation(s) in RCA: 90] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Early detection of late-onset neonatal sepsis, before the onset of obvious and potentially catastrophic clinical signs, is an important goal in neonatal medicine. Sepsis causes a well-known series of physiologic changes including abnormalities of blood pressure, respiration, temperature, and heart rate, and less well-known changes in heart rate variability. Although vital signs are frequently or continuously monitored in patients in the neonatal intensive care unit (NICU), changes in these parameters are subtle in the early phase of sepsis and difficult to interpret using traditional NICU monitoring tools. A new tool, continuous monitoring of heart rate characteristics (HRC), is now available for clinical use. Recent research has established that 2 abnormalities of HRC that have long been used by obstetricians to identify fetal compromise, reduced heart rate variability and transient decelerations, occur early in the course of sepsis in patients in the NICU, often before clinical signs of illness. Through mathematical modeling of electrocardiogram data from hundreds of patients in the NICU, an HRC index that represents the fold increase in risk that a neonate will be diagnosed with clinical or culture-proven sepsis within the next 24 hours was derived. The effect of continuous HRC monitoring on outcomes in preterm very low birth weight infants is the subject of a multicenter randomized clinical trial of 3000 patients, which will be complete in 2010. Further research into mechanisms of abnormal HRC and regulation of autonomic nervous system function in sepsis and other disease processes will shed light on additional applications of this exciting new technology.
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Affiliation(s)
- Karen D. Fairchild
- Associate Professor of Pediatrics Division of Neonatology University of Virginia
| | - T. Michael O'Shea
- Professor of Pediatrics Chief, Division of Neonatology Wake Forest University
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37
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Heart Rate Variability (HRV) and Posttraumatic Stress Disorder (PTSD): A Pilot Study. Appl Psychophysiol Biofeedback 2010; 36:27-35. [DOI: 10.1007/s10484-010-9141-y] [Citation(s) in RCA: 154] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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38
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Pu J, Schmeichel BJ, Demaree HA. Cardiac vagal control predicts spontaneous regulation of negative emotional expression and subsequent cognitive performance. Biol Psychol 2010. [DOI: 10.1016/j.biopsycho.2009.07.006] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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Müngen B, Berilgen MS, Arıkanoğlu A. Autonomic nervous system functions in interictal and postictal periods of nonepileptic psychogenic seizures and its comparison with epileptic seizures. Seizure 2010; 19:269-73. [DOI: 10.1016/j.seizure.2010.04.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2009] [Revised: 03/06/2010] [Accepted: 04/01/2010] [Indexed: 10/19/2022] Open
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Filaire E, Portier H, Massart A, Ramat L, Teixeira A. Effect of lecturing to 200 students on heart rate variability and alpha-amylase activity. Eur J Appl Physiol 2009; 108:1035-43. [PMID: 20012447 DOI: 10.1007/s00421-009-1310-4] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/23/2009] [Indexed: 10/20/2022]
Abstract
The aim of this study was to examine cardiovascular [heart rate variability (HRV)] and autonomic nervous system activation (by evaluating salivary alpha-amylase activity) that occur in professors both to, and after, the delivery of a lecture to 200 students and to determine whether gender is an influencing factor upon response. Fifty-two participants (26 women and 26 men) collected eight unstimulated saliva samples on 2 days (one a working day on which the lecture was given, the other a non-work or rest day). They also completed the Trait version of the State-Trait Anxiety Inventory (STAI) to assess their dispositional anxiety on the rest day and the State section of the STAI 15 min before and 10 min after their lecture, repeated at the same hour on the control (rest) day. The Perceived Stress Scale (PSS) was also recorded 15 min before the lecture. Continuous RR intervals were recorded before and after the lecture and the following HRV parameters were calculated: total spectral power (P (TOT)); the spectral power of the low frequency component (P (LF)); the high frequency component (P (HF)); and the ratio LF/HF. A reduction (P < 0.05) in the HF and HFnu component of HRV and an increase in the LH/HF ratio (P < 0.05) were observed at the end of the lecture. AA activity measured on the teaching day was significantly higher than that noted on the resting day. Lecturing resulted in a significant increase in the secretion of the stress marker alpha-amylase. Men and women did not differ in trait and state anxiety and no gender differences for HRV or AA activity were found.
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Affiliation(s)
- Edith Filaire
- Laboratoire AMAPP, UFRSTAPS-2, allée du Château, BP 6237, 45062, Orléans Cedex, France.
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Thayer JF, Yamamoto SS, Brosschot JF. The relationship of autonomic imbalance, heart rate variability and cardiovascular disease risk factors. Int J Cardiol 2009; 141:122-31. [PMID: 19910061 DOI: 10.1016/j.ijcard.2009.09.543] [Citation(s) in RCA: 1295] [Impact Index Per Article: 86.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2009] [Accepted: 09/09/2009] [Indexed: 12/12/2022]
Abstract
Cardiovascular disease (CVD) is the leading cause of death and disability worldwide. The understanding of the risk factors for CVD may yield important insights into the prevention, etiology, course, and treatment of this major public health concern. Autonomic imbalance, characterized by a hyperactive sympathetic system and a hypoactive parasympathetic system, is associated with various pathological conditions. Over time, excessive energy demands on the system can lead to premature aging and diseases. Therefore, autonomic imbalance may be a final common pathway to increased morbidity and mortality from a host of conditions and diseases, including cardiovascular disease. Heart rate variability (HRV) may be used to assess autonomic imbalances, diseases and mortality. Parasympathetic activity and HRV have been associated with a wide range of conditions including CVD. Here we review the evidence linking HRV to established and emerging modifiable and non-modifiable CVD risk factors such as hypertension, obesity, family history and work stress. Substantial evidence exists to support the notion that decreased HRV precedes the development of a number of risk factors and that lowering risk profiles is associated with increased HRV. We close with a suggestion that a model of autonomic imbalance may provide a unifying framework within which to investigate the impact of risk factors, including psychosocial factors and work stress, on cardiovascular disease.
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Affiliation(s)
- Julian F Thayer
- The Ohio State University, Department of Psychology, 1835 Neil Avenue, Columbus, Ohio 43210, USA.
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Bakvis P, Roelofs K, Kuyk J, Edelbroek PM, Swinkels WA, Spinhoven P. Trauma, stress, and preconscious threat processing in patients with psychogenic nonepileptic seizures. Epilepsia 2009; 50:1001-11. [DOI: 10.1111/j.1528-1167.2008.01862.x] [Citation(s) in RCA: 145] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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43
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Miu AC, Heilman RM, Miclea M. Reduced heart rate variability and vagal tone in anxiety: trait versus state, and the effects of autogenic training. Auton Neurosci 2008; 145:99-103. [PMID: 19059813 DOI: 10.1016/j.autneu.2008.11.010] [Citation(s) in RCA: 126] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2007] [Revised: 11/13/2008] [Accepted: 11/19/2008] [Indexed: 11/27/2022]
Abstract
This study investigated heart rate variability (HRV) in healthy volunteers that were selected for extreme scores of trait anxiety (TA), during two opposite psychophysiological conditions of mental stress, and relaxation induced by autogenic training. R-R intervals, HF and LF powers, and LF/HF ratios were derived from short-term electrocardiographic recordings made during mental stress and relaxation by autogenic training, with respiratory rate and skin conductance being controlled for in all the analyses. The main finding was that high TA was associated with reduced R-R intervals and HF power across conditions. In comparison to mental stress, autogenic training increased HRV and facilitated the vagal control of the heart. There were no significant effects of TA or the psychophysiological conditions on LF power, or LF/HF ratio. These results support the view that TA, which is an important risk factor for anxiety disorders and predictor of cardiovascular morbidity and mortality, is associated with autonomic dysfunction that seems likely to play a pathogenetic role in the long term.
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Affiliation(s)
- Andrei C Miu
- Program of Cognitive Neuroscience, Department of Psychology, Babes-Bolyai University, Cluj-Napoca, CJ 400015, Romania.
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Shinba T, Kariya N, Matsui Y, Ozawa N, Matsuda Y, Yamamoto KI. Decrease in heart rate variability response to task is related to anxiety and depressiveness in normal subjects. Psychiatry Clin Neurosci 2008; 62:603-9. [PMID: 18950382 DOI: 10.1111/j.1440-1819.2008.01855.x] [Citation(s) in RCA: 80] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIMS Previous studies have shown that heart rate variability (HRV) measurement is useful in investigating the pathophysiology of various psychiatric disorders. The present study further examined its usefulness in evaluating the mental health of normal subjects with respect to anxiety and depressiveness. METHODS Heart rate (HR) and HRV were measured tonometrically at the wrist in 43 normal subjects not only in the resting condition but also during a task (random number generation) to assess the responsiveness. For HRV measurement, high-frequency (HF; 0.15-0.4 Hz) and low-frequency (LF; 0.04-0.15 Hz) components of HRV were obtained using MemCalc, a time series analysis technique that combines a non-linear least square method with maximum entropy method. For psychological evaluation of anxiety and depressiveness, two self-report questionnaires were used: State-Trait Anxiety Inventory (STAI) and Self-Rating Depression Scale (SDS). RESULTS No significant relation was observed between HR and HRV indices, and the psychological scores both in the resting and task conditions. By task application, HF decreased, and LF/HF and HR increased, and significant correlation with psychological scores was found in the responsiveness to task measured by the ratio of HRV and HR indices during the task to that at rest (task/rest ratio). A positive relationship was found between task/rest ratio for HF, and STAI and SDS scores. Task/rest ratio of HR was negatively correlated with STAI-state score. CONCLUSION Decreased HRV response to task application is related to anxiety and depressiveness. Decreased autonomic responsiveness could serve as a sign of psychological dysfunction.
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Affiliation(s)
- Toshikazu Shinba
- Stress Disorders Research Team, Tokyo Institute of Psychiatry, Metropolitan Ohtsuka Hospital, Tokyo, Japan.
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45
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Ohira H, Isowa T, Nomura M, Ichikawa N, Kimura K, Miyakoshi M, Iidaka T, Fukuyama S, Nakajima T, Yamada J. Imaging brain and immune association accompanying cognitive appraisal of an acute stressor. Neuroimage 2007; 39:500-14. [PMID: 17913515 DOI: 10.1016/j.neuroimage.2007.08.017] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2006] [Revised: 07/24/2007] [Accepted: 08/17/2007] [Indexed: 12/30/2022] Open
Abstract
Acute stress elicits multiple responses in autonomic, endocrine, and immune systems. Cognitive appraisal is believed to be one important modulator of such stress responses. To investigate brain substrates of crosstalks between the homeostasis-maintaining systems accompanying appraisal of stressor controllability, we simultaneously recorded regional cerebral blood flow (rCBF) using 15O-water positron emission tomography, cardiovascular indices (heart rate (HR) and blood pressure (BP)), neuroendocrine indices (concentrations of epinephrine, norepinephrine, and adrenocorticotropic hormone (ACTH) in blood), and immune indices (proportions of subsets of lymphocytes (NK cells, helper T cells, cytotoxic T cells, and B cells) in blood), in 11 male subjects who performed a mental arithmetic task with either high controllability (HC) and low controllability (LC). The LC task resulted in less sense of control in subjects than the HC task. Significant increases of rCBF in the medial and lateral orbitofrontal cortices (OFC), and in the medial and lateral prefrontal cortices (MPFC, LPFC) were observed by subtracting the HC task from the LC task. More importantly, significant positive correlations between rCBF and HR, BP, and NK cells were commonly found in the OFC and MPFC during the LC tasks, but not during the HC tasks. The present results showed for the first time that the prefrontal neural network including the OFC and MPFC might be one pivotal region for bi-directional functional association between the brain and peripheral autonomic and immune activities accompanying appraisal of an acute stressor.
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Affiliation(s)
- Hideki Ohira
- Department of Psychology, Nagoya University, Furo-cho, Chikusa-ku, Nagoya, 464-8601 Japan.
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Abstract
Cardiac vagal control, as measured by indices of respiratory sinus arrhythmia (RSA), has been investigated as a marker of impaired self-regulation in mental disorders, including depression. Past work in depressed samples has focused on deficits in resting RSA levels, with mixed results. This study tested the hypothesis that depression involves abnormal RSA fluctuation. RSA was measured in depressed and healthy control participants during rest and during two reactivity tasks, each followed by a recovery period. Relative to controls, depressed persons exhibited lower resting RSA levels as well as less RSA fluctuation, primarily evidenced by a lack of task-related vagal suppression. Group differences in RSA fluctuation were not accounted for by differences in physical health or respiration, whereas group differences in resting RSA level did not survive covariate analyses. Depression may involve multiple deficits in cardiac vagal control.
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Affiliation(s)
- Jonathan Rottenberg
- Mood and Emotion Laboratory, Department of Psychology, University of South Florida, 4202 E. Fowler Avenue, Tampa, FL 33620, USA.
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47
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Thayer JF, Sternberg E. Beyond heart rate variability: vagal regulation of allostatic systems. Ann N Y Acad Sci 2007; 1088:361-72. [PMID: 17192580 DOI: 10.1196/annals.1366.014] [Citation(s) in RCA: 448] [Impact Index Per Article: 26.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
The autonomic nervous system (ANS) plays a role in a wide range of somatic and mental diseases. Whereas the role of the ANS in the regulation of the cardiovascular system seems evident, its role in the regulation of other systems associated with allostasis is less clear. Using a model of neurovisceral integration we describe how the ANS and parasympathetic tone in particular may be associated with the regulation of allostatic systems associated with glucose regulation, hypothalamic-pituitary-adrenal (HPA) axis function, and inflammatory processes. Decreased vagal function and heart rate variability (HRV) were shown to be associated with increased fasting glucose and hemoglobin A1c levels, increased overnight urinary cortisol, and increased proinflammatory cytokines and acute-phase proteins. All of these factors have been associated with increased allostatic load and poor health. Thus, vagal activity appears to play an inhibitory function in the regulation of allostatic systems. The prefrontal cortex and the amygdala are important central nervous system structures linked to the regulation of these allostatic systems via the vagus nerve. Finally, the identification of this neurovisceral regulatory system may help to illuminate the pathway via which psychosocial factors may influence health and disease.
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Affiliation(s)
- Julian F Thayer
- Department of Psychology, The Ohio State University, Columbus, OH 43210, USA.
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48
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Friedman BH. An autonomic flexibility–neurovisceral integration model of anxiety and cardiac vagal tone. Biol Psychol 2007; 74:185-99. [PMID: 17069959 DOI: 10.1016/j.biopsycho.2005.08.009] [Citation(s) in RCA: 484] [Impact Index Per Article: 28.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/16/2005] [Indexed: 11/22/2022]
Abstract
Research on heart rate variability (HRV), cardiac vagal tone, and their relationship to anxiety is reviewed in the context of the autonomic flexibility and neurovisceral integration models of adaptive functioning. These perspectives address the qualities of response flexibility and inhibition across multiple levels, incorporating central and autonomic nervous system mechanisms of environmental engagement, as well as principles derived from non-linear dynamics. These models predict reduced HRV and vagal tone in anxiety, and the literature has generally supported this prediction, with exceptions as are noted. State, trait, and clinical expressions of anxiety are considered, along with the clinical, methodological, and theoretical implications of this research. A portrayal of anxiety as a restricted response range across biological and behavioral realms of functioning is drawn from the literature on anxiety and HRV.
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Affiliation(s)
- Bruce H Friedman
- Department of Psychology, Virginia Polytechnic Institute and State University, Blacksburg, VA 24061-0436, USA.
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Nickel C, Lahmann C, Muehlbacher M, Pedrosa Gil F, Kaplan P, Buschmann W, Tritt K, Kettler C, Bachler E, Egger C, Anvar J, Fartacek R, Loew T, Rother W, Nickel M. Pregnant women with bronchial asthma benefit from progressive muscle relaxation: a randomized, prospective, controlled trial. PSYCHOTHERAPY AND PSYCHOSOMATICS 2006; 75:237-43. [PMID: 16785773 DOI: 10.1159/000092894] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND Asthma is a serious medical problem in pregnancy and is often associated with stress, anger and poor quality of life. The aim of this study was to determine the efficacy of progressive muscle relaxation (PMR) on change in blood pressure, lung parameters, heart rate, anger and health-related quality of life in pregnant women with bronchial asthma. METHODS We treated a sample of 64 pregnant women with bronchial asthma from the local population in an 8-week randomized, prospective, controlled trial. Thirty-two were selected for PMR, and 32 received a placebo intervention. The systolic blood pressure, forced expiratory volume in the first second, peak expiratory flow and heart rate were tested, and the State-Trait Anger Expression Inventory and Health Survey (SF-36) were employed. RESULTS According to the intend-to-treat principle, a significant reduction in systolic blood pressure and a significant increase in both forced expiratory volume in the first second and peak expiratory flow were observed after PMR. The heart rate showed a significant increase in the coefficient of variation, root mean square of successive differences and high frequency ranges, in addition to a significant reduction in low and middle frequency ranges. A significant reduction on three of five State-Trait Anger Expression Inventory scales, and a significant increase on seven of eight SF-36 scales were observed. CONCLUSIONS PMR appears to be an effective method to improve blood pressure, lung parameters and heart rate, and to decrease anger levels, thus enhancing health-related quality of life in pregnant women with bronchial asthma.
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Affiliation(s)
- Cerstin Nickel
- Clinic for Psychosomatic Medicine, Inntalklinik, Simbach/Inn, Germany.
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50
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Thayer JF, Lane RD. The role of vagal function in the risk for cardiovascular disease and mortality. Biol Psychol 2006; 74:224-42. [PMID: 17182165 DOI: 10.1016/j.biopsycho.2005.11.013] [Citation(s) in RCA: 652] [Impact Index Per Article: 36.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/11/2005] [Indexed: 11/22/2022]
Abstract
Cardiovascular disease (CVD) is the leading cause of death and disability worldwide. The understanding of the risk factors for CVD may yield important insights into the prevention, etiology, course, and treatment of this major public health concern. We review the evidence for the role of vagal function in the risk for cardiovascular disease and mortality. Using a broad range of indicators of vagal function including resting heart rate, heart rate recovery, heart rate variability, and baroreflex sensitivity we show that decreased vagal function is associated with an increased risk for morbidity and mortality. These effects are independent of traditional risk factors. Moreover, we show that decreased vagal function is associated with both traditional and emerging risk factors as well as modifiable and non-modifiable risk factors. Most importantly, we provide evidence to support the notion that decreased vagal function precedes the development of a number of risk factors and that modification of risk profiles in the direction of lower risk is associated with increased vagal function. We close with a brief overview of the neural concomitants of vagal function and suggest that a model of neurovisceral integration may provide a unifying framework within which to investigate the impact of risk factors, including psychosocial factors, on cardiovascular disease.
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Affiliation(s)
- Julian F Thayer
- Department of Psychology, The Ohio State University, Columbus, OH 43210, USA.
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