Music induces different cardiac autonomic arousal effects in young and older persons

Estimating the cardiac signals of chimpanzees using a digital camera: validation and application of a novel non-invasive method for primate research

Cardiac measures such as heart rate measurements are important indicators of both physiological and psychological states. However, despite their extraordinary potential, their use is restricted in comparative psychology because traditionally cardiac measures involved the attachment of sensors to the participant's body, which, in the case of undomesticated animals such as nonhuman primates, is usually only possible during anesthesia or after extensive training. Here, we validate and apply a camera-based system that enables contact-free detection of animals' heart rates. The system automatically detects and estimates the cardiac signals from cyclic change in the hue of the facial area of a chimpanzee. In Study 1, we recorded the heart rate of chimpanzees using the new technology, while simultaneously measuring heart rate using classic PPG (photoplethysmography) finger sensors. We found that both methods were in good agreement. In Study 2, we applied our new method to measure chimpanzees' heart rate in response to seeing different types of video scenes (groupmates in an agonistic interaction, conspecific strangers feeding, nature videos, etc.). Heart rates changed during video presentation, depending on the video content: Agonistic interactions and conspecific strangers feeding lead to accelerated heart rate relative to baseline, indicating increased emotional arousal. Nature videos lead to decelerated heart rate relative to baseline, indicating a relaxing effect or heightened attention caused by these stimuli. Our results show that the new contact-free technology can reliably assess the heart rate of unrestrained chimpanzees, and most likely other primates. Furthermore, our technique opens up new avenues of research within comparative psychology and facilitates the health management of captive individuals.

Music-Evoked Autobiographical Memories are Associated with Negative Affect in Younger and Older Adults

BACKGROUND

Music evokes strong and persistent emotional responses. However, the mechanisms underlying the emotional effects of music, particularly in older adults, are largely unknown. One purported mechanism by which music evokes emotions is through memory - that is, music evokes personal, autobiographical memories that then lead to emotional responses.

METHOD

Here, we investigated whether memory-evoking music induces stronger and longer-lasting emotional responses than non-memory-evoking music, and whether these emotional responses differ between younger and older adults. Older (N = 30) and younger adults (N =30) listened to two blocks of self-selected music (one block of memory-evoking music and one block of familiar but non-memory-evoking music). Participants reported their emotions prior to and at three timepoints post-listening.

RESULTS

Older adults reported higher levels of positive affect than younger adults. For both groups, positive affect increased after listening to both memory-evoking and non-memory-evoking music. However, negative affect only increased after listening to memory-evoking music.

CONCLUSIONS

These results suggest that both memory-evoking and non-memory-evoking music generate strong emotions in younger and older adults, but music that conjures personal memories is more likely to elicit mixed emotions. Our results have important clinical implications when designing music-based interventions for mood and affect, particularly in older adult populations.

Silence and its effects on the autonomic nervous system: A systematic review

This systematic review explores the influence of silence on the autonomic nervous system. The Polyvagal Theory has been used as a reference model to describe the autonomic nervous system by explaining its role in emotional regulation, social engagement, and adaptive physiological responses. PubMed, Scopus, PsycInfo, EMBASE, and Google Scholar were systematically searched up until July 2023 for relevant studies. The literature search yielded 511 results, and 37 studies were eventually included in this review. Silence affects the autonomic nervous system differently based on whether it is inner or outer silence. Inner silence enhances activity of the ventral vagus, favoring social engagement, and reducing sympathetic nervous system activity and physiological stress. Outer silence, conversely, can induce a heightened state of alertness, potentially triggering vagal brake removal and sympathetic nervous system activation, though with training, it can foster inner silence, preventing such activation. The autonomic nervous system response to silence can also be influenced by other factors such as context, familiarity with silence, presence and quality of outer noise, and empathy.

Potential impact of music interventions in managing diabetic conditions

Diabetes is one of the most prevalent diseases, characterized by an insufficiency in insulin secretion as well as chronic hyperglycemia and disturbances in carbohydrate, lipid, and protein metabolism. The major aim of this study was to conduct a literature review on the impact of music intervention on the management of diabetic conditions among patients. Available studies on the impact of music interventions on the management of diabetic conditions were reviewed and analysed using descriptive literature review approach. This review showed that music intervention plays a dual role in managing patients' diabetic conditions. First, music intervention is impactful in managing the health condition of diabetic patients through enhancing the patient’s compliance with exercise, improving lower limb blood circulation, and enhancing health parameters that increase autonomous balance among diabetic patients. Second, music therapy is impactful in the management of diabetic conditions through lowering blood sugar, heart rate, glucose levels, and stress among patients. However, with the number of empirical studies available in this regard, the impact of music intervention is still growing, and longer-term studies and randomised controlled trials with robust sample size are recommended to reach a more valid conclusion.

Posterior circulation ischemic stroke not involving the brainstem is associated with cardiovascular autonomic dysfunction

BACKGROUND AND PURPOSE

Ischemic stroke may induce cardiovascular autonomic dysfunction. Yet, most previous studies included patients with anterior circulation ischemic stroke or brainstem stroke. It remains unclear whether posterior circulation ischemic stroke (PCIS) without brainstem involvement also compromises cardiovascular autonomic modulation (CAM). Therefore, we aimed to assess CAM in PCIS patients with and without brainstem involvement.

METHODS

In four subgroups of 61 PCIS-patients (14 occipital lobe, 16 thalamic, 12 cerebellar, and 19 brainstem strokes) and 30 healthy controls, we recorded RR-intervals (RRI), systolic, diastolic blood pressures (BPsys, BPdia), and respiration at supine rest during the first week after stroke-onset. We calculated parameters reflecting total CAM [RRI-standard-deviation (RRI-SD), RRI-total-powers], predominantly sympathetic CAM [RRI-low-frequency-powers (RRI-LF-powers) and BPsys-LF-powers] and parasympathetic CAM [Root-Mean-Square-of-Successive-RRI-Differences (RMSSD), RRI-high-frequency-powers (RRI-HF-powers)], sympathetic-parasympathetic balance (RRI-LF/HF-ratios), and baroreflex-sensitivity (BRS). Values were compared between the four PCIS-groups and controls using one-way ANOVA Kruskal-Wallis-tests, with post-hoc analyses. Significance was assumed for P<0.05.

RESULTS

In each PCIS-subgroup, values of RRI, RRI-SD, RMSSD, RRI-HF-powers, and BRS were significantly lower, while BPsys-LF-powers were higher than in the controls. Only in patients with occipital lobe stroke, RRI-LF/HF-ratios were significantly higher than in controls. Otherwise, autonomic parameters did not differ between the four PCIS-subgroups.

CONCLUSIONS

During the first week after stroke-onset, our PCIS patients with occipital lobe, thalamic, cerebellar, or brainstem strokes all had reduced cardiovagal modulation, compromised baroreflex, and increased peripheral sympathetic modulation. The RRI-LF/HF-ratios suggest that sympathetic predominance is slightly more prominent after occipital lobe stroke. PCIS may trigger cardiovascular autonomic dysfunction even without brainstem involvement.

Spatial Connectivity and Temporal Dynamic Functional Network Connectivity of Musical Emotions Evoked by Dynamically Changing Tempo

Music tempo is closely connected to listeners' musical emotion and multifunctional neural activities. Music with increasing tempo evokes higher emotional responses and music with decreasing tempo enhances relaxation. However, the neural substrate of emotion evoked by dynamically changing tempo is still unclear. To investigate the spatial connectivity and temporal dynamic functional network connectivity (dFNC) of musical emotion evoked by dynamically changing tempo, we collected dynamic emotional ratings and conducted group independent component analysis (ICA), sliding time window correlations, and k-means clustering to assess the FNC of emotion evoked by music with decreasing tempo (180-65 bpm) and increasing tempo (60-180 bpm). Music with decreasing tempo (with more stable dynamic valences) evoked higher valence than increasing tempo both with stronger independent components (ICs) in the default mode network (DMN) and sensorimotor network (SMN). The dFNC analysis showed that with time-decreasing FNC across the whole brain, emotion evoked by decreasing music was associated with strong spatial connectivity within the DMN and SMN. Meanwhile, it was associated with strong FNC between the DMN-frontoparietal network (FPN) and DMN-cingulate-opercular network (CON). The paired t-test showed that music with a decreasing tempo evokes stronger activation of ICs within DMN and SMN than that with an increasing tempo, which indicated that faster music is more likely to enhance listeners' emotions with multifunctional brain activities even when the tempo is slowing down. With increasing FNC across the whole brain, music with an increasing tempo was associated with strong connectivity within FPN; time-decreasing connectivity was found within CON, SMN, VIS, and between CON and SMN, which explained its unstable valence during the dynamic valence rating. Overall, the FNC can help uncover the spatial and temporal neural substrates of musical emotions evoked by dynamically changing tempi.

Music therapy for stress reduction: a systematic review and meta-analysis

Music therapy is increasingly being used as an intervention for stress reduction in both medical and mental healthcare settings. Music therapy is characterized by personally tailored music interventions initiated by a trained and qualified music therapist, which distinguishes music therapy from other music interventions, such as 'music medicine', which concerns mainly music listening interventions offered by healthcare professionals. To summarize the growing body of empirical research on music therapy, a multilevel meta-analysis, containing 47 studies, 76 effect sizes and 2.747 participants, was performed to assess the strength of the effects of music therapy on both physiological and psychological stress-related outcomes, and to test potential moderators of the intervention effects. Results showed that music therapy showed an overall medium-to-large effect on stress-related outcomes (d = .723, [.51-.94]). Larger effects were found for clinical controlled trials (CCT) compared to randomized controlled trials (RCT), waiting list controls instead of care as usual (CAU) or other stress-reducing interventions, and for studies conducted in Non-Western countries compared to Western countries. Implications for both music therapy and future research are discussed.

Hooked on a Feeling: Influence of Brief Exposure to Familiar Music on Feelings of Emotion in Individuals with Alzheimer’s Disease

Background: Research has indicated that individuals with Alzheimer’s-type dementia (AD) can experience prolonged emotions, even when they cannot recall the eliciting event. Less is known about whether music can modify the emotional state of individuals with AD and whether emotions evoked by music linger in the absence of a declarative memory for the eliciting event. Objective: We examined the effects of participant-selected recorded music on self-reported feelings of emotion in individuals with AD, and whether these feelings persisted irrespective of declarative memory for the emotion-inducing stimuli. Methods: Twenty participants with AD and 19 healthy comparisons (HCs) listened to two 4.5-minute blocks of self-selected music that aimed to induce either sadness or happiness. Participants reported their feelings at baseline and three times post-induction and completed recall and recognition tests for the music selections after each induction. Results: Participants with AD had impaired memory for music selections compared to HCs. Both groups reported elevated sadness and negative affect after listening to sad music and increased happiness and positive affect after listening to happy music, relative to baseline. Sad/negative and happy/positive emotions endured up to 20 minutes post-induction. Conclusion: Brief exposure to music can induce strong and lingering emotions in individuals with AD. These findings extend the intriguing phenomenon whereby lasting emotions can be prompted by stimuli that are not remembered declaratively. Our results underscore the utility of familiar music for inducing emotions in individuals with AD and may ultimately inform strategies for using music listening as a therapeutic tool with this population.

Emotional and Autonomic Processing of Olfactory Stimuli Is Compromised in Patients with a History of Mild Traumatic Brain Injury

Patients with a history of mild traumatic brain injury (post-mTBI patients) may have enduring cardiovascular-autonomic dysregulation and emotional problems. Olfactory stimulation (OS) triggers emotional and cardiovascular-autonomic responses that might be compromised in post-mTBI patients. We therefore evaluated these responses to OS in post-mTBI patients. In 17 post-mTBI patients (interval since mTBI: 32.4 ± 6.8 months) and 17 age- and sex-matched controls, we recorded respiration, electrocardiographic RR intervals, and systolic and diastolic blood pressures (BPsys, BPdia) before and during pleasant vanilla stimulation and unpleasant hydrogen sulphide (H2S) stimulation. Participants rated OS-related pleasantness, arousal, intensity, and familiarity on 9-point Likert scales. Analyses of variance (ANOVAs) with post hoc analyses compared parameters within each group before and during OS. To assess associations between pleasantness, arousal, intensity, and familiarity, we correlated OS scores within groups (significance: p < 0.05). Baseline parameters were similar between groups. Only in controls, vanilla stimulation significantly lowered BPsys and BPdia, whereas H2S stimulation lowered RR intervals. Vanilla-related pleasantness scores were lower, intensity scores were higher in patients than controls. During vanilla stimulation, pleasantness scores correlated negatively with arousal scores in controls, whereas familiarity scores correlated positively with intensity scores in patients. During H2S stimulation, familiarity scores correlated negatively with pleasantness scores in controls, whereas pleasantness scores correlated negatively with arousal scores in mTBI patients. Post-mTBI patients could not change BP or RR intervals during OS but perceived vanilla stimuli as less pleasant and more intense than did controls. Associations between pleasantness, arousal, intensity, and familiarity differed between groups suggesting different activation of the olfactory network and the central autonomic network upon OS. Subtle lesions within these networks might cause persistent changes in emotional and cognitive odor perception and cardiovascular responses.

The Effect of Emotional Valence on Ventricular Repolarization Dynamics Is Mediated by Heart Rate Variability: A Study of QT Variability and Music-Induced Emotions

Background

Emotions can affect cardiac activity, but their impact on ventricular repolarization variability, an important parameter providing information about cardiac risk and autonomic nervous system activity, is unknown. The beat-to-beat variability of the QT interval (QTV) from the body surface ECG is a non-invasive marker of repolarization variability, which can be decomposed into QTV related to RR variability (QTVrRRV) and QTV unrelated to RRV (QTVuRRV), with the latter thought to be a marker of intrinsic repolarization variability.

Aim

To determine the effect of emotional valence (pleasant and unpleasant) on repolarization variability in healthy volunteers by means of QTV analysis.

Methods

75 individuals (24.5 ± 3.2 years, 36 females) without a history of cardiovascular disease listened to music-excerpts that were either felt as pleasant (n = 6) or unpleasant (n = 6). Excerpts lasted about 90 s and were presented in a random order along with silent intervals (n = 6). QTV and RRV were derived from the ECG and the time-frequency spectrum of RRV, QTV, QTVuRRV and QTVrRRV as well as time-frequency coherence between QTV and RRV were estimated. Analysis was performed in low-frequency (LF), high frequency (HF) and total spectral bands.

Results

The heart rate-corrected QTV showed a small but significant increase from silence (median 347/interquartile range 31 ms) to listening to music felt as unpleasant (351/30 ms) and pleasant (355/32 ms). The dynamic response of QTV to emotional valence showed a transient phase lasting about 20 s after the onset of each musical excerpt. QTV and RRV were highly correlated in both HF and LF (mean coherence ranging 0.76–0.85). QTV and QTVrRRV decreased during listening to music felt as pleasant and unpleasant with respect to silence and further decreased during listening to music felt as pleasant. QTVuRRV was small and not affected by emotional valence.

Conclusion

Emotional valence, as evoked by music, has a small but significant effect on QTV and QTVrRRV, but not on QTVuRRV. This suggests that the interaction between emotional valence and ventricular repolarization variability is mediated by cycle length dynamics and not due to intrinsic repolarization variability.

Effects of music interventions on stress-related outcomes: a systematic review and two meta-analyses

Music interventions are used for stress reduction in a variety of settings because of the positive effects of music listening on both physiological arousal (e.g., heart rate, blood pressure, and hormonal levels) and psychological stress experiences (e.g., restlessness, anxiety, and nervousness). To summarize the growing body of empirical research, two multilevel meta-analyses of 104 RCTs, containing 327 effect sizes and 9,617 participants, were performed to assess the strength of the effects of music interventions on both physiological and psychological stress-related outcomes, and to test the potential moderators of the intervention effects. Results showed that music interventions had an overall significant effect on stress reduction in both physiological (d = .380) and psychological (d = .545) outcomes. Further, moderator analyses showed that the type of outcome assessment moderated the effects of music interventions on stress-related outcomes. Larger effects were found on heart rate (d = .456), compared to blood pressure (d = .343) and hormone levels (d = .349). Implications for stress-reducing music interventions are discussed.

The Aim Justifies the Means-Differences Among Musical and Nonmusical Means of Relaxation or Activation Induction in Daily Life

Music is an effective means of stress-reduction. However, to date there has been no systematic comparison between musical and language-based means of stress reduction in an ambulatory setting. Furthermore, although the aim for listening to music appears to play a role in its effect, this has not yet been investigated thoroughly. We compared musical means, language-based means like guided relaxation or self-enhancement exercises, and a combination of both with respect to their potential to reduce perceived stress. Furthermore, we investigated whether the aim one wants to achieve by listening to these means had an impact on their effect. We tested 64 participants (age: M = 40.09 years; 18 female) for 3–10 days during their everyday life using an app containing three means: musical means, language-based means, and a combination of both. For the music and the combination conditions participants were asked to select an aim: relaxation or activation. We measured perceived stress, relaxation, activation, and electrical skin resistance (ESR) as a marker of sympathetic nervous system (SNS) activity before and after using the app. Participants were instructed to use the app as often as desired. Overall, perceived stress was reduced after using the app, while perceived relaxation and activation were increased. There were no differences between the three means regarding their effect on perceived stress and relaxation, but music led to a greater increase in ESR and perceived activation compared to the other means. There was a decrease in ESR only for music. Moreover, perceived stress was reduced and perceived relaxation was increased to greater extent if the aim “relaxation” had been selected. Perceived activation, however, showed a larger increase if the aim had been “activation,” which was even more marked in the case of music listening. Our results indicate that all three means reduced perceived stress and promoted feelings of relaxation and activation. For enhancing feelings of activation music seems to be more effective than the other means, which was reflected in increased SNS activity as well. Furthermore, the choice of an aim plays an important role for the reduction of stress, and promotion of relaxation and activation.

EVALUATION OF SIGNAL PROCESSING TECHNIQUES IN DISCRIMINATING ECG SIGNALS OF MEN AND WOMEN DURING REST CONDITION AND EMOTIONAL STATES

Great range of electrocardiogram (ECG) signal processing methods can be found in the literature. In addition, the importance of gender differences in physiological activities was also identified in various conditions. This article aims to provide a comprehensive evaluation of linear and nonlinear ECG parameters to indicate suitable signal processing approaches which can show significant differences between men and women. These differences were investigated in two conditions: (i) during rest condition, and (ii) during the affective image inducements. A wide range of parameters from time-, frequency-, wavelet-, and nonlinear-techniques were examined. Applying the Wilcoxon rank sum test, significant differences between two genders were inspected. The analysis was performed on 47 college students at rest condition and while subjects watching four types of affective pictures, including sadness, happiness, fear, and peacefulness. The impact of these emotions on the results was also investigated. The results indicated that 72.95% and 72.61% of all features were significantly different between male and female in rest condition and affective inducements, respectively. In addition, the highest percentage of the significant difference between ECG parameters of men and women was achieved using nonlinear characteristics. Considering all features together, the highest significant difference between two genders was achieved for negative emotions, including sadness and fear. In conclusion, the results of this study emphasized the importance of gender role in cardiac responses during rest condition and different emotional states. Since these gender differences are well manifested by nonlinear signal processing techniques, dynamical gender-specific ECG system may improve the automatic emotion recognition accuracies.

Eyeball pressure stimulation induces subtle sympathetic activation in patients with a history of moderate or severe traumatic brain injury

OBJECTIVE

After traumatic brain injury (TBI), there may be persistent central-autonomic-network (CAN) dysfunction causing cardiovascular-autonomic dysregulation. Eyeball-pressure-stimulation (EPS) normally induces cardiovagal activation. In patients with a history of moderate or severe TBI (post-moderate-severe-TBI), we determined whether EPS unveils cardiovascular-autonomic dysregulation.

METHODS

In 51 post-moderate-severe-TBI patients (32.7 ± 10.5 years old, 43.1 ± 33.4 months post-injury), and 30 controls (29.1 ± 9.8 years), we recorded respiration, RR-intervals (RRI), systolic and diastolic blood-pressure (BPsys, BPdia), before and during EPS (120 sec; 30 mmHg), using an ocular-pressure-device (Okulopressor®). We calculated spectral-powers of mainly sympathetic low (LF: 0.04-0.15 Hz) and parasympathetic high (HF: 0.15-0.5 Hz) frequency RRI-fluctuations, sympathetically mediated LF-powers of BPsys, and calculated normalized (nu) LF- and HF-powers of RRI. We compared parameters between groups before and during EPS by repeated-measurement-analysis-of-variance with post-hoc analysis (significance: p < 0.05).

RESULTS

At rest, sympathetically mediated LF-BPsys-powers were significantly lower in the patients than the controls. During EPS, only controls significantly increased RRIs and parasympathetically mediated HFnu-RRI-powers, but decreased LF-RRI-powers, LFnu-RRI-powers, and LF-BPsys-powers; in contrast, the patients slightly though significantly increased BPsys upon EPS, without changing any other parameter.

CONCLUSIONS

In post-moderate-severe-TBI patients, autonomic BP-modulation was already compromised at rest. During EPS, our patients failed to activate cardiovagal modulation but slightly increased BPsys, indicating persistent CAN dysregulation.

SIGNIFICANCE

Our findings unveil persistence of subtle cardiovascular-autonomic dysregulation even years after TBI.

Severity of traumatic brain injury correlates with long-term cardiovascular autonomic dysfunction

After traumatic brain injury (TBI), central autonomic dysfunction might contribute to long-term increased mortality rates. Central autonomic dysfunction might depend on initial trauma severity. This study was performed to evaluate differences in autonomic modulation at rest and upon standing between patients with a history of mild TBI (post-mild-TBI patients), moderate or severe TBI (post-moderate–severe-TBI patients), and healthy controls. In 20 post-mild-TBI patients (6–78 months after TBI), age-matched 20 post-moderate–severe-TBI patients (6–94 months after TBI) and 20 controls, we monitored respiration, RR intervals (RRI) and systolic blood pressure (BPsys) at supine rest and upon standing. We determined mainly sympathetic low (LF) and parasympathetic high (HF) frequency powers of RRI fluctuations, sympathetically mediated LF-BPsys powers, LF/HF-RRI ratios, normalized (nu) LF-RRI and HF-RRI powers, and compared data between groups, at rest and upon standing (ANOVA with post hoc testing). We correlated autonomic parameters with initial Glasgow Coma Scale (GCS) scores (Spearman test; significance: p < 0.05). Supine BPsys and LFnu-RRI powers were higher while HFnu-RRI powers were lower in post-moderate–severe-TBI patients than post-mild-TBI patients and controls. LFnu-RRI powers were higher and HFnu-RRI powers were lower in post-mild-TBI patients than controls. Upon standing, only post-mild-TBI patients and controls increased LF-BPsys powers and BPsys and decreased HF-RRI powers. GCS scores correlated positively with LFnu-RRI powers, LF/HF-RRI ratios, and inversely with HFnu-RRI powers, at standing position. More than 6 months after TBI, there is autonomic dysfunction at rest and upon standing which is more pronounced after moderate–severe than mild TBI and in part correlates with initial trauma severity.

Tolerance to exercise intensity modulates pleasure when exercising in music: The upsides of acoustic energy for High Tolerant individuals

Moderate physical activity can be experienced by some as pleasurable and by others as discouraging. This may be why many people lack sufficient motivation to participate in the recommended 150 minutes of moderately intense exercise per week. In the present study, we assessed how pleasure and enjoyment were modulated differently by one's tolerance to self-paced physical activity. Sixty-three healthy individuals were allocated to three independent experimental conditions: a resting condition (watching TV), a cycling in silence condition, and a cycling in music condition. The tolerance threshold was assessed using the PRETIE-Questionnaire. Physical activity consisted in cycling during 30 minutes, at an intensity perceived as "somewhat difficult" on the Ratings of Perceived Exertion Scale. While controlling for self-reported physical activity level, results revealed that for the same perception of exertion and a similar level of enjoyment, the High Tolerance group produced more power output than the Low Tolerance group. There was a positive effect of music for High Tolerant individuals only, with music inducing greater power output and more pleasure. There was an effect of music on heart rate frequency in the Low Tolerant individuals without benefits in power output or pleasure. Our results suggest that for Low Tolerant individuals, energizing environments can interfere with the promised (positive) distracting effects of music. Hence, tolerance to physical effort must be taken into account to conceive training sessions that seek to use distracting methods as means to sustain pleasurable exercising over time.

Fingolimod initiation in multiple sclerosis patients is associated with potential beneficial cardiovascular autonomic effects

BACKGROUND

Fingolimod slows heart rate (HR) due to vagomimetic effects and might cause additional cardiovascular autonomic changes. While the time course of HR changes is well described, the extent and course of cardiovascular autonomic changes upon fingolimod initiation has not yet been evaluated. This study, therefore, intended to assess cardiovascular autonomic changes during the first 6 h after fingolimod initiation.

METHODS

In 21 patients with relapsing-remitting multiple sclerosis (RRMS), we recorded respiration (RESP), electrocardiographic RR interval (RRI), systolic and diastolic blood pressure (BPsys, BPdia) at rest, before and 0.5, 1, 2, 3, 4, 5, and 6 h after fingolimod initiation. We calculated parameters of total autonomic modulation [RRI standard deviation (RRI-SD), RRI coefficient of variation (RRI-CV), RRI-total powers], mainly sympathetic cardiac modulation [RRI low frequency (LF) powers], sympathetic BP modulation (BPsys-LF powers), parasympathetic modulation [square root of the mean squared difference of successive RRIs (RMSSD), RRI high frequency (HF) powers], sympatho-vagal cardiac balance (RRI-LF/HF ratios), and baroreflex sensitivity (BRS). We compared parameters between the eight measurements [analysis of variance (ANOVA) or Friedman test with post-hoc analysis; significance: p < 0.05].

RESULTS

After fingolimod initiation, RESP, BPsys, and BPsys-LF powers remained unchanged while RRIs, RRI-CV, RRI-SD, RRI-total powers, RRI-LF powers, RMSSD, RRI-HF powers, and BRS increased after 1 h and rose to peak values occurring after 5, 1, 2, 2, 1, 4, 4, and 4 h, respectively. After 3 h, BPdia had decreased significantly and was lowest after 5 h. RRI-LF/HF ratios decreased to a nadir after 4 h.

CONCLUSIONS

The increases in parasympathetic and overall cardiac autonomic modulation and in BRS seen with fingolimod initiation are theoretically beneficial for the MS patient's cardiovascular system. However, long-term studies must show whether these effects persist or are attenuated (e.g. due to S1P1 receptor down-regulation upon continued fingolimod therapy).

Valsalva maneuver unveils central baroreflex dysfunction with altered blood pressure control in persons with a history of mild traumatic brain injury

Background

Patients with a history of mild TBI (post-mTBI-patients) have an unexplained increase in long-term mortality which might be related to central autonomic dysregulation (CAD). We investigated whether standardized baroreflex-loading, induced by a Valsalva maneuver (VM), unveils CAD in otherwise healthy post-mTBI-patients.

Methods

In 29 healthy persons (31.3 ± 12.2 years; 9 women) and 25 post-mTBI-patients (35.0 ± 13.2 years, 7 women, 4–98 months post-injury), we monitored respiration (RESP), RR-intervals (RRI) and systolic blood pressure (BP) at rest and during three VMs. At rest, we calculated parameters of total autonomic modulation [RRI-coefficient-of-variation (CV), RRI-standard-deviation (RRI-SD), RRI-total-powers], of sympathetic [RRI-low-frequency-powers (LF), BP-LF-powers] and parasympathetic modulation [square-root-of-mean-squared-differences-of-successive-RRIs (RMSSD), RRI-high-frequency-powers (HF)], the index of sympatho-vagal balance (RRI LF/HF-ratios), and baroreflex sensitivity (BRS). We calculated Valsalva-ratios (VR) and times from lowest to highest RRIs after strain (VR-time) as indices of parasympathetic activation, intervals from highest systolic BP-values after strain-release to the time when systolic BP had fallen by 90 % of the differences between peak-phase-IV-BP and baseline-BP (90 %-BP-normalization-times), and velocities of BP-normalization (90 %-BP-normalization-velocities) as indices of sympathetic withdrawal.

We compared patient- and control-parameters before and during VM (Mann-Whitney-U-tests or t-tests; significance: P < 0.05).

Results

At rest, RRI-CVs, RRI-SDs, RRI-total-powers, RRI-LF-powers, BP-LF-powers, RRI-RMSSDs, RRI-HF-powers, and BRS were lower in patients than controls. During VMs, 90 %-BP-normalization-times were longer, and 90 %-BP-normalization-velocities were lower in patients than controls (P < 0.05).

Conclusions

Reduced autonomic modulation at rest and delayed BP-decrease after VM-induced baroreflex-loading indicate subtle CAD with altered baroreflex adjustment to challenge. More severe autonomic challenge might trigger more prominent cardiovascular dysregulation and thus contribute to increased mortality risk in post-mTBI-patients.

Non-expert listeners show decreased heart rate and increased blood pressure (fear bradycardia) in response to atonal music

Previous studies suggested that listening to different types of music may modulate differently psychological mood and physiological responses associated with the induced emotions. In this study the effect of listening to instrumental classical vs. atonal contemporary music was examined in a group of 50 non-expert listeners. The subjects’ heart rate and diastolic and systolic blood pressure values were measured while they listened to music of different style and emotional typologies. Pieces were selected by asking a group of composers and conservatory professors to suggest a list of the most emotional music pieces (from Renaissance to present time). A total of 214 suggestions from 20 respondents were received. Then it was asked them to identify which pieces best induced in the listener feelings of agitation, joy or pathos and the number of suggested pieces per style was computed. Atonal pieces were more frequently indicated as agitating, and tonal pieces as joyful. The presence/absence of tonality in a musical piece did not affect the affective dimension of pathos (being touching). Among the most frequently cited six pieces were selected that were comparable for structure and style, to represent each emotion and style. They were equally evaluated as unfamiliar by an independent group of 10 students of the same cohort) and were then used as stimuli for the experimental session in which autonomic parameters were recorded. Overall, listening to atonal music (independent of the pieces’ emotional characteristics) was associated with a reduced heart rate (fear bradycardia) and increased blood pressure (both diastolic and systolic), possibly reflecting an increase in alertness and attention, psychological tension, and anxiety. This evidence fits with the results of the esthetical assessment showing how, overall, atonal music is perceived as more agitating and less joyful than tonal one.

The effect of background music on episodic memory and autonomic responses: listening to emotionally touching music enhances facial memory capacity

The aim of this study was to investigate how background auditory processing can affect other perceptual and cognitive processes as a function of stimulus content, style and emotional nature. Previous studies have offered contrasting evidence, and it has been recently shown that listening to music negatively affected concurrent mental processing in the elderly but not in young adults. To further investigate this matter, the effect of listening to music vs. listening to the sound of rain or silence was examined by administering an old/new face memory task (involving 448 unknown faces) to a group of 54 non-musician university students. Heart rate and diastolic and systolic blood pressure were measured during an explicit face study session that was followed by a memory test. The results indicated that more efficient and faster recall of faces occurred under conditions of silence or when participants were listening to emotionally touching music. Whereas auditory background (e.g., rain or joyful music) interfered with memory encoding, listening to emotionally touching music improved memory and significantly increased heart rate. It is hypothesized that touching music is able to modify the visual perception of faces by binding facial properties with auditory and emotionally charged information (music), which may therefore result in deeper memory encoding.