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Breuer F, Meyhöfer I, Lencer R, Sprenger A, Roesmann K, Schag K, Dannlowski U, Leehr EJ. Aberrant inhibitory control as a transdiagnostic dimension of mental disorders - A meta-analysis of the antisaccade task in different psychiatric populations. Neurosci Biobehav Rev 2024; 165:105840. [PMID: 39103067 DOI: 10.1016/j.neubiorev.2024.105840] [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: 03/19/2024] [Revised: 06/29/2024] [Accepted: 08/01/2024] [Indexed: 08/07/2024]
Abstract
This meta-analysis examined inhibitory control performance in the antisaccade task across mental disorders. Following PRISMA guidelines, we analyzed data from k = 146 studies (n = 13,807 participants) on antisaccade performance. Effect sizes were estimated using random-effects models and restricted maximum-likelihood estimation, with robustness tests for study heterogeneity and publication bias. Most disorders displayed elevated error rates, with schizophrenia showing the greatest impairments, followed by autism spectrum disorder, bipolar disorder and attention deficit hyperactivity disorder. Small to medium impairments were also found in eating disorders, major depressive disorder, obsessive-compulsive disorder and substance use disorder. Results were robust against corrections for publication bias and largely unaffected by confounding variables. Prolonged latencies were observed in schizophrenia, attention deficit hyperactivity disorder, bipolar disorder and obsessive compulsive disorder, with smaller and less robust effect sizes. Results indicate inhibitory control deficits in the antisaccade task across mental disorders, especially evident for error rates. While present in most disorders, results imply varying degrees of impairments, ranging from small to large in effect sizes, with largest impairments in schizophrenia.
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Affiliation(s)
- Fabian Breuer
- Institute for Translational Psychiatry, University of Münster, Germany
| | - Inga Meyhöfer
- Institute for Translational Psychiatry, University of Münster, Germany; Otto-Creutzfeldt Center for Cognitive and Behavioral Neuroscience, University of Münster, Germany
| | - Rebekka Lencer
- Institute for Translational Psychiatry, University of Münster, Germany; Otto-Creutzfeldt Center for Cognitive and Behavioral Neuroscience, University of Münster, Germany; Department of Psychiatry and Psychotherapy, University of Lübeck, Germany
| | - Andreas Sprenger
- Department of Psychiatry and Psychotherapy, University of Lübeck, Germany; Institute of Psychology II, University of Lübeck, Germany
| | - Kati Roesmann
- Institute for Psychology, Unit for Clinical Psychology and Psychotherapy in Childhood and Adolescence. University of Osnabrück, Germany; Institute for Biomagnetism and Biosignalanalysis, University of Münster, Germany
| | - Kathrin Schag
- Medical University Hospital Tübingen, Department of Psychosomatic Medicine and Psychotherapy, Tübingen, Germany
| | - Udo Dannlowski
- Institute for Translational Psychiatry, University of Münster, Germany
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Notebaert L, Clarke PJF, Meeten F, Todd J, Van Bockstaele B. Cognitive flexibility and resilience measured through a residual approach. ANXIETY, STRESS, AND COPING 2024:1-15. [PMID: 38767336 DOI: 10.1080/10615806.2024.2353654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 05/05/2024] [Indexed: 05/22/2024]
Abstract
BACKGROUND AND OBJECTIVES Resilience refers to the process through which individuals show better outcomes than what would be expected based on the adversity they experienced. Several theories have proposed that variation in resilience is underpinned by cognitive flexibility, however, no study has investigated this using an outcome-based measure of resilience. DESIGN We used a residual-based approach to index resilience, which regresses a measure of mental health difficulties onto a measure of adversity experienced. The residuals obtained from this regression constitute how much better or worse someone is functioning relative to what is predicted by the adversity they have experienced. METHODS A total of 463 undergraduate participants completed questionnaires of mental health difficulties and adversity, as well as a number-letter task-switching task to assess cognitive flexibility. RESULTS Multiple regression analyses showed that better cognitive flexibility was not associated with greater resilience. CONCLUSIONS Our findings do not support theoretical models that propose the existence of a relationship between cognitive flexibility and resilience. Future research may serve to refine the residual-based approach to measure resilience, as well as investigate the contribution of "hot" rather than "cold" cognitive flexibility to individual differences in resilience.
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Affiliation(s)
- Lies Notebaert
- Centre for the Advancement of Research on Emotion, School of Psychological Science, University of Western Australia, Crawley, Australia
| | - Patrick J F Clarke
- Centre for the Advancement of Research on Emotion, School of Psychological Science, University of Western Australia, Crawley, Australia
- Cognition and Emotion Research Group, Curtin University, Perth, Australia
| | - Frances Meeten
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Jemma Todd
- Centre for the Advancement of Research on Emotion, School of Psychological Science, University of Western Australia, Crawley, Australia
- Clinical Psychology Unit, School of Psychology, University of Sydney, Sydney, Australia
| | - Bram Van Bockstaele
- Centre for the Advancement of Research on Emotion, School of Psychological Science, University of Western Australia, Crawley, Australia
- Developmental Psychopathology, University of Amsterdam, Amsterdam, Netherlands
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Zhou H, Xiong T, Dai Z, Zou H, Wang X, Tang H, Huang Y, Sun H, You W, Yao Z, Lu Q. Brain-heart interaction disruption in major depressive disorder: disturbed rhythm modulation of the cardiac cycle on brain transient theta bursts. Eur Arch Psychiatry Clin Neurosci 2024; 274:595-607. [PMID: 37318589 DOI: 10.1007/s00406-023-01628-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 05/22/2023] [Indexed: 06/16/2023]
Abstract
Brain neurons support arousal and cognitive activity in the form of spectral transient bursts and cooperate with the peripheral nervous system to adapt to the surrounding environment. However, the temporal dynamics of brain-heart interactions have not been confirmed, and the mechanism of brain-heart interactions in major depressive disorder (MDD) remains unclear. This study aimed to provide direct evidence for brain-heart synchronization in temporal dynamics and clarify the mechanism of brain-heart interaction disruption in MDD. Eight-minute resting-state (closed eyes) electroencephalograph and electrocardiogram signals were acquired simultaneously. The Jaccard index (JI) was used to measure the temporal synchronization between cortical theta transient bursts and cardiac cycle activity (diastole and systole) in 90 MDD patients and 44 healthy controls (HCs) at rest. The deviation JI was used to reflect the equilibrium of brain activity between diastole and systole. The results showed that the diastole JI was higher than the systole JI in both the HC and MDD groups; compared to HCs, the deviation JI attenuated at F4, F6, FC2, and FC4 in the MDD patients. The eccentric deviation JI was negatively correlated with the despair factor scores of the HAMD, and after 4 weeks of antidepressant treatment, the eccentric deviation JI was positively correlated with the despair factor scores of the HAMD. It was concluded that brain-heart synchronization existed in the theta band in healthy individuals and that disturbed rhythm modulation of the cardiac cycle on brain transient theta bursts at right frontoparietal sites led to brain-heart interaction disruption in MDD.
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Affiliation(s)
- Hongliang Zhou
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, 210029, People's Republic of China
| | - Tingting Xiong
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, 210029, People's Republic of China
| | - Zhongpeng Dai
- School of Biological Sciences and Medical Engineering, Southeast University, Nanjing, 210096, People's Republic of China
| | - Haowen Zou
- Nanjing Brain Hospital, Medical School of Nanjing University, Nanjing, 210093, People's Republic of China
| | - Xvmiao Wang
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, 210029, People's Republic of China
| | - Hao Tang
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, 210029, People's Republic of China
| | - Yinghong Huang
- Nanjing Brain Hospital, Medical School of Nanjing University, Nanjing, 210093, People's Republic of China
| | - Hao Sun
- Nanjing Brain Hospital, Medical School of Nanjing University, Nanjing, 210093, People's Republic of China
| | - Wei You
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, 210029, People's Republic of China
| | - Zhijian Yao
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, 210029, People's Republic of China.
- Nanjing Brain Hospital, Medical School of Nanjing University, Nanjing, 210093, People's Republic of China.
| | - Qing Lu
- School of Biological Sciences and Medical Engineering, Southeast University, Nanjing, 210096, People's Republic of China.
- Child Development and Learning Science, Key Laboratory of Ministry of Education, Nanjing, People's Republic of China.
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Nicolini P, Malfatto G, Lucchi T. Heart Rate Variability and Cognition: A Narrative Systematic Review of Longitudinal Studies. J Clin Med 2024; 13:280. [PMID: 38202287 PMCID: PMC10780278 DOI: 10.3390/jcm13010280] [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: 11/05/2023] [Revised: 12/23/2023] [Accepted: 12/27/2023] [Indexed: 01/12/2024] Open
Abstract
BACKGROUND Heart rate variability (HRV) is a reliable and convenient method to assess autonomic function. Cross-sectional studies have established a link between HRV and cognition. Longitudinal studies are an emerging area of research with important clinical implications in terms of the predictive value of HRV for future cognition and in terms of the potential causal relationship between HRV and cognition. However, they have not yet been the objective of a systematic review. Therefore, the aim of this systematic review was to investigate the association between HRV and cognition in longitudinal studies. METHODS The review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The Embase, PsycINFO and PubMed databases were searched from the earliest available date to 26 June 2023. Studies were included if they involved adult human subjects and evaluated the longitudinal association between HRV and cognition. The risk of bias was assessed with the Newcastle-Ottawa Scale for Cohort Studies. The results were presented narratively. RESULTS Of 14,359 records screened, 12 studies were included in this systematic review, with a total of 24,390 participants. Two thirds of the studies were published from 2020 onwards. All studies found a longitudinal relationship between HRV and cognition. There was a consistent association between higher parasympathetic nervous system (PNS) activity and better cognition, and some association between higher sympathetic nervous system activity and worse cognition. Also, higher PNS activity persistently predicted better executive functioning, while data on episodic memory and language were more scant and/or controversial. CONCLUSIONS Our results support the role of HRV as a biomarker of future cognition and, potentially, as a therapeutic target to improve cognition. They will need confirmation by further, more comprehensive studies also including unequivocal non-HRV sympathetic measures and meta-analyses.
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Affiliation(s)
- Paola Nicolini
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Geriatric Unit, Internal Medicine Department, 20122 Milan, Italy;
| | - Gabriella Malfatto
- Istituto Auxologico Italiano IRCCS, Department of Cardiovascular, Neural and Metabolic Sciences, Ospedale San Luca, 20149 Milan, Italy;
| | - Tiziano Lucchi
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Geriatric Unit, Internal Medicine Department, 20122 Milan, Italy;
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Westbrook A, Yang X, Bylsma LM, Daches S, George CJ, Seidman AJ, Jennings JR, Kovacs M. Economic Choice and Heart Rate Fractal Scaling Indicate That Cognitive Effort Is Reduced by Depression and Boosted by Sad Mood. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2023; 8:687-694. [PMID: 35948258 PMCID: PMC10919246 DOI: 10.1016/j.bpsc.2022.07.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 07/15/2022] [Accepted: 07/19/2022] [Indexed: 05/28/2023]
Abstract
BACKGROUND People with depression typically exhibit diminished cognitive control. Control is subjectively costly, prompting speculation that control deficits reflect reduced cognitive effort. Evidence that people with depression exert less cognitive effort is mixed, however, and motivation may depend on state affect. METHODS We used a cognitive effort discounting task to measure propensity to expend cognitive effort and fractal structure in the temporal dynamics of interbeat intervals to assess on-task effort exertion for 49 healthy control subjects, 36 people with current depression, and 67 people with remitted depression. RESULTS People with depression discounted more steeply, indicating that they were less willing to exert cognitive effort than people with remitted depression and never-depressed control subjects. Also, steeper discounting predicted worse functioning in daily life. Surprisingly, a sad mood induction selectively boosted motivation among participants with depression, erasing differences between them and control subjects. During task performance, depressed participants with the lowest cognitive motivation showed blunted autonomic reactivity as a function of load. CONCLUSIONS Discounting patterns supported the hypothesis that people with current depression would be less willing to exert cognitive effort, and steeper discounting predicted lower global functioning in daily life. Heart rate fractal scaling proved to be a highly sensitive index of cognitive load, and data implied that people with lower motivation for cognitive effort had a diminished physiological capacity to respond to rising cognitive demands. State affect appeared to influence motivation among people with current depression given that they were more willing to exert cognitive effort following a sad mood induction.
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Affiliation(s)
- Andrew Westbrook
- Department of Cognitive, Linguistic & Psychological Sciences, Brown University, Providence, Rhode Island.
| | - Xiao Yang
- Department of Psychology, Old Dominion University, Norfolk, Virginia
| | - Lauren M Bylsma
- Department of Psychiatry, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania; Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Shimrit Daches
- Department of Psychology, Bar-Ilan University, Ramat-Gan, Israel
| | - Charles J George
- Department of Psychiatry, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Andrew J Seidman
- Department of Psychiatry, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - J Richard Jennings
- Department of Psychiatry, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Maria Kovacs
- Department of Psychiatry, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
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Dell'Acqua C, Messerotti Benvenuti S, Vallesi A, Palomba D, Ambrosini E. Depressive symptoms and cognitive control: the role of affective interference. Cogn Emot 2022; 36:1389-1403. [PMID: 36154616 DOI: 10.1080/02699931.2022.2128065] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 08/26/2022] [Accepted: 09/18/2022] [Indexed: 01/21/2023]
Abstract
Depressive symptoms are characterised by reduced cognitive control. However, whether depressive symptoms are linked to difficulty in exerting cognitive control in general or over emotional content specifically remains unclear. To better differentiate between affective interference or general cognitive control difficulties in people with depressive symptoms, we employed a non emotional (cold) and an emotional (hot) version of a task-switching paradigm in a nonclinical sample of young adults (N = 82) with varying levels of depressive symptoms. Depressive symptoms were linked to greater difficulties in exerting cognitive control in complex situations (mixed-task blocks) compared to simple and semiautomatic situations (single-task blocks) in both task versions. Moreover, greater depressive symptoms were associated with longer latencies in the emotional version of the task across all trial types. Thus, the emotion-specific effect was not modulated by the degree of cognitive control required to perform the task. In sum, depressive symptoms were characterised by a general difficulty to exert cognitive control in both emotional and non emotional contexts and by greater difficulty in even simple attentional processing of emotional material. This study granted novel insights on the extent of cognitive control difficulties in emotional and non emotional contexts for people with depressive symptoms.
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Affiliation(s)
- Carola Dell'Acqua
- Department of General Psychology, University of Padua, Padua, Italy
- Padova Neuroscience Center (PNC), University of Padua, Padua, Italy
| | - Simone Messerotti Benvenuti
- Department of General Psychology, University of Padua, Padua, Italy
- Padova Neuroscience Center (PNC), University of Padua, Padua, Italy
| | - Antonino Vallesi
- Padova Neuroscience Center (PNC), University of Padua, Padua, Italy
- Department of Neuroscience, Padova Neuroscience Center, University of Padua, Padua, Italy
| | - Daniela Palomba
- Department of General Psychology, University of Padua, Padua, Italy
- Padova Neuroscience Center (PNC), University of Padua, Padua, Italy
| | - Ettore Ambrosini
- Department of General Psychology, University of Padua, Padua, Italy
- Padova Neuroscience Center (PNC), University of Padua, Padua, Italy
- Department of Neuroscience, Padova Neuroscience Center, University of Padua, Padua, Italy
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The Role of Depressive Disorders in Autonomic Cardiovascular Dysregulation in Fibromyalgia. Psychosom Med 2022; 84:793-802. [PMID: 35796593 DOI: 10.1097/psy.0000000000001097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Previous research revealed aberrances in autonomic cardiovascular regulation in fibromyalgia, which may be relevant to symptoms genesis and the increased risk of cardiovascular disorders in individuals with fibromyalgia. This study investigated the role of comorbid depression in autonomic cardiovascular dysregulations in fibromyalgia. METHODS Cardiovascular recordings were obtained in 53 participants with fibromyalgia who also had depression ( n = 27), in participants with fibromyalgia without depression ( n = 26), and in 29 healthy controls, at rest and during a cold pressor test and an arithmetic task. Assessed parameters included interbeat interval, blood pressure, heart rate variability, baroreflex sensitivity, stroke volume, preejection period, left ventricular ejection time, Heather index, and total peripheral resistance. RESULTS Participants with both fibromyalgia and depression displayed lower tonic interbeat interval, baroreflex sensitivity, and heart rate variability compared with participants with fibromyalgia without depression and controls ( p values < .012, d values = 0.71-1.06). Participants with fibromyalgia but without depression did not differ from controls in these variables. Moreover, participants with fibromyalgia who also had depression, but not those without depression, exhibited lower Heather index, stroke volume, and left ventricular ejection time compared with controls ( p values < .013, d values = 0.62-0.78). No group differences arose for preejection period or total peripheral resistance. Stress reactivity was reduced in participants with fibromyalgia, independently of depression, for diastolic blood pressure, interbeat interval, left ventricular ejection time, and heart rate variability, than in controls. CONCLUSIONS The role of depression in the autonomic dysregulation in fibromyalgia involves chronotropic cardiac control rather than adrenergic influences on contractility and vascular tone. Blunted cardiovascular reactivity may be ascribable to pathological factors inherent to fibromyalgia. These results underline the importance of diagnostics and treatment of comorbid depressive disorders in the management of fibromyalgia.
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Cardiovascular reactivity during sadness induction predicts inhibitory control performance. Physiol Behav 2022; 254:113869. [PMID: 35691588 DOI: 10.1016/j.physbeh.2022.113869] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Revised: 05/18/2022] [Accepted: 06/08/2022] [Indexed: 12/25/2022]
Abstract
Higher negative affectivity has an association with decreased executive function and cognitive control. Heart rate variability (HRV) serves as an index of cardiac vagal regulation differences in the autonomic nervous system for both cognition and emotion. The current study investigates this association using a classic as well as emotional antisaccade paradigm to study inhibitory control performance. Ninety participants completed affective questionnaires (Beck Depression Inventory-II, and Mood Scale), a 6-minute baseline electrocardiogram, and two different antisaccade tasks. After the baseline, subjects were presented with a video sequence with either neutral, sad, or emotionally arousing content. By subtracting the baseline from the video sequence, we computed HRV reactivity and tested whether the reactivity score could predict inhibitory control performance. We hypothesized that this would be the case in both the sadness and arousal group, but not in the neutral one. Furthermore, we awaited significant performance differences between experimental groups. Contrary to our assumption, inhibitory control performance did not differ between experimental groups. Moreover, there was no significant relation between affective measures and task performance. Nevertheless, cardiovascular reactivity in terms of HRV was predictive of error rates in both antisaccade tasks in the sadness group. We could find this effect neither in the neutral nor in the arousal group. In addition, BDI scores moderated the effect in the emotional task. Results indicate that emotional reactivity to a sad video stimulus as indexed by HRV as well as the interaction with current emotional state predict inhibitory control performance.
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Buchmann A, Ritter C, Müller ST, Haynes M, Ghisleni C, Tuura R, Hasler G. Associations between heart rate variability, peripheral inflammatory markers and major depressive disorder. J Affect Disord 2022; 304:93-101. [PMID: 35196535 DOI: 10.1016/j.jad.2022.02.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 12/31/2021] [Accepted: 02/09/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Measures for the irregularity of the heartbeat, for example respiratory sinus arrhythmia, have been implicated as a measure for restorative functions of the vegetative nervous system. METHODS In the current observational study, we investigated 265 subjects, 70 of whom had a lifetime history of major depression, with a plethysmographic heartbeat monitor, blood sampling, as well as a range of psychiatric questionnaires. RESULTS Subjects with a history of MDE had significantly reduced respiratory sinus arrhythmia (RSA) as compared to never-depressed controls; in the whole sample, higher RSA went with lower anxiety/fear variables, especially in subscores related to cardiac symptoms as well as being afraid of dying. A reduced RSA was also associated with an increased concentration of cytokines (TNFa, IL1a, IL6, IFNg) and thyroid-stimulating hormone in the serum, pointing to a possible triangular relationship between immune system, vegetative nervous system, and emotional dysregulation. LIMITATIONS We used a plethysmographic device for the measurement of heartbeat instead of an electrocardiogram, and had a single time point only. CONCLUSIONS This data corroborate the idea that a disequilibrium of the vegetative nervous, especially if accompanied by a dysregulation system in immune function, can increase the risk for depression. Conversely, vagal stimulation and anti-inflammatory treatments may support the treatment with antidepressants.
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Affiliation(s)
- Andreas Buchmann
- Psychiatric University Hospital, University of Bern, Bolligenstrasse 111, 3000 Bern 60, Switzerland; Unit of Psychiatry Research, University of Fribourg, Chemin du Cardinal-Journet 3, 1752 Villars-sur-Glâne, Fribourg, Switzerland; Center of MR-Research, University Children's Hospital Zurich, Steinwiesstrasse 75, 8032 Zurich, Switzerland.
| | - Christopher Ritter
- Psychiatric University Hospital, University of Bern, Bolligenstrasse 111, 3000 Bern 60, Switzerland; Unit of Psychiatry Research, University of Fribourg, Chemin du Cardinal-Journet 3, 1752 Villars-sur-Glâne, Fribourg, Switzerland; Center of MR-Research, University Children's Hospital Zurich, Steinwiesstrasse 75, 8032 Zurich, Switzerland
| | - Sabrina Theresia Müller
- Psychiatric University Hospital, University of Bern, Bolligenstrasse 111, 3000 Bern 60, Switzerland
| | - Melanie Haynes
- Psychiatric University Hospital, University of Bern, Bolligenstrasse 111, 3000 Bern 60, Switzerland
| | - Carmen Ghisleni
- Center of MR-Research, University Children's Hospital Zurich, Steinwiesstrasse 75, 8032 Zurich, Switzerland
| | - Ruth Tuura
- Center of MR-Research, University Children's Hospital Zurich, Steinwiesstrasse 75, 8032 Zurich, Switzerland
| | - Gregor Hasler
- Unit of Psychiatry Research, University of Fribourg, Chemin du Cardinal-Journet 3, 1752 Villars-sur-Glâne, Fribourg, Switzerland
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Bair A, Marksteiner J, Stöcklein T, Reyes del Paso GA, Duschek S. Parasympathetic cardiac control during attentional focus and worry in major depressive disorder. Int J Psychophysiol 2022; 177:1-10. [DOI: 10.1016/j.ijpsycho.2022.04.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Revised: 04/06/2022] [Accepted: 04/11/2022] [Indexed: 10/18/2022]
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Lazaridi M, Panagiotaropoulou G, Covanis P, Karantinos T, Aggelopoulos E, Klein C, Smyrnis N. Brain-Heart Link in Schizophrenia: Cognitive Inhibitory Control Deficit in Patients Is Specifically Related to Parasympathetic Dysregulation. Schizophr Bull 2022; 48:1155-1163. [PMID: 35357485 PMCID: PMC9434444 DOI: 10.1093/schbul/sbac033] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
BACKGROUND This study examined the connection between two prominent deficits in schizophrenia: the deficit in parasympathetic regulation and the deficit in cognitive inhibitory control, within the framework of the Neurovisceral Integration Model (NIM). STUDY DESIGN Thirty healthy controls and 30 patients with schizophrenia performed the internationally standardized antisaccade protocol while their electrocardiographic data were recorded. The interaction between the group, the cognitive inhibitory control as measured with error rate (ER) in the antisaccade task and parasympathetic activity as measured with the High Frequency power component of Heart Rate Variability (HF-HRV) was tested. STUDY RESULTS Findings confirmed that decreased HF-HRV was specifically related to increased ER in patients with schizophrenia. In contrast, patient deficits in other oculomotor function measures such as reaction time and reaction time variability related to volitional movement control and cognitive stability respectively were not linked to the deficit in parasympathetic regulation. CONCLUSIONS Our study validates the theory behind NIM proposing that cognitive inhibition has common physiological substrate with parasympathetic regulation. Future research could test this brain-heart link in other mental disorders especially those with a prominent deficit in inhibitory cognitive function.
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Affiliation(s)
- Marina Lazaridi
- Laboratory of Cognitive Neuroscience and Sensorimotor Control, University Mental Health, Neurosciences and Precision Medicine Research Institute “COSTAS STEFANIS”, Athens, Greece,1st Department of Psychiatry, Eginition Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Georgia Panagiotaropoulou
- Laboratory of Cognitive Neuroscience and Sensorimotor Control, University Mental Health, Neurosciences and Precision Medicine Research Institute “COSTAS STEFANIS”, Athens, Greece,Department of Psychiatry, Charité – Universitätsmedizin Berlin, Berlin, Germany
| | - Panagiotis Covanis
- Laboratory of Cognitive Neuroscience and Sensorimotor Control, University Mental Health, Neurosciences and Precision Medicine Research Institute “COSTAS STEFANIS”, Athens, Greece
| | - Thomas Karantinos
- Laboratory of Cognitive Neuroscience and Sensorimotor Control, University Mental Health, Neurosciences and Precision Medicine Research Institute “COSTAS STEFANIS”, Athens, Greece
| | - Elias Aggelopoulos
- 1st Department of Psychiatry, Eginition Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Christoph Klein
- 2nd Department of Psychiatry, University General Hospital “ATTIKON”, Medical School, National and Kapodistrian University of Athens, Athens, Greece,Department of Child and Adolescent Psychiatry, Medical Faculty, University of Freiburg, Freiburg, Germany,Department of Child and Adolescent Psychiatry, Medical Faculty, University of Cologne, Cologne, Germany
| | - Nikolaos Smyrnis
- To whom correspondence should be addressed; 2nd Department of Psychiatry, National and Kapodistrian University of Athens, Medical School, University General Hospital “ATTIKON”, 1 Rimini St., Athens GR-12462, Greece; tel: +302105832426, fax: 2106528354, e-mail:
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Paccione CE, Bruehl S, My Diep L, Rosseland LA, Stubhaug A, Jacobsen HB. The indirect impact of heart rate variability on cold pressor pain tolerance and intensity through psychological distress in individuals with chronic pain: the Tromsø Study. Pain Rep 2022; 7:e970. [PMID: 35187378 PMCID: PMC8849278 DOI: 10.1097/pr9.0000000000000970] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 09/03/2021] [Accepted: 09/11/2021] [Indexed: 11/25/2022] Open
Abstract
Supplemental Digital Content is Available in the Text. The hypoalgesic impact of cardiovascular regulatory systems on evoked pain responsiveness in those with chronic pain is conveyed via the indirect effects of psychological distress. Introduction: Chronic pain (CP) patients often display lower heart rate variability (HRV) and baroreceptor sensitivity (BRS), which are associated with increased evoked pain intensity and decreased pain tolerance. Objective: The purpose of this study was to test whether the association between low levels of HRV and BRS and increased evoked pain responsiveness in individuals with CP is mediated by psychological distress and whether this mediation is sex dependent. Methods: The sample consisted of 877 participants in Wave 6 of the Tromsø population study who reported clinically meaningful CP. Resting HRV and BRS parameters were derived from continuous beat-to-beat blood pressure recordings. Psychological distress was assessed using the Hopkins Symptom Checklist-10. After cardiovascular assessment, participants completed a 106-second cold pressor task (3°C bath), which assessed cold pressor pain intensity (CPI) and cold pressor pain tolerance (CPT). Results: In the full CP sample, mediation analyses showed significant indirect effects, without direct effects, of HRV and BRS on both CPT and CPI via psychological distress. When stratified by sex, significant indirect effects via psychological distress were only found in males for the impact of rMSSD on CPT, the impact of SDNN on CPT, and the impact of BRS on CPT via psychological distress. Moderated mediation analyses revealed that there were no significant sex differences in the indirect effects of HRV and BRS on both CPT and CPI via psychological distress. Conclusions: The hypoalgesic impact of cardiovascular regulatory systems on evoked pain responses is conveyed via the indirect effects of psychological distress.
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Affiliation(s)
- Charles E Paccione
- Department of Pain Management and Research, Oslo University Hospital, Oslo, Norway.,Mind-Body Lab, Department of Psychology, University of Oslo, Norway.,Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Stephen Bruehl
- Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Lien My Diep
- Institute of Basic Medical Sciences, Oslo Center for Biostatistics and Epidemiology, University of Oslo, Oslo, Norway
| | - Leiv A Rosseland
- Department of Research and Development, Division of Emergencies and Critical Care, Oslo University Hospital, Oslo Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Audun Stubhaug
- Department of Pain Management and Research, Division of Emergencies and Critical Care, Oslo University Hospital, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Henrik B Jacobsen
- Mind-Body Lab, Department of Psychology, University of Oslo, Norway.,Department of Pain Management and Research, Oslo University Hospital, Oslo, Norway.,Department of Psychology, University of Oslo, Oslo, Norway
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Abstract
AbstractMourning constitutes an important human emotion, which might cause—among other things—major depressive symptoms when lasting for too long. To date, no study investigated whether mourning is related to specific psychophysiological activation patterns. Therefore, we examined physiological reactions induced by iconographic mourning-related stimuli in comparison to neutral and attachment stimuli in healthy adults (N = 77, mean age: 21.9). We evaluated pupillometric and eye-tracking parameters as well as heart rate variability (HRV) and skin conductance (EDA). Eye-tracking revealed a stronger dilated pupil during mourning in comparison to the neutral, but not to the attachment condition; furthermore, fixation patterns revealed less fixations on mourning stimuli. While HF HRV was reduced during mourning and attachment, we found no differences concerning EDA parameters between conditions. Results suggest specific eye-movement and pupil adaptations during representations of mourning, which might point toward inward cognition or avoidance, but no specific physiological pattern concerning HRV and EDA.
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Muñoz Ladrón de Guevara C, Reyes Del Paso GA, Fernández-Serrano MJ, Duschek S. Facial Emotion Recognition and Executive Functions in Fibromyalgia. PAIN MEDICINE 2021; 22:1619-1629. [PMID: 33538840 DOI: 10.1093/pm/pnab024] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
OBJECTIVE The ability to accurately identify facial expressions of emotions is crucial in human interaction. Although a previous study suggested deficient emotional face recognition in patients with fibromyalgia, not much is known about the origin of this impairment. Against this background, the present study investigated the role of executive functions. Executive functions refer to cognitive control mechanisms enabling implementation and coordination of basic mental operations. Deficits in this domain are prevalent in fibromyalgia. METHODS Fifty-two fibromyalgia patients and thirty-two healthy individuals completed the Ekman-60 Faces Test, which requires classification of facial displays of happiness, sadness, anger, fear, surprise, and disgust. They also completed eight tasks assessing the executive function components of shifting, updating, and inhibition. Effects of comorbid depression and anxiety disorders, as well as medication use, were tested in stratified analyses of patient subgroups. RESULTS Patients made more errors overall than controls in classifying the emotional expressions. Moreover, their recognition accuracy correlated positively with performance on most of the executive function tasks. Emotion recognition did not vary as a function of comorbid psychiatric disorders or medication use. CONCLUSIONS The study supports impaired facial emotion recognition in fibromyalgia, which may contribute to the interaction problems and poor social functioning characterizing this condition. Facial emotion recognition is regarded as a complex process, which may be particularly reliant on efficient coordination of various basic operations by executive functions. As such, the correlations between cognitive task performance and recognition accuracy suggest that deficits in higher cognitive functions underlie impaired emotional communication in fibromyalgia.
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Affiliation(s)
| | | | | | - Stefan Duschek
- Institute of Psychology, UMIT Tirol-University for Health Sciences Medical Informatics and Technology, Hall in Tirol, Austria
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15
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Davila MI, Kizakevich PN, Eckhoff R, Morgan J, Meleth S, Ramirez D, Morgan T, Strange LB, Lane M, Weimer B, Lewis A, Lewis GF, Hourani LI. Use of Mobile Technology Paired with Heart Rate Monitor to Remotely Quantify Behavioral Health Markers among Military Reservists and First Responders. Mil Med 2021; 186:17-24. [PMID: 33499533 DOI: 10.1093/milmed/usaa395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 07/13/2020] [Accepted: 10/20/2020] [Indexed: 11/14/2022] Open
Abstract
INTRODUCTION Heart rate variability (HRV) is a biological marker that reflects an individual's autonomic nervous system regulation. Psychological resilience is an individual's ability to recover from an adverse event and return to physiological homeostasis and mental well-being, indicated by higher resting HRV. The Biofeedback Assisted Resilience Training (BART) study evaluates a resilience-building intervention, with or without HRV biofeedback. This article evaluates the feasibility of remote psychophysiological research by validating the HRV data collected. MATERIALS AND METHODS The BART platform consists of a mobile health application (BART app) paired to a wearable heart rate monitor. The BART app is installed on the participant's personal phone/tablet to track and collect self-report psychological and physiological data. The platform collects raw heart rate data and processes HRV to server as online biofeedback. The raw data is processed offline to derive HRV for statistical analysis. The following HRV parameters are validated: inter-beat interval, respiratory sinus arrhythmia, low-frequency HRV, biofeedback HRV, and heart period. Bland-Altman and scatter plots are used to compare and contrast online and offline HRV measures. Repeated-measures ANOVA are used to compared means across tasks during the stress (rest, stress, and recovery) and training (rest and paced breathing) sessions in order to validate autonomic nervous system changes to physiological challenges. RESULTS The analyses included 245 participants. Bland-Altman plots showed excellent agreement and minimal bias between online and offline unedited inter-beat interval data during the stress session. RMANOVA during the training session indicated a significant strong effect on biofeedback HRV, F(11,390) = 967.96, P < .01. During the stress session, RMANOVA showed significant strong effect on respiratory sinus arrhythmia and low-frequency HRV, and a significant but weak effect on heart period. CONCLUSIONS The BART digital health platform supports remote behavioral and physiological data collection, intervention delivery, and online HRV biofeedback.
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Affiliation(s)
- Maria I Davila
- Department of Psychiatry, University of North Carolina at Chapel Hill, 388 Med School, Chapel Hill, NC, 27599, USA
| | | | - Randy Eckhoff
- RTI International, Research Triangle Park, NC 27719, USA
| | - Jessica Morgan
- RTI International, Research Triangle Park, NC 27719, USA
| | | | - Derek Ramirez
- RTI International, Research Triangle Park, NC 27719, USA
| | - Tim Morgan
- RTI International, Research Triangle Park, NC 27719, USA
| | | | - Marion Lane
- RTI International, Research Triangle Park, NC 27719, USA
| | - Belinda Weimer
- RTI International, Research Triangle Park, NC 27719, USA
| | - Amanda Lewis
- RTI International, Research Triangle Park, NC 27719, USA
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16
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Duschek S, Bair A, Hoffmann A, Marksteiner J, Montoro CI, Reyes del Paso GA. Cardiovascular Variability and Reactivity in Major Depressive Disorder. J PSYCHOPHYSIOL 2021. [DOI: 10.1027/0269-8803/a000277] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Abstract. This study investigated cardiovascular variability and stress reactivity in major depressive disorder (MDD). While previous research has documented reduced heart rate variability, knowledge about blood pressure variability in MDD remains scarce. Regarding reactivity, a particular focus was placed on the time courses of the cardiovascular responses, which may provide insight into the autonomic mechanisms underlying the hypo-reactivity expected in MDD. In 76 MDD patients and 71 healthy controls, blood pressure was continuously recorded at rest and during mental stress induced by a 3-min serial subtraction task. Compared to controls, patients exhibited lower systolic and diastolic blood pressure, heart rate variability, and systolic and diastolic blood pressure variability. Moreover, smaller stress-related changes in heart rate, systolic and diastolic blood pressure, and sensitivity of the cardiac baroreflex arose in patients. Cardiovascular parameters did not differ between patients using antidepressants and unmedicated patients. According to time-course analysis, reduced hemodynamic modulations in MDD mainly occurred after 50 s of the stress period. Low heart rate variability in MDD reflects deficient top-down integration of the brain mechanisms allowing flexible autonomic and behavioral control; diminished blood pressure variability is indicative of poor homeostatic capacity with respect to the regulation of blood pressure and organ perfusion. Moreover, blunted cardiovascular reactivity implies poor adjustment of energetic resources to internal and environmental demands and may be a correlate of deficient motivational dynamics characterizing MDD. While cardiovascular hypo-reactivity in MDD may be mediated by baroreflex and adrenergic mechanisms, the fast-acting parasympathetic system may play a subordinate role.
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Affiliation(s)
- Stefan Duschek
- UMIT – University of Health Sciences, Medical Informatics and Technology, Institute of Psychology, Hall in Tirol, Austria
| | - Angela Bair
- UMIT – University of Health Sciences, Medical Informatics and Technology, Institute of Psychology, Hall in Tirol, Austria
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17
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Brandt E, Wilson JK, Rieger RE, Gill D, Mayer AR, Cavanagh JF. Respiratory Sinus Arrhythmia Correlates With Depressive Symptoms Following Mild Traumatic Brain Injury. J PSYCHOPHYSIOL 2020. [DOI: 10.1027/0269-8803/a000268] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Abstract. Depression is a pervasive psychiatric problem following mild traumatic brain injury (mTBI). However, the onset and course of symptom expression following mTBI can differ from that of spontaneous episodes of depression. Here, we aimed to assess a physiological metric closely linked to depression: respiratory sinus arrhythmia (RSA), a measure of high frequency heart rate variability. RSA is reduced during depressive episodes, and higher resting RSA has been shown to predict future recovery from depression. In this study, we investigated if these patterns were observed throughout the typical timeframe of sub-acute mTBI recovery. Although RSA did not differ between mTBI ( n = 50) and control ( n = 27) groups, depressive symptoms were reliably correlated with RSA only in the mTBI group. This pattern was consistent 2 weeks, 2 months, and 4 months post-injury. Furthermore, resting RSA shortly following injury predicted the trajectory of depressive symptoms 2 months later. These findings generalize the connection between RSA and depression to a clinical population where depressive symptoms are common but often difficult to parse from other post-trauma consequences.
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Affiliation(s)
- Emma Brandt
- University of New Mexico Health Sciences Center, Department of Neuroscience, University of New Mexico, Albuquerque, NM, USA
| | - J. Kevin Wilson
- University of New Mexico Health Sciences Center, Department of Neuroscience, University of New Mexico, Albuquerque, NM, USA
| | - Rebecca E. Rieger
- University of New Mexico Health Sciences Center, Department of Neuroscience, University of New Mexico, Albuquerque, NM, USA
| | - Darbi Gill
- University of New Mexico Health Sciences Center, Department of Neuroscience, University of New Mexico, Albuquerque, NM, USA
| | - Andrew R. Mayer
- University of New Mexico Health Sciences Center, Department of Neuroscience, University of New Mexico, Albuquerque, NM, USA
- Mind Research Network, Albuquerque, NM, USA
- Department of Psychology, University of New Mexico, Albuquerque NM, USA
| | - James F. Cavanagh
- Department of Psychology, University of New Mexico, Albuquerque NM, USA
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18
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Bair A, Marksteiner J, Falch R, Ettinger U, Reyes Del Paso GA, Duschek S. Features of autonomic cardiovascular control during cognition in major depressive disorder. Psychophysiology 2020; 58:e13628. [PMID: 32621782 DOI: 10.1111/psyp.13628] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 05/18/2020] [Accepted: 05/22/2020] [Indexed: 11/27/2022]
Abstract
Previous research has suggested reduced parasympathetic cardiac regulation during cognitive activity in major depressive disorder (MDD). However, little is known about possible abnormalities in sympathetic control and cardiovascular reactivity. This study aimed to provide a comprehensive analysis of autonomic cardiovascular control in the context of executive functions in MDD. Thirty six MDD patients and 39 healthy controls participated. Parameters of sympathetic (pre-ejection period, PEP) and parasympathetic control (high and low frequency heart rate variability, HF HRV, LF HRV; and baroreflex sensitivity, BRS) as well as RR interval were obtained at rest and during performance of executive function tasks (number-letter task, n-back task, continuous performance test, and Stroop task). Patients, as compared to controls, exhibited lower HF HRV and LF HRV during task execution and smaller shortenings in PEP and RR interval between baseline and tasks. They displayed longer reaction times during all conditions of the tasks and more omission errors and false alarms on the continuous performance test. In the total sample, on-task HF HRV, LF HRV and BRS, and reactivity in HF HRV, LF HRV, and PEP, were positively associated with task performance. As performance reduction arose independent of executive function load of the tasks, the behavioral results reflect impairments in attention and processing speed rather than executive dysfunctions in MDD. Abnormalities in cardiovascular control during cognition in MDD appear to involve both divisions of the autonomic nervous system. Low tonic parasympathetic control and blunted sympathetic reactivity imply reduced physiological adjustment resources and, by extension, provide suboptimal conditions for cognitive performance.
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Affiliation(s)
- Angela Bair
- Institute of Psychology, UMIT - University of Health Sciences, Medical Informatics and Technology, Hall in Tirol, Austria
| | - Josef Marksteiner
- Department of Psychiatry, County Hospital of Hall in Tirol, Hall in Tirol, Austria
| | - Reingard Falch
- Department of Psychiatry, County Hospital of Hall in Tirol, Hall in Tirol, Austria
| | | | | | - Stefan Duschek
- Institute of Psychology, UMIT - University of Health Sciences, Medical Informatics and Technology, Hall in Tirol, Austria
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19
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Bair A, Reyes Del Paso GA, Duschek S. Parasympathetic cardiac control and attentional focus in trait worry. Int J Psychophysiol 2020; 162:181-189. [PMID: 32437724 DOI: 10.1016/j.ijpsycho.2020.05.002] [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: 02/10/2020] [Revised: 04/30/2020] [Accepted: 05/03/2020] [Indexed: 10/24/2022]
Abstract
Trait worry refers to a tendency toward increased vigilance to threat and reduced tolerance of uncertainty. While it has been established as a risk factor of general morbidity, knowledge about autonomic regulation in trait worry remains scarce. This study investigated parasympathetic cardiac control in trait worry, in the context of attentional focus. Healthy groups with high and low worry were selected using the Penn State Worry Questionnaire (n = 40 per group). Heart rate variability (HRV) was recorded in the high frequency (HF) and low frequency (LF) bands while participants performed a breathing focus task. The task included a phase of instructed worry and two phases during which participants´ ability to concentrate on their breathing was assessed. As compared to the low worry group, the high worry group exhibited lower HRV in the LF band during both breathing focus phases and smaller reduction of LF HRV during instructed worry. HF HRV did not differ between groups. High worry was associated with impaired ability to concentrate on breathing and more intrusive thoughts. In the total sample, negative intrusions correlated negatively with LF HRV during the first breathing focus phase and LF HRV reactivity. Instructed worry led to greater perceived stress and deterioration of mood in high worry participants. Reduced LF HRV reflects blunted parasympathetic cardiac control in trait worry, associated with elevated risk of poor health outcomes. In addition, it might represent a psychophysiological correlate of reduced cognitive inhibition, which interferes with attentional focus and impedes control of threat processing and perseverative thinking.
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Affiliation(s)
- Angela Bair
- UMIT - University of Health Sciences, Medical Informatics and Technology, Institute of Psychology, Hall in Tirol, Austria.
| | | | - Stefan Duschek
- UMIT - University of Health Sciences, Medical Informatics and Technology, Institute of Psychology, Hall in Tirol, Austria
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20
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Commentary: About the logical, theoretical, and physiological differences between pre-task and post-task measurements of cardiac vagal activity. Physiol Behav 2020; 218:112685. [PMID: 31618616 DOI: 10.1016/j.physbeh.2019.112685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Revised: 09/17/2019] [Accepted: 09/17/2019] [Indexed: 11/21/2022]
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21
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Hourani LL, Davila MI, Morgan J, Meleth S, Ramirez D, Lewis G, Kizakevich PN, Eckhoff R, Morgan T, Strange L, Lane M, Weimer B, Lewis A. Mental health, stress, and resilience correlates of heart rate variability among military reservists, guardsmen, and first responders. Physiol Behav 2020; 214:112734. [DOI: 10.1016/j.physbeh.2019.112734] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Revised: 11/08/2019] [Accepted: 11/09/2019] [Indexed: 01/22/2023]
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Cerebral blood flow responses during prosaccade and antisaccade preparation in major depression. Eur Arch Psychiatry Clin Neurosci 2019; 269:813-822. [PMID: 30421150 DOI: 10.1007/s00406-018-0956-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Accepted: 11/03/2018] [Indexed: 12/17/2022]
Abstract
While impairments in executive functions have been well established in major depressive disorder (MDD), specific deficits in proactive control have scarcely been studied so far. Proactive control refers to cognitive processes during anticipation of a behaviorally relevant event that facilitate readiness to react. In this study, cerebral blood flow responses were investigated in MDD patients during a precued antisaccade task requiring preparatory attention and proactive inhibition. Using functional transcranial Doppler sonography, blood flow velocities in the middle cerebral arteries of both hemispheres were recorded in 40 MDD patients and 40 healthy controls. In the task, a target appeared left or right of the fixation point 5 s after a cuing stimulus; subjects had to move their gaze to the target (prosaccade) or its mirror image position (antisaccade). Video-based eye-tracking was applied for ocular recording. A right dominant blood flow increase arose during prosaccade and antisaccade preparation, which was smaller in MDD patients than controls. Patients exhibited a higher error rate than controls for antisaccades but not prosaccades. The smaller blood flow response may reflect blunted anticipatory activation of the dorsolateral prefrontal and inferior parietal cortices in MDD. The patients' increased antisaccade error rate suggests deficient inhibitory control. The findings support the notion of impairments in proactive control in MDD, which are clinically relevant as they may contribute to the deficits in cognition and behavioral regulation that characterize the disorder.
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23
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Bruehl S, Olsen RB, Tronstad C, Sevre K, Burns JW, Schirmer H, Nielsen CS, Stubhaug A, Rosseland LA. Chronic pain-related changes in cardiovascular regulation and impact on comorbid hypertension in a general population: the Tromsø study. Pain 2019; 159:119-127. [PMID: 28953193 DOI: 10.1097/j.pain.0000000000001070] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Heart rate variability (HRV) and baroreflex sensitivity (BRS) are indexes reflecting the ability to maintain cardiovascular homeostasis amidst changing conditions. Evidence primarily from small studies suggests that both HRV and BRS may be reduced in individuals with chronic pain (CP), with potential implications for cardiovascular risk. We compared HRV and BRS between individuals with CP (broadly defined) and pain-free controls in a large unselected population sample. Participants were 1143 individuals reporting clinically meaningful CP and 5640 pain-free controls who completed a 106-second cold pressor test (CPT). Participants self-reported hypertension status. Resting HRV and BRS were derived from continuous beat-to-beat blood pressure recordings obtained before and after the CPT. Hierarchical regressions for the pre-CPT period indicated that beyond effects of age, sex, and body mass index, the CP group displayed significantly lower HRV in both the time domain (SDNN and rMSSD) and frequency domain (high-frequency HRV power), as well as lower BRS. Results were somewhat weaker for the post-CPT period. Mediation analyses indicated that for 6 of 7 HRV and BRS measures tested, there were significant indirect (mediated) effects of CP status on the presence of comorbid hypertension via reduced HRV or BRS. Results confirm in the largest and broadest sample tested to date that the presence of CP is linked to impaired cardiovascular regulation and for the first time provide support for the hypothesis that links between CP and comorbid hypertension reported in previous population studies may be due in part to CP-related decrements in cardiovascular regulation.
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Affiliation(s)
- Stephen Bruehl
- Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, TN, USA
| | | | | | - Knut Sevre
- Cardiology, Oslo University Hospital, Oslo, Norway
| | - John W Burns
- Department of Behavioral Science, Rush University, Chicago, IL, USA
| | - Henrik Schirmer
- Division of Medicine and Laboratory Sciences, Akershus University Hospital, Lørenskog, Norway.,Department of Clinical Medicine, University of Tromsø, The Arctic University, Tromsø, Norway.,Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Christopher Sivert Nielsen
- Department of Aging, Norwegian Institute of Public Health, Oslo, Norway.,Departments of Pain Management and Research and
| | - Audun Stubhaug
- Departments of Pain Management and Research and.,Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Leiv Arne Rosseland
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.,Research and Development, Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway
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Hoffmann A, Montoro CI, Reyes del Paso GA, Duschek S. Cerebral blood flow modulations during proactive control in major depressive disorder. Int J Psychophysiol 2018; 133:175-181. [DOI: 10.1016/j.ijpsycho.2018.07.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Revised: 06/13/2018] [Accepted: 07/05/2018] [Indexed: 02/06/2023]
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Sánchez-Fernández MDM, Reyes del Paso GA, Gil-Cunquero JM, Fernández-Serrano MJ. Executive function in end-stage renal disease: Acute effects of hemodialysis and associations with clinical factors. PLoS One 2018; 13:e0203424. [PMID: 30180208 PMCID: PMC6122819 DOI: 10.1371/journal.pone.0203424] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2018] [Accepted: 08/21/2018] [Indexed: 01/21/2023] Open
Abstract
Objective There is evidence of cognitive impairment in patients with end-stage renal disease in hemodialysis (ESRD-HD). However, few studies have exhaustively analyzed executive functions (EFs) in this population, especially considering the influence of a wide range of clinical variables. This study analyzes performance in different EF components in ESRD-HD patients compared to a group of healthy controls (HCs), in addition to the acute effects of HD and the associations of cognitive performance with clinical variables. Method EFs were evaluated pre- and post-HD in 43 ESRD-HD patients and 42 HCs, using a battery of tests designed to assess EF domains. Age, schooling, mood and blood pressure were statistically controlled. Associations between performance and clinical factors were computed by correlations and hierarchical multiple regression analyses. Results The performance of the ESRD-HD patients was significantly lower than that of HCs in all the EF domains except for planning. Group differences were marginally significant for reasoning. HD produced no acute changes in global performance, with improvements see only in inhibition and working memory. EF scores were positively associated with total number of months previously transplanted, body mass index (BMI), dry weight, and levels of hemoglobin, albumin, ferritin, calcium, phosphorus, sodium, urea, and creatinine. Conclusions Global EF functioning was lower in ESRD-HD patients than in HCs. No major acute HD-related EF changes were detected. These findings underline the importance of an adequate nutritional status for maintaining executive functioning in ESRD-HD patients.
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Hoffmann A, Montoro CI, Reyes Del Paso GA, Duschek S. Cerebral blood flow modulations during cognitive control in major depressive disorder. J Affect Disord 2018; 237:118-125. [PMID: 29803902 DOI: 10.1016/j.jad.2018.05.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Revised: 04/23/2018] [Accepted: 05/13/2018] [Indexed: 01/25/2023]
Abstract
BACKGROUND This study investigated cerebral blood flow modulations during proactive and reactive cognitive control in major depressive disorder (MDD). Proactive control refers to preparatory processes during anticipation of a behaviorally relevant event; reactive control is activated after such an event to ensure goal attainment. METHODS Using functional transcranial Doppler sonography, blood flow velocities in the middle cerebral arteries of both hemispheres were recorded in 40 MDD patients and 40 healthy controls during a precued Stroop task. The font color of color words, which appeared 5 s after an acoustic warning signal, had to be indicated while ignoring word meaning. RESULTS Patients, as compared to controls, exhibited smaller bilateral blood flow increases during task preparation and larger increases after color word presentation. Response time was longer in patients irrespective of the match or mismatch between font color and word meaning. The blood flow increase after word presentation correlated positively with response time. LIMITATIONS Potential effects of psychotropic medication on cognition and cerebral blood flow could not be controlled. CONCLUSIONS The study revealed evidence of reduced cortical activity during proactive and elevated activity that occurs during reactive control in MDD. Deficient implementation of proactive control in MDD may lead to increased reliance on reactive control. The association between the blood flow increase after color word presentation and poorer performance indicates that deficient response preparation cannot be compensated for by reactive strategies. The findings are clinically relevant, as they may contribute to our understanding of the mechanisms relevant to cognitive impairments in MDD.
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Affiliation(s)
- Alexandra Hoffmann
- UMIT - Institute of Psychology, University for Health Sciences Medical Informatics and Technology, Eduard-Wallnöfer Zentrum 1, Hall in Tirol 6060, Austria.
| | | | | | - Stefan Duschek
- UMIT - Institute of Psychology, University for Health Sciences Medical Informatics and Technology, Eduard-Wallnöfer Zentrum 1, Hall in Tirol 6060, Austria
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27
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Duschek S, Hoffmann A, Montoro CI, Reyes Del Paso GA, Schuepbach D, Ettinger U. Cerebral blood flow modulations during preparatory attention and proactive inhibition. Biol Psychol 2018; 137:65-72. [PMID: 30006269 DOI: 10.1016/j.biopsycho.2018.07.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Revised: 07/05/2018] [Accepted: 07/06/2018] [Indexed: 01/07/2023]
Abstract
This study investigated cerebral blood flow modulations during task preparation in a precued saccade paradigm. Bilateral blood flow velocities in the middle cerebral arteries were recorded in 48 subjects using functional transcranial Doppler sonography. Video-based eye-tracking was applied for ocular recording. Antisaccade and prosaccade trials were presented in both block-wise and interleaved order. A right dominant flow response arose during task preparation. While the response was stronger during antisaccade than prosaccade trials, the degree of lateralisation did not differ between the two trial types. Direction error rates were higher and latencies were longer for antisaccades than prosaccades. There were no differences between block-wise and interleaved trials in blood flow or performance. The stronger blood flow increases during antisaccade than prosaccade preparation reflects the complexity of the upcoming task demands as well as proactive inhibition. The right hemispheric lateralisation may be attributed to preparatory attention independent of demands on inhibitory control.
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Affiliation(s)
- Stefan Duschek
- UMIT - Institute of Psychology, University for Health Sciences Medical Informatics and Technology, Eduard Wallnöfer-Zentrum 1, 6060 Hall in Tirol, Austria.
| | - Alexandra Hoffmann
- UMIT - Institute of Psychology, University for Health Sciences Medical Informatics and Technology, Eduard Wallnöfer-Zentrum 1, 6060 Hall in Tirol, Austria.
| | - Casandra I Montoro
- UMIT - Institute of Psychology, University for Health Sciences Medical Informatics and Technology, Eduard Wallnöfer-Zentrum 1, 6060 Hall in Tirol, Austria.
| | | | - Daniel Schuepbach
- Hospital Weissenhof, Weinsberg, Department of General Psychiatry, University of Heidelberg, 74189 Weinsberg, Germany.
| | - Ulrich Ettinger
- Department of Psychology, University of Bonn, Kaiser-Karl-Ring 9, 53111 Bonn, Germany.
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Talanow T, Ettinger U. Effects of task repetition but no transfer of inhibitory control training in healthy adults. Acta Psychol (Amst) 2018; 187:37-53. [PMID: 29772392 DOI: 10.1016/j.actpsy.2018.04.016] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Revised: 03/21/2018] [Accepted: 04/24/2018] [Indexed: 02/04/2023] Open
Abstract
Executive functions (EFs) comprise the updating, shifting and inhibition dimensions. According to the Unity and Diversity Model, the inhibition dimension is fully accounted for by a general EFs factor. This suggests that training of inhibition should transfer, in part, to updating and shifting. Therefore, we tested the effectiveness of a three-week inhibition training (high-conflict Stroop task) and explored near transfer effects to an untrained inhibition task (antisaccade task) and far transfer effects to untrained tasks demanding task-set shifting (number-letter-task), working memory updating (n-back task) and planning abilities (Stockings of Cambridge task). We employed a randomized pretest/treatment/posttest study design in n = 102 healthy young adults, assigned to an intensive Stroop training (n = 38), an active control condition (n = 34) or no training intervention (n = 30). In the Stroop training group, Stroop performance improved with practice, while performance in the active control group remained unchanged. The Stroop training group showed improvements in overall Stroop task performance from pretest to posttest, but we observed neither near nor far transfer effects. Additionally, specifically stronger gains on incongruent Stroop trials compared to congruent trials were observed in the Stroop training group when color bar trials were excluded from the pretest-posttest-analysis. Generally, there were substantial improvements from pretest to posttest independent of training condition in all transfer tasks. In sum, our data do not support the existence of transfer effects from inhibition training in healthy young adults.
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Muñoz Ladrón de Guevara C, Fernández-Serrano MJ, Reyes del Paso GA, Duschek S. Executive function impairments in fibromyalgia syndrome: Relevance of clinical variables and body mass index. PLoS One 2018; 13:e0196329. [PMID: 29694417 PMCID: PMC5918817 DOI: 10.1371/journal.pone.0196329] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Accepted: 04/11/2018] [Indexed: 11/18/2022] Open
Abstract
Background Several investigations suggest the presence of deterioration of executive function in fibromyalgia syndrome (FMS). The study quantified executive functions in patients with FMS. A wide array of functions was assessed, including updating, shifting and inhibition, as well as decision making and mental planning. Moreover, clinical variables were investigated as possible mediators of executive dysfunction, including pain severity, psychiatric comorbidity, medication and body mass index (BMI). Methods Fifty-two FMS patients and 32 healthy controls completed a battery of 14 neuropsychological tests. Clinical interviews were conducted and the McGill Pain Questionnaire, Beck Depression Inventory, State-Trait Anxiety Inventory, Fatigue Severity Scale and Oviedo Quality of Sleep Questionnaire were presented. Results Patients performed poorer than controls on the Letter Number Sequencing, Arithmetic and Similarities subtests of the Wechsler Adult Intelligence Scale, the Spatial Span subtest of the Wechsler Memory Scale, an N-back task, a verbal fluency task, the Ruff Figural Fluency Test, the Inhibition score of the Stroop Test, the Inhibition and Shifting scores of the Five Digits Test, the Key Search Test and the Zoo Map Task. Moreover, patients exhibited less steep learning curves on the Iowa Gambling Task. Among clinical variables, BMI and pain severity explained the largest proportion of performance variance. Conclusions This study demonstrated impairments in executive functions of updating, shifting inhibition, decision making and planning in FMS. While the mediating role of pain in cognitive impairments in FMS had been previously established, the influence of BMI is a novel finding. Overweight and obesity should be considered by FMS researchers, and in the treatment of the condition.
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Affiliation(s)
| | | | | | - Stefan Duschek
- UMIT—University for Health Sciences Medical Informatics and Technology, Hall in Tirol, Austria
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Galvez-Sánchez CM, Reyes del Paso GA, Duschek S. Cognitive Impairments in Fibromyalgia Syndrome: Associations With Positive and Negative Affect, Alexithymia, Pain Catastrophizing and Self-Esteem. Front Psychol 2018; 9:377. [PMID: 29623059 PMCID: PMC5874325 DOI: 10.3389/fpsyg.2018.00377] [Citation(s) in RCA: 60] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Accepted: 03/07/2018] [Indexed: 12/11/2022] Open
Abstract
Fibromyalgia syndrome (FMS) is a chronic condition characterized by widespread pain accompanied by symptoms like depression, anxiety, sleep disturbance and fatigue. In addition, affected patients frequently report cognitive disruption such as forgetfulness, concentration difficulties or mental slowness. Though cognitive deficits in FMS have been confirmed in various studies, not much is known about the mechanisms involved in their origin. This study aimed to investigate the contribution of affect-related variables to cognitive impairments in FMS. For this purpose, 67 female FMS patients and 32 healthy control subjects completed a battery of cognitive tests measuring processing speed, attention, visuospatial and verbal memory, cognitive flexibility and planning abilities. In addition, participants completed self-report questionnaires pertaining to positive and negative affect, alexithymia, pain catastrophizing and self-esteem. Clinical characteristics including pain severity, symptoms of depression and anxiety, insomnia and fatigue were also assessed. FMS patients showed markedly poorer performance than healthy controls in all of the cognitive domains assessed, in addition to greater levels of depression, anxiety, negative affect, alexithymia and pain catastrophizing, and lower self-esteem and positive affect. In exploratory correlation analysis in the FMS sample, lower cognitive performance was associated with higher pain severity, depression, anxiety, negative affect, alexithymia and pain catastrophizing, as well as lower self-esteem and positive affect. However, in regression analyses, pain, self-esteem, alexithymia, and pain catastrophizing explained the largest portion of the variance in performance. While interference effects of clinical pain in cognition have been previously described, the present findings suggest that affective factors also substantially contribute to the genesis of cognitive impairments. They support the notion that affective disturbances form a crucial aspect of FMS pathology, whereas strategies aiming to improve emotional regulation may be a beneficial element of psychological therapy in the management of FMS.
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Affiliation(s)
| | | | - Stefan Duschek
- Department of Psychology, University for Health Sciences, Medical Informatics and Technology, Hall in Tirol, Austria
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