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Alacreu-Crespo A, Sebti E, Moret RM, Courtet P. From Social Stress and Isolation to Autonomic Nervous System Dysregulation in Suicidal Behavior. Curr Psychiatry Rep 2024; 26:312-322. [PMID: 38717659 PMCID: PMC11147891 DOI: 10.1007/s11920-024-01503-6] [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] [Accepted: 04/11/2024] [Indexed: 06/04/2024]
Abstract
PURPOSE OF REVIEW In this narrative review we wanted to describe the relationship of autonomic nervous system activity with social environment and suicidal spectrum behaviors. RECENT FINDINGS Patients with suicidal ideation/suicide attempt have higher sympathetic nervous system (SNS) and lower parasympathetic nervous system (PNS) activity in resting conditions and during acute stress tasks compared with patients without suicidal ideation/suicide attempt. Death by suicide and violent suicide attempt also are related to SNS hyperactivation. Similarly, a SNS/PNS imbalance has been observed in people with childhood trauma, stressful life events or feelings of loneliness and isolation. Social support seems to increase PNS control and resilience. Due to the importance of the social context and stressful life events in suicidal behavior, SNS/PNS imbalance could act as a mediator in this relationship and be a source of relevant biomarkers. Childhood trauma and stressful life events may impair the autonomic nervous system response in suicidal patients. Loneliness, isolation and social support may act as moderators in acute stress situations.
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Affiliation(s)
- Adrián Alacreu-Crespo
- Department of Psychology and Sociology, University of Zaragoza, C/Atarazana 4, Aragon, Teruel, 44003, Spain.
- FondaMental Foundation, Créteil, France.
| | - Emma Sebti
- IGF, Univ. Montpellier, CNRS, INSERM, Montpellier, France
- Department of Emergency Psychiatry and Acute Care, Lapeyronie Hospital, CHU Montpellier, Montpellier, France
| | - Rosa María Moret
- Department of Psychology and Sociology, University of Zaragoza, C/Atarazana 4, Aragon, Teruel, 44003, Spain
| | - Philippe Courtet
- FondaMental Foundation, Créteil, France
- IGF, Univ. Montpellier, CNRS, INSERM, Montpellier, France
- Department of Emergency Psychiatry and Acute Care, Lapeyronie Hospital, CHU Montpellier, Montpellier, France
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Alosaimi F, Dominguez-Paredes D, Knoben R, Almasabi F, Hescham S, Kozielski K, Temel Y, Jahanshahi A. Wireless stimulation of the subthalamic nucleus with nanoparticles modulates key monoaminergic systems similar to contemporary deep brain stimulation. Behav Brain Res 2023; 444:114363. [PMID: 36849047 DOI: 10.1016/j.bbr.2023.114363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 12/14/2022] [Accepted: 02/24/2023] [Indexed: 02/27/2023]
Abstract
BACKGROUND Deep brain stimulation (DBS) is commonly used to alleviate motor symptoms in several movement disorders. However, the procedure is invasive, and the technology has remained largely stagnant since its inception decades ago. Recently, we have shown that wireless nanoelectrodes may offer an alternative approach to conventional DBS. However, this method is still in its infancy, and more research is required to characterize its potential before it can be considered as an alternative to conventional DBS. OBJECTIVES Herein, we aimed to investigate the effect of stimulation via magnetoelectric nanoelectrodes on primary neurotransmitter systems that have implications for DBS in movement disorders. METHODS Mice were injected with either magnetoelectric nanoparticles (MENPs) or magnetostrictive nanoparticles (MSNPs, as a control) in the subthalamic nucleus (STN). Mice then underwent magnetic stimulation, and their motor behavior was assessed in the open field test. In addition, magnetic stimulation was applied before sacrifice and post-mortem brains were processed for immunohistochemistry (IHC) to assess the co-expression of c-Fos with either tyrosine hydroxylase (TH), tryptophan hydroxylase-2 (TPH2) or choline acetyltransferase (ChAT). RESULTS Stimulated animals covered longer distances in the open field test when compared to controls. Moreover, we found a significant increase in c-Fos expression in the motor cortex (MC) and paraventricular region of the thalamus (PV-thalamus) after magnetoelectric stimulation. Stimulated animals showed fewer TPH2/c-Fos double-labeled cells in the dorsal raphe nucleus (DRN), as well as TH/c-Fos double-labeled cells in the ventral tegmental area (VTA), but not in the substantia nigra pars compacta (SNc). There was no significant difference in the number of ChAT/ c-Fos double-labeled cells in the pedunculopontine nucleus (PPN). CONCLUSIONS Magnetoelectric DBS in mice enables selective modulation of deep brain areas and animal behavior. The measured behavioral responses are associated with changes in relevant neurotransmitter systems. These changes are somewhat similar to those observed in conventional DBS, suggesting that magnetoelectric DBS might be a suitable alternative.
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Affiliation(s)
- Faisal Alosaimi
- Department of Neurosurgery, Maastricht University Medical Centre, Maastricht 6202AZ, the Netherlands; Department of Physiology, Faculty of Medicine, King Abdulaziz University, Rabigh, Saudi Arabia
| | - David Dominguez-Paredes
- Department of Neurosurgery, Maastricht University Medical Centre, Maastricht 6202AZ, the Netherlands
| | - Rick Knoben
- Department of Neurosurgery, Maastricht University Medical Centre, Maastricht 6202AZ, the Netherlands
| | - Faris Almasabi
- Department of Neurosurgery, Maastricht University Medical Centre, Maastricht 6202AZ, the Netherlands
| | - Sarah Hescham
- Department of Neurosurgery, Maastricht University Medical Centre, Maastricht 6202AZ, the Netherlands
| | - Kristen Kozielski
- School of Computation, Information and Technology, Technical University of Munich, Munich 80333, Germany
| | - Yasin Temel
- Department of Neurosurgery, Maastricht University Medical Centre, Maastricht 6202AZ, the Netherlands
| | - Ali Jahanshahi
- Department of Neurosurgery, Maastricht University Medical Centre, Maastricht 6202AZ, the Netherlands; Netherlands Institute for Neuroscience, Royal Netherlands Academy of Arts and Sciences, Amsterdam, the Netherlands.
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Miller A, Barros I, Callendar A, Schroeder G, Shakeshaft M, St Ours S, Lucero J, Miller K. High-trait anxious individuals show positive relationship between HRV and threat vigilance. Psychophysiology 2023:e14282. [PMID: 36869018 DOI: 10.1111/psyp.14282] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 02/08/2023] [Accepted: 02/09/2023] [Indexed: 03/05/2023]
Abstract
Selectively attending to threat-related stimuli in the environment, known as threat bias (TB), is a prominent feature of anxiety. Individuals with high anxiety also tend to show lower heart rate variability (HRV), a reflection of reduced parasympathetic cardiac control. Previous investigations have established associations between low HRV and various attentional processes that facilitate attention to threat, though these have primarily been conducted among non-anxious individuals. The current analysis, derived from a larger TB modification study, examined the relationship between TB and HRV among a young, nonclinical sample of individuals with either high or low trait anxiety (HTA, LTA, respectively; Mage = 25.8, SD = 13.2, 61.3% female). Consistent with expectations, HTA (β = -.18, p = .087) trended toward an association with higher threat vigilance. A significant moderation effect showed the relationship between HRV and threat vigilance was influenced by TA (β = .42, p = .004). Simple slopes analysis revealed that for the LTA group, lower HRV trended toward higher threat vigilance (p = .123), consistent with expectations. However, this relationship was unexpectedly reversed for the HTA group, for whom higher HRV was a significant predictor of higher threat vigilance (p = .015). These results are interpreted within a cognitive control framework, in which regulatory ability, as assessed via HRV, may influence which cognitive strategy is employed when encountering threatening stimuli. Results suggest that HTA individuals with greater regulatory ability may employ a contrast avoidance mechanism, while those with reduced regulatory ability engage in cognitive avoidance.
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Affiliation(s)
- Aaron Miller
- Department of Psychology, California State University, Long Beach, Long Beach, California, USA
| | - Isabel Barros
- Department of Psychology, California State University, Long Beach, Long Beach, California, USA
| | - Alyssa Callendar
- Department of Psychology, California State University, Long Beach, Long Beach, California, USA
| | - Grace Schroeder
- Department of Psychology, California State University, Long Beach, Long Beach, California, USA
| | - Morgan Shakeshaft
- Department of Psychology, California State University, Long Beach, Long Beach, California, USA
| | - Sirena St Ours
- Department of Psychology, California State University, Long Beach, Long Beach, California, USA
| | - John Lucero
- Department of Psychology, California State University, Long Beach, Long Beach, California, USA
| | - Karissa Miller
- Department of Psychology, California State University, Long Beach, Long Beach, California, USA
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High-frequency stimulation of the subthalamic nucleus induces a sustained inhibition of serotonergic system via loss of cell phenotype. Sci Rep 2022; 12:14011. [PMID: 35978112 PMCID: PMC9385659 DOI: 10.1038/s41598-022-18294-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 08/09/2022] [Indexed: 11/08/2022] Open
Abstract
Deep brain stimulation (DBS) of the subthalamic nucleus (STN) has become a standard treatment for Parkinson's disease (PD). However, in a considerable number of patients debilitating psychiatric side-effects occur. Recent research has revealed that external stimuli can alter the neurotransmitters' homeostasis in neurons, which is known as "neurotransmitter respecification". Herein, we addressed if neurotransmitter respecification could be a mechanism by which DBS suppresses the serotonergic function in the dorsal raphe nucleus (DRN) leading to mood changes. We infused transgenic 5-HT-Cre (ePET-Cre) mice with AAV viruses to achieve targeted expression of eYFP and the genetically encoded calcium indicator GCaMP6s in the DRN prior to methyl-4phenyl-1,2,3,6-tetrahydropyridine (MPTP) treatment. Mice received bilateral DBS electrodes in the STN and an optic fiber in the DRN for calcium photometry. MPTP-treated mice demonstrated behavioral and histological PD phenotype, whereas all STN-DBS animals exhibited an increased immobility time in the forced swim test, reduced calcium activity, and loss of tryptophan hydroxylase-2 expression in the DRN. Given the prominent role of calcium transients in mediating neurotransmitter respecification, these results suggest a loss of serotonergic phenotype in the DRN following STN-DBS. These findings indicate that loss of serotonergic cell phenotype may underlie the unwanted depressive symptoms following STN-DBS.
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Kuo CY, Chen KC, Lee IH, Tseng HH, Chiu NT, Chen PS, Yang YK, Chang WH. Serotonin Modulates the Correlations between Obsessive-compulsive Trait and Heart Rate Variability in Normal Healthy Subjects: A SPECT Study with [ 123I]ADAM and Heart Rate Variability Measurement. CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE 2022; 20:271-278. [PMID: 35466098 PMCID: PMC9048010 DOI: 10.9758/cpn.2022.20.2.271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 03/30/2021] [Accepted: 04/15/2021] [Indexed: 11/25/2022]
Abstract
Objective The impact of serotonergic system on obsessive-compulsive disorder (OCD) is well studied. However, the correlation between OC presentations and autonomic nervous system (ANS) is still unclear. Furthermore, whether the correlation might be modulated by serotonin is also uncertain. Methods We recruited eighty-nine healthy subjects. Serotonin transporter (SERT) availability by [123I]ADAM and heart rate variability (HRV) tests were measured. Symptoms checklist-90 was measured for the OC presentations. The interaction between HRV and SERT availability were calculated and the correlation between HRV and OC symptoms were analyzed after stratified SERT level into two groups, split at medium. Results The interactions were significant in the factors of low frequency (LF), high frequency (HF), and root mean square of successive differences (RMSSD). Furthermore, the significantly negative correlations between OC symptoms and the above HRV indexes existed only in subjects with higher SERT availability. Conclusion OC symptoms might be correlated with ANS regulations in subjects with higher SERT availability.
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Affiliation(s)
- Che Yu Kuo
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Kao Chin Chen
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - I Hui Lee
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Huai-Hsuan Tseng
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Institute of Behavioral Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Nan Tsing Chiu
- Department of Nuclear Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Po See Chen
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Institute of Behavioral Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yen Kuang Yang
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Institute of Behavioral Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Department of Psychiatry, Tainan Hospital, Ministry of Health and Welfare, Tainan, Taiwan
| | - Wei Hung Chang
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Department of Psychiatry, National Cheng Kung University Hospital, Dou-Liou Branch, Yunlin, Taiwan
- Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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Devine SL, Walker SC, Makdani A, Stockton ER, McFarquhar MJ, McGlone FP, Trotter PD. Childhood Adversity and Affective Touch Perception: A Comparison of United Kingdom Care Leavers and Non-care Leavers. Front Psychol 2020; 11:557171. [PMID: 33240148 PMCID: PMC7683385 DOI: 10.3389/fpsyg.2020.557171] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Accepted: 09/29/2020] [Indexed: 11/21/2022] Open
Abstract
In the United Kingdom, the most common reasons for a child to come under the care of social services are neglect and abuse. Such early childhood adversity is a risk factor for social-isolation and poor mental health in adulthood. Touch is a key channel for nurturing interactions, and previous studies have shown links between early somatosensory input, experience dependent neural plasticity, and later life emotional functioning. The aim of the present study was to test the relationship between childhood neglect/abuse and later life experiences, attitudes, and hedonic ratings of affective touch. Here, affective touch is defined as low force, dynamic touch which C-Tactile afferents (CTs) respond optimally to. We hypothesized that a childhood lacking in early nurturing tactile stimulation would be associated with reduced sensitivity to socially relevant affective touch in adulthood. To test this, 19 care leavers (average 9.32 ± 3.70 years in foster care) and 32 non-care leavers were recruited through opportunity sampling (mean age = 21.25 ± 1.74 years). Participants completed a range of psychophysical somatosensory tests. First, they rated the pleasantness of CT-optimal (3 cm/s) and non-CT-optimal (0.3 and 30 cm/s) stroking touch applied to their forearm, both robotically and by an experimenter. They also made vicarious ratings of the anticipated pleasantness of social tactile interactions depicted in a series of videos. Finally, they filled in the Childhood Trauma Questionnaire (CTQ) and the Touch Experiences and Attitudes Questionnaire (TEAQ). As expected, care leavers reported significantly higher levels of childhood trauma than the control group. They also reported significantly lower levels of positive childhood touch compared to non-care leavers, but their attitudes and experiences of current intimate and affiliative touch did not differ. Across all psychophysical tests, care leavers showed specific reduction in sensitivity to the affective value of CT targeted 3 cm/s touch. The results of this study support the hypothesis that a lack of nurturing touch in early developmental periods leads to blunted sensitivity to the specific social value of affective touch. Future research should investigate the neural and physiological mechanisms underlying the observed effect.
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Affiliation(s)
- Shaunna L Devine
- Research Centre for Brain and Behaviour, Liverpool John Moores University, Liverpool, United Kingdom
| | - Susannah C Walker
- Research Centre for Brain and Behaviour, Liverpool John Moores University, Liverpool, United Kingdom
| | - Adarsh Makdani
- Research Centre for Brain and Behaviour, Liverpool John Moores University, Liverpool, United Kingdom
| | - Elizabeth R Stockton
- Research Centre for Brain and Behaviour, Liverpool John Moores University, Liverpool, United Kingdom
| | - Martyn J McFarquhar
- Division of Neuroscience and Experimental Psychology, The University of Manchester, Manchester, United Kingdom
| | - Francis P McGlone
- Research Centre for Brain and Behaviour, Liverpool John Moores University, Liverpool, United Kingdom.,Institute of Psychology, Health and Society, University of Liverpool, Liverpool, United Kingdom
| | - Paula D Trotter
- Research Centre for Brain and Behaviour, Liverpool John Moores University, Liverpool, United Kingdom
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7
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Doroshenko YM, Lelevich VV. Biogenic Monoamines, Their Precursors, and Metabolites in the Brain of Rats under Experimental Circulatory Failure. NEUROCHEM J+ 2020. [DOI: 10.1134/s1819712420030034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Chesin M, Cascardi M, Tsang W, Smith S. Blunted Arousal in Response to Psychological Stress is Associated with Current Suicide Ideation. Arch Suicide Res 2020; 24:S381-S390. [PMID: 30955451 DOI: 10.1080/13811118.2019.1592041] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The purpose of this study was to test the association between arousal in response to psychological stress, as measured by standardized maximum decrease in high-frequency heart rate variability (HF HRV) during a stressful laboratory task, and current suicide ideation (SI). 81 emerging adult college students completed a stressful laboratory task consisting of the computerized Stroop and Cyberball while having their heart activity recorded. Spectral analysis and Fast Fourier transformations were used to decompose and transform the recording into the high (0.15 Hz-0.4 Hz) frequency component. After the task, participants completed the Beck Scale for Suicide Ideation to measure current SI, the Beck Depression Inventory-II to assess depressive symptom severity, and a brief medical history. Multivariate negative binomial regression analysis showed that the negative association between SI and arousal in response to psychological stress remained statistically significant when suicide attempt history, depressive symptom severity, female gender, and current smoking behavior were controlled. Identification of potential biomarkers for SI is important for suicide behavior prevention given limits to self-report SI assessment. Our results suggest arousal in response to psychological stress merits further consideration as a biomarker for current SI.
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Affiliation(s)
- Megan Chesin
- Department of Psychology, William Paterson University, Wayne, New Jersey, USA
| | - Michele Cascardi
- Department of Psychology, William Paterson University, Wayne, New Jersey, USA
| | - William Tsang
- Department of Psychology, William Paterson University, Wayne, New Jersey, USA
| | - Samantha Smith
- Department of Psychology, William Paterson University, Wayne, New Jersey, USA
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Lin SH, Lee IH, Tsai HC, Chi MH, Chang WH, Chen PS, Chen KC, Yang YK. The association between plasma cholesterol and the effect of tryptophan depletion on heart rate variability. Kaohsiung J Med Sci 2019; 35:440-445. [PMID: 30972948 DOI: 10.1002/kjm2.12067] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Accepted: 03/25/2019] [Indexed: 11/11/2022] Open
Abstract
Studies on the cholesterol-serotonin hypothesis and its link to mood disorders are scarce. In addition, little is known about the association between cholesterol and the effects of tryptophan depletion (TD). The aim of the present study was to investigate the association between plasma cholesterol and changes in heart rate variability (HRV), an important marker of depression and anxiety, after TD. The plasma cholesterol levels of 28 healthy participants were noted, and their HRVs were measured by spectrum analysis. TD was carried out on testing day, and participants provided blood samples just before and 5 hours for tryptophan level after TD. HRV was measured again after TD. An association was found between plasma cholesterol levels and the change in HRV. Decreased high frequency HRV was marginally associated with lower levels of high-density lipoprotein cholesterol, while increased low frequency HRV was significantly associated with lower levels of total and low-density lipoprotein cholesterol. Our findings indicate that low cholesterol levels may play parts of role in the mechanism of the deactivation of parasympathetic, and activation of sympathetic, functions induced by altered serotonergic function.
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Affiliation(s)
- Shih-Hsien Lin
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.,Institute of Behavioral Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - I Hui Lee
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Hsin Chun Tsai
- Department of Psychiatry, National Cheng Kung University Hospital, Dou-Liou Branch, Yunlin, Taiwan
| | - Mei Hung Chi
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Wei Hung Chang
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Po See Chen
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.,Institute of Behavioral Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Kao Chin Chen
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yen Kuang Yang
- Institute of Behavioral Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan.,Department of Psychiatry, National Cheng Kung University Hospital, Dou-Liou Branch, Yunlin, Taiwan
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10
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Agorastos A, Heinig A, Stiedl O, Hager T, Sommer A, Müller JC, Schruers KR, Wiedemann K, Demiralay C. Vagal effects of endocrine HPA axis challenges on resting autonomic activity assessed by heart rate variability measures in healthy humans. Psychoneuroendocrinology 2019; 102:196-203. [PMID: 30579237 DOI: 10.1016/j.psyneuen.2018.12.017] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Revised: 11/26/2018] [Accepted: 12/12/2018] [Indexed: 12/25/2022]
Abstract
BACKGROUND The hypothalamic-pituitary-adrenal axis (HPA axis) and the autonomic nervous system (ANS) are considered to play the most crucial role in the pathophysiology of stress responsiveness and are increasingly studied together. However, only few studies have simultaneously assessed HPA axis and ANS activity to investigate their direct interaction in pathophysiology, while no study so far has assessed the dynamic interplay between the two systems in healthy subjects through endocrine challenges. METHODS The present study assessed the direct effects of overnight pharmacoendocrine HPA axis challenges with dexamethasone (suppression) and metyrapone (stimulation) on ANS activity at rest as determined by linear and nonlinear measures of heart rate variability (HRV) in 39 young healthy individuals. RESULTS Findings indicated significant effects of metyrapone, but not dexamethasone on autonomic activity at rest based on HRV measures. HRV after metyrapone was overall significantly reduced in comparison to baseline or post-dexamethasone conditions, while the combined metyrapone-related reduction of HRV measures RMSSD, NN50(%) and HF(%) with concomitant increase of the unifractal scaling coefficient αfast value jointly indicated a specifically diminished vagal activity. CONCLUSIONS We provide first data that HPA axis stimulation (metyrapone) is associated with reduced vagal tone, while HPA axis suppression (dexamethasone) has no effect on autonomic modulation of heart function. Our results support a vital role of the parasympathetic nervous system in the interplay between ANS and HPA axis and, thus, in the modulation of stress-related cardiovascular responsiveness and the susceptibility to stress-related disorders.
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Affiliation(s)
- Agorastos Agorastos
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, D-20246, Hamburg, Germany; Department of Psychiatry, Division of Neurosciences, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, GR-54124, Thessaloniki, Greece.
| | - Alexandra Heinig
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, D-20246, Hamburg, Germany
| | - Oliver Stiedl
- Center for Neurogenomics and Cognitive Research, VU University Amsterdam, NL-1081, HV, Amsterdam, the Netherlands; Department of Health, Safety and Environment, VU University Amsterdam, NL-1081, BT, Amsterdam, the Netherlands
| | - Torben Hager
- Center for Neurogenomics and Cognitive Research, VU University Amsterdam, NL-1081, HV, Amsterdam, the Netherlands
| | - Anne Sommer
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, D-20246, Hamburg, Germany
| | - Jana C Müller
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, D-20246, Hamburg, Germany
| | - Koen R Schruers
- School of Mental Health and Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht University, NL-6200 MD, Maastricht, the Netherlands
| | - Klaus Wiedemann
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, D-20246, Hamburg, Germany
| | - Cüneyt Demiralay
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, D-20246, Hamburg, Germany
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Koenig J, Westlund Schreiner M, Klimes-Dougan B, Ubani B, Mueller BA, Lim KO, Kaess M, Cullen KR. Increases in orbitofrontal cortex thickness following antidepressant treatment are associated with changes in resting state autonomic function in adolescents with major depression - Preliminary findings from a pilot study. Psychiatry Res Neuroimaging 2018; 281:35-42. [PMID: 30216863 PMCID: PMC6204080 DOI: 10.1016/j.pscychresns.2018.08.013] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Revised: 07/23/2018] [Accepted: 08/22/2018] [Indexed: 12/18/2022]
Abstract
In adults with major depressive disorder (MDD), effective treatment has been associated with increases in both heart rate variability (HRV) and cortical thickness. However, the impact of treatment on these indices has not yet been examined in adolescents. Cortical thickness and HRV were measured in twelve adolescents with MDD before and after 8 weeks of treatment with a selective serotonin reuptake inhibitor (SSRI). We examined treatment-related changes in depression symptoms, HRV, heart rate (HR), and cortical thickness, and analyzed correlations among these change indices. At follow-up, patients showed significantly decreased depression severity, increased HRV and increased thickness of the left medial orbitofrontal cortex (OFC). Clinical improvement was associated with increased HRV and decreased HR. Increased HRV was associated with increased cortical thickness of left lateral OFC and superior frontal cortex. Due to the small sample size, results represent preliminary findings that need replication. Further, in the absence of a placebo arm, we cannot confirm that the observed effects are due solely to medication. These preliminary findings suggest that SSRI treatment in adolescents impacts both cortical thickness and autonomic functioning. Confirmation of these findings would support OFC thickness and HRV as neurobiological mediators of treatment outcome.
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Affiliation(s)
- Julian Koenig
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Stöckli, Bolligenstrasse 111, 3000, Bern 60, Switzerland; Section for Translational Psychobiology in Child and Adolescent Psychiatry, Department of Child and Adolescent Psychiatry, Centre for Psychosocial Medicine, University of Heidelberg, Blumenstr. 8, 69115, Heidelberg, Germany.
| | - Melinda Westlund Schreiner
- Department of Psychology, University of Minnesota, College of Liberal Arts, N218 Elliott Hall, 75 East River Road, Minneapolis, MN, USA
| | - Bonnie Klimes-Dougan
- Department of Psychology, University of Minnesota, College of Liberal Arts, N218 Elliott Hall, 75 East River Road, Minneapolis, MN, USA
| | - Benjamin Ubani
- Department of Psychiatry, University of Minnesota, Medical School, F256/2B West Building, 2450 Riverside Avenue, Minneapolis, MN, USA
| | - Bryon A Mueller
- Department of Psychiatry, University of Minnesota, Medical School, F256/2B West Building, 2450 Riverside Avenue, Minneapolis, MN, USA
| | - Kelvin O Lim
- Department of Psychiatry, University of Minnesota, Medical School, F256/2B West Building, 2450 Riverside Avenue, Minneapolis, MN, USA
| | - Michael Kaess
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Stöckli, Bolligenstrasse 111, 3000, Bern 60, Switzerland; Section for Translational Psychobiology in Child and Adolescent Psychiatry, Department of Child and Adolescent Psychiatry, Centre for Psychosocial Medicine, University of Heidelberg, Blumenstr. 8, 69115, Heidelberg, Germany
| | - Kathryn R Cullen
- Department of Psychiatry, University of Minnesota, Medical School, F256/2B West Building, 2450 Riverside Avenue, Minneapolis, MN, USA.
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12
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Bahi A, Dreyer JL. Dopamine transporter (DAT) knockdown in the nucleus accumbens improves anxiety- and depression-related behaviors in adult mice. Behav Brain Res 2018; 359:104-115. [PMID: 30367968 DOI: 10.1016/j.bbr.2018.10.028] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Revised: 10/18/2018] [Accepted: 10/20/2018] [Indexed: 12/11/2022]
Abstract
Many epidemiological and clinical studies have demonstrated a strong comorbidity between anxiety and depression, and a number of experimental studies indicates that the dopamine transporter (DAT) is involved in the pathophysiology of anxiety and depression. However, studies using laboratory animals have yielded inconclusive results. The aim of the present study was to examine the effects of DAT manipulation on anxiety- and depression-like behaviors in mice. For this purpose, animals were stereotaxically injected with DAT siRNA-expressing lentiviral vectors (siDAT) in the caudate putamen (CPu) or in the nucleus accumbens (Nacc) and the behavioral outcomes were assessed using the open-field (OF), elevated-plus maze (EPM), light-dark box (LDB), sucrose preference (SPT), novelty suppressed feeding (NSF), and forced-swim (FST) tests. The results showed that in the Nacc, but not in the CPu, siDAT increased the time spent at the center of the arena and decreased the number of fecal boli in the OF test. In the EPM and LDB tests, Nacc siDAT injection increased the entries and time spent on open arms, and increased the time spent in the light side of the box, respectively, suggesting an anxiolytic-like activity. In addition, siDAT, in the Nacc, induced significant antidepressant-like effects, evidenced by increased sucrose preference, shorter latency to feed in the NSF test, and decreased immobility time in the FST. Most importantly, Pearson's test clearly showed significant correlations between DAT mRNA in the Nacc with anxiety and depression parameters. Overall, these results suggest that low DAT levels, in the Nacc, might act as protective factors against anxiety and depression. Therefore, targeting DAT activity might be a very attractive approach to tackle affective disorders.
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Affiliation(s)
- Amine Bahi
- Department of Anatomy, Tawam Medical Campus, United Arab Emirates University, Al Ain, United Arab Emirates.
| | - Jean-Luc Dreyer
- Division of Biochemistry, Department of Medicine, University of Fribourg, CH-1700 Fribourg, Switzerland
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13
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Chang WH, Lee IH, Chi MH, Lin SH, Chen KC, Chen PS, Chiu NT, Yao WJ, Yang YK. Prefrontal cortex modulates the correlations between brain-derived neurotrophic factor level, serotonin, and the autonomic nervous system. Sci Rep 2018; 8:2558. [PMID: 29416077 PMCID: PMC5803248 DOI: 10.1038/s41598-018-20923-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Accepted: 01/15/2018] [Indexed: 12/13/2022] Open
Abstract
Top-down regulation in the human brain and anatomical connections between the prefrontal cortex (PFC) and specific catecholamine-related regions have been well-studied. However, the way in which the PFC modulates downstream neuro-networks in terms of serotonin and the autonomic nervous system (ANS) by variation in the level of brain-derived neurotrophic factor (BDNF) is still unclear. We recruited sixty-seven healthy subjects. Serotonin transporter (SERT) availability was examined by SPECT with [123I]ADAM analysis; heart rate variability (HRV) testing was performed, and the BDNF level was measured. The Wisconsin card-sorting test (WCST), which assesses PFC activation, was also conducted. The interactions of BDNF level and SERT availability were significant in relation to the HRV indexes of low frequency, high frequency, total power, and mean heart rate range. Moderate to significant positive correlations between SERT availability and the above-mentioned HRV indexes existed only in subjects with a low BDNF level. Furthermore, in the low BDNF level group, only those with high WCST perseveration errors or low category completions exhibited significant positive correlations between SERT availability and HRV indexes. A lower BDNF level and poorer PFC function might modulate the synergistic effects of serotonergic and ANS systems in order to maintain brain physiological and psychological homeostasis.
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Affiliation(s)
- Wei Hung Chang
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.,Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - I Hui Lee
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Mei Hung Chi
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Shih-Hsien Lin
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Kao Chin Chen
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Po See Chen
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Nan Tsing Chiu
- Department of Nuclear Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Wei Jen Yao
- Department of Nuclear Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yen Kuang Yang
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan. .,Department of Psychiatry, National Cheng Kung University Hospital, Dou-Liou Branch, Yunlin, Taiwan. .,Institute of Behavioral Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
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14
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Chang CC, Tzeng NS, Kao YC, Yeh CB, Chang HA. The relationships of current suicidal ideation with inflammatory markers and heart rate variability in unmedicated patients with major depressive disorder. Psychiatry Res 2017; 258:449-456. [PMID: 28886903 DOI: 10.1016/j.psychres.2017.08.076] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2016] [Revised: 07/11/2017] [Accepted: 08/27/2017] [Indexed: 10/19/2022]
Abstract
Studies investigating inflammatory status and autonomic functioning simultaneously in depressed patients with current suicidal ideation (SI) are lacking. We recruited 58 unmedicated depressed patients with current SI but without lifetime history of suicidal behavior, as well as 61 equally depressed patients without lifetime history of SI or suicidal behavior. We measured serum cortisol, high-sensitivity C-reactive protein (hs-CRP), erythrocyte sedimentation rate (ESR), and autonomic functioning evaluated by frequency-domain measures of heart rate variability (HRV). The intensity of current SI was rated with the Columbia Suicide Severity Rating Scale. Chronic psychological stress was assessed using the Chinese version of the Perceived Stress Scale (PSS). Patients with current SI showed higher hs-CRP and ESR but lower variance (total HRV), low frequency (LF), and high frequency (HF) HRV than those without lifetime history of SI. We found no differences in cortisol levels and PSS scores. The intensity of current SI was negatively correlated with variance, LF, and HF but positively correlated with hs-CRP. Our results help improve the understanding of the relationships among current SI, inflammation, and autonomic functioning in depressed patients. The combined use of inflammatory markers and HRV indices may one day be applied in predicting and monitoring patients' suicide risk.
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Affiliation(s)
- Chuan-Chia Chang
- Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Nian-Sheng Tzeng
- Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan; Student Counseling Center, National Defense Medical Center, Taipei, Taiwan
| | - Yu-Chen Kao
- Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan; Department of Psychiatry, Tri-Service General Hospital Songshan Branch, Taipei, Taiwan
| | - Chin-Bin Yeh
- Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Hsin-An Chang
- Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
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15
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Liu RT, Trout ZM, Hernandez EM, Cheek SM, Gerlus N. A behavioral and cognitive neuroscience perspective on impulsivity, suicide, and non-suicidal self-injury: Meta-analysis and recommendations for future research. Neurosci Biobehav Rev 2017; 83:440-450. [PMID: 28928071 DOI: 10.1016/j.neubiorev.2017.09.019] [Citation(s) in RCA: 112] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Revised: 08/16/2017] [Accepted: 09/15/2017] [Indexed: 12/13/2022]
Abstract
We conducted a meta-analysis of neurobehavioral and neurocognitive indices of impulsivity in relation to suicidal thoughts and behaviors, as well as non-suicidal self-injury (NSSI). In our systematic review, 34 studies were identified and submitted to a random-effects meta-analysis. A small pooled effect size was observed for the association between behavioral impulsivity and NSSI (OR=1.34, p<0.05). A small-to-medium pooled effect size (OR=2.23, p<0.001) was found for the association between behavioral impulsivity and suicide attempts, and a medium-to-large pooled effect size was observed for this outcome in relation to cognitive impulsivity (OR=3.14, p<0.01). Length of time between suicide attempt and impulsivity assessment moderated the strength of the relation between impulsivity and attempts, with a large pooled effect size (OR=5.54, p<0.001) evident when the suicide attempt occurred within a month of behavioral impulsivity assessment. Studies of clinically significant NSSI temporally proximal to impulsivity assessment are needed. Longitudinal research is required to clarify the prognostic value of behavioral and cognitive impulsivity for short-term risk for self-harm.
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Affiliation(s)
- Richard T Liu
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, United States.
| | - Zoë M Trout
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, United States
| | - Evelyn M Hernandez
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, United States
| | - Shayna M Cheek
- Department of Psychology and Neuroscience, Duke University, United States
| | - Nimesha Gerlus
- Department of Cognitive, Linguistic, and Psychological Sciences, Brown University, United States
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16
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Bandelow B, Baldwin D, Abelli M, Bolea-Alamanac B, Bourin M, Chamberlain SR, Cinosi E, Davies S, Domschke K, Fineberg N, Grünblatt E, Jarema M, Kim YK, Maron E, Masdrakis V, Mikova O, Nutt D, Pallanti S, Pini S, Ströhle A, Thibaut F, Vaghix MM, Won E, Wedekind D, Wichniak A, Woolley J, Zwanzger P, Riederer P. Biological markers for anxiety disorders, OCD and PTSD: A consensus statement. Part II: Neurochemistry, neurophysiology and neurocognition. World J Biol Psychiatry 2017; 18:162-214. [PMID: 27419272 PMCID: PMC5341771 DOI: 10.1080/15622975.2016.1190867] [Citation(s) in RCA: 173] [Impact Index Per Article: 24.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2016] [Accepted: 05/03/2016] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Biomarkers are defined as anatomical, biochemical or physiological traits that are specific to certain disorders or syndromes. The objective of this paper is to summarise the current knowledge of biomarkers for anxiety disorders, obsessive-compulsive disorder (OCD) and posttraumatic stress disorder (PTSD). METHODS Findings in biomarker research were reviewed by a task force of international experts in the field, consisting of members of the World Federation of Societies for Biological Psychiatry Task Force on Biological Markers and of the European College of Neuropsychopharmacology Anxiety Disorders Research Network. RESULTS The present article (Part II) summarises findings on potential biomarkers in neurochemistry (neurotransmitters such as serotonin, norepinephrine, dopamine or GABA, neuropeptides such as cholecystokinin, neurokinins, atrial natriuretic peptide, or oxytocin, the HPA axis, neurotrophic factors such as NGF and BDNF, immunology and CO2 hypersensitivity), neurophysiology (EEG, heart rate variability) and neurocognition. The accompanying paper (Part I) focuses on neuroimaging and genetics. CONCLUSIONS Although at present, none of the putative biomarkers is sufficient and specific as a diagnostic tool, an abundance of high quality research has accumulated that should improve our understanding of the neurobiological causes of anxiety disorders, OCD and PTSD.
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Affiliation(s)
- Borwin Bandelow
- Department of Psychiatry and Psychotherapy, University of Göttingen, Germany
| | - David Baldwin
- Faculty of Medicine, University of Southampton, Southampton, UK
| | - Marianna Abelli
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Pisa, Italy
| | - Blanca Bolea-Alamanac
- School of Social and Community Medicine, Academic Unit of Psychiatry, University of Bristol, Bristol, UK
| | - Michel Bourin
- Neurobiology of Anxiety and Mood Disorders, University of Nantes, Nantes, France
| | - Samuel R. Chamberlain
- Hertfordshire Partnership University NHS Foundation Trust and University of Hertfordshire, Parkway, UK
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Eduardo Cinosi
- Department of Neuroscience Imaging and Clinical Sciences, Gabriele D’Annunzio University, Chieti, Italy
| | - Simon Davies
- Centre for Addiction and Mental Health, Geriatric Psychiatry Division, University of Toronto, Toronto, Canada
- School of Social and Community Medicine, Academic Unit of Psychiatry, University of Bristol, Bristol, UK
| | - Katharina Domschke
- Department of Psychiatry Psychosomatics and Psychotherapy, University of Wuerzburg, Wuerzburg, Germany
| | - Naomi Fineberg
- Hertfordshire Partnership University NHS Foundation Trust and University of Hertfordshire, Parkway, UK
| | - Edna Grünblatt
- Department of Psychiatry Psychosomatics and Psychotherapy, University of Wuerzburg, Wuerzburg, Germany
- Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
- Neuroscience Center Zurich, University of Zurich and the ETH Zurich, Zurich, Switzerland
- Zurich Center for Integrative Human Physiology, University of Zurich, Zurich, Switzerland
| | - Marek Jarema
- Third Department of Psychiatry, Institute of Psychiatry and Neurology, Warszawa, Poland
| | - Yong-Ku Kim
- Department of Psychiatry College of Medicine, Korea University, Seoul, Republic of Korea
| | - Eduard Maron
- Department of Psychiatry, North Estonia Medical Centre, Tallinn, Estonia
- Department of Psychiatry, University of Tartu, Estonia
- Faculty of Medicine Department of Medicine, Centre for Neuropsychopharmacology, Division of Brain Sciences, Imperial College London, UK
| | - Vasileios Masdrakis
- Athens University Medical School, First Department of Psychiatry, Eginition Hospital, Athens, Greece
| | - Olya Mikova
- Foundation Biological Psychiatry, Sofia, Bulgaria
| | - David Nutt
- Faculty of Medicine Department of Medicine, Centre for Neuropsychopharmacology, Division of Brain Sciences, Imperial College London, UK
| | - Stefano Pallanti
- UC Davis Department of Psychiatry and Behavioural Sciences, Sacramento, CA, USA
| | - Stefano Pini
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Pisa, Italy
| | - Andreas Ströhle
- Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charité – University Medica Center Berlin, Berlin, Germany
| | - Florence Thibaut
- Faculty of Medicine Paris Descartes, University Hospital Cochin, Paris, France
| | - Matilde M. Vaghix
- Department of Psychology and Behavioural and Clinical Neuroscience Institute, University of Cambridge, UK
| | - Eunsoo Won
- Department of Psychiatry College of Medicine, Korea University, Seoul, Republic of Korea
| | - Dirk Wedekind
- Department of Psychiatry and Psychotherapy, University of Göttingen, Germany
| | - Adam Wichniak
- Third Department of Psychiatry, Institute of Psychiatry and Neurology, Warszawa, Poland
| | - Jade Woolley
- Faculty of Medicine, University of Southampton, Southampton, UK
| | - Peter Zwanzger
- kbo-Inn-Salzach-Klinikum Wasserburg am Inn, Germany
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University Munich, Munich, Germany
| | - Peter Riederer
- Department of Psychiatry Psychosomatics and Psychotherapy, University of Wuerzburg, Wuerzburg, Germany
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17
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Cardiac autonomic regulation as a predictor for childhood obesity intervention success. Int J Obes (Lond) 2017; 41:824-827. [PMID: 28127042 DOI: 10.1038/ijo.2017.25] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Revised: 12/05/2016] [Accepted: 01/11/2017] [Indexed: 11/09/2022]
Abstract
Childhood obesity is a major public health concern; behavioural interventions induce weight reduction in some, but success is variable. Heart rate variability (HRV) has been associated with impulse control and extent of dieting success. This study investigated the relationship between HRV and post childhood obesity intervention weight-management success, and involved recording the frequency-domain HRV measures ratio between low frequency and high frequency power (LF/HF) and high frequency power (HF), and the time-domain measure, percentage of successive beat-to-beat intervals that differ by more than 50ms (PNN50). It was expected that greater LF/HF and lower HF would be associated with greater post-intervention weight gain, and that greater PNN50 would be associated with greater impulse control. Seventy-four participants aged 9-14 (M=10.7; s.d.: 1.1) attended a weight-management camp, where HRV was recorded. Stop signal reaction time (SSRT) was also recorded as a measure of impulse control. As expected, SSRT was positively associated with pre-intervention body mass (r=0.301, P=0.010) and negatively associated with PNN50 (β=0.29, P=0.031). Post-intervention body mass change was positively associated with LF/HF (β=0.34, P=0.037), but was not associated with HF. Lifestyle interventions may have a greater chance of effectively supporting long-term weight-management for children with lower LF/HF; assessing HRV of obese children may be helpful in informing obesity treatment decisions.
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18
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Khandoker AH, Luthra V, Abouallaban Y, Saha S, Ahmed KI, Mostafa R, Chowdhury N, Jelinek HF. Predicting depressed patients with suicidal ideation from ECG recordings. Med Biol Eng Comput 2016; 55:793-805. [PMID: 27538398 DOI: 10.1007/s11517-016-1557-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Accepted: 07/30/2016] [Indexed: 12/11/2022]
Abstract
Globally suicidal behavior is the third most common cause of death among patients with major depressive disorder (MDD). This study presents multi-lag tone-entropy (T-E) analysis of heart rate variability (HRV) as a screening tool for identifying MDD patients with suicidal ideation. Sixty-one ECG recordings (10 min) were acquired and analyzed from control subjects (29 CONT), 16 MDD subjects with (MDDSI+) and 16 without suicidal ideation (MDDSI-). After ECG preprocessing, tone and entropy values were calculated for multiple lags (m: 1-10). The MDDSI+ group was found to have a higher mean tone value compared to that of the MDDSI- group for lags 1-8, whereas the mean entropy value was lower in MDDSI+ than that in CONT group at all lags (1-10). Leave-one-out cross-validation tests, using a classification and regression tree (CART), obtained 94.83 % accuracy in predicting MDDSI+ subjects by using a combination of tone and entropy values at all lags and including demographic factors (age, BMI and waist circumference) compared to results with time and frequency domain HRV analysis. The results of this pilot study demonstrate the usefulness of multi-lag T-E analysis in identifying MDD patients with suicidal ideation and highlight the change in autonomic nervous system modulation of the heart rate associated with depression and suicidal ideation.
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Affiliation(s)
- A H Khandoker
- Department of Biomedical Engineering, Khalifa University, PO Box 127788, Abu Dhabi, UAE. .,Department of Electrical and Electronic Engineering, The University of Melbourne, Melbourne, VIC, 3010, Australia.
| | - V Luthra
- American Center for Psychiatry and Neurology, Abu Dhabi, UAE
| | - Y Abouallaban
- American Center for Psychiatry and Neurology, Abu Dhabi, UAE
| | - S Saha
- United International University, Dhaka, Bangladesh
| | - K I Ahmed
- United International University, Dhaka, Bangladesh
| | - R Mostafa
- United International University, Dhaka, Bangladesh
| | - N Chowdhury
- Department of Biomedical Engineering, Khalifa University, PO Box 127788, Abu Dhabi, UAE
| | - H F Jelinek
- School of Community Health and Centre for Research in Complex Systems, Charles Sturt University, Albury, NSW, Australia.,Australian School of Advanced Medicine, Macquarie University, Sydney, NSW, Australia
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19
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Wilson ST, Chesin M, Fertuck E, Keilp J, Brodsky B, Mann JJ, Sönmez CC, Benjamin-Phillips C, Stanley B. Heart rate variability and suicidal behavior. Psychiatry Res 2016; 240:241-247. [PMID: 27124209 DOI: 10.1016/j.psychres.2016.04.033] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2015] [Revised: 02/22/2016] [Accepted: 04/15/2016] [Indexed: 12/21/2022]
Abstract
Identification of biological indicators of suicide risk is important given advantages of biomarker-based models. Decreased high frequency heart rate variability (HF HRV) may be a biomarker of suicide risk. The aim of this research was to determine whether HF HRV differs between suicide attempters and non-attempters. Using the Trier Social Stress Test (TSST), we compared HF HRV between females with and without a history of suicide attempt, all with a lifetime diagnosis of a mood disorder. To investigate a potential mechanism explaining association between HF HRV and suicide, we examined the association between self-reported anger and HF HRV. Results of an Area under the Curve (AUC) analysis showed attempters had a lower cumulative HF HRV during the TSST than non-attempters. In addition, while there was no difference in self-reported anger at baseline, the increase in anger was greater in attempters, and negatively associated with HF HRV. Results suggest that suicide attempters have a reduced capacity to regulate their response to stress, and that reduced capacity to regulate anger may be a mechanism through which decreased HF HRV can lead to an increase in suicide risk. Our results have implications for the prevention of suicidal behavior in at-risk populations.
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Affiliation(s)
- Scott T Wilson
- Department of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York, NY, USA; Department of Psychiatry, Columbia University College of Physicians & Surgeons, New York, NY, USA.
| | - Megan Chesin
- Department of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York, NY, USA; Department of Psychology, City University of New York, New York, NY, USA
| | - Eric Fertuck
- Department of Psychology, William Paterson University, Wayne, NJ, USA
| | - John Keilp
- Department of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York, NY, USA; Department of Psychiatry, Columbia University College of Physicians & Surgeons, New York, NY, USA
| | - Beth Brodsky
- Department of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York, NY, USA; Department of Psychiatry, Columbia University College of Physicians & Surgeons, New York, NY, USA
| | - J John Mann
- Department of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York, NY, USA; Department of Psychiatry, Columbia University College of Physicians & Surgeons, New York, NY, USA
| | - Cemile Ceren Sönmez
- Department of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York, NY, USA
| | | | - Barbara Stanley
- Department of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York, NY, USA; Department of Psychiatry, Columbia University College of Physicians & Surgeons, New York, NY, USA
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20
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Hsiao CY, Tsai HC, Chi MH, Chen KC, Chen PS, Lee IH, Yeh TL, Yang YK. The Association between Baseline Subjective Anxiety Rating and Changes in Cardiac Autonomic Nervous Activity in Response to Tryptophan Depletion in Healthy Volunteers. Medicine (Baltimore) 2016; 95:e3498. [PMID: 27175645 PMCID: PMC4902487 DOI: 10.1097/md.0000000000003498] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
The aim of this study was to investigate the influence of serotonin on anxiety and autonomic nervous system (ANS) function; the correlation between subjective anxiety rating and changes of ANS function following tryptophan depletion (TD) in healthy volunteers was examined. Twenty-eight healthy participants, consisting of 15 females and 13 males, with an average age of 33.3 years, were recruited.Baseline Chinese Symptom Checklist-90-Revised and ANS function measurements were taken. TD was carried out on the testing day, and participants provided blood samples right before and 5 hours after TD. ANS function, somatic symptoms, and Visual Analogue Scales (VASs) were determined after TD. Wilcoxon signed rank test and Spearman ρ correlation were adapted for analyses of the results.The TD procedure reduced total and free plasma tryptophan effectively. After TD, the sympathetic nervous activity increased and parasympathetic nervous activity decreased. Baseline anxiety ratings positively correlated with post-TD changes in sympathetic nervous activity, VAS ratings, and physical symptoms. However, a negative correlation with post-TD changes in parasympathetic nervous activity was found.The change in ANS function after TD was associated with the severity of anxiety in healthy volunteers. This supports the fact that the effect of anxiety on heart rate variability is related to serotonin vulnerability. Furthermore, it also shows that the subjective anxiety rating has a biological basis related to serotonin.
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Affiliation(s)
- Chih Yin Hsiao
- From the Department of Psychiatry, National Cheng Kung University Hospital (CYH, HCT, MHC, KCC, PSC, IHL, TLY, YKY), College of Medicine; Addiction Research Center (CYH, KCC, PSC, IHL, TLY, YKY), National Cheng Kung University, Tainan; Department of Psychiatry (HCT, KCC, YKY), National Cheng Kung University Hospital, Dou-Liou Branch, Yunlin; and Institute of Behavioral Medicine (YKY), College of Medicine, National Cheng Kung University, Tainan, Taiwan
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21
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Forkmann T, Meessen J, Teismann T, Sütterlin S, Gauggel S, Mainz V. Resting vagal tone is negatively associated with suicide ideation. J Affect Disord 2016; 194:30-2. [PMID: 26802504 DOI: 10.1016/j.jad.2016.01.032] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2015] [Revised: 01/07/2016] [Accepted: 01/12/2016] [Indexed: 11/28/2022]
Abstract
BACKGROUND The present study aimed at investigating whether resting vagally mediated heart rate variability (HRV) as a trait-like biomarker of cognitive inhibitory control capacity is related to suicide ideation in a sample without suicide attempt history. METHODS Thirty-seven healthy students participated voluntarily (18 to 34 years, M=24.5, SD=4.1; 73.0% female). Time and frequency measures of HRV were derived from an electrocardiogram that was recorded using Einthoven's Triangle lead II. Participants filled in the Rasch-based Depression Screening and four questions concerning lifetime suicide ideation (SI). Bivariate Pearson's and partial (controlling for depression severity) correlation coefficients were calculated between SI and measures of vagally mediated HRV. RESULTS A significant correlation between the ln10-transformed high-frequency band of resting vagally mediated HRV and SI was found (r=-.33, p<.05). Correlations did not change substantially when controlling for depression. Mean heart rate as a time domain measure also significantly correlated with SI while controlling for depression (r=.36, p<.05). A trend correlation between SI and Root Mean Square of Successive Differences between interbeat intervals emerged. LIMITATIONS SI was assessed with a composite score of four items measuring SI. Future studies should consider using more comprehensive assessment instruments. CONCLUSIONS The relation between resting vagally mediated HRV and suicide ideation may be interpreted as indicating that reduced inhibitory cognitive control capacity may be a risk factor for suicidality. It may act already early in the suicidal process, before suicidal behavior develops and should be further investigated as potentially clinically important physiological predictor of suicidality.
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Affiliation(s)
- Thomas Forkmann
- Institute of Medical Psychology and Medical Sociology, University Hospital of RWTH Aachen University, Germany.
| | - Judith Meessen
- Institute of Medical Psychology and Medical Sociology, University Hospital of RWTH Aachen University, Germany
| | - Tobias Teismann
- Department of Clinical Psychology and Psychotherapy, Ruhr-Universität Bochum, Germany
| | - Stefan Sütterlin
- Section of Psychology, Lillehammer University College, Norway; Department of Psychosomatic Medicine, Division of Surgery and Clinical Neuroscience, Oslo University Hospital - Rikshospitalet, Norway
| | - Siegfried Gauggel
- Institute of Medical Psychology and Medical Sociology, University Hospital of RWTH Aachen University, Germany
| | - Verena Mainz
- Institute of Medical Psychology and Medical Sociology, University Hospital of RWTH Aachen University, Germany
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22
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Chang SS, Bjørngaard JH, Tsai MK, Bjerkeset O, Wen CP, Yip PSF, Tsao CK, Gunnell D. Heart rate and suicide: findings from two cohorts of 533 000 Taiwanese and 75 000 Norwegian adults. Acta Psychiatr Scand 2016; 133:277-88. [PMID: 26493376 DOI: 10.1111/acps.12513] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/17/2015] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To investigate the association of resting heart rate with suicide in two large cohorts. METHOD The MJ cohort (Taiwan) included 532 932 adults from a health check-up programme (1994-2008). The HUNT cohort (Norway) included 74 977 adults in the Nord-Trøndelag County study (1984-1986), followed up to 2004. In both cohorts heart rate was measured at baseline, and suicide was ascertained through linkage to cause-of-death registers. Risk of suicide was estimated using Cox proportional hazards models. RESULTS There were 569 and 188 suicides (average follow-up period of 8.1 and 16.9 years) in the MJ and HUNT cohorts respectively. Sex- and age-adjusted hazard ratio for every 10 beat increase in heart rate per minute was 1.08 (95% Confidence Interval 1.00-1.16) and 1.24 (1.12-1.38) in the MJ and HUNT cohorts, respectively. In the MJ cohort this association was confined to individuals with a history of heart diseases vs. those without such a history (P for interaction = 0.008). In the HUNT cohort the association did not differ by history of heart diseases and was robust to adjustment for health-related life style, medication use, and symptoms of anxiety and depression. CONCLUSION Elevated resting heart rate may be a marker of increased suicide risk.
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Affiliation(s)
- S-S Chang
- Institute of Health Behaviors and Community Sciences, and Department of Public Health, College of Public Health, National Taiwan University, Taipei, Taiwan.,Hong Kong Jockey Club Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong SAR, China.,Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong SAR, China
| | - J H Bjørngaard
- Department of Public Health, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway.,Forensic Department and Research Centre, Bröset St. Olav's University Hospital Trondheim, Trondheim, Norway
| | - M K Tsai
- China Medical University Hospital, Taichung, Taiwan.,Institute of Population Health Science, National Health Research Institutes, Miaoli, Taiwan
| | - O Bjerkeset
- Faculty of Health Sciences, Nord-Trøndelag University College (HiNT), Levanger, Norway.,Institute of Neuromedicine, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - C P Wen
- China Medical University Hospital, Taichung, Taiwan.,Institute of Population Health Science, National Health Research Institutes, Miaoli, Taiwan
| | - P S F Yip
- Hong Kong Jockey Club Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong SAR, China.,Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong SAR, China
| | - C K Tsao
- MJ Health Management Institution, Taipei, Taiwan
| | - D Gunnell
- School of Social and Community Medicine, University of Bristol, Bristol, UK
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Beauchaine TP, Thayer JF. Heart rate variability as a transdiagnostic biomarker of psychopathology. Int J Psychophysiol 2015; 98:338-350. [PMID: 26272488 DOI: 10.1016/j.ijpsycho.2015.08.004] [Citation(s) in RCA: 488] [Impact Index Per Article: 54.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2014] [Revised: 08/01/2015] [Accepted: 08/03/2015] [Indexed: 02/06/2023]
Abstract
The Research Domain Criteria (RDoC), developed by the National Institute of Mental Health as a neuroscience-informed alternative to traditional psychiatric nosology, is an explicitly dimensional system in which classification of psychopathology is derived inductively (i.e., from basic science), across multiple levels of analysis (e.g., genetic, neural, psychophysiological, and behavioral). Although RDoC is often presented as paradigmatically revolutionary, a review of the history of psychophysiology suggests that roots of RDoC thinking extend at least as far back as the mid-20th Century. In this paper, we briefly and selectively review the historical emergence of neurobiologically-informed dimensional trait models of psychopathology, and we summarize our thinking regarding high frequency heart rate variability (HF-HRV) as a transdiagnostic biomarker of self-regulation and cognitive control. When functional interactions between HF-HRV and systems of behavioral approach and avoidance are considered, diverse patterns of behavioral maladjustment can be subsumed into a single model. This model accommodates the general bifactor structure of psychopathology, and suggests that HF-HRV can be viewed as an autonomic, transdiagnostic biomarker of mental illness.
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24
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Booij L, Tremblay RE, Szyf M, Benkelfat C. Genetic and early environmental influences on the serotonin system: consequences for brain development and risk for psychopathology. J Psychiatry Neurosci 2015; 40:5-18. [PMID: 25285876 PMCID: PMC4275332 DOI: 10.1503/jpn.140099] [Citation(s) in RCA: 79] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Despite more than 60 years of research in the role of serotonin (5-HT) in psychopathology, many questions still remain. From a developmental perspective, studies have provided more insight into how 5-HT dysfunctions acquired in utero or early in life may modulate brain development. This paper discusses the relevance of the developmental role of 5-HT for the understanding of psychopathology. We review developmental milestones of the 5-HT system, how genetic and environmental 5-HT disturbances could affect brain development and the potential role of DNA methylation in 5-HT genes for brain development. METHODS Studies were identified using common databases (e.g., PubMed, Google Scholar) and reference lists. RESULTS Despite the widely supported view that the 5-HT system matures in early life, different 5-HT receptors, proteins and enzymes have different developmental patterns, and development is brain region-specific. A disruption in 5-HT homeostasis during development may lead to structural and functional changes in brain circuits that modulate emotional stress responses, including subcortical limbic and (pre)frontal areas. This may result in a predisposition to psychopathology. DNA methylation might be one of the underlying physiologic mechanisms. LIMITATIONS There is a need for prospective studies. The impact of stressors during adolescence on the 5-HT system is understudied. Questions regarding efficacy of drugs acting on 5-HT still remain. CONCLUSION A multidisciplinary and longitudinal approach in designing studies on the role of 5-HT in psychopathology might help to bring us closer to the understanding of the role of 5-HT in psychopathology.
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Affiliation(s)
- Linda Booij
- Correspondence to: L. Booij, Departments of Psychology and Psychiatry, Queen’s University, 62 Arch St., Kingston ON K7L 3N6; or
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25
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Abstract
Impulsivity is associated with various psychopathologies, and elevated impulsivity is typically disadvantageous. This manuscript reviews recent investigations into the neurobiology of impulsivity using human imaging techniques and animal models. Both human imaging and preclinical pharmacological manipulations have yielded important insights into the neurobiological underpinnings of impulsivity. A more thorough understanding of the complex neurobiology underlying aspects of impulsivity may provide insight into new treatment options that target elevated impulsivity and psychopathologies such as addictions.
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Affiliation(s)
- Marci R Mitchell
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT
| | - Marc N Potenza
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT ; Department of Neurobiology, Yale University School of Medicine, New Haven, CT ; Child Study Center, Yale University School of Medicine, New Haven, CT
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26
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Chang HA, Chang CC, Tzeng NS, Kuo TBJ, Lu RB, Huang SY. Heart rate variability in unmedicated patients with bipolar disorder in the manic phase. Psychiatry Clin Neurosci 2014; 68:674-82. [PMID: 24612182 DOI: 10.1111/pcn.12178] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2013] [Revised: 01/29/2014] [Accepted: 02/18/2014] [Indexed: 12/14/2022]
Abstract
AIMS Decreased heart rate variability (HRV) has been proposed in bipolar disorder. To date, there has been no adequate study that has investigated resting HRV in unmedicated patients with bipolar disorder in the manic state. METHODS To examine whether bipolar mania is associated with decreased HRV, 61 unmedicated patients with bipolar mania and 183 healthy volunteers aged 20-65 years were recruited for this case-control analysis. The Young Mania Rating Scale (YMRS), Clinical Global Impression-Severity, Hamilton Depression Rating Scale (HAM-D), and Hamilton Anxiety Rating Scale (HAM-A) were used for the clinical ratings. Cardiac autonomic function was evaluated by measuring HRV parameters and the frequency-domain indices of HRV were obtained. RESULTS Patients with bipolar mania exhibited significantly lower mean RR interval, variance, low-frequency (LF)-HRV, and high-frequency (HF)-HRV but higher LF/HF compared to controls. Decreased HRV (variance) was associated with the YMRS total scores. Both the YMRS total scores and the Clinical Global Impression-Severity scores were positively correlated with the LH/HF ratio and inversely correlated with the HF-HRV. There was no significant correlation between the HAM-D/HAM-A scores and any HRV parameter. CONCLUSIONS Bipolar mania is associated with cardiac autonomic dysregulation, highlighting the importance of assessing HRV in manic patients. Further studies examining the influence of anti-manic psychotropic drugs on cardiac autonomic regulation in bipolar mania are needed.
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Affiliation(s)
- Hsin-An Chang
- Department of Psychiatry, Tri-Service General Hospital, Taipei, Taiwan
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27
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Impact of escitalopram on vagally mediated cardiovascular function in healthy participants: implications for understanding differential age-related, treatment emergent effects. Psychopharmacology (Berl) 2014; 231:2281-90. [PMID: 24337078 DOI: 10.1007/s00213-013-3374-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2013] [Accepted: 11/25/2013] [Indexed: 10/25/2022]
Abstract
RATIONALE Black box warnings for young adults under the age of 25 years indicate that antidepressants may increase risk of suicide. While underlying mechanisms for age-related treatment effects remain unclear, vagally mediated cardiovascular function may play a key role. Decreased heart rate (HR) and an increase in its variability (HRV) improve one's capacity to adapt to environmental stress and attenuate risk for suicide. OBJECTIVES Using a double blind, randomized, placebo-controlled, crossover, experimental study, we examine whether a single dose of escitalopram (20 mg) attenuates cardiovascular responses to stress under experimental conditions and determine whether age moderates these effects. METHODS Forty-four healthy females received a single dose of escitalopram (20 mg) and placebo treatment separated by a 1-week interval (>5 half-lives). HR and high frequency HRV (HF HRV normalized units; 0.15-0.40 Hz) were measured during resting state and stress. RESULTS While escitalopram attenuated the increase in HR and increased HF HRV, these moderate to large effects were only significant in participants over 25 years of age. No beneficial cardiovascular effects of escitalopram were observed in those under the age of 25. CONCLUSIONS Maturational differences in the development of the prefrontal cortex--a critical region in the central network of autonomic control--may underpin these differential findings. This study provides a theoretical framework on which future research on treatment-emergent suicidality in clinical populations could be based.
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Anderson G, Berk M, Maes M. Biological phenotypes underpin the physio-somatic symptoms of somatization, depression, and chronic fatigue syndrome. Acta Psychiatr Scand 2014; 129:83-97. [PMID: 23952563 DOI: 10.1111/acps.12182] [Citation(s) in RCA: 77] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/19/2013] [Indexed: 12/26/2022]
Abstract
OBJECTIVE Somatization is a symptom cluster characterized by 'psychosomatic' symptoms, that is, medically unexplained symptoms, and is a common component of other conditions, including depression and myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). This article reviews the data regarding the pathophysiological foundations of 'psychosomatic' symptoms and the implications that this has for conceptualization of what may more appropriately be termed physio-somatic symptoms. METHOD This narrative review used papers published in PubMed, Scopus, and Google Scholar electronic databases using the keywords: depression and chronic fatigue, depression and somatization, somatization and chronic fatigue syndrome, each combined with inflammation, inflammatory, tryptophan, and cell-mediated immune (CMI). RESULTS The physio-somatic symptoms of depression, ME/CFS, and somatization are associated with specific biomarkers of inflammation and CMI activation, which are correlated with, and causally linked to, changes in the tryptophan catabolite (TRYCAT) pathway. Oxidative and nitrosative stress induces damage that increases neoepitopes and autoimmunity that contribute to the immuno-inflammatory processes. These pathways are all known to cause physio-somatic symptoms, including fatigue, malaise, autonomic symptoms, hyperalgesia, intestinal hypermotility, peripheral neuropathy, etc. CONCLUSION Biological underpinnings, such as immune-inflammatory pathways, may explain, at least in part, the occurrence of physio-somatic symptoms in depression, somatization, or myalgic encephalomyelitis/chronic fatigue syndrome and thus the clinical overlap among these disorders.
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29
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Cunningham KA, Anastasio NC. Serotonin at the nexus of impulsivity and cue reactivity in cocaine addiction. Neuropharmacology 2014; 76 Pt B:460-78. [PMID: 23850573 PMCID: PMC4090081 DOI: 10.1016/j.neuropharm.2013.06.030] [Citation(s) in RCA: 100] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2013] [Revised: 06/24/2013] [Accepted: 06/28/2013] [Indexed: 01/07/2023]
Abstract
Cocaine abuse and addiction remain great challenges on the public health agendas in the U.S. and the world. Increasingly sophisticated perspectives on addiction to cocaine and other drugs of abuse have evolved with concerted research efforts over the last 30 years. Relapse remains a particularly powerful clinical problem as, even upon termination of drug use and initiation of abstinence, the recidivism rates can be very high. The cycling course of cocaine intake, abstinence and relapse is tied to a multitude of behavioral and cognitive processes including impulsivity (a predisposition toward rapid unplanned reactions to stimuli without regard to the negative consequences), and cocaine cue reactivity (responsivity to cocaine-associated stimuli) cited as two key phenotypes that contribute to relapse vulnerability even years into recovery. Preclinical studies suggest that serotonin (5-hydroxytryptamine; 5-HT) neurotransmission in key neural circuits may contribute to these interlocked phenotypes well as the altered neurobiological states evoked by cocaine that precipitate relapse events. As such, 5-HT is an important target in the quest to understand the neurobiology of relapse-predictive phenotypes, to successfully treat this complex disorder and improve diagnostic and prognostic capabilities. This review emphasizes the role of 5-HT and its receptor proteins in key addiction phenotypes and the implications of current findings to the future of therapeutics in addiction. This article is part of a Special Issue entitled 'NIDA 40th Anniversary Issue'.
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Affiliation(s)
- Kathryn A Cunningham
- Center for Addiction Research, Department of Pharmacology and Toxicology, University of Texas Medical Branch, Galveston, TX 77555, USA.
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30
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Maes M, Ringel K, Kubera M, Anderson G, Morris G, Galecki P, Geffard M. In myalgic encephalomyelitis/chronic fatigue syndrome, increased autoimmune activity against 5-HT is associated with immuno-inflammatory pathways and bacterial translocation. J Affect Disord 2013; 150:223-30. [PMID: 23664637 DOI: 10.1016/j.jad.2013.03.029] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2012] [Revised: 03/03/2013] [Accepted: 03/28/2013] [Indexed: 11/25/2022]
Abstract
BACKGROUND Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is accompanied by activation of immuno-inflammatory pathways, increased bacterial translocation and autoimmune responses to serotonin (5-HT). Inflammation is known to damage 5-HT neurons while bacterial translocation may drive autoimmune responses. This study has been carried out to examine the autoimmune responses to 5-HT in ME/CFS in relation to inflammation and bacterial translocation. METHODS We examined 5-HT antibodies in 117 patients with ME/CFS (diagnosed according to the centers for disease control and prevention criteria, CDC) as compared with 43 patients suffering from chronic fatigue (CF) but not fulfilling the CDC criteria and 35 normal controls. Plasma interleukin-1 (IL-1), tumor necrosis factor (TNF)α, neopterin and the IgA responses to Gram-negative bacteria were measured. Severity of physio-somatic symptoms was measured using the fibromyalgia and chronic fatigue syndrome rating scale (FF scale). RESULTS The incidence of positive autoimmune activity against 5-HT was significantly higher (p<0.001) in ME/CFS (61.5%) than in patients with CF (13.9%) and controls (5.7%). ME/CFS patients with 5-HT autoimmune activity displayed higher TNFα, IL-1 and neopterin and increased IgA responses against LPS of commensal bacteria than those without 5-HT autoimmune activity. Anti-5-HT antibody positivity was significantly associated with increased scores on hyperalgesia, fatigue, neurocognitive and autonomic symptoms, sadness and a flu-like malaise. DISCUSSION The results show that, in ME/CFS, increased 5-HT autoimmune activity is associated with activation of immuno-inflammatory pathways and increased bacterial translocation, factors which are known to play a role in the onset of autoimmune reactions. 5-HT autoimmune activity could play a role in the pathophysiology of ME/CFS and the onset of physio-somatic symptoms. These results provide mechanistic support for the notion that ME/CFS is a neuro-immune disorder.
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31
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Booij L, Wang D, Lévesque ML, Tremblay RE, Szyf M. Looking beyond the DNA sequence: the relevance of DNA methylation processes for the stress-diathesis model of depression. Philos Trans R Soc Lond B Biol Sci 2013; 368:20120251. [PMID: 23440465 DOI: 10.1098/rstb.2012.0251] [Citation(s) in RCA: 83] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
The functioning of the hypothalamic-pituitary-adrenal (HPA) axis and serotonergic (5-HT) system are known to be intertwined with mood. Alterations in these systems are often associated with depression. However, neither are sufficient to cause depression in and of themselves. It is now becoming increasingly clear that the environment plays a crucial role, particularly, the perinatal environment. In this review, we posit that early environmental stress triggers a series of epigenetic mechanisms that adapt the genome and programme the HPA axis and 5-HT system for survival in a harsh environment. We focus on DNA methylation as it is the most stable epigenetic mark. Given that DNA methylation patterns are in large part set within the perinatal period, long-term gene expression programming by DNA methylation is especially vulnerable to environmental insults during this period. We discuss specific examples of genes in the 5-HT system (serotonin transporter) and HPA axis (glucocorticoid receptor and arginine vasopressin enhancer) whose DNA methylation state is associated with early life experience and may potentially lead to depression vulnerability. We conclude with a discussion on the relevance of studying epigenetic mechanisms in peripheral tissue as a proxy for those occurring in the human brain and suggest avenues for future research.
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Affiliation(s)
- Linda Booij
- Sainte-Justine Hospital Research Center, University of Montreal, Montreal, Quebec, Canada.
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32
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Chang HA, Chang CC, Chen CL, Kuo TBJ, Lu RB, Huang SY. Heart rate variability in patients with fully remitted major depressive disorder. Acta Neuropsychiatr 2013; 25:33-42. [PMID: 26953072 DOI: 10.1111/j.1601-5215.2012.00658.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVE Cardiac autonomic dysregulation has been reported in major depressive disorder (MDD), but scarce studies investigated that in fully remitted MDD. METHODS To examine cardiac autonomic function in remitted MDD, 470 unmedicated individuals with a diagnosis of MDD earlier in life and 462 healthy volunteers, aged 18-65 years, were recruited for a case-control analysis. Cardiac autonomic function was evaluated by measuring heart rate variability (HRV) parameters. Frequency-domain indices of HRV were obtained. The obtained results were evaluated in association with personality traits assessed by the Tridimensional Personality Questionnaire. RESULTS In patients with remitted MDD, no differences in RR intervals and all frequency-domain indices of HRV could be detected as compared with controls. Stratified analyses by the presence of a history of suicide ideation (the SI+ vs. the SI-subgroup) revealed decreased cardiac vagal control in the SI+ subgroup. The correlation analysis revealed an inverse relation between HRV levels and the harm avoidance score (which has been suggested to be associated with serotonergic activity), mainly attributable to the robust association in the SI+ subgroup. CONCLUSION Our study shows that cardiac autonomic dysregulation is not shown in remitted MDD patients as a whole but is limited to the subgroup of remitted MDD patients with a history of suicidal ideation. In view of the higher risk for cardiac complications in these vulnerable individuals, one might consider the treatment to restore their autonomic function.
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Affiliation(s)
- Hsin-An Chang
- 1 Department of Psychiatry, Tri-Service General Hospital, Taipei, Taiwan, ROC
| | - Chuan-Chia Chang
- 1 Department of Psychiatry, Tri-Service General Hospital, Taipei, Taiwan, ROC
| | - Chih-Lun Chen
- 1 Department of Psychiatry, Tri-Service General Hospital, Taipei, Taiwan, ROC
| | - Terry B J Kuo
- 2 Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan, ROC
| | - Ru-Band Lu
- 3 Institute of Behavioral Medicine and Department of Psychiatry, College of Medicine, National Cheng Kung University, Tainan, Taiwan, ROC
| | - San-Yuan Huang
- 1 Department of Psychiatry, Tri-Service General Hospital, Taipei, Taiwan, ROC
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Fikke LT, Melinder A, Landrø NI. The effects of acute tryptophan depletion on impulsivity and mood in adolescents engaging in non-suicidal self-injury. Hum Psychopharmacol 2013; 28:61-71. [PMID: 23359467 DOI: 10.1002/hup.2283] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2011] [Accepted: 11/14/2012] [Indexed: 01/11/2023]
Abstract
OBJECTIVE Non-suicidal self-injury (NSSI) is associated with impaired emotion regulation and impulsivity. Low serotonin (5-hydroxytryptamine) function is associated with NSSI, impaired emotion regulation and impulsivity. We investigated the effects of experimentally lowered 5-hydroxytryptamine activity, via acute tryptophan depletion (ATD), on impulsive action, reflection impulsivity and mood in female adolescents engaging in NSSI. METHODS Thirty-two female adolescents engaging in NSSI participated in a parallel group ATD study. Following ATD, impulsive action was assessed using the Continuous Performance Test, Identical Pairs Version. Reflection impulsivity was assessed using the Matching Familiar Figures Test. Mood-lowering was examined using the Profile of Mood States. RESULTS Following ATD, the participants showed an impulsive response style (as reflected in their low β) and increased attentional capacity (as reflected in their elevated d'). ATD did not affect reflection impulsivity or mood. CONCLUSIONS Acute tryptophan depletion caused an impulsive response style and increased attentional capacity. Importantly, the findings suggest that low serotonin function is a vulnerability among female adolescents for engaging in NSSI when in emotional distress.
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Affiliation(s)
- Linn T Fikke
- The Cognitive Developmental Research Unit, EKUP, Department of Psychology, University of Oslo, Norway.
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Tan Y, Li J, Liu X, Ko J, He X, Lu C, Liu Z, Zhao H, Xiao C, Niu X, Zha Q, Yu Z, Zhang W, Lu A. Deciphering the differential toxic responses of Radix aconiti lateralis praeparata in healthy and hydrocortisone-pretreated rats based on serum metabolic profiles. J Proteome Res 2012. [PMID: 23205644 DOI: 10.1021/pr300965d] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Radix aconiti lateralis praeparata (Baifupian) has received great attention because of its excellent therapeutic effects as well as the associated adverse drug reactions. According to the traditional Chinese medicine (TCM) principle, Baifupian should only be used in patients with TCM "kidney-yang" deficiency pattern, a clinical state that can be mimicked by hydrocortisone induction in rats. This study aimed to decipher the differential toxic responses of Baifupian in healthy and hydrocortisone-pretreated rats based on serum metabolic profiles. Drug-treated rats received Baifupian intragastrically at the dose of 1.28 g/kg/day for 15 days. Serum metabolic profiles were obtained by using the LC-Q-TOF-MS technique. Our results show that Baifupian could induce severe toxicity in the heart, liver, and kidneys of healthy rats. These drug-induced toxic reactions were largely alleviated in hydrocortisone-pretreated animals. Changes of metabolic profiles in drug-treated healthy and hydrocortisone-pretreated rats were demonstrated, involving oxidative phosphorylation, amino acid and lipid metabolism as characterized by altered phosphate, betaine, and phosphatidyl choline. These metabolic alterations could be responsible at least in part for the differential toxic responses of Baifupian under various health conditions. This study provides a new paradigm for better understanding of the risks and limitations when using potentially toxic herbs in clinical applications.
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Affiliation(s)
- Yong Tan
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Science, Beijing 100700, China
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Chang HA, Chang CC, Chen CL, Kuo TBJ, Lu RB, Huang SY. Major depression is associated with cardiac autonomic dysregulation. Acta Neuropsychiatr 2012; 24:318-27. [PMID: 25287173 DOI: 10.1111/j.1601-5215.2011.00647.x] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Chang H-A, Chang C-C, Chen C-L, Kuo TBJ, Lu R-B, Huang S-Y. Major depression is associated with cardiac autonomic dysregulation.Objective: Altered cardiac autonomic function has been proposed in patients with major depression (MD), but the results are mixed. Therefore, analyses with larger sample sizes and better methodology are needed.Methods: To examine whether cardiac autonomic dysfunction is associated with MD, 498 unmedicated patients with MD and 462 healthy volunteers, aged 18–65 years, were recruited for a case-control analysis. We used the Hamilton Depression Rating Scale (HAM-D) and the Beck Depression Inventory (BDI) to assess depression severity. Cardiac autonomic function was evaluated by measuring heart rate variability (HRV) parameters. Frequency-domain indices of HRV were obtained.Results: Patients with MD exhibited reduced cardiac vagal control compared to healthy volunteers, and depression severity was negatively correlated with cardiac vagal control. Stratified analyses by suicide ideation revealed more pronounced cardiac vagal withdrawal among MD patients with suicide ideation.Conclusion: This study shows that MD is associated with cardiac autonomic dysregulation, highlighting the importance of assessing HRV in currently depressed patients, given the higher risk for cardiac complications in these individuals. Taking into account that suicidal depressed patients had more adverse patterns of HRV, one might consider the treatment to restore the autonomic function for the patient population having increased susceptibility to autonomic dysregulation.
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Affiliation(s)
- Hsin-An Chang
- Department of Psychiatry, Tri-Service General Hospital, Taipei, Taiwan
| | - Chuan-Chia Chang
- Department of Psychiatry, Tri-Service General Hospital, Taipei, Taiwan
| | - Chih-Lun Chen
- Department of Psychiatry, Tri-Service General Hospital, Taipei, Taiwan
| | - Terry B J Kuo
- Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan
| | - Ru-Band Lu
- Institute of Behavioral Medicine and Department of Psychiatry, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - San-Yuan Huang
- Department of Psychiatry, Tri-Service General Hospital, Taipei, Taiwan
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36
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Modulation of central serotonin affects emotional information processing in impulsive aggressive personality disorder. J Clin Psychopharmacol 2012; 32:329-35. [PMID: 22544009 DOI: 10.1097/jcp.0b013e31825368b7] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND The mechanistic model whereby serotonin affects impulsive aggression is not completely understood. The purpose of this study was to test the hypothesis that depletion of serotonin reserves by tryptophan depletion affects emotional information processing in susceptible individuals. METHODS The effect of tryptophan (vs placebo) depletion on processing of Ekman emotional faces was compared in impulsive aggressive personality disordered, male and female adults with normal controls. All subjects were free of psychotropic medications, medically healthy, nondepressed, and substance free. Additionally, subjective mood state and vital signs were monitored. RESULTS For emotion recognition, a significant interaction of Aggression × Drug × Sex (F(1, 31) = 7.687, P = 0.009) was found, with male normal controls but not impulsive aggressive males showing increased recognition of fear. For intensity ratings of emotional faces, a significant interaction was discovered of Drug × Group × Sex (F(1, 31) = 5.924, P = 0.021), with follow-up tests revealing that males with intermittent explosive disorder tended to increase intensity ratings of angry faces after tryptophan depletion. Additionally, tryptophan depletion was associated with increased heart rate in all subjects, and increased intensity of the subjective emotional state of "anger" in impulsive aggressive subjects. CONCLUSIONS Individuals with clinically relevant levels of impulsive aggression may be susceptible to effects of serotonergic depletion on emotional information processing, showing a tendency to exaggerate their impression of the intensity of angry expressions and to report an angry mood state after tryptophan depletion. This may reflect heightened sensitivity to the effects of serotonergic dysregulation, and suggests that what underlies impulsive aggression is either supersensitivity to serotonergic disturbances or susceptibility to fluctuations in central serotonergic availability.
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Maes M, Rief W. Diagnostic classifications in depression and somatization should include biomarkers, such as disorders in the tryptophan catabolite (TRYCAT) pathway. Psychiatry Res 2012; 196:243-9. [PMID: 22364930 DOI: 10.1016/j.psychres.2011.09.029] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2011] [Revised: 09/20/2011] [Accepted: 09/28/2011] [Indexed: 12/17/2022]
Abstract
The tryptophan catabolite (TRYCAT) pathway is induced by indoleamine 2,3-dioxygenase (IDO), which upon activation depletes plasma tryptophan (TRP) and increases the synthesis of TRYCATs. Both phenomena are associated with somatization and depression. The aims of this study are to examine whether disorders in the TRYCAT pathway are specific to depression or somatization and whether the diagnoses somatization, depression, and comorbid depression+somatization reflect qualitatively distinct clinical and biological categories. Plasma TRP, the kynurenine (KY)/TRP and KY/kynurenic acid (KA) ratios were measured in 36 patients with somatization, 35 depressed and 38 depressed+somatization patients and 22 controls. Using pattern recognition methods, the diagnosis comorbid depression+somatization could not be validated, while there was an important overlap between depression and somatization, which form one continuum. Cluster analysis detected a) a control cluster; b) a cluster with lower tryptophan, and higher KY/TRP and KY/KA ratios and somatization scores; and c) a cluster with increased depression but lower KY/TRP values. The differences between both patient clusters were quantitative and not qualitative. Within the patient group, cluster analysis has generated a "pathway phenotype", i.e. aberrations in the TRYCAT pathway, which are associated with somatization rather than with depression.
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Dalley JW, Roiser JP. Dopamine, serotonin and impulsivity. Neuroscience 2012; 215:42-58. [PMID: 22542672 DOI: 10.1016/j.neuroscience.2012.03.065] [Citation(s) in RCA: 278] [Impact Index Per Article: 23.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2012] [Revised: 03/08/2012] [Accepted: 03/10/2012] [Indexed: 12/17/2022]
Abstract
Impulsive people have a strong urge to act without thinking. It is sometimes regarded as a positive trait but rash impulsiveness is also widely present in clinical disorders such as attention deficit hyperactivity disorder (ADHD), drug dependence, mania, and antisocial behaviour. Contemporary research has begun to make major inroads into unravelling the brain mechanisms underlying impulsive behaviour with a prominent focus on the limbic cortico-striatal systems. With this progress has come the understanding that impulsivity is a multi-faceted behavioural trait involving neurally and psychologically diverse elements. We discuss the significance of this heterogeneity for clinical disorders expressing impulsive behaviour and the pivotal contribution made by the brain dopamine and serotonin systems in the aetiology and treatment of behavioural syndromes expressing impulsive symptoms.
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Affiliation(s)
- J W Dalley
- Behavioural and Clinical Neuroscience Institute and Department of Experimental Psychology, University of Cambridge, Downing Street, Cambridge CB2 3EB, UK. jwd20@cam. ac. uk
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Abstract
There is considerable controversy around the factors influencing the attentional biases involved in anxiety, controversies pinpointing to the role of trait anxiety (TA) in these biases. Previous studies have disregarded psychophysiological factors, such as cardiac vagal control, from the relation between TA and attention biases to threat, though cardiac vagal control serves as a proxy of attention regulation. By using a spatial cueing task, the present correlational study examines cardiac vagal tone as a moderator of the relation between TA and attention biases to threat. Cardiac vagal tone was indexed by high-frequency heart-rate variability (HF-HRV) and recorded, at baseline, from participants with high trait anxiety (HTA, N = 34) or low trait anxiety (LTA, N = 40). Our data indicate that HF-HRV significantly moderates the relation between TA and disengagement bias, but does not moderate the relation between TA and engagement bias. Extended analysis on the significant moderation showed that HF-HRV moderated the relation between TA and disengagement bias in the case of the participants with mean to low HF-HRV values. This was not the case for the participants with high values of HF-HRV. Our results suggest implications for redefining groups at risk for anxiety disorders, as well as future considerations of the cardiac vagal tone in attention bias research.
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Affiliation(s)
- Ioana R. Cocia
- Department of Clinical Psychology and Psychotherapy, Babeş-Bolyai University, Cluj-Napoca, Romania
| | - Lavinia C. Uscătescu
- Department of Clinical Psychology and Psychotherapy, Babeş-Bolyai University, Cluj-Napoca, Romania
| | - Alina S. Rusu
- Department of Clinical Psychology and Psychotherapy, Babeş-Bolyai University, Cluj-Napoca, Romania
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Anderson G, Maes M, Berk M. Inflammation-Related Disorders in the Tryptophan Catabolite Pathway in Depression and Somatization. ADVANCES IN PROTEIN CHEMISTRY AND STRUCTURAL BIOLOGY VOLUME 88 2012; 88:27-48. [DOI: 10.1016/b978-0-12-398314-5.00002-7] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Abstract
OBJECTIVE Many suicide-related features such as affective disorders, impulsivity, and hostility have been associated with an aberrant regulation of heart rate (HR) and blood pressure (BP). Moreover, the neural bases of HR and BP regulation are similar to those of emotion regulation. The present study examined whether high resting HR or BP would be associated with an increased risk of suicide. METHODS Resting HR and BP were measured among 204,600 men (mean [standard deviation] age = 44.5 [12.1] years) and 119,110 women (mean [standard deviation] age = 45.0 [14.0] years), together with depressive mood and perceived stress. Age, marital status, working status, socioeconomic status, physical activity, alcohol intake, and current medications were self-reported. Dates and causes of death were obtained from the French National Institute of Statistics and Economic Studies and the French National Cause-of-Death Registry, respectively. RESULTS During a mean follow-up of 9.1 years, 133 participants (106 men) completed suicide. Resting HR, but not BP, was positively associated with suicide, together with depressive mood, perceived stress, low body mass index, male sex, status as a current smoker, and taking a psychotropic medication. Adjusting for these covariates, resting HR still independently predicted suicide. Ten additional beats per minute increased the risk of suicide by 19% in the unadjusted model and by 24% to 37% in the adjusted models. CONCLUSIONS Resting HR and suicide risk may share some biologic determinants, such as genetic factors or neural bases. These results may inform further attempts to understand how suicide is mediated at a brain level.
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Booij L, Van der Does AJW. Emotional processing as a predictor of symptom change: an acute tryptophan depletion study in depressed patients. Eur Neuropsychopharmacol 2011; 21:379-83. [PMID: 20943352 DOI: 10.1016/j.euroneuro.2010.09.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2010] [Revised: 09/08/2010] [Accepted: 09/12/2010] [Indexed: 11/28/2022]
Abstract
Acute tryptophan depletion (ATD) in currently depressed patients has no immediate effect on symptoms, but leads to transient symptom improvement or worsening the next day. In view of recent findings concerning the cognitive effects of serotonin manipulations, we used ATD in fourteen depressed patients to investigate whether cognitive effects following ATD predict symptom changes. We found that symptom improvement 24h after ATD was associated with an improved recall of positive words and with less attentional bias and recall of negative words, 5h after ATD. These results indicate that serotonergic alterations affect emotional processing which may subsequently lead to symptom changes.
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Affiliation(s)
- Linda Booij
- Sainte-Justine Hospital Research Center, University of Montreal, Montreal, QC, Canada.
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Sockalingam S, Links PS, Abbey SE. Suicide risk in hepatitis C and during interferon-alpha therapy: a review and clinical update. J Viral Hepat 2011; 18:153-60. [PMID: 21070503 DOI: 10.1111/j.1365-2893.2010.01393.x] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Chronic hepatitis C (CHC) affects over 170 million individuals worldwide and is a growing public health concern. Despite the availability of CHC treatment, specifically interferon-α and ribavirin, treatment of CHC is limited by concerns about psychiatric side effects including risks of suicide. Although depression has been the focus of neuropsychiatric complications from interferon-alpha (IFNα), emerging evidence has contributed to our understanding of IFNα-induced suicidal ideation and attempts. Using Pubmed, we performed a literature review of all English articles published between 1989 and April 1, 2010 on suicide in untreated and IFNα-treated patients with CHC. References in all identified review articles were scanned and included in our review. A total of 17 articles were identified. Studies have suggested that the first 12 weeks of IFNα therapy are the high-risk period. Moreover, the emergence of suicidal ideation can be linked to neuropsychiatric abnormalities, specifically serotonin depletion. Pretreatment with antidepressant treatment should be reserved for high-risk groups, as this may reduce the risk of depression and thus decrease the suicide risk indirectly. Although there is a paucity of literature on suicide and suicide risk during IFNα therapy for CHC, recent studies on IFNα-induced depression have provided some potential insights into suicide in this patient population. Further research examining the effects of pharmacological and nonpharmacological interventions on suicide risk during IFNα treatment is needed.
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Affiliation(s)
- S Sockalingam
- University Health Network, Toronto General Hospital, Toronto, ON, Canada.
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Time series fMRI measures detect changes in pontine raphé following acute tryptophan depletion. Psychiatry Res 2011; 191:112-21. [PMID: 21236648 PMCID: PMC3042244 DOI: 10.1016/j.pscychresns.2010.10.007] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2010] [Revised: 09/16/2010] [Accepted: 10/25/2010] [Indexed: 11/23/2022]
Abstract
Serotonin is synthesized from its precursor, tryptophan, by brainstem raphé neurons and their synaptic terminals in limbic regions. The omission of tryptophan from an Acute Tryptophan Depletion (ATD) diet transiently diminishes serotonin synthesis, alters raphé activity, and mimics symptoms of depression. Raphé functional magnetic resonance imaging (fMRI) poses challenges using signal-averaging analyses. Time-series properties of fMRI blood oxygenation level dependent (BOLD) signals may hold promise, so we analyzed raphé signals for changes with the ATD diet. Eleven remitted (previously depressed) patients were awake with eyes-closed during seven-minute resting scans with 0.5s(-1) sampling. BOLD signal time-series data were frequency-filtered using wavelet transforms, yielding three octave-width frequency bands from 0.25 to 0.03s(-1) and an unbounded band below 0.03s(-1). Spectral power, reflecting signal information, increased in pontine raphé at high frequencies (0.25 to 0.125s(-1)) during ATD (compared to control, balanced, diet, P<0.004) but was unchanged at other frequencies. Functional connectivity, the correlation between time-series data from pairs of regions, weakened between pontine raphé and anterior thalamus at low frequencies during ATD (P<0.05). This preliminarily supports using fMRI time-series features to assess pontine raphé function. Whether, and how, high frequency activity oscillations interfere with low frequency signaling requires further study.
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Harlé KM, Allen JJB, Sanfey AG. The impact of depression on social economic decision making. JOURNAL OF ABNORMAL PSYCHOLOGY 2010; 119:440-6. [PMID: 20455617 DOI: 10.1037/a0018612] [Citation(s) in RCA: 78] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Although the role of emotion in social economic decision making has been increasingly recognized, the impact of mood disorders, such as depression, on such decisions has been surprisingly neglected. To address this gap, 15 depressed and 23 nondepressed individuals completed a well-known economic task, in which they had to accept or reject monetary offers from other players. Although depressed individuals reported a more negative emotional reaction to unfair offers, they accepted significantly more of these offers than did controls. A positive relationship was observed in the depressed group, but not in controls, between acceptance rates of unfair offers and resting cardiac vagal control, a physiological index of emotion regulation capacity. The discrepancy between depressed individuals' increased emotional reactions to unfair offers and their decisions to accept more of these offers contrasts with recent findings that negative mood in nondepressed individuals can lead to lower acceptance rates. This suggests distinct biasing processes in depression, which may be related to higher reliance on regulating negative emotion.
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Affiliation(s)
- Katia M Harlé
- Department of Psychology, University of Arizona, Tucson, AZ 85721, USA
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Walderhaug E, Herman AI, Magnusson A, Morgan MJ, Landrø NI. The short (S) allele of the serotonin transporter polymorphism and acute tryptophan depletion both increase impulsivity in men. Neurosci Lett 2010; 473:208-11. [PMID: 20188795 DOI: 10.1016/j.neulet.2010.02.048] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2010] [Revised: 02/17/2010] [Accepted: 02/19/2010] [Indexed: 11/30/2022]
Abstract
Reduced serotonergic neurotransmission is implicated in impulsive behavior. We studied the triallelic system of the serotonin transporter gene linked polymorphic region (5-HTTLPR) and acute manipulation of serotonin together to further delineate the mechanisms by which serotonergic neurotransmission affects impulsivity. Fifty-two healthy participants (38 men and 14 women) underwent acute tryptophan depletion (ATD) or placebo in a randomized, double-blind, parallel group experiment. Impulsive response style was measured on two versions of the Continuous Performance Task (CPT), and calculated using signal detection theory. We observed a dose-dependent effect for the short (S') allele of the 5-HTTLPR on impulsive response style. Individuals who had the S'/S' genotype were more impulsive than individuals with the L/S' genotype. Participants with the L/S' genotype were more impulsive than those with the L/L genotype. ATD increased impulsivity in men, and decreased impulsivity in women. These data demonstrate for the first time that reduced serotonergic tone as a result of either 5-HTTLPR genotype, or experimental ATD, are both independently and additively, associated with elevated impulsive response style in Caucasian men.
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Affiliation(s)
- Espen Walderhaug
- Department of Psychiatry, Yale University School of Medicine, West Haven, CT 06516, USA.
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Henry BL, Minassian A, Paulus MP, Geyer MA, Perry W. Heart rate variability in bipolar mania and schizophrenia. J Psychiatr Res 2010; 44:168-76. [PMID: 19700172 PMCID: PMC2822123 DOI: 10.1016/j.jpsychires.2009.07.011] [Citation(s) in RCA: 129] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2009] [Revised: 07/17/2009] [Accepted: 07/29/2009] [Indexed: 11/17/2022]
Abstract
BACKGROUND Autonomic nervous system (ANS) dysfunction and reduced heart rate variability (HRV) have been reported in a wide variety of psychiatric disorders, but have not been well characterized in bipolar mania. We recorded cardiac activity and assessed HRV in acutely hospitalized manic bipolar (BD) and schizophrenia (SCZ) patients compared to age- and gender-matched healthy comparison (HC) subjects. METHOD HRV was assessed using time domain, frequency domain, and nonlinear analyses in 23 manic BD, 14 SCZ, and 23 HC subjects during a 5min rest period. Psychiatric symptoms were assessed by administration of the Brief Psychiatric Rating Scale (BPRS) and the Young Mania Rating Scale (YMRS). RESULTS Manic BD patients demonstrated a significant reduction in HRV, parasympathetic activity, and cardiac entropy compared to HC subjects, while SCZ patients demonstrated a similar, but non-significant, trend towards lower HRV and entropy. Reduction in parasympathetic tone was significantly correlated with higher YMRS scores and the unusual thought content subscale on the BPRS. Decreased entropy was associated with increased aggression and diminished personal hygiene on the YMRS scale. CONCLUSION Cardiac function in manic BD individuals is characterized by decreased HRV, reduced vagal tone, and a decline in heart rate complexity as assessed by linear and nonlinear methods of analysis. Autonomic dysregulation is associated with more severe psychiatric symptoms, suggesting HRV dysfunction in this disorder may be dependent on the phase of the illness.
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Affiliation(s)
- Brook L Henry
- University of California San Diego, Department of Psychiatry, La Jolla, CA 92103-0851, United States.
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Hansen AL, Dahl L, Bakke L, Frøyland L, Thayer JF. Fish Consumption and Heart Rate Variability. J PSYCHOPHYSIOL 2010. [DOI: 10.1027/0269-8803/a000005] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
The present study investigates the impact of seafood intake on biological markers in blood such as the marine very long-chain polyunsaturated omega-3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), 25-hydroxyvitamin D (25(OH)D), in addition to heart rate variability (HRV), which is an important biological marker of good health, both physical and mental. A total of 53 male inmates from a Norwegian prison were randomly assigned to intervention and control groups, although attrition reduced some comparisons at the end of the study to 13 (intervention group (n = 6) and control group (n = 7). The intervention group received seafood (mainly fatty fish, > 8% fat) for dinner three times per week for a period of 6 months. Both groups were requested to eat their usual diet provided by the prison. Blood samples were collected and HRV (high frequency (HF) and low frequency (LF) power) was measured before and after the study period. Overall, the intervention group showed significant increase in levels of 25(OH)D and HF-power, and a significant reduction in the sympathovagal balance (LF/HF). The present findings may have important implications with regard to health improvement.
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Affiliation(s)
- Anita L. Hansen
- University of Bergen, Department of Clinical Psychology, Bergen, Norway
- Centre for Research and Education in Forensic Psychiatry, Haukeland University Hospital, Bergen, Norway
| | - Lisbeth Dahl
- National Institute of Nutrition and Seafood Research (NIFES), Bergen, Norway
| | - Lene Bakke
- Bergen University College, Faculty of Education, Norway
| | - Livar Frøyland
- National Institute of Nutrition and Seafood Research (NIFES), Bergen, Norway
| | - Julian F. Thayer
- The Ohio State University, Department of Psychology, Columbus, OH, USA
- Mannheim Institute of Public Health, Social and Preventive Medicine, Mannheim Medical Faculty, Heidelberg University, Mannheim, Germany
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Temel Y, Tan S, Visser-Vandewalle V, Sharp T. Parkinson's disease, DBS and suicide: a role for serotonin? Brain 2009; 132:e126; author reply e127. [PMID: 19553275 DOI: 10.1093/brain/awp150] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
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Allen MT, Hogan AM, Laird LK. The relationships of impulsivity and cardiovascular responses: The role of gender and task type. Int J Psychophysiol 2009; 73:369-76. [DOI: 10.1016/j.ijpsycho.2009.05.014] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2009] [Revised: 05/19/2009] [Accepted: 05/26/2009] [Indexed: 10/20/2022]
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