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Nevels TL, Wirth MD, Ginsberg JP, McLain AC, Burch JB. The role of sleep and heart rate variability in metabolic syndrome: evidence from the Midlife in the United States study. Sleep 2023; 46:zsad013. [PMID: 36727300 PMCID: PMC10171632 DOI: 10.1093/sleep/zsad013] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 12/11/2022] [Indexed: 02/03/2023] Open
Abstract
STUDY OBJECTIVES Poor sleep and autonomic dysregulation can both disrupt metabolic processes. This study examined the individual and combined effects of poor sleep and reduced heart rate variability (HRV) on metabolic syndrome among 966 participants in the Midlife in the United States II (MIDUS II) study. METHODS Self-reported sleep was assessed using the Pittsburgh Sleep Quality Index (PSQI). HRV was acquired from 11-minute resting heart rate recordings. Spearman correlations, general linear regression, and logistic regression models were used to examine the study hypotheses. RESULTS Poor sleep quality was associated with metabolic syndrome when global PSQI scores were evaluated as a continuous (odds ratio [OR]: 1.07, 95% confidence interval [CI]: 1.03 to 1.11) or categorical measure (cutoff > 5, OR: 1.58, 95% CI: 1.19 to 2.10), after adjustment for confounding. There also was an association between reduced HRV and metabolic syndrome (ln [HF-HRV] OR: 0.89, 95% CI: 0.80 to 0.99; ln [LF-HRV] OR: 0.82, 95% CI: 0.72 to 0.92; ln [SDRR] OR: 0.59, 95% CI: 0.43 to 0.79; ln [RMSSD] OR: 0.75, 95% CI: 0.60 to 0.94). When the combined effects of poor sleep and low HRV were examined, the association with metabolic syndrome was further strengthened relative to those with normal sleep and HRV. CONCLUSIONS To the best of the author's knowledge, this is the first study to suggest a combined effect of poor sleep and low HRV on the odds of metabolic syndrome.
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Affiliation(s)
- Torrance L Nevels
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
- Columbia Veterans Affairs Health Care System, Columbia, SC, USA
- U.S. Military Interservice Physician Assistant Program, MEDCoE, Joint Base San Antonio-Fort Sam Houston, TX, USA
| | - Michael D Wirth
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
- College of Nursing, University of South Carolina, Columbia, SC, USA
| | - J P Ginsberg
- Department of Pathology, Microbiology, and Immunology, Saybrook University, Pasadena, CA, USA
| | - Alexander C McLain
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - James B Burch
- Department of Family Medicine and Population Health, School of Medicine, Virginia Commonwealth University, Richmond, VA, USA
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2
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Nashiro K, Yoo HJ, Cho C, Min J, Feng T, Nasseri P, Bachman SL, Lehrer P, Thayer JF, Mather M. Effects of a Randomised Trial of 5-Week Heart Rate Variability Biofeedback Intervention on Cognitive Function: Possible Benefits for Inhibitory Control. Appl Psychophysiol Biofeedback 2023; 48:35-48. [PMID: 36030457 PMCID: PMC9420180 DOI: 10.1007/s10484-022-09558-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/01/2022] [Indexed: 12/01/2022]
Abstract
Previous research suggests that higher heart rate variability (HRV) is associated with better cognitive function. However, since most previous findings on the relationship between HRV and cognitive function were correlational in nature, it is unclear whether individual differences in HRV play a causal role in cognitive performance. To investigate whether there are causal relationships, we used a simple breathing manipulation that increases HRV through a 5-week HRV biofeedback intervention and examined whether this manipulation improves cognitive performance in younger and older adults (N = 165). The 5-week HRV biofeedback intervention did not significantly improve inhibitory control, working memory and processing speed across age groups. However, improvement in the Flanker score (a measure of inhibition) was associated with the amplitude of heart rate oscillations during practice sessions in the younger and older intervention groups. Our results suggest that daily practice to increase heart rate oscillations may improve inhibitory control, but future studies using longer intervention periods are warranted to replicate the present finding.
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Affiliation(s)
- Kaoru Nashiro
- University of Southern California, 3715 McClintock Avenue, Los Angeles, CA, 90089, USA.
| | - Hyun Joo Yoo
- University of Southern California, 3715 McClintock Avenue, Los Angeles, CA, 90089, USA
| | - Christine Cho
- University of Southern California, 3715 McClintock Avenue, Los Angeles, CA, 90089, USA
| | - Jungwon Min
- University of Southern California, 3715 McClintock Avenue, Los Angeles, CA, 90089, USA
| | - Tiantian Feng
- University of Southern California, 3715 McClintock Avenue, Los Angeles, CA, 90089, USA
| | - Padideh Nasseri
- University of Southern California, 3715 McClintock Avenue, Los Angeles, CA, 90089, USA
| | - Shelby L Bachman
- University of Southern California, 3715 McClintock Avenue, Los Angeles, CA, 90089, USA
| | | | | | - Mara Mather
- University of Southern California, 3715 McClintock Avenue, Los Angeles, CA, 90089, USA
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3
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King DLO, Henson RN, Kievit R, Wolpe N, Brayne C, Tyler LK, Rowe JB, Tsvetanov KA. Distinct components of cardiovascular health are linked with age-related differences in cognitive abilities. Sci Rep 2023; 13:978. [PMID: 36653428 PMCID: PMC9849401 DOI: 10.1038/s41598-022-27252-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 12/28/2022] [Indexed: 01/19/2023] Open
Abstract
Cardiovascular ageing contributes to cognitive impairment. However, the unique and synergistic contributions of multiple cardiovascular factors to cognitive function remain unclear because they are often condensed into a single composite score or examined in isolation. We hypothesized that vascular risk factors, electrocardiographic features and blood pressure indices reveal multiple latent vascular factors, with independent contributions to cognition. In a population-based deep-phenotyping study (n = 708, age 18-88), path analysis revealed three latent vascular factors dissociating the autonomic nervous system response from two components of blood pressure. These three factors made unique and additive contributions to the variability in crystallized and fluid intelligence. The discrepancy in fluid relative to crystallized intelligence, indicative of cognitive decline, was associated with a latent vascular factor predominantly expressing pulse pressure. This suggests that higher pulse pressure is associated with cognitive decline from expected performance. The effect was stronger in older adults. Controlling pulse pressure may help to preserve cognition, particularly in older adults. Our findings highlight the need to better understand the multifactorial nature of vascular aging.
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Affiliation(s)
- Deborah L O King
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, CB2 0SP, UK.
- Department of Psychology, Centre for Speech, Language and the Brain, University of Cambridge, Cambridge, CB23 6HT, UK.
| | - Richard N Henson
- Department of Psychiatry, University of Cambridge, Cambridge, CB2 2QQ, UK
- Medical Research Council Cognition and Brain Sciences Unit, Cambridge, CB2 7EF, UK
- Cambridge Centre for Ageing and Neuroscience (Cam-CAN), University of Cambridge and MRC Cognition and Brain Sciences Unit, Cambridge, CB2 7EF, UK
| | - Rogier Kievit
- Donders Research Institute for Brain, Cognition and Behaviour, Radboud University, 6525 AJ, Nijmegen, The Netherlands
| | - Noham Wolpe
- Department of Psychiatry, University of Cambridge, Cambridge, CB2 2QQ, UK
- Department of Physical Therapy, The Stanley Steer School of Health Professions, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Carol Brayne
- Cambridge Public Health, Cambridge Public Health, University of Cambridge, Cambridge, CB2 0SR, UK
| | - Lorraine K Tyler
- Department of Psychology, Centre for Speech, Language and the Brain, University of Cambridge, Cambridge, CB23 6HT, UK
- Cambridge Centre for Ageing and Neuroscience (Cam-CAN), University of Cambridge and MRC Cognition and Brain Sciences Unit, Cambridge, CB2 7EF, UK
| | - James B Rowe
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, CB2 0SP, UK
- Medical Research Council Cognition and Brain Sciences Unit, Cambridge, CB2 7EF, UK
- Cambridge Centre for Ageing and Neuroscience (Cam-CAN), University of Cambridge and MRC Cognition and Brain Sciences Unit, Cambridge, CB2 7EF, UK
| | - Kamen A Tsvetanov
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, CB2 0SP, UK
- Department of Psychology, Centre for Speech, Language and the Brain, University of Cambridge, Cambridge, CB23 6HT, UK
- Cambridge Centre for Ageing and Neuroscience (Cam-CAN), University of Cambridge and MRC Cognition and Brain Sciences Unit, Cambridge, CB2 7EF, UK
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4
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Spangler DP, Yang X, Weidler BJ, Thayer JF, McGinley JJ. Unraveling the cognitive correlates of heart rate variability with the drift diffusion model. Int J Psychophysiol 2022; 181:73-84. [PMID: 36029919 DOI: 10.1016/j.ijpsycho.2022.08.003] [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: 03/15/2022] [Revised: 07/20/2022] [Accepted: 08/18/2022] [Indexed: 11/19/2022]
Abstract
The Neurovisceral Integration Model posits a link between resting vagally mediated heart rate variability (vmHRV) and cognitive control. Empirical support for this link is mixed, potentially due to coarse performance metrics such as mean response time (RT). To clarify this issue, we tested the relationships between resting vmHRV and refined estimates of cognitive control- as revealed by the ex-Gaussian model of RT and, to a greater extent, the drift diffusion model (DDM, a computational model of two-choice performance). Participants (N = 174) completed a five-minute resting baseline while ECG was collected followed by a Simon spatial conflict task. The root mean square of successive differences in interbeat intervals was calculated to index resting vmHRV. Resting vmHRV was unrelated to Simon's mean RT and accuracy rates, but was inversely related to the ex-Gaussian parameter reflecting slow RTs (tau); however, this finding was attenuated after adjustment for covariates. High resting vmHRV was related to faster drift rates and slower non-decision times, DDM parameters reflecting goal-directed cognition and sensorimotor processes, respectively. The DDM effects survived covariate adjustment and were specific to incongruent trials (i.e., when cognitive control demands were high). Findings suggest a link between vmHRV and cognitive control vis-a-vis drift rate, and potentially, a link between vmHRV and motoric inhibition vis-a-vis non-decision time. These cognitive correlates would have been missed with reliance on traditional performance. Findings are discussed with respect to the inhibitory processes that promote effective performance in high vmHRV individuals.
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Affiliation(s)
- Derek P Spangler
- Department of Biobehavioral Health, Penn State University, United States of America.
| | - Xiao Yang
- Department of Psychology, Old Dominion University, United States of America
| | - Blaire J Weidler
- Department of Psychology, Towson University, United States of America
| | - Julian F Thayer
- Department of Psychological Science, University of California, Irvine, United States of America; The Ohio State University, Deparatment of Psychology, United States of America
| | - Jared J McGinley
- Department of Psychology, Towson University, United States of America
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5
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Liu XX, Wang S. Effect of aerobic exercise on executive function in individuals with methamphetamine use disorder: Modulation by the autonomic nervous system. Psychiatry Res 2021; 306:114241. [PMID: 34688059 DOI: 10.1016/j.psychres.2021.114241] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 09/06/2021] [Accepted: 10/10/2021] [Indexed: 12/30/2022]
Abstract
This study assessed the effects of aerobic exercise on cardiac autonomic nervous system function (based on heart rate variability [HRV]) and executive function among individuals with methamphetamine use disorder (MUD). We further examine the role of autonomic nervous system control in aerobic exercise (assessed via cardiopulmonary fitness) and executive function. A total of 330 individuals with MUD were randomly divided into exercise (n = 165) and control (n = 165) groups, who underwent eight-week aerobic exercise/health education program consisting of five 60 min sessions a week. The outcome measures included cardiopulmonary fitness, HRV time-domain and frequency-domain parameters, and executive function. Our statistical analyses comprised repeated-measures analyses of variance, correlation analyses, and mediation and moderation effect tests. The results indicated that aerobic exercise could simultaneously improve autonomic nervous system function and executive function among individuals with MUD. Moreover, the changes in cardiopulmonary fitness, high frequency HRV, and executive function were positively correlated. HRV did not significantly mediate the relationship between aerobic exercise and executive function; however, it did have a moderating effect, which was eliminated after adjusting for demographic and drug-use covariates. Among the covariates, age was the greatest confounder and was inversely proportional to cardiopulmonary function, HRV, and executive function. Cardiac autonomic nervous system function exerted a moderating, rather than a mediating, effect on the relationship between aerobic exercise and executive function. However, this potential effect was largely influenced by covariates, particularly age.
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Affiliation(s)
- Xiao-Xia Liu
- School of Physical Education and Sport Science, Fujian Normal University, 1 Keji Road, Minhou District, Fuzhou, Fujian 350117, China
| | - Shen Wang
- School of Physical Education and Sport Science, Fujian Normal University, 1 Keji Road, Minhou District, Fuzhou, Fujian 350117, China.
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6
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Nealis LJ, Sherry SB, Lee-Baggley DL. Perfectionism and Stressful Perseveration in the Psychophysiological Experience of Stress: A 7-Day Multi-Method Study. JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2021. [DOI: 10.1007/s10862-021-09932-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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7
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Spangler DP, McGinley JJ. Vagal Flexibility Mediates the Association Between Resting Vagal Activity and Cognitive Performance Stability Across Varying Socioemotional Demands. Front Psychol 2020; 11:2093. [PMID: 33013534 PMCID: PMC7509204 DOI: 10.3389/fpsyg.2020.02093] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Accepted: 07/28/2020] [Indexed: 11/13/2022] Open
Abstract
Vagal flexibility describes the ability to modulate cardiac vagal responses to fit a dynamic range of challenges. Extant theory on vagal function implies that vagal flexibility is a mediating mechanism through which resting vagal activity, a putative individual difference related to self-regulation, affects adaptive behavior and cognition. Nevertheless, little research has directly tested this hypothesis, thereby leaving fundamental mechanisms of vagal function and adaptability unclear. To this end, 47 healthy subjects completed a 5 min baseline followed by Stroop tasks combined with concurrent auditory distractors. There were four different Stroop task conditions that varied the social and emotional content of the auditory distractors. Electrocardiogram was continuously recorded to assess vagal responses to each condition as heart rate variability [root mean square of successive differences (RMSSDs)] reactivity. Vagal flexibility significantly mediated the association between resting vagal activity and stability of inhibition performance (Stroop interference) scores. In particular, higher resting RMSSD was related to higher standard deviation of RMSSD reactivity scores, reflecting greater differences in RMSSD reactivity between distractor conditions (i.e., greater vagal flexibility). Greater vagal flexibility was in turn related to more stability in Stroop interference across the same conditions. The mean of RMSSD reactivity scores across conditions was not significantly related to resting RMSSD or stability in Stroop performance, and mean RMSSD reactivity did not mediate relations between resting RMSSD and stability in Stroop performance. Overall, findings suggest that vagal flexibility may promote the effects of resting vagal activity on stabilizing cognitive inhibition in the face of environmental perturbations.
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Affiliation(s)
- Derek P Spangler
- Human Research and Engineering Directorate, U.S. Army Research Laboratory, Aberdeen, MD, United States
| | - Jared J McGinley
- Department of Psychology, Towson University, Towson, MD, United States
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8
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Reed RG, Combs HL, Segerstrom SC. The Structure of Self-Regulation and Its Psychological and Physical Health Correlates in Older Adults. COLLABRA-PSYCHOLOGY 2020; 6. [PMID: 32457933 DOI: 10.1525/collabra.297] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Self-regulation refers to effortful control over one's thoughts, emotions, choices, impulses, and behaviors, and has implications for older adults' health. Executive function, physiological, and subjective indices have all been proposed to reflect self-regulation. Pairwise associations among these indices have been previously examined; however, a self-regulation constellation encompassing all of these indices has never been tested in older adults. The present study described the relationships among indices of self-regulation and tested their between- and within-person associations with upstream personality factors (conscientiousness) and downstream psychological and physical health in 149 older adults aged 60-93 years, assessed semi-annually for five years (up to 10 waves). Indices of self-regulation were only modestly correlated with each other but were each associated with health. Better executive function was associated with better psychological and physical health between and within people, whereas higher heart rate variability was associated with psychological health within people. Better subjective self-regulation had the most between- and within-person associations with better psychological and physical health. Conscientiousness was associated with subjective self-regulation and better psychological and physical health. These findings support the non-unitary nature of self-regulation in older adults and the health relevance of each of its indices between and within older adults. The aging process may change how the indices relate to each other, and older adults may draw more on certain self-regulatory components over others, given limited resources. Subjective self-regulation may be an important final common pathway to psychological and physical health in older adults.
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Affiliation(s)
- Rebecca G Reed
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, US.,Formerly affiliated with the Department of Psychology, University of Kentucky, Lexington, KY, US
| | - Hannah L Combs
- Houston Methodist Sugar Land Neurology Associates, Sugar Land, TX, US.,Formerly affiliated with the Department of Psychology, University of Kentucky, Lexington, KY, US
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9
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Jung W, Jang KI, Lee SH. Heart and Brain Interaction of Psychiatric Illness: A Review Focused on Heart Rate Variability, Cognitive Function, and Quantitative Electroencephalography. CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE 2019; 17:459-474. [PMID: 31671483 PMCID: PMC6852682 DOI: 10.9758/cpn.2019.17.4.459] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Revised: 11/30/2018] [Accepted: 12/19/2018] [Indexed: 12/26/2022]
Abstract
Heart rate variability (HRV) reflects beat-to-beat variability in the heart rate due to the dynamic interplay of the sympathetic and parasympathetic nervous systems. HRV is considered an index of the functional status of the autonomic nervous system. A decrease in HRV is thus observed in individuals with autonomic dysfunction. Abnormal HRV has been reported in a range of mental disorders. In this review, we give an overview of HRV in patients with major depressive disorder (MDD), schizophrenia, and posttraumatic stress disorder (PTSD), one of whose core symptoms is cognitive dysfunction. The association between HRV and cognitive function is highlighted in this review. This review consists of three main sections. In the first section, we examine how HRV in patients with MDD, schizophrenia, and PTSD is characterized, and how it is different when compared to that in healthy controls. In the second section, beyond the heart itself, we discuss the intimate connection between the heart and the brain, focusing on how HRV interacts with quantitative electroencephalography (qEEG) in the context of physiological changes in the sleep cycle. Lastly, we finish the review with the examination of the association between HRV and cognitive function. The overall findings indicate that the reduction in HRV is one of main manifestations in MDD, schizophrenia, and PTSD, and also more generally HRV is closely linked to the change in qEEG and also to individual differences in cognitive performance.
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Affiliation(s)
- Wookyoung Jung
- Department of Psychology, Keimyung University, Daegu, Korea
| | - Kuk-In Jang
- 2Department of Biomedicine and Health Sciences, College of Medicine, The Catholic University of Korea, Korea.,Institute of Biomedical Industry, The Catholic University of Korea, Seoul, Korea
| | - Seung-Hwan Lee
- Department of Psychiatry,Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea.,Clinical Emotion and Cognition Research Laboratory, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea
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10
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Williams PG, Cribbet MR, Tinajero R, Rau HK, Thayer JF, Suchy Y. The association between individual differences in executive functioning and resting high-frequency heart rate variability. Biol Psychol 2019; 148:107772. [PMID: 31577925 DOI: 10.1016/j.biopsycho.2019.107772] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Revised: 09/13/2019] [Accepted: 09/14/2019] [Indexed: 10/25/2022]
Abstract
Both resting high-frequency heart rate variability (HF-HRV) and executive functioning (EF) are individual differences implicated in vulnerability to a wide range of adverse outcomes. The overlapping set of associations, along with theoretical models positing connections between the brain regions subserving the executive functions and the parasympathetic nervous system, suggest that the two factors should be correlated. Seeking to address limitations in prior research, the current study examined the association between EF, measured comprehensively with individually-administered neuropsychological tests and controlling for lower-order cognitive processes, and resting physiology, measured with impedence cardiography, in healthy, community participants (68% female; mean age = 27, SD = 6.5). Results confirmed a significant association between EF and resting HF-HRV, but no association with resting state sympathetic nervous system activation (pre-ejection period). These findings may inform future investigation of transdiagnostic mechanisms related to these two individual difference factors.
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Affiliation(s)
| | | | | | - Holly K Rau
- VA Puget Sound Health Care System, United States
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11
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Wagner JA, Feinn R, Lampert R, Bermúdez-Millán A, Pérez-Escamilla R. Changes in negative affect and changes in heart rate variability among low-income latinos with type 2 diabetes in a randomized, controlled stress management trial. J Psychosom Res 2019; 124:109774. [PMID: 31443815 DOI: 10.1016/j.jpsychores.2019.109774] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 07/05/2019] [Accepted: 07/05/2019] [Indexed: 01/02/2023]
Abstract
BACKGROUND Structural equation modeling examined the relationship between change in negative affect (NA) and change in heart rate variability (HRV) among 121 Latinos with type 2 diabetes. METHODS This study leveraged data from the Community Health Workers Assisting Latinos Manage Stress and Diabetes (CALMSD) study which compared diabetes education vs diabetes education plus stress management. Participants completed surveys of NA at baseline and again 8-10 weeks later. They also wore 7‑lead, 3-channel ambulatory ECG monitors for 24 h at both time points. The latent variable NA was modeled by observed scores on symptoms of depression, anxiety, diabetes distress, and wellbeing (reversed). The latent variable HRV was modeled by observed scores in the time domain (the standard deviation of the R-R interval [SDNN] and the root mean square of the successive differences [RMSSD]) and in the frequency domain, i.e., log-transformed ultra-low frequency, very-low frequency, low frequency, and high frequency. RESULTS At baseline, there were strong, negative cross-sectional associations between NA and HRV. Baseline NA predicted change in HRV, whereas baseline HRV did not predict change in NA. Controlling for fasting glucose and treatment assignment did not meaningfully alter the findings. Stress management improved NA but not HRV. At followup, a greater reduction (improvement) in NA was associated with a larger increase (improvement) in HRV, with a small-to-medium negative association that approached statistical significance. CONCLUSIONS Findings indicate a longitudinal relationship between NA and HRV, and suggest that improvement in one may be associated with improvement in the other.
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Affiliation(s)
- Julie A Wagner
- University of Connecticut Schools of Medicine and Dental Medicine, United States of America.
| | - Richard Feinn
- Quinnipiac University School of Medicine, United States of America
| | - Rachel Lampert
- Yale University School of Medicine, United States of America
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12
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Forte G, Favieri F, Casagrande M. Heart Rate Variability and Cognitive Function: A Systematic Review. Front Neurosci 2019; 13:710. [PMID: 31354419 PMCID: PMC6637318 DOI: 10.3389/fnins.2019.00710] [Citation(s) in RCA: 241] [Impact Index Per Article: 48.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2018] [Accepted: 06/24/2019] [Indexed: 11/20/2022] Open
Abstract
Background: Autonomic dysfunctions may precede the development of cognitive impairment, but the connection between these dimensions is unclear. This systematic review aims to analyze the relationship between heart rate variability (HRV) and cognitive functions. Methods: The review process was conducted according to the PRISMA-Statement. Restrictions were made, selecting the studies in English and published in peer-review journals, including at least one cognitive measure and presenting the measurement of HRV. Studies that included participants with medical conditions, dementia, psychiatric disorders, strokes, and traumatic brain injury were excluded. Twenty studies were selected, with a total of 19,431 participants. The results were divided into different cognitive domains determined a priori: global cognitive functioning, attention, processing speed, executive functions, memory, language and visuospatial skills. Results: Both increased sympathetic activity and decreased parasympathetic activity seem to be associated with a worse performance in the cognitive domains considered, in the absence of dementia and severe cardiovascular diseases or other medical and psychiatric diseases. Conclusion: The results highlight the influence of the autonomic nervous system (ANS) in cognitive functioning. However, the marked interest facing toward a specific domain, i.e., the executive functions, and the relatively small number of the studies on this topic do not allow understanding better this relationship. Despite these limits, HRV could be considered a promising early biomarker of cognitive impairment in populations without dementia or stroke. This index should be evaluated within a preventative perspective to minimize the risk of developing cognitive impairment.
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Affiliation(s)
- Giuseppe Forte
- Dipartimento di Psicologia, Sapienza Università di Roma, Rome, Italy
| | - Francesca Favieri
- Dipartimento di Psicologia, Sapienza Università di Roma, Rome, Italy
| | - Maria Casagrande
- Dipartimento di Psicologia Dinamica e Clinica, Sapienza Università di Roma, Rome, Italy
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13
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Ottaviani C, Zingaretti P, Petta AM, Antonucci G, Thayer JF, Spitoni GF. Resting Heart Rate Variability Predicts Inhibitory Control Above and Beyond Impulsivity. J PSYCHOPHYSIOL 2019. [DOI: 10.1027/0269-8803/a000222] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Abstract. Heart rate variability (HRV) has been linked to effective functioning of prefrontal-subcortical inhibitory circuits. Despite the recognized role of the prefrontal cortex (PFC) in executive functions linked to inhibitory capacity, studies linking HRV to executive functions are inconsistent, likely due to potential confounders. The present study sought to examine this relation in a sample of 50 healthy participants (31 females; Mage = 24.2 years) who underwent assessment of resting HRV and two executive tasks assessing inhibitory control, namely the Rule Shift Cards and the Hayling Sentence Completion Test. Hierarchical multiple regressions showed that HRV predicted performance on both tasks (i.e., time taken to inhibit a strongly activated response) above and beyond the role of sex, body mass index, and impulsivity. Present results disconfirm that the HRV-executive function association is only due to confounders, and corroborate such relationship with the use of two ecological tasks assessing inhibitory control. Current findings support the Neurovisceral Integration Model and provide plausible explanation for previous inconsistent results.
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Affiliation(s)
- Cristina Ottaviani
- Department of Psychology, Sapienza University of Rome, Italy
- IRCCS Santa Lucia Foundation, Rome, Italy
| | - Pietro Zingaretti
- PhD Program in Behavioral Neuroscience, Department of Psychology, Sapienza University of Rome, Italy
| | | | - Gabriella Antonucci
- Department of Psychology, Sapienza University of Rome, Italy
- IRCCS Santa Lucia Foundation, Rome, Italy
| | - Julian F. Thayer
- Department of Psychology, The Ohio State University, Columbus, OH, USA
| | - Grazia Fernanda Spitoni
- Department of Psychology, Sapienza University of Rome, Italy
- IRCCS Santa Lucia Foundation, Rome, Italy
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14
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Karr JE, Areshenkoff CN, Rast P, Hofer SM, Iverson GL, Garcia-Barrera MA. The unity and diversity of executive functions: A systematic review and re-analysis of latent variable studies. Psychol Bull 2018; 144:1147-1185. [PMID: 30080055 DOI: 10.1037/bul0000160] [Citation(s) in RCA: 258] [Impact Index Per Article: 43.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Confirmatory factor analysis (CFA) has been frequently applied to executive function measurement since first used to identify a three-factor model of inhibition, updating, and shifting; however, subsequent CFAs have supported inconsistent models across the life span, ranging from unidimensional to nested-factor models (i.e., bifactor without inhibition). This systematic review summarized CFAs on performance-based tests of executive functions and reanalyzed summary data to identify best-fitting models. Eligible CFAs involved 46 samples (N = 9,756). The most frequently accepted models varied by age (i.e., preschool = one/two-factor; school-age = three-factor; adolescent/adult = three/nested-factor; older adult = two/three-factor), and most often included updating/working memory, inhibition, and shifting factors. A bootstrap reanalysis simulated 5,000 samples from 21 correlation matrices (11 child/adolescent; 10 adult) from studies including the three most common factors, fitting seven competing models. Model results were summarized as the mean percent accepted (i.e., average rate at which models converged and met fit thresholds: CFI ≥ .90/RMSEA ≤ .08) and mean percent selected (i.e., average rate at which a model showed superior fit to other models: ΔCFI ≥ .005/.010/ΔRMSEA ≤ -.010/-.015). No model consistently converged and met fit criteria in all samples. Among adult samples, the nested-factor was accepted (41-42%) and selected (8-30%) most often. Among child/adolescent samples, the unidimensional model was accepted (32-36%) and selected (21-53%) most often, with some support for two-factor models without a differentiated shifting factor. Results show some evidence for greater unidimensionality of executive function among child/adolescent samples and both unity and diversity among adult samples. However, low rates of model acceptance/selection suggest possible bias toward the publication of well-fitting but potentially nonreplicable models with underpowered samples. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
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Stange JP, Alloy LB, Fresco DM. Inflexibility as a Vulnerability to Depression: A Systematic Qualitative Review. CLINICAL PSYCHOLOGY-SCIENCE AND PRACTICE 2017; 24:245-276. [PMID: 29038622 PMCID: PMC5640320 DOI: 10.1111/cpsp.12201] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
The study of vulnerabilities to depression typically identifies factors that are thought to be universally maladaptive or adaptive. In contrast, researchers recently have theorized that the ability to flexibly engage in different thoughts and behaviors that fit situational demands may be most indicative of psychological health. We review empirical evidence from 147 studies reporting associations between five components of flexibility (set-shifting, affective set-shifting, cardiac vagal control, explanatory flexibility, and coping flexibility) and depression and classify studies according to strength of study design. Evidence from correlational and case-controlled studies suggests cross-sectional relationships, but few prospective studies have been conducted. We discuss limitations of existing studies, identify new directions for programmatic research, and discuss implications that flexibility has for the prevention and treatment of depression.
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Holzman JB, Bridgett DJ. Heart rate variability indices as bio-markers of top-down self-regulatory mechanisms: A meta-analytic review. Neurosci Biobehav Rev 2017; 74:233-255. [PMID: 28057463 DOI: 10.1016/j.neubiorev.2016.12.032] [Citation(s) in RCA: 252] [Impact Index Per Article: 36.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Revised: 12/13/2016] [Accepted: 12/28/2016] [Indexed: 12/29/2022]
Abstract
Theoretical perspectives posit that heart-rate variability (HRV) reflects self-regulatory capacity and therefore can be employed as a bio-marker of top-down self-regulation (the ability to regulate behavioral, cognitive, and emotional processes). However, existing findings of relations between self-regulation and HRV indices are mixed. To clarify the nature of such relations, we conducted a meta-analysis of 123 studies (N=14,347) reporting relations between HRV indices and aspects of top-down self-regulation (e.g., executive functioning, emotion regulation, effortful control). A significant, albeit small, effect was observed (r=0.09) such that greater HRV was related to better top-down self-regulation. Differences in relations were negligible across aspects of self-regulation, self-regulation measurement methods, HRV computational techniques, at-risk compared with healthy samples, and the context of HRV measurement. Stronger relations were observed in older relative to younger samples and in published compared to unpublished studies. These findings generally support the notion that HRV indices can tentatively be employed as bio-markers of top-down self-regulation. Conceptual and theoretical implications, and critical gaps in current knowledge to be addressed by future work, are discussed.
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Stenfors CUD, Hanson LM, Theorell T, Osika WS. Executive Cognitive Functioning and Cardiovascular Autonomic Regulation in a Population-Based Sample of Working Adults. Front Psychol 2016; 7:1536. [PMID: 27761124 PMCID: PMC5050226 DOI: 10.3389/fpsyg.2016.01536] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Accepted: 09/21/2016] [Indexed: 01/06/2023] Open
Abstract
Objective: Executive cognitive functioning is essential in private and working life and is sensitive to stress and aging. Cardiovascular (CV) health factors are related to cognitive decline and dementia, but there is relatively few studies of the role of CV autonomic regulation, a key component in stress responses and risk factor for cardiovascular disease (CVD), and executive processes. An emerging pattern of results from previous studies suggest that different executive processes may be differentially associated with CV autonomic regulation. The aim was thus to study the associations between multiple measures of CV autonomic regulation and measures of different executive cognitive processes. Method: Participants were 119 healthy working adults (79% women), from the Swedish Longitudinal Occupational Survey of Health. Electrocardiogram was sampled for analysis of heart rate variability (HRV) measures, including the Standard Deviation of NN, here heart beats (SDNN), root of the mean squares of successive differences (RMSSD), high frequency (HF) power band from spectral analyses, and QT variability index (QTVI), a measure of myocardial repolarization patterns. Executive cognitive functioning was measured by seven neuropsychological tests. The relationships between CV autonomic regulation measures and executive cognitive measures were tested with bivariate and partial correlational analyses, controlling for demographic variables, and mental health symptoms. Results: Higher SDNN and RMSSD and lower QTVI were significantly associated with better performance on cognitive tests tapping inhibition, updating, shifting, and psychomotor speed. After adjustments for demographic factors however (age being the greatest confounder), only QTVI was clearly associated with these executive tests. No such associations were seen for working memory capacity. Conclusion: Poorer CV autonomic regulation in terms of lower SDNN and RMSSD and higher QTVI was associated with poorer executive cognitive functioning in terms of inhibition, shifting, updating, and speed in healthy working adults. Age could largely explain the associations between the executive measures and SDNN and RMSSD, while associations with QTVI remained. QTVI may be a useful measure of autonomic regulation and promising as an early indicator of risk among otherwise healthy adults, compared to traditional HRV measures, as associations between QTVI and executive functioning was not affected by age.
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Affiliation(s)
- Cecilia U D Stenfors
- Aging Research Center, Department of Neurobiology, Care Science and Society, Karolinska InstituteStockholm, Sweden; Environmental Neuroscience Lab, Department of Psychology, University of ChicagoChicago, IL, USA
| | - Linda M Hanson
- Stress Research Institute, Stockholm University Stockholm, Sweden
| | - Töres Theorell
- Stress Research Institute, Stockholm University Stockholm, Sweden
| | - Walter S Osika
- Department of Neurobiology, Care Science and Society, Center for Social Sustainability, Karolinska InstituteStockholm, Sweden; Department of Clinical Neuroscience, Karolinska InstituteStockholm, Sweden
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Cheng TH, Tsai CG. Female Listeners' Autonomic Responses to Dramatic Shifts Between Loud and Soft Music/Sound Passages: A Study of Heavy Metal Songs. Front Psychol 2016; 7:182. [PMID: 26925009 PMCID: PMC4756174 DOI: 10.3389/fpsyg.2016.00182] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2015] [Accepted: 01/31/2016] [Indexed: 11/17/2022] Open
Abstract
Although music and the emotion it conveys unfold over time, little is known about how listeners respond to shifts in musical emotions. A special technique in heavy metal music utilizes dramatic shifts between loud and soft passages. Loud passages are penetrated by distorted sounds conveying aggression, whereas soft passages are often characterized by a clean, calm singing voice and light accompaniment. The present study used heavy metal songs and soft sea sounds to examine how female listeners’ respiration rates and heart rates responded to the arousal changes associated with auditory stimuli. The high-frequency power of heart rate variability (HF-HRV) was used to assess cardiac parasympathetic activity. The results showed that the soft passages of heavy metal songs and soft sea sounds expressed lower arousal and induced significantly higher HF-HRVs than the loud passages of heavy metal songs. Listeners’ respiration rate was determined by the arousal level of the present music passage, whereas the heart rate was dependent on both the present and preceding passages. Compared with soft sea sounds, the loud music passage led to greater deceleration of the heart rate at the beginning of the following soft music passage. The sea sounds delayed the heart rate acceleration evoked by the following loud music passage. The data provide evidence that sound-induced parasympathetic activity affects listeners’ heart rate in response to the following music passage. These findings have potential implications for future research on the temporal dynamics of musical emotions.
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Affiliation(s)
- Tzu-Han Cheng
- Department of Psychology, National Taiwan University Taipei, Taiwan
| | - Chen-Gia Tsai
- Graduate Institute of Musicology, National Taiwan UniversityTaipei, Taiwan; Center for Neurobiology and Cognitive Science, National Taiwan UniversityTaipei, Taiwan
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