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Li B, Guo S, Xu H, Zhou Y, Zhang M, Wang J, Chen Y, Chen H, Song J, Tan S. Abnormal circadian rhythm of heart rate variability and their association with symptoms in patients with major depressive disorder. J Affect Disord 2024; 362:14-23. [PMID: 38942206 DOI: 10.1016/j.jad.2024.06.102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 06/21/2024] [Accepted: 06/25/2024] [Indexed: 06/30/2024]
Abstract
BACKGROUND Heart rate variability (HRV) is often reduced in patients with major depressive disorder (MDD) and is linked to symptoms. However, prior studies have mainly focused on short-term HRV, with limited exploration of the 24-h HRV circadian rhythm, despite its ability to comprehensively capture overall HRV distribution and dynamic fluctuations. In this study, we investigated the circadian rhythms of 24-h HRV indices in patients with MDD and their associations with symptom severity. METHODS We recorded 24-h electrocardiograms in 73 patients with MDD (53 in major depressive episode and 20 in remission period) and 31 healthy controls. An extended cosine model was used to model the circadian rhythm of six HRV indices by five parameters: the mesor, amplitude, duty cycle, curve smoothness, and acrophase. Symptom severity was evaluated using the Hamilton Depression Scale and Hamilton Anxiety Scale. RESULTS Compared with the control group, patients with MDD had a significantly smaller SampEn mesor, higher HF duty cycle, and lower heart rate (HR) duty cycle. They also had a significantly higher curve smoothness for HR, RMSSD, and HF. The mesor for SampEn, along with the curve smoothness for HR and ln RMSSD, were associated with certain symptoms in patients with MDD. LIMITATIONS The cross-sectional design and psychiatric treatment of most patients with MDD limited our findings. CONCLUSION Patients with MDD exhibit abnormal HRV circadian rhythms that are associated with symptoms. Moreover, 24-h ECG monitoring may potentially serve as an adjunct value to objectively evaluate clinical symptoms in these patients.
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Affiliation(s)
- Bing Li
- Peking University HuiLongGuan Clinical Medical School, Beijing HuiLongGuan Hospital, Beijing 100096, China
| | - Sheng Guo
- Image Processing Center, Beihang University, Beijing 100191, China
| | - Hao Xu
- Peking University HuiLongGuan Clinical Medical School, Beijing HuiLongGuan Hospital, Beijing 100096, China; North China University of Science and Technology, Tangshan 063210, China
| | - Yanfang Zhou
- Peking University HuiLongGuan Clinical Medical School, Beijing HuiLongGuan Hospital, Beijing 100096, China
| | - Meng Zhang
- Peking University HuiLongGuan Clinical Medical School, Beijing HuiLongGuan Hospital, Beijing 100096, China
| | - Jinghan Wang
- Peking University HuiLongGuan Clinical Medical School, Beijing HuiLongGuan Hospital, Beijing 100096, China
| | - Yan Chen
- Peking University HuiLongGuan Clinical Medical School, Beijing HuiLongGuan Hospital, Beijing 100096, China
| | - Haitao Chen
- Peking University HuiLongGuan Clinical Medical School, Beijing HuiLongGuan Hospital, Beijing 100096, China
| | - Jiaqi Song
- Peking University HuiLongGuan Clinical Medical School, Beijing HuiLongGuan Hospital, Beijing 100096, China
| | - Shuping Tan
- Peking University HuiLongGuan Clinical Medical School, Beijing HuiLongGuan Hospital, Beijing 100096, China.
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Liu S, Wang J, Chen S, Chai J, Wen J, Tian X, Chen N, Xu C. Vagal predominance correlates with mood state changes of winter-over expeditioners during prolonged Antarctic residence. PLoS One 2024; 19:e0298751. [PMID: 38968274 PMCID: PMC11226091 DOI: 10.1371/journal.pone.0298751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 01/29/2024] [Indexed: 07/07/2024] Open
Abstract
OBJECTIVE Winter-over expeditioners in Antarctica are challenged by various environmental and psycho-social stress factors, which may induce psychophysiological changes. The autonomic nervous system (ANS) plays a crucial role in the adaptation process under stress. However, the relationship between ANS activity and the mood states of expeditioners remains largely unexplored. This study aims to uncover the pattern of ANS adjustment under extreme Antarctic environments and provide new insights into the correlations between ANS activity and mood state changes, which may provide scientific data for medical interventions. METHODS Fourteen expeditioners at Zhongshan Station participated in this study. The study was conducted during four representative periods: pre-Antarctica, Antarctica-1 (pre-winter), Antarctica-2 (winter), and Antarctica-3 (summer). The heart rate variability (HRV) of the expeditioners was continuously measured for 24 hours to evaluate ANS activity. Plasma levels of catecholamines were tested by ELISA. Mood states were assessed by the Profile of Mood States (POMS) scale. RESULTS HRV analysis showed a disturbance of ANS during winter and summer periods. For frequency domain parameters, very low frequency (VLF), low frequency (LF), high frequency (HF), and total power (TP) significantly increased during the second half of the mission. Especially, LF/HF ratio decreased during summer, indicating the predominance of vagal tone. Results of the time domain analysis showed increased heart rate variability during the austral winter and summer. Plasma epinephrine (E) significantly increased during residence in Antarctica. Compared with pre-Antarctica, the vigor, depression, and anger scores of the expeditioners decreased significantly during the austral summer. Notably, the depression score showed a moderate positive correlation with LF/HF, while weak negative correlations with other HRV indicators, including TP, VLF, and LF. Anger score showed a moderate positive correlation with LF/HF and weak negative correlations with the average normal-to-normal (NN) interval, and the root mean square of differences between adjacent RR intervals (RMSSD). Plasma E level weakly correlated with the average NN interval. CONCLUSION Prolonged residence in Antarctica increased the ANS activities and shifted the cardiac autonomic modulation towards vagal predominance. The alteration of HRV correlated with mood states and plasma epinephrine levels.
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Affiliation(s)
- Shiying Liu
- Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, Beijing, China
| | - Jianan Wang
- Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, Beijing, China
| | - Shaoling Chen
- Pingxiang Third People’s Hospital, Pingxiang, Jiangxi, China
| | - Jiamin Chai
- Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, Beijing, China
| | - Jigang Wen
- Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, Beijing, China
| | - Xuan Tian
- Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, Beijing, China
| | - Nan Chen
- Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, Beijing, China
| | - Chengli Xu
- Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, Beijing, China
- Center of Environmental and Health Sciences, Chinese Academy of Medical Sciences, Beijing, China
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Galin S, Keren H. The Predictive Potential of Heart Rate Variability for Depression. Neuroscience 2024; 546:88-103. [PMID: 38513761 DOI: 10.1016/j.neuroscience.2024.03.013] [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: 08/17/2023] [Revised: 02/29/2024] [Accepted: 03/16/2024] [Indexed: 03/23/2024]
Abstract
Heart rate variability (HRV),a measure of the fluctuations in the intervals between consecutive heartbeats, is an indicator of changes in the autonomic nervous system. A chronic reduction in HRV has been repeatedly linked to clinical depression. However, the chronological and mechanistic aspects of this relationship, between the neural, physiological, and psychopathological levels, remain unclear. In this review we present evidence by which changes in HRV might precede the onset of depression. We describe several pathways that can facilitate this relationship. First, we examine a theoretical model of the impact of autonomic imbalance on HRV and its role in contributing to mood dysregulation and depression. We then highlight brain regions that are regulating both HRV and emotion, suggesting these neural regions, and the Insula in particular, as potential mediators of this relationship. We also present additional possible mediating mechanisms involving the immune system and inflammation processes. Lastly, we support this model by showing evidence that modification of HRV with biofeedback leads to an improvement in some symptoms of depression. The possibility that changes in HRV precede the onset of depression is critical to put to the test, not only because it could provide insights into the mechanisms of the illness but also because it may offer a predictive anddiagnosticphysiological marker for depression. Importantly, it could also help to develop new effective clinical interventions for treating depression.
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Affiliation(s)
- Shir Galin
- Azrieli Faculty of Medicine, Bar Ilan University, Safed, Israel; Gonda Interdisciplinary Brain Research Center, Bar Ilan University, Ramat Gan, Israel
| | - Hanna Keren
- Azrieli Faculty of Medicine, Bar Ilan University, Safed, Israel; Gonda Interdisciplinary Brain Research Center, Bar Ilan University, Ramat Gan, Israel.
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Cui J, Wen J, Wang D. Cognitive manipulation of emotional and non-emotional information in working memory of patients with depression: a rigid processing style. Front Psychol 2023; 14:1183893. [PMID: 37384177 PMCID: PMC10293631 DOI: 10.3389/fpsyg.2023.1183893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 05/25/2023] [Indexed: 06/30/2023] Open
Abstract
Introduction Cognitive psychology is one of the important perspectives to understand depression. Compared with previous studies, recent researchers increasingly focused on the exploration of the comprehensive cognitive process of patients with depression. The cognitive operation ability of working memory is an important comprehensive cognitive process, which reflects how individuals establish representations. This is the basis for the formation of experience and schema. The purpose of this study is to explore whether there are abnormalities in cognitive manipulation in patients with depression, and to analyze its possible role in the pathogenesis and maintenance of depression. Method In this cross-sectional study, depressed patients was enrolled in the clinical psychology department of Beijing Chaoyang Hospital as the case group, while healthy individuals were recruited in the hospital and social meetings as the control group. Hamilton Depression Scale (HAMD)-17, Hamilton Anxiety Scale (HAMA) and rumination thinking scale (RRS) were adopted as measurement tools, and working memory operation tasks were adopted to test each subject, so as to measure their cognitive operation ability. Result A total of 78 depressed patients and 81 healthy individuals completed the study. The results showed that the rumination level of the case group was higher than that of the control group, and the difference was significant first; Second, in the "inconsistent" condition, the case group under different stimulus conditions when the response was significantly higher than the control group; Thirdly, the "cognitive operation consumption" value of the case group was significantly higher than that of the control group under the three stimulus conditions, among which, the operational cost value of sadness-neutral stimulus was significantly higher than that of the other two stimulus conditions. Conclusion Patients with depression had obvious difficulties in cognitive manipulation of information with different values in working memory, which reflected in the fact that it took them longer time to adjust the relationship between information and established new representations. Among them, patients with depression had a higher degree of cognitive manipulation of sad stimuli, indicating that their abnormal cognitive manipulation had certain emotion specificity. Finally, the difficulty of cognitive operation was closely related to the level of rumination.
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Affiliation(s)
- Jiacheng Cui
- Department of Applied Psychology, Binzhou Medical University, Yantai, Shandong Province, China
| | - Jianglin Wen
- Department of Applied Psychology, Binzhou Medical University, Yantai, Shandong Province, China
| | - Dong Wang
- Department of Clinical Psychology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
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Moretta T, Messerotti Benvenuti S. Familial risk for depression is associated with reduced P300 and late positive potential to affective stimuli and prolonged cardiac deceleration to unpleasant stimuli. Sci Rep 2023; 13:6432. [PMID: 37081143 PMCID: PMC10119159 DOI: 10.1038/s41598-023-33534-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 04/14/2023] [Indexed: 04/22/2023] Open
Abstract
Despite evidence of abnormal affective processing as a key correlate of depression, specific attentional mechanisms underlying processing of emotions in familial risk for depression have yet to be investigated in a single study. To this end, the amplitude of the P300 and late positive potential (LPP) complex and cardiac deceleration were assessed during the passive viewing of affective pictures in 32 individuals who had family history of depression (without depressive symptoms) and in 30 controls (without depressive symptoms and family history of depression). Individuals with familial risk for depression revealed reduced P300-LPP amplitudes in response to pleasant and unpleasant stimuli relative to controls, and comparable P300-LPP amplitudes in response to pleasant and neutral stimuli. Controls, but not individuals with familial risk for depression, reported cardiac deceleration during the viewing of pleasant vs. neutral and unpleasant stimuli in the 0-3 s time window. Also, only individuals with familial risk for depression showed a prolonged cardiac deceleration in response to unpleasant vs. neutral stimuli. Overall, the present study provides new insights into the characterization of emotion-related attentional processes in familial risk for depression as potential vulnerability factors for the development of the disorder.
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Affiliation(s)
- Tania Moretta
- Department of General Psychology, University of Padua, Via Venezia, 8, 35131, Padua, Italy.
| | - Simone Messerotti Benvenuti
- Department of General Psychology, University of Padua, Via Venezia, 8, 35131, Padua, Italy
- Padova Neuroscience Center (PNC), University of Padua, Padua, Italy
- Hospital Psychology Unit, Padua University Hospital, Padua, Italy
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Cao YT, Zhao XX, Yang YT, Zhu SJ, Zheng LD, Ying T, Sha Z, Zhu R, Wu T. Potential of electronic devices for detection of health problems in older adults at home: A systematic review and meta-analysis. Geriatr Nurs 2023; 51:54-64. [PMID: 36893611 DOI: 10.1016/j.gerinurse.2023.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Revised: 02/11/2023] [Accepted: 02/13/2023] [Indexed: 03/09/2023]
Abstract
OBJECTIVE The aim of this review was to evaluate the overall diagnostic performance of e-devices for detection of health problems in older adults at home. METHODS A systematic review was conducted following the PRISMA-DTA guidelines. RESULTS 31 studies were included with 24 studies included in meta-analysis. The included studies were divided into four categories according to the signals detected: physical activity (PA), vital signs (VS), electrocardiography (ECG) and other. The meta-analysis showed the pooled estimates of sensitivity and specificity were 0.94 and 0.98 respectively in the 'VS' group. The pooled sensitivity and specificity were 0.97 and 0.98 respectively in the 'ECG' group. CONCLUSIONS All kinds of e-devices perform well in diagnosing the common health problems. While ECG-based health problems detection system is more reliable than VS-based ones. For sole signal detection system has limitation in diagnosing specific health problems, more researches should focus on developing new systems combined of multiple signals.
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Affiliation(s)
- Yu-Ting Cao
- Shanghai YangZhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University, Shanghai 200092, China; Key Laboratory of Spine and Spinal Cord Injury Repair and Regeneration of the Ministry of Education, Tongji Hospital, School of Medicine, Tongji University, 389 Xincun Road, 200065 Shanghai, China
| | - Xin-Xin Zhao
- Shanghai YangZhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University, Shanghai 200092, China
| | - Yi-Ting Yang
- Shanghai YangZhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University, Shanghai 200092, China; Key Laboratory of Spine and Spinal Cord Injury Repair and Regeneration of the Ministry of Education, Tongji Hospital, School of Medicine, Tongji University, 389 Xincun Road, 200065 Shanghai, China
| | - Shi-Jie Zhu
- Shanghai YangZhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University, Shanghai 200092, China; Key Laboratory of Spine and Spinal Cord Injury Repair and Regeneration of the Ministry of Education, Tongji Hospital, School of Medicine, Tongji University, 389 Xincun Road, 200065 Shanghai, China
| | - Liang-Dong Zheng
- Shanghai YangZhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University, Shanghai 200092, China; Key Laboratory of Spine and Spinal Cord Injury Repair and Regeneration of the Ministry of Education, Tongji Hospital, School of Medicine, Tongji University, 389 Xincun Road, 200065 Shanghai, China
| | - Ting Ying
- Shanghai YangZhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University, Shanghai 200092, China; Key Laboratory of Spine and Spinal Cord Injury Repair and Regeneration of the Ministry of Education, Tongji Hospital, School of Medicine, Tongji University, 389 Xincun Road, 200065 Shanghai, China
| | - Zhou Sha
- Shanghai YangZhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University, Shanghai 200092, China; Key Laboratory of Spine and Spinal Cord Injury Repair and Regeneration of the Ministry of Education, Tongji Hospital, School of Medicine, Tongji University, 389 Xincun Road, 200065 Shanghai, China
| | - Rui Zhu
- Shanghai YangZhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University, Shanghai 200092, China; Key Laboratory of Spine and Spinal Cord Injury Repair and Regeneration of the Ministry of Education, Tongji Hospital, School of Medicine, Tongji University, 389 Xincun Road, 200065 Shanghai, China.
| | - Tao Wu
- Shanghai University of Medicine & Health Sciences, 201318 Shanghai, China
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Dell’Acqua C, Palomba D, Patron E, Messerotti Benvenuti S. Rethinking the risk for depression using the RDoC: A psychophysiological perspective. Front Psychol 2023; 14:1108275. [PMID: 36814670 PMCID: PMC9939768 DOI: 10.3389/fpsyg.2023.1108275] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 01/12/2023] [Indexed: 02/08/2023] Open
Abstract
Considering that the classical categorical approach to mental disorders does not allow a clear identification of at-risk conditions, the dimensional approach provided by the Research Domain Criteria (RDoC) is useful in the exploration of vulnerability to psychopathology. In the RDoC era, psychophysiological models have an important role in the reconceptualization of mental disorders. Indeed, progress in the study of depression vulnerability has increasingly been informed by psychophysiological models. By adopting an RDoC lens, this narrative review focuses on how psychophysiological models can be used to advance our knowledge of the pathophysiological mechanisms underlying depression vulnerability. Findings from psychophysiological research that explored multiple RDoC domains in populations at-risk for depression are reviewed and discussed. Future directions for the application of psychophysiological research in reaching a more complete understanding of depression vulnerability and, ultimately, improving clinical utility, are presented.
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Affiliation(s)
- Carola Dell’Acqua
- Department of General Psychology, University of Padua, Padua, Italy,Padova Neuroscience Center (PNC), University of Padua, Padua, Italy,*Correspondence: Carola Dell’Acqua, ✉
| | - Daniela Palomba
- Department of General Psychology, University of Padua, Padua, Italy,Padova Neuroscience Center (PNC), University of Padua, Padua, Italy
| | | | - Simone Messerotti Benvenuti
- Department of General Psychology, University of Padua, Padua, Italy,Padova Neuroscience Center (PNC), University of Padua, Padua, Italy,Hospital Psychology Unit, Padua University Hospital, Padua, Italy
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Brinkman HR, Hoyt DL, Fedorenko EJ, Mendes WB, Leyro TM. Cardiac Vagal Control Among Community Cigarette Smokers with Low to Moderate Depressive Symptoms. Appl Psychophysiol Biofeedback 2023; 48:159-169. [PMID: 36732418 DOI: 10.1007/s10484-023-09580-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/22/2023] [Indexed: 02/04/2023]
Abstract
Impairments in cardiac vagal control (CVC) have been independently linked to smoking status and depression and are implicated in self-regulatory processes that may exacerbate depressive symptoms and maintain smoking behavior. Yet, few studies have examined how depressive symptoms, even at low levels, influence CVC reactivity among individuals who smoke. Investigating these relationships may provide novel insights into how depressive symptoms exacerbate existing regulatory vulnerabilities among smokers. This study investigated how depression symptoms affect CVC reactivity as a function of changing situational demands among a community sample of 60 daily adult cigarette smokers. Participants completed a mildly demanding cognitive task while physiological data was recorded. Growth curve modeling was used to examine the main and interactive effects of self-reported depressive symptoms on CVC reactivity over the course of the task. We hypothesized that greater depressive symptoms would be associated with less CVC reactivity, characterized by smaller initial reductions in CVC values and a flatter slope over time. Participants were daily smokers with mild to moderate levels of depression. Final model results, where time was specified as linear and the slope was fixed, showed no significant main or interactive effects of time and depression symptoms on CVC reactivity. Findings suggest that at low to moderate levels, depressive symptom severity is not related to patterns of CVC reactivity among adults who smoke. This is the first study to examine this relationship in this population. Future investigations that examine patterns of CVC reactivity among smokers and non-smokers with more severe depression are needed.
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Affiliation(s)
- Hannah R Brinkman
- Department of Psychology, Rutgers, the State University of New Jersey, 53 Avenue E, Piscataway, NJ, 08854, USA.
| | - Danielle L Hoyt
- Department of Psychology, Rutgers, the State University of New Jersey, 53 Avenue E, Piscataway, NJ, 08854, USA
| | - Erick J Fedorenko
- Department of Psychology, Rutgers, the State University of New Jersey, 53 Avenue E, Piscataway, NJ, 08854, USA
| | - Wendy Berry Mendes
- Department of Psychiatry, University of California, San Francisco, CA, USA
| | - Teresa M Leyro
- Department of Psychology, Rutgers, the State University of New Jersey, 53 Avenue E, Piscataway, NJ, 08854, USA
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Garrett L, Trümbach D, Spielmann N, Wurst W, Fuchs H, Gailus-Durner V, Hrabě de Angelis M, Hölter SM. A rationale for considering heart/brain axis control in neuropsychiatric disease. Mamm Genome 2022:10.1007/s00335-022-09974-9. [DOI: 10.1007/s00335-022-09974-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 12/08/2022] [Indexed: 12/24/2022]
Abstract
AbstractNeuropsychiatric diseases (NPD) represent a significant global disease burden necessitating innovative approaches to pathogenic understanding, biomarker identification and therapeutic strategy. Emerging evidence implicates heart/brain axis malfunction in NPD etiology, particularly via the autonomic nervous system (ANS) and brain central autonomic network (CAN) interaction. This heart/brain inter-relationship harbors potentially novel NPD diagnosis and treatment avenues. Nevertheless, the lack of multidisciplinary clinical approaches as well as a limited appreciation of molecular underpinnings has stymied progress. Large-scale preclinical multi-systemic functional data can therefore provide supplementary insight into CAN and ANS interaction. We here present an overview of the heart/brain axis in NPD and establish a unique rationale for utilizing a preclinical cardiovascular disease risk gene set to glean insights into heart/brain axis control in NPD. With a top-down approach focusing on genes influencing electrocardiogram ANS function, we combined hierarchical clustering of corresponding regional CAN expression data and functional enrichment analysis to reveal known and novel molecular insights into CAN and NPD. Through ‘support vector machine’ inquiries for classification and literature validation, we further pinpointed the top 32 genes highly expressed in CAN brain structures altering both heart rate/heart rate variability (HRV) and behavior. Our observations underscore the potential of HRV/hyperactivity behavior as endophenotypes for multimodal disease biomarker identification to index aberrant executive brain functioning with relevance for NPD. This work heralds the potential of large-scale preclinical functional genetic data for understanding CAN/ANS control and introduces a stepwise design leveraging preclinical data to unearth novel heart/brain axis control genes in NPD.
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