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Aydin BN, Stinson EJ, Travis KT, Krakoff J, Rodzevik T, Chang DC, Gluck ME. Reduced plasma interleukin-6 concentration after transcranial direct current stimulation to the prefrontal cortex. Behav Brain Res 2024; 474:115201. [PMID: 39151649 PMCID: PMC11401619 DOI: 10.1016/j.bbr.2024.115201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2024] [Revised: 07/26/2024] [Accepted: 08/10/2024] [Indexed: 08/19/2024]
Abstract
OBJECTIVES Transcranial direct stimulation (tDCS) targeted to the dorsolateral prefrontal cortex (DLPFC) reduces food intake and hunger, but its effects on circulating factors are unclear. We assessed the effect of repeated administration of tDCS to the left DLPFC (L-DLPFC) on concentrations of pro/anti-inflammatory and appetitive hormone concentrations. MATERIALS AND METHODS Twenty-nine healthy adults with obesity (12 M; 42±11 y; BMI=39±8 kg/m2) received 3 consecutive inpatient sessions of either anodal or sham tDCS targeted to the L-DLPFC during a period of ad libitum food intake. Fasting plasma concentrations of IL-6, orexin, cortisol, TNF-α, IL-1β, ghrelin, PYY, and GLP-1 were measured before the initial and after the final tDCS sessions. RESULTS IL-6 (β=-0.92 pg/ml p=0.03) decreased in the anodal group compared with sham, even after adjusting for kcal intake; there were no changes in other hormones. Mean kcal intake was associated with higher IL-1β and ghrelin concentrations after the ad libitum period (β=0.00018 pg/ml/kcal, p=0.03; β=0.00011 pg/ml/kcal, p=0.02; respectively), but not differ by intervention groups. CONCLUSIONS IL-6 concentrations were reduced following anodal tDCS to the L-DLPFC independent of ad libitum intake. IL-6 concentrations reflect the inflammatory state of adiposity and may affect eating behavior and weight gain. These findings provide evidence of therapeutic benefit of tDCS.
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Affiliation(s)
- Beyza N Aydin
- Obesity and Diabetes Clinical Research Section, Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, Phoenix, AZ, United States
| | - Emma J Stinson
- Obesity and Diabetes Clinical Research Section, Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, Phoenix, AZ, United States
| | - Katherine T Travis
- Obesity and Diabetes Clinical Research Section, Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, Phoenix, AZ, United States
| | - Jonathan Krakoff
- Obesity and Diabetes Clinical Research Section, Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, Phoenix, AZ, United States
| | - Theresa Rodzevik
- Obesity and Diabetes Clinical Research Section, Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, Phoenix, AZ, United States
| | - Douglas C Chang
- Obesity and Diabetes Clinical Research Section, Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, Phoenix, AZ, United States
| | - Marci E Gluck
- Obesity and Diabetes Clinical Research Section, Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, Phoenix, AZ, United States.
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Schmaußer M, Raab M, Laborde S. The dynamic role of the left dlPFC in neurovisceral integration: Differential effects of theta burst stimulation on vagally mediated heart rate variability and cognitive-affective processing. Psychophysiology 2024; 61:e14606. [PMID: 38867447 DOI: 10.1111/psyp.14606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 03/06/2024] [Accepted: 04/22/2024] [Indexed: 06/14/2024]
Abstract
Adapting to the ever-changing demands of the environment requires a complex interplay between cognitive-affective, neuronal, and autonomic processes. Vagally mediated heart rate variability (vmHRV) is positively associated with both cognitive-affective functioning and prefrontal cortex (PFC) activity. Accordingly, the Neurovisceral Integration Model has posited a shared role of the PFC in the regulation of cognitive-affective processes and autonomic nervous system (ANS) activity. While there are numerous correlational findings in this regard, no study so far has investigated whether the manipulation of PFC activity induces changes in vmHRV and cognitive-affective processing in an inter-dependent manner. In a sample of 64 participants, we examined the effects of continuous (cTBS; n = 21) and intermittent theta-burst stimulation (iTBS; n = 20) compared to sham stimulation (n = 23) over the left dorsolateral PFC (dlPFC) on vmHRV and cognitive-affective processing within an emotional stop-signal task (ESST). Our results revealed that both resting vmHRV and vmHRV reactivity predicted cognitive-affective processing. Furthermore, we found a dampening effect of cTBS on resting and on-task vmHRV, as well as an enhancing effect of iTBS on ESST performance. Our results show no direct association between vmHRV changes and ESST performance alterations following stimulation. We interpret our results in the light of a hierarchical model of neurovisceral integration, suggesting a dynamical situation-dependent recruitment of higher-order cortical areas like the dlPFC in the regulation of the ANS. In conclusion, our results highlight the complex interplay between PFC activity, autonomic regulation, and cognitive-affective processing, emphasizing the need for further research to understand the causal dynamics of the underlying neural mechanisms.
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Affiliation(s)
- Maximilian Schmaußer
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
- Performance Psychology Department, Institute of Psychology, German Sport University, Cologne, Germany
| | - Markus Raab
- Performance Psychology Department, Institute of Psychology, German Sport University, Cologne, Germany
| | - Sylvain Laborde
- Performance Psychology Department, Institute of Psychology, German Sport University, Cologne, Germany
- UFR STAPS, Université de Caen Normandie, Caen, France
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3
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Ko DK, Lee H, Kim DI, Park YM, Kang N. Transcranial direct current stimulation improves heart rate variability: A systematic review and meta-analysis. Prog Neuropsychopharmacol Biol Psychiatry 2024; 134:111072. [PMID: 38925337 DOI: 10.1016/j.pnpbp.2024.111072] [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: 10/28/2023] [Revised: 04/09/2024] [Accepted: 06/17/2024] [Indexed: 06/28/2024]
Abstract
BACKGROUND Heart rate variability (HRV) is a useful tool for evaluating cardiovascular autonomic nervous system (ANS) functions. This systematic review and meta-analysis examined the potential effects of transcranial direct current stimulation (tDCS) protocols on HRV parameters. METHODS This study acquired 97 comparisons from 24 qualified studies for data synthesis. Using standardized mean difference (SMD), individual and overall effect sizes were estimated to show differences in HRV variables between active tDCS and sham stimulation conditions. More positive effect size values indicated that active tDCS caused greater increases in HRV than sham stimulation. Furthermore, moderator variable analyses were performed to determine whether changes in HRV variables differed depending on (a) task types (physical stress versus psychological stress versus resting condition), (b) targeted brain regions, (c) stimulation polarity, (d) characteristics of participants, and (e) specific HRV variables. Finally, we used meta-regression analyses to determine whether different tDCS parameters (i.e., the number of tDCS sessions, stimulation duration, and density) were associated with changes in HRV patterns. RESULTS The random-effects model meta-analysis showed that tDCS protocols significantly improved HRV variables (SMD = 0.400; P < 0.001). Moreover, for increasing HRV during the physical stress task (SMD = 1.352; P = 0.001), anodal stimulation on the M1 was effective, while combined polarity stimulation on the PFC improved HRV during the psychological stress task (SMD = 0.550; P < 0.001) and resting condition (SMD = 0.192; P = 0.012). Additional moderator variables and meta-regression analyses failed to show that tDCS protocols had positive effects in certain conditions, such as different stimulus polarity, characteristics of participants, specific HRV variables, and tDCS parameters. CONCLUSION These findings tentatively suggest that using tDCS protocols to stimulate optimal targeted brain areas may be effective in improving HRV patterns potentially related to cardiovascular ANS functions.
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Affiliation(s)
- Do-Kyung Ko
- Department of Human Movement Science, Incheon National University, Incheon, South Korea; Neuromechanical Rehabilitation Research Laboratory, Incheon National University, Incheon, South Korea.
| | - Hajun Lee
- Department of Human Movement Science, Incheon National University, Incheon, South Korea; Neuromechanical Rehabilitation Research Laboratory, Incheon National University, Incheon, South Korea.
| | - Dong-Il Kim
- Department of Human Movement Science, Incheon National University, Incheon, South Korea; Division of Health & Kinesiology, Incheon National University, Incheon, South Korea.
| | - Young-Min Park
- Department of Human Movement Science, Incheon National University, Incheon, South Korea; Division of Health & Kinesiology, Incheon National University, Incheon, South Korea.
| | - Nyeonju Kang
- Department of Human Movement Science, Incheon National University, Incheon, South Korea; Division of Sport Science, Sport Science Institute & Health Promotion Center, Incheon National University, Incheon, South Korea; Neuromechanical Rehabilitation Research Laboratory, Incheon National University, Incheon, South Korea.
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4
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Li Z, Schoonjans E, Allaert J, De Smet S, Kappen M, Houfflyn J, Ottaviani C, De Raedt R, Pulopulos MM, Vanderhasselt MA. Unraveling the temporal interplay of slow-paced breathing and prefrontal transcranial direct current stimulation on cardiac indices of autonomic activity. Psychophysiology 2024:e14650. [PMID: 38997945 DOI: 10.1111/psyp.14650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 06/09/2024] [Accepted: 06/28/2024] [Indexed: 07/14/2024]
Abstract
The neurovisceral integration model proposes that information flows bidirectionally between the brain and the heart via the vagus nerve, indexed by vagally mediated heart rate variability (vmHRV). Voluntary reduction in breathing rate (slow-paced breathing, SPB, 5.5 Breathing Per Minute (BPM)) can enhance vmHRV. Additionally, prefrontal transcranial direct current stimulation (tDCS) can modulate the excitability of the prefrontal region and influence the vagus nerve. However, research on the combination of SPB and prefrontal tDCS to increase vmHRV and other cardiac (heart rate (HR) and blood pressure) and peripheral (skin conductance) indices is scarce. We hypothesized that the combination of 20 min of SPB and prefrontal tDCS would have a greater effect than each intervention in isolation. Hence, 200 participants were divided into four groups: active tDCS with SPB, active tDCS with 15 BPM breathing, sham tDCS with SPB, and sham tDCS with 15 BPM breathing. Regardless of the tDCS condition, the 5.5 BPM group showed a significant increase in vmHRV over 20 minutes and significant decreases in HR at the first and second 5-min epochs of the intervention. Regardless of breathing condition, the active tDCS group exhibited higher HR at the fourth 5-min epoch of the intervention than the sham tDCS group. No other effects were observed. Overall, SPB is a robust technique for increasing vmHRV, whereas prefrontal tDCS may produce effects that counteract those of SPB. More research is necessary to test whether and how SPB and neuromodulation approaches can be combined to improve cardiac vagal tone.
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Affiliation(s)
- Zefeng Li
- Department of Head and Skin, Ghent Experimental Psychiatry Lab, Ghent University, Ghent, Belgium
| | - Emmanuelle Schoonjans
- Department of Head and Skin, Ghent Experimental Psychiatry Lab, Ghent University, Ghent, Belgium
| | - Jens Allaert
- Department of Head and Skin, Ghent Experimental Psychiatry Lab, Ghent University, Ghent, Belgium
- Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Stefanie De Smet
- Department of Head and Skin, Ghent Experimental Psychiatry Lab, Ghent University, Ghent, Belgium
| | - Mitchel Kappen
- Department of Head and Skin, Ghent Experimental Psychiatry Lab, Ghent University, Ghent, Belgium
| | - Joni Houfflyn
- Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | | | - Rudi De Raedt
- Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Matias M Pulopulos
- Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Marie-Anne Vanderhasselt
- Department of Head and Skin, Ghent Experimental Psychiatry Lab, Ghent University, Ghent, Belgium
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5
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Razza LB, De Smet S, Cornelis X, Nikolin S, Pulopulos MM, De Raedt R, Brunoni AR, Vanderhasselt MA. Dose-dependent response of prefrontal transcranial direct current stimulation on the heart rate variability: An electric field modeling study. Psychophysiology 2024; 61:e14556. [PMID: 38459778 DOI: 10.1111/psyp.14556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 02/01/2024] [Accepted: 02/20/2024] [Indexed: 03/10/2024]
Abstract
Transcranial direct current stimulation (tDCS) of the prefrontal cortex (PFC) modulates the autonomic nervous system by activating deeper brain areas via top-down pathway. However, effects on the nervous system are heterogeneous and may depend on the amount of current that penetrates. Therefore, we aimed to investigate the variable effects of tDCS on heart rate variability (HRV), a measure of the functional state of the autonomic nervous system. Using three prefrontal tDCS protocols (1.5, 3 mA and sham), we associated the simulated individual electric field (E-field) magnitude in brain regions of interest with the HRV effects. This was a randomized, double-blinded, sham-controlled and within-subject trial, in which healthy young-adult participants received tDCS sessions separated by 2 weeks. The brain regions of interest were the dorsolateral PFC (DLPFC), anterior cingulate cortex, insula and amygdala. Overall, 37 participants were investigated, corresponding to a total of 111 tDCS sessions. The findings suggested that HRV, measured by root mean squared of successive differences (RMSSD) and high-frequency HRV (HF-HRV), were significantly increased by the 3.0 mA tDCS when compared to sham and 1.5 mA. No difference was found between sham and 1.5 mA. E-field analysis showed that all brain regions of interest were associated with the HRV outcomes. However, this significance was associated with the protocol intensity, rather than inter-individual brain structural variability. To conclude, our results suggest a dose-dependent effect of tDCS for HRV. Therefore, further research is warranted to investigate the optimal current dose to modulate HRV.
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Affiliation(s)
- Laís B Razza
- Department of Head and Skin, Psychiatry and Medical Psychology, Ghent University Hospital, Ghent University, Ghent, Belgium
- Ghent Experimental Psychiatry (GHEP) Lab, Ghent University, Ghent, Belgium
| | - Stefanie De Smet
- Department of Head and Skin, Psychiatry and Medical Psychology, Ghent University Hospital, Ghent University, Ghent, Belgium
- Ghent Experimental Psychiatry (GHEP) Lab, Ghent University, Ghent, Belgium
| | - Xander Cornelis
- Ghent Experimental Psychiatry (GHEP) Lab, Ghent University, Ghent, Belgium
| | - Stevan Nikolin
- School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia
- Black Dog Institute, Sydney, New South Wales, Australia
| | - Matias M Pulopulos
- Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Rudi De Raedt
- Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Andre R Brunoni
- Departamento de Clínica Médica, Faculdade de Medicina da Universidade de São Paulo & Hospital Universitário, Universidade de São Paulo, São Paulo, Brazil
- Hospital Universitário, Universidade de São Paulo, São Paulo, Brazil
- Serviço Interdisciplinar de Neuromodulação, Laboratório de Neurociências (LIM-27), Departamento e Instituto de Psiquiatria, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Marie-Anne Vanderhasselt
- Department of Head and Skin, Psychiatry and Medical Psychology, Ghent University Hospital, Ghent University, Ghent, Belgium
- Ghent Experimental Psychiatry (GHEP) Lab, Ghent University, Ghent, Belgium
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6
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Stuyck H, Demeyer F, Bratanov C, Cleeremans A, Van den Bussche E. Insight and non-insight problem solving: A heart rate variability study. Q J Exp Psychol (Hove) 2024; 77:1462-1484. [PMID: 37688497 DOI: 10.1177/17470218231202519] [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] [Indexed: 09/11/2023]
Abstract
Occasionally, problems are solved with a sudden Aha! moment (insight), while the mundane approach to solving problems is analytical (non-insight). At first glance, non-insight appears to depend on the availability and taxation of cognitive resources to execute the step-by-step approach, whereas insight does not, or to a lesser extent. However, this remains debated. To investigate the reliance of both solution types on cognitive resources, we assessed the involvement of the prefrontal cortex using vagally mediated heart rate variability (vmHRV) as an index. Participants (N = 68) solved 70 compound remote associates word puzzles solvable with insight and non-insight. Before, during, and after solving the word puzzles, we measured the vmHRV. Our results showed that resting-state vmHRV (trait) showed a negative association with behavioural performance for both solution types. This might reflect inter-individual differences in inhibitory control. As the solution search requires one to think of remote associations, inhibitory control might hamper rather than aid this process. Furthermore, we observed, for both solution types, a vmHRV increase from resting-state to solution search (state), lingering on in the post-task recovery period. This could mark the increase of prefrontal resources to promote an open-minded stance, essential for divergent thinking, which arguably is crucial for this task. Our findings suggest that, at a general level, both solution types share common aspects. However, a closer analysis of early and late solutions and puzzle difficulty suggested that metacognitive differentiation between insight and non-insight improved with higher trait vmHRV, and that a unique association between trait vmHRV and puzzle difficulty was present for each solution type.
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Affiliation(s)
- Hans Stuyck
- Brain and Cognition, Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
- Center for Research in Cognition and Neurosciences, Faculty of Psychology and Education Sciences, Université libre de Bruxelles, Brussel, Belgium
| | - Febe Demeyer
- Brain and Cognition, Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
| | - Christo Bratanov
- Brain and Cognition, Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
| | - Axel Cleeremans
- Center for Research in Cognition and Neurosciences, Faculty of Psychology and Education Sciences, Université libre de Bruxelles, Brussel, Belgium
| | - Eva Van den Bussche
- Brain and Cognition, Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
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7
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Jiao Y, Cheng C, Jia M, Chu Z, Song X, Zhang M, Xu H, Zeng X, Sun JB, Qin W, Yang XJ. Neuro-cardiac-guided transcranial magnetic stimulation: Unveiling the modulatory effects of low-frequency and high-frequency stimulation on heart rate. Psychophysiology 2024:e14631. [PMID: 38898649 DOI: 10.1111/psyp.14631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Revised: 05/18/2024] [Accepted: 05/29/2024] [Indexed: 06/21/2024]
Abstract
Transcranial magnetic stimulation (TMS) is pivotal in the field of major depressive disorder treatment. Due to its unsatisfied response rate, an increasing number of researchers have turned their attention towards optimizing TMS site localization. Since the influence of TMS in reducing heart rate (HR) offers insights into its regulatory impact on the autonomic nervous system, a novel approach, called neurocardiac-guided TMS (NCG-TMS), has been proposed to pinpoint the brain region eliciting the maximal individual reduction in HR as a personalized optimal stimulation target. The present study intends to systematically explore the effects of stimulation frequency, left and right hemispheres, stimulation positions, and individual differences on HR modulation using the NCG-TMS method. In experiment 1, low-frequency TMS was administered to 30 subjects, and it was found that low-frequency NCG-TMS significantly downregulated HR, with more significant effects in the right hemisphere than in the left hemisphere and the prefrontal cortex than in other brain areas. In experiment 2, high-frequency NCG-TMS stimulation was administered to 30 subjects, showing that high-frequency NCG-TMS also downregulated HR and had the greatest modulatory effect in the right prefrontal region. Simultaneously, both experiments revealed sizeable individual variability in the optimal stimulation site, which in turn validated the feasibility of the NCG-TMS method. In conclusion, the present experiments independently replicated the effect of NCG-TMS, provided an effect of high-/low-frequency TMS stimulation to downregulate HR, and identified a right lateralization of the HR modulation effect.
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Affiliation(s)
- Yunyun Jiao
- Engineering Research Center of Molecular and Neuro Imaging of the Ministry of Education, School of Life Science and Technology, Xidian University, Xi'an, Shaanxi, China
- Intelligent Non-invasive Neuromodulation Technology and Transformation Joint Laboratory, Xidian University, Xi'an, Shaanxi, China
| | - Chen Cheng
- Engineering Research Center of Molecular and Neuro Imaging of the Ministry of Education, School of Life Science and Technology, Xidian University, Xi'an, Shaanxi, China
- Intelligent Non-invasive Neuromodulation Technology and Transformation Joint Laboratory, Xidian University, Xi'an, Shaanxi, China
| | - Mengnan Jia
- Engineering Research Center of Molecular and Neuro Imaging of the Ministry of Education, School of Life Science and Technology, Xidian University, Xi'an, Shaanxi, China
- Intelligent Non-invasive Neuromodulation Technology and Transformation Joint Laboratory, Xidian University, Xi'an, Shaanxi, China
| | - Zhaoyang Chu
- Engineering Research Center of Molecular and Neuro Imaging of the Ministry of Education, School of Life Science and Technology, Xidian University, Xi'an, Shaanxi, China
- Intelligent Non-invasive Neuromodulation Technology and Transformation Joint Laboratory, Xidian University, Xi'an, Shaanxi, China
| | - Xiaoyu Song
- Engineering Research Center of Molecular and Neuro Imaging of the Ministry of Education, School of Life Science and Technology, Xidian University, Xi'an, Shaanxi, China
- Intelligent Non-invasive Neuromodulation Technology and Transformation Joint Laboratory, Xidian University, Xi'an, Shaanxi, China
| | - Mengkai Zhang
- Engineering Research Center of Molecular and Neuro Imaging of the Ministry of Education, School of Life Science and Technology, Xidian University, Xi'an, Shaanxi, China
- Intelligent Non-invasive Neuromodulation Technology and Transformation Joint Laboratory, Xidian University, Xi'an, Shaanxi, China
| | - Heng Xu
- Engineering Research Center of Molecular and Neuro Imaging of the Ministry of Education, School of Life Science and Technology, Xidian University, Xi'an, Shaanxi, China
- Intelligent Non-invasive Neuromodulation Technology and Transformation Joint Laboratory, Xidian University, Xi'an, Shaanxi, China
| | - Xiao Zeng
- Engineering Research Center of Molecular and Neuro Imaging of the Ministry of Education, School of Life Science and Technology, Xidian University, Xi'an, Shaanxi, China
- Intelligent Non-invasive Neuromodulation Technology and Transformation Joint Laboratory, Xidian University, Xi'an, Shaanxi, China
- Guangzhou Institute of Technology, Xidian University, Xi'an, Shaanxi, China
| | - Jin-Bo Sun
- Engineering Research Center of Molecular and Neuro Imaging of the Ministry of Education, School of Life Science and Technology, Xidian University, Xi'an, Shaanxi, China
- Intelligent Non-invasive Neuromodulation Technology and Transformation Joint Laboratory, Xidian University, Xi'an, Shaanxi, China
- Guangzhou Institute of Technology, Xidian University, Xi'an, Shaanxi, China
| | - Wei Qin
- Engineering Research Center of Molecular and Neuro Imaging of the Ministry of Education, School of Life Science and Technology, Xidian University, Xi'an, Shaanxi, China
- Intelligent Non-invasive Neuromodulation Technology and Transformation Joint Laboratory, Xidian University, Xi'an, Shaanxi, China
- Guangzhou Institute of Technology, Xidian University, Xi'an, Shaanxi, China
| | - Xue-Juan Yang
- Engineering Research Center of Molecular and Neuro Imaging of the Ministry of Education, School of Life Science and Technology, Xidian University, Xi'an, Shaanxi, China
- Intelligent Non-invasive Neuromodulation Technology and Transformation Joint Laboratory, Xidian University, Xi'an, Shaanxi, China
- Guangzhou Institute of Technology, Xidian University, Xi'an, Shaanxi, China
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8
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De Smet S, Int-Veen I, Vanhollebeke G, Pulopulos MM, Barth B, Pasche S, Baeken C, Nuerk HC, Plewnia C, Nieratschker V, Jochen Fallgatter A, Ehlis AC, Vanderhasselt MA, Rosenbaum D. Trait-dependent effects of theta burst stimulation after psychosocial stress: a sham-controlled study in healthy individuals. Clin Neurophysiol 2024; 162:235-247. [PMID: 38556367 DOI: 10.1016/j.clinph.2024.03.016] [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: 05/08/2023] [Revised: 01/11/2024] [Accepted: 03/05/2024] [Indexed: 04/02/2024]
Abstract
OBJECTIVE Previous studies suggest that theta burst stimulation (TBS), a form of repetitive transcranial magnetic stimulation (rTMS), applied to the left dorsolateral prefrontal cortex (DLPFC) might be a promising approach to modulate stress-reactive rumination and the associated psychophysiological stress response. Crucially, individuals showing higher levels of trait rumination might benefit more from prefrontal stimulation. METHODS In this sham-controlled study, 127 healthy individuals, with varying ruminative tendencies, received a single-session of intermittent TBS (iTBS), continuous TBS (cTBS) or sham TBS (sTBS) over the left DLPFC before being confronted with a Trier Social Stress Test. RESULTS Results showed significant TBS effects on salivary cortisol as a function of trait rumination. cTBS, as compared to sTBS and iTBS, resulted in an attenuated stress-induced cortisol response in high compared to low trait ruminators. Although independent of trait rumination levels, cTBS showed positive effects on stress-related changes in mood and, both cTBS and iTBS (versus sham) presented an enhanced heart rate recovery following the stressor. We found no evidence for (trait rumination-dependent) TBS effects on stress-reactive rumination, negative affect, subjective stress or heart rate variability. CONCLUSIONS cTBS shows beneficial effects on certain measures of stress, especially in high trait ruminators. SIGNIFICANCE These findings highlight the importance of accounting for individual differences when examining TBS effects.
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Affiliation(s)
- Stefanie De Smet
- Department of Head and Skin, Psychiatry and Medical Psychology, Ghent University Hospital, Ghent University, Ghent, Belgium; Ghent Experimental Psychiatry (GHEP) Lab, Ghent, Belgium; Brain Stimulation and Cognition (BSC) Lab, Department of Cognitive Neuroscience, Faculty of Psychology & Neuroscience, Maastricht University, Maastricht, The Netherlands.
| | - Isabell Int-Veen
- Tübingen Center for Mental Health (TüCMH), Department of Psychiatry and Psychotherapy, University Hospital of Tuebingen, Tuebingen, Germany
| | - Gert Vanhollebeke
- Department of Head and Skin, Psychiatry and Medical Psychology, Ghent University Hospital, Ghent University, Ghent, Belgium; Ghent Experimental Psychiatry (GHEP) Lab, Ghent, Belgium; Department of Electronics and Information Systems, Ghent University, Belgium; Medical Imaging and Signal Processing (MEDISIP) Group, Ghent, Belgium
| | - Matias M Pulopulos
- Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Beatrix Barth
- Tübingen Center for Mental Health (TüCMH), Department of Psychiatry and Psychotherapy, University Hospital of Tuebingen, Tuebingen, Germany; German Center for Mental Health (DZPG), Germany
| | - Sarah Pasche
- Tübingen Center for Mental Health (TüCMH), Department of Psychiatry and Psychotherapy, University Hospital of Tuebingen, Tuebingen, Germany; German Center for Mental Health (DZPG), Germany
| | - Chris Baeken
- Department of Head and Skin, Psychiatry and Medical Psychology, Ghent University Hospital, Ghent University, Ghent, Belgium; Ghent Experimental Psychiatry (GHEP) Lab, Ghent, Belgium; Department of Psychiatry, University Hospital (UZBrussel), Brussels, Belgium; Eindhoven University of Technology, Department of Electrical Engineering, Eindhoven, the Netherlands
| | | | - Christian Plewnia
- Tübingen Center for Mental Health (TüCMH), Department of Psychiatry and Psychotherapy, University Hospital of Tuebingen, Tuebingen, Germany; German Center for Mental Health (DZPG), Germany
| | - Vanessa Nieratschker
- Tübingen Center for Mental Health (TüCMH), Department of Psychiatry and Psychotherapy, University Hospital of Tuebingen, Tuebingen, Germany; German Center for Mental Health (DZPG), Germany
| | - Andreas Jochen Fallgatter
- Tübingen Center for Mental Health (TüCMH), Department of Psychiatry and Psychotherapy, University Hospital of Tuebingen, Tuebingen, Germany; German Center for Mental Health (DZPG), Germany
| | - Ann-Christine Ehlis
- Tübingen Center for Mental Health (TüCMH), Department of Psychiatry and Psychotherapy, University Hospital of Tuebingen, Tuebingen, Germany; German Center for Mental Health (DZPG), Germany
| | - Marie-Anne Vanderhasselt
- Department of Head and Skin, Psychiatry and Medical Psychology, Ghent University Hospital, Ghent University, Ghent, Belgium; Ghent Experimental Psychiatry (GHEP) Lab, Ghent, Belgium
| | - David Rosenbaum
- Tübingen Center for Mental Health (TüCMH), Department of Psychiatry and Psychotherapy, University Hospital of Tuebingen, Tuebingen, Germany
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9
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Silva-Filho E, Bikson M, Gebodh N, Khadka N, da Cruz Santos A, Pegado R, do Socorro Brasileiro-Santos M. A pilot randomized controlled trial of transcranial direct current stimulation adjunct to moderate-intensity aerobic exercise in hypertensive individuals. FRONTIERS IN NEUROERGONOMICS 2024; 5:1236486. [PMID: 38660589 PMCID: PMC11040684 DOI: 10.3389/fnrgo.2024.1236486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 03/22/2024] [Indexed: 04/26/2024]
Abstract
Background Hypertension is a global issue that is projected to worsen with increasingly obese populations. The central nervous system including the parts of the cortex plays a key role in hemodynamic stability and homeostatic control of blood pressure (BP), making them critical components in understanding and investigating the neural control of BP. This study investigated the effects of anodal transcranial direct current stimulation (tDCS) associated with aerobic physical exercise on BP and heart rate variability in hypertensive patients. Methods Twenty hypertensive patients were randomized into two groups: active tDCS associated with aerobic exercise or sham tDCS associated with aerobic exercise. BP and heart rate variability were analyzed before (baseline) and after twelve non-consecutive sessions. After each tDCS session (2 mA for 20 min), moderate-intensity aerobic exercise was carried out on a treadmill for 40 min. Results A total of 20 patients were enrolled (53.9 ± 10.6 years, 30.1 ± 3.7 Kg/m2). There were no significant interactions between time and groups on diastolic BP during wake, sleep, over 24 and 3 h after the last intervention. Heart rate variability variables showed no significant difference for time, groups and interaction analysis, except for HF (ms2) between groups (p < 0.05). Conclusion Anodal tDCS over the temporal cortex associated with aerobic exercise did not induce improvements in BP and heart rate variability. Clinical trial registration https://ensaiosclinicos.gov.br/rg/RBR-56jg3n/1, identifier: RBR-56jg3n.
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Affiliation(s)
- Edson Silva-Filho
- Associated Postgraduate Program in Physical Education, Federal University of Paraíba, João Pessoa, Paraíba, Brazil
- Postgraduate Program in Physiotherapy and Postgraduate Program in Health Science, Federal University of Rio Grande do Norte, Santa Cruz, Brazil
| | - Marom Bikson
- Department of Biomedical Engineering, The City College of The City University of New York, New York, NY, United States
| | - Nigel Gebodh
- Department of Biomedical Engineering, The City College of The City University of New York, New York, NY, United States
| | - Niranjan Khadka
- Department of Biomedical Engineering, The City College of The City University of New York, New York, NY, United States
| | - Amilton da Cruz Santos
- Associated Postgraduate Program in Physical Education, Federal University of Paraíba, João Pessoa, Paraíba, Brazil
| | - Rodrigo Pegado
- Postgraduate Program in Physiotherapy and Postgraduate Program in Health Science, Federal University of Rio Grande do Norte, Santa Cruz, Brazil
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10
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Batallas D, Rodriguez-Hernandez V, Hidalgo V, Salvador A. Loneliness during the post-confinement period: The significance of social living conditions for stress biomarkers and memory. Behav Brain Res 2024; 459:114771. [PMID: 38000531 DOI: 10.1016/j.bbr.2023.114771] [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: 07/11/2023] [Revised: 10/29/2023] [Accepted: 11/18/2023] [Indexed: 11/26/2023]
Abstract
In the aftermath of the COVID-19 lockdown, concerns about the impact of loneliness and reduced social interactions on mental health have arisen. This study explored the repercussions of post-lockdown social restrictions across psychological (loneliness, perceived stress, and depressive symptoms), biological (hair cortisol and cardiovascular activity), and cognitive dimensions (subjective memory complaints and working, declarative, and prospective memory), with a specific emphasis on perceived loneliness and the living situation. The study included 45 students: 23 (mean age = 25.69 years) in the Alone Group (AG), who experienced significant family changes and international relocation, and 22 (mean age = 25.50 years) in the Not Alone Group (NAG), who maintained their nuclear family and did not move from their home country. We assessed heart rate variability (HRV) before, during, and after immediate memory evaluations using time-domain (the square root of the mean, RMSSD) measures. The analysis revealed no significant group differences in telematic contact with family and friends, perceived stress, or depression. However, the AG participants reported fewer face-to-face interactions and greater perceived loneliness compared to the NAG. Additionally, the AG group exhibited slightly higher hair cortisol levels and worse working memory (WM) and prospective memory (PM) performance. Importantly, no significant associations were observed between memory outcomes and stress biomarkers. However, a significant interaction effect of loneliness in the relationship between hair cortisol levels and PM was found. That is, hair cortisol concentrations were negatively related to PM when participants perceived high and moderate loneliness. This interaction was absent in the working and declarative memory domains. In summary, these findings underscore the intricate interplay between loneliness, cortisol, and memory, emphasizing the need for comprehensive research on the complex mechanisms governing these multifaceted relationships.
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Affiliation(s)
- Daniela Batallas
- Laboratory of Social Cognitive Neuroscience, Department of Psychobiology and IDOCAL, University of Valencia, Valencia, Spain
| | - Valerie Rodriguez-Hernandez
- Laboratory of Social Cognitive Neuroscience, Department of Psychobiology and IDOCAL, University of Valencia, Valencia, Spain
| | - Vanesa Hidalgo
- Laboratory of Social Cognitive Neuroscience, Department of Psychobiology and IDOCAL, University of Valencia, Valencia, Spain; Department of Psychology and Sociology, Area of Psychobiology, University of Zaragoza, Teruel, Spain
| | - Alicia Salvador
- Laboratory of Social Cognitive Neuroscience, Department of Psychobiology and IDOCAL, University of Valencia, Valencia, Spain; Spanish National Network for Research in Mental Health CIBERSAM, 28029, Spain
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11
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Cox OD, Munjal A, McCall WV, Miller BJ, Baeken C, Rosenquist PB. A review of clinical studies of electrodermal activity and transcranial magnetic stimulation. Psychiatry Res 2023; 329:115535. [PMID: 37839318 DOI: 10.1016/j.psychres.2023.115535] [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: 06/12/2023] [Revised: 10/01/2023] [Accepted: 10/07/2023] [Indexed: 10/17/2023]
Abstract
There is a growing body of evidence indicative of changes in autonomic nervous system (ANS) activity in patients with disorders of the central nervous system (CNS). Non-invasive measures of the ANS, including heart rate variability (HRV), electrodermal activity (EDA), and pupillary light reflex (PLR) may have value as markers of symptom severity, subtype, risk profile, and/or treatment response. In this paper we provide an introduction into the anatomy and physiology of EDA and review the literature published after 2007 in which EDA was an outcome measure of cortical stimulation with transcranial magnetic stimulation (TMS). Eleven studies were included and considered regarding the potential of EDA as an outcome measure reflecting ANS activity in TMS research and treatment. These studies are summarized according to study population, experimental methodology, cortical region targeted, and correlation with other measures of ANS activity. Results indicate that EDA changes vary with the frequency and target of TMS. Inhibitory TMS to the dorsolateral prefrontal cortex (dlPFC) was the most common paradigm in these studies, consistently resulting in decreased EDA.
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Affiliation(s)
- Olivia D Cox
- Department of Psychiatry and Health Behavior, Medical College of Georgia at Augusta University, Augusta, GA, USA.
| | - Ananya Munjal
- Department of Psychiatry and Health Behavior, Medical College of Georgia at Augusta University, Augusta, GA, USA
| | - William V McCall
- Department of Psychiatry and Health Behavior, Medical College of Georgia at Augusta University, Augusta, GA, USA
| | - Brian J Miller
- Department of Psychiatry and Health Behavior, Medical College of Georgia at Augusta University, Augusta, GA, USA
| | - Chris Baeken
- Ghent University, Faculty of Medicine and Health Sciences, Department of Head and Skin, Ghent Experimental Psychiatry (GHEP) lab, Ghent, Belgium; Vrije Universiteit Brussel (VUB), Department of Psychiatry, University Hospital (UZBrussel), Brussels, Belgium; Eindhoven University of Technology, Department of Electrical Engineering, Eindhoven, The Netherlands
| | - Peter B Rosenquist
- Department of Psychiatry and Health Behavior, Medical College of Georgia at Augusta University, Augusta, GA, USA
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12
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Lee H, Lee JH, Hwang MH, Kang N. Repetitive transcranial magnetic stimulation improves cardiovascular autonomic nervous system control: A meta-analysis. J Affect Disord 2023; 339:443-453. [PMID: 37459970 DOI: 10.1016/j.jad.2023.07.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 06/15/2023] [Accepted: 07/08/2023] [Indexed: 07/23/2023]
Abstract
BACKGROUND Cardiovascular autonomic system (ANS) may be affected by altered neural activations in the brain. This systematic review and meta-analysis investigated potential effects of repetitive transcranial magnetic stimulation (rTMS) protocols on cardiovascular ANS control. METHODS Through 19 qualified studies, we acquired 70 comparisons for data synthesis. Individual effect sizes were estimated by comparing changes in following cardiovascular ANS control variables between active and sham stimulation conditions: (a) blood pressure (BP), (b) heart rate (HR), and (c) heart rate variability (HRV). Moreover, two moderator variable analyses determined whether changes in cardiovascular ANS control were different based on (a) rTMS protocols (excitatory rTMS versus inhibitory rTMS) and (b) specific targeted cortical regions, respectively. RESULTS The random-effects model meta-analysis revealed significant improvements in cardiovascular ANS control after the rTMS protocols. Specifically, applying excitatory and inhibitory rTMS protocols significantly decreased values of BP and HR variables. For HRV variables, excitatory rTMS protocols showed significant positive effects. These improvements in cardiovascular ANS control were observed while applying either excitatory rTMS protocols to the left dorsolateral prefrontal cortex or inhibitory rTMS protocols to the right dorsolateral prefrontal cortex. LIMITATIONS Relatively small number of studies for inhibitory rTMS on the right dorsolateral prefrontal cortex were included in this meta-analysis. CONCLUSION These findings suggest that applying excitatory and inhibitory rTMS protocols on prefrontal cortical regions may be effective to improve cardiovascular ANS control.
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Affiliation(s)
- Hanall Lee
- Department of Human Movement Science, Incheon National University, Incheon, South Korea; Neuromechanical Rehabilitation Research Laboratory, Incheon National University, Incheon, South Korea.
| | - Joon Ho Lee
- Department of Human Movement Science, Incheon National University, Incheon, South Korea; Neuromechanical Rehabilitation Research Laboratory, Incheon National University, Incheon, South Korea.
| | - Moon-Hyon Hwang
- Department of Human Movement Science, Incheon National University, Incheon, South Korea; Division of Health & Kinesiology, Incheon National University, Incheon, South Korea.
| | - Nyeonju Kang
- Department of Human Movement Science, Incheon National University, Incheon, South Korea; Division of Sport Science, Sport Science Institute & Health Promotion Center, Incheon National University, Incheon, South Korea; Neuromechanical Rehabilitation Research Laboratory, Incheon National University, Incheon, South Korea.
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13
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Arêas FZDS, Kuster E, Souza LCD, Domingues WJR, Siqueira J, Serudo LHA, Arêas GP. Transcranial Direct Current Stimulation in the Management of Hypertension: A Plausible Hypothesis? Arq Bras Cardiol 2023; 120:e20230100. [PMID: 37820174 PMCID: PMC10519356 DOI: 10.36660/abc.20230100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 06/19/2023] [Accepted: 07/17/2023] [Indexed: 10/13/2023] Open
Affiliation(s)
| | - Elizangela Kuster
- Universidade Federal do Espírito Santo - Neurociências - Ciências Fisiológicas, Vitória, ES - Brasil
| | - Lenon Corrêa de Souza
- Universidade Federal do Amazonas - Instituto de Educação em Ciências Sociais e Zootecnia, Manaus, AM - Brasil
| | | | - João Siqueira
- Universidade Federal do Amazonas - Departamento de Fisiologia, Manaus, AM - Brasil
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Lin FV, Heffner KL. Autonomic nervous system flexibility for understanding brain aging. Ageing Res Rev 2023; 90:102016. [PMID: 37459967 PMCID: PMC10530154 DOI: 10.1016/j.arr.2023.102016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 07/07/2023] [Accepted: 07/13/2023] [Indexed: 07/20/2023]
Abstract
A recent call was made for autonomic nervous system (ANS) measures as digital health markers for early detection of Alzheimer's disease and related dementia (AD/ADRD). Nevertheless, contradictory or inconclusive findings exist. To help advance understanding of ANS' role in dementia, we draw upon aging and dementia-related literature, and propose a framework that centers on the role of ANS flexibility to guide future work on application of ANS function to differentiating the degree and type of dementia-related brain pathologies. We first provide a brief review of literature within the past 10 years on ANS and dementia-related brain pathologies. Next, we present an ANS flexibility model, describing how the model can be applied to understand these brain pathologies, as well as differentiate or even be leveraged to modify typical brain aging and dementia. Lastly, we briefly discuss the implication of the model for understanding resilience and vulnerability to dementia-related outcomes.
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Affiliation(s)
- Feng V Lin
- Department of Psychiatry and Behavioral Sciences, Stanford University, USA; Wu Tsai Neurosciences Institute, Stanford University, USA.
| | - Kathi L Heffner
- School of Nursing, University of Rochester, USA; Department of Psychiatry, School of Medicine and Dentistry, University of Rochester, USA; Department of Medicine, School of Medicine and Dentistry, University of Rochester, USA
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15
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Champaneria MK, Patel RS, Oroszi TL. When blood pressure refuses to budge: exploring the complexity of resistant hypertension. Front Cardiovasc Med 2023; 10:1211199. [PMID: 37416924 PMCID: PMC10322223 DOI: 10.3389/fcvm.2023.1211199] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 05/25/2023] [Indexed: 07/08/2023] Open
Abstract
Resistant hypertension, defined as blood pressure that remains above goal despite using three or more antihypertensive medications, including a diuretic, affects a significant proportion of the hypertensive population and is associated with increased cardiovascular morbidity and mortality. Despite the availability of a wide range of pharmacological therapies, achieving optimal blood pressure control in patients with resistant hypertension remains a significant challenge. However, recent advances in the field have identified several promising treatment options, including spironolactone, mineralocorticoid receptor antagonists, and renal denervation. In addition, personalized management approaches based on genetic and other biomarkers may offer new opportunities to tailor therapy and improve outcomes. This review aims to provide an overview of the current state of knowledge regarding managing resistant hypertension, including the epidemiology, pathophysiology, and clinical implications of the condition, as well as the latest developments in therapeutic strategies and future prospects.
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16
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Gellisch M, Morosan-Puopolo G, Wolf OT, Moser DA, Zaehres H, Brand-Saberi B. Interactive teaching enhances students' physiological arousal during online learning. Ann Anat 2023; 247:152050. [PMID: 36693546 DOI: 10.1016/j.aanat.2023.152050] [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: 10/21/2022] [Revised: 12/16/2022] [Accepted: 01/06/2023] [Indexed: 01/22/2023]
Abstract
The pure transfer of face-to-face teaching to a digital learning environment can be accompanied by a significant reduction in the physiological arousal of students, which in turn can be associated with passivity during the learning process, often linked to insufficient levels of concentration and engagement in the course work. Therefore, the aim of this study was to investigate whether students' psychobiological stress responses can be enhanced in the context of anatomical online learning and how increased physiological parameters correlate with characteristics of learning experiences in a digital learning environment. Healthy first-year medical students (n = 104) experienced a regular practical course in Microscopic Anatomy either in face-to-face learning, in passive online learning or in an interaction-enhanced version of online learning. Compared to passive online learning, students engaged in the interaction-enhanced version of online learning displayed a significantly reduced Heart Rate Variability (P 0.001, partial η2 = 0.381) along with a strong increase in salivary cortisol (P 0.001, partial η2 = 0.179) and salivary alpha-amylase activity (P 0.001, partial η2 = 0.195). These results demonstrated that the physiological arousal of students engaged in online learning can be enhanced via interactive teaching methods and pointed towards clear correlations between higher physiological responses and elementary criteria of learning experience such as engagement and attention.
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Affiliation(s)
- Morris Gellisch
- Department of Anatomy and Molecular Embryology, Institute of Anatomy, Medical Faculty, Ruhr University Bochum, Bochum, Germany.
| | - Gabriela Morosan-Puopolo
- Department of Anatomy and Molecular Embryology, Institute of Anatomy, Medical Faculty, Ruhr University Bochum, Bochum, Germany
| | - Oliver T Wolf
- Department of Cognitive Psychology, Faculty of Psychology, Ruhr University Bochum, Bochum, Germany
| | - Dirk A Moser
- Department of Genetic Psychology, Faculty of Psychology, Ruhr University Bochum, Bochum, Germany
| | - Holm Zaehres
- Department of Anatomy and Molecular Embryology, Institute of Anatomy, Medical Faculty, Ruhr University Bochum, Bochum, Germany
| | - Beate Brand-Saberi
- Department of Anatomy and Molecular Embryology, Institute of Anatomy, Medical Faculty, Ruhr University Bochum, Bochum, Germany
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17
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Heart rate change as a predictor of treatment outcome for ring-coil accelerated low frequency repetitive transcranial magnetic stimulation in major depressive disorder: An exploratory study. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2023. [DOI: 10.1016/j.jadr.2023.100518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023] Open
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18
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Pinto TP, Inácio JC, de Aguiar Ferreira E, de Sá Ferreira A, Sudo FK, Tovar-Moll F, Rodrigues E. Prefrontal tDCS modulates autonomic responses in COVID-19 inpatients. Brain Stimul 2023; 16:657-666. [PMID: 36940750 PMCID: PMC10027235 DOI: 10.1016/j.brs.2023.03.001] [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: 11/17/2022] [Revised: 02/22/2023] [Accepted: 03/02/2023] [Indexed: 03/23/2023] Open
Abstract
BACKGROUND maladaptive changes in the autonomic nervous system (ANS) have been observed in short and long-term phases of COVID-19 infection. Identifying effective treatments to modulate autonomic imbalance could be a strategy for preventing and reducing disease severity and induced complications. OBJECTIVE to investigate the efficacy, safety, and feasibility of a single session of bihemispheric prefrontal tDCS on indicators of cardiac autonomic regulation and mood of COVID-19 inpatients. METHODS patients were randomized to receive a single 30-minute session of bihemispheric active tDCS over the dorsolateral prefrontal cortex (2mA; n = 20) or sham (n = 20). Changes in time [post-pre intervention] in heart rate variability (HRV), mood, heart rate, respiratory rate, and oxygen saturation were compared between groups. Additionally, clinical worsening indicators and the occurrence of falls and skin injuries were evaluated. The Brunoni Adverse Effects Questionary was employed after the intervention. RESULTS there was a large effect size (Hedges' g = 0.7) of intervention on HRV frequency parameters, suggesting alterations in cardiac autonomic regulation. An increment in oxygen saturation was observed in the active group but not in the sham after the intervention (P = 0.045). There were no group differences regarding mood, incidence and intensity of adverse effects, no occurrence of skin lesions, falls, or clinical worsening. CONCLUSIONS a single prefrontal tDCS session is safe and feasible to modulate indicators of cardiac autonomic regulation in acute COVID-19 inpatients. Further research comprising a thorough assessment of autonomic function and inflammatory biomarkers is required to verify its potential to manage autonomic dysfunctions, mitigate inflammatory responses and enhance clinical outcomes.
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Affiliation(s)
- Talita P Pinto
- Instituto D'Or de Pesquisa e Ensino (IDOR), Rua Diniz Cordeiro 30, Botafogo, 22281-100, Rio de Janeiro, Brazil.
| | - Jacqueline Cunha Inácio
- Programa de Pós-Graduação Em Ciências da Reabilitação, Centro Universitário Augusto Motta - UNISUAM, Rio de Janeiro, Brazil.
| | - Erivelton de Aguiar Ferreira
- Programa de Pós-Graduação Em Ciências da Reabilitação, Centro Universitário Augusto Motta - UNISUAM, Rio de Janeiro, Brazil.
| | - Arthur de Sá Ferreira
- Programa de Pós-Graduação Em Ciências da Reabilitação, Centro Universitário Augusto Motta - UNISUAM, Rio de Janeiro, Brazil.
| | - Felipe Kenji Sudo
- Instituto D'Or de Pesquisa e Ensino (IDOR), Rua Diniz Cordeiro 30, Botafogo, 22281-100, Rio de Janeiro, Brazil.
| | - Fernanda Tovar-Moll
- Instituto D'Or de Pesquisa e Ensino (IDOR), Rua Diniz Cordeiro 30, Botafogo, 22281-100, Rio de Janeiro, Brazil.
| | - Erika Rodrigues
- Instituto D'Or de Pesquisa e Ensino (IDOR), Rua Diniz Cordeiro 30, Botafogo, 22281-100, Rio de Janeiro, Brazil; Programa de Pós-Graduação Em Ciências da Reabilitação, Centro Universitário Augusto Motta - UNISUAM, Rio de Janeiro, Brazil.
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19
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Li H, Qin W, Li N, Feng S, Wang J, Zhang Y, Wang T, Wang C, Cai X, Sun W, Song Y, Han D, Liu Y. Effect of mindfulness on anxiety and depression in insomnia patients: A systematic review and meta-analysis. Front Psychiatry 2023; 14:1124344. [PMID: 36937735 PMCID: PMC10018191 DOI: 10.3389/fpsyt.2023.1124344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 02/07/2023] [Indexed: 03/06/2023] Open
Abstract
Background As a common clinical symptom, insomnia has a high incidence of combined mental illness and it is also a risk factor for the development of depression, anxiety and suicide. As a new concept in the field of health in recent years, mindfulness therapy can improve insomnia, anxiety and depression, which is a new way to solve such diseases. Objective This study aims to systematically evaluate the effects of mindfulness compared with conventional treatment on scores of the Hamilton Depression Scale (HAMD), Hamilton Anxiety Scale (HAMA), Self-Rating Depression Scale (SDS) and Self-Rating Anxiety Scale (SAS) in people with insomnia and anxiety-depressive symptoms. Methods Articles published before October 2022 were searched from seven databases and included in randomized controlled trials (RCTs) to evaluate mindfulness therapy. The assessment tool of Cochrane bias risk was used to evaluate the methodological quality of the literature. The main outcome indicators were HAMD and HAMA scores, and the secondary outcome indicators were SDS and SAS scores. Results Ten randomized controlled trials including 1,058 subjects were systematically evaluated and meta-analyzed in this study. In the main outcome indicators, there was a significant difference between mindfulness therapy and conventional treatment in reducing HAMD score (MD: -3.67, 95% CI: -5.22-2.11, p < 0.01) and HAMA score (MD: -3.23, 95% CI: -3.90-2.57, p < 0.01). In the secondary outcome indicators, mindfulness therapy also showed a significant difference in reducing SDS scores (MD: -6.49, 95% CI: -6.86-6.11, p < 0.01) and SAS scores (MD: -7.97, 95% CI: -9.68-6.27, p < 0.01) compared with conventional treatment. Conclusion For the people with insomnia, anxiety and depression, the use of conventional treatment with the addition of 4-12 weeks of mindfulness treatment can significantly improve anxiety and depression symptoms of patients. This is a new diagnosis and treatment idea recommended for insomniacs with or without anxiety and depression symptoms. Due to the methodological defects in the included study and the limited sample size of this paper, more well-designed randomized controlled trials are needed for verification.
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Affiliation(s)
- Hangyu Li
- School of Life and Science, Beijing University of Chinese Medicine, Beijing, China
| | - Wanli Qin
- School of Life and Science, Beijing University of Chinese Medicine, Beijing, China
| | - Nannan Li
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Shixing Feng
- Department of Neurology, Dongfang Hospital Beijing University of Chinese Medicine, Beijing, China
| | - Junqi Wang
- Dongzhimen Hospital Beijing University of Chinese Medicine, Beijing, China
| | - Yuan Zhang
- School of Life and Science, Beijing University of Chinese Medicine, Beijing, China
| | - Tianyi Wang
- School of Management, Beijing University of Chinese Medicine, Beijing, China
| | - Chenlu Wang
- School of Life and Science, Beijing University of Chinese Medicine, Beijing, China
| | - Xuanyi Cai
- School of Management, Beijing University of Chinese Medicine, Beijing, China
| | - Wen Sun
- School of Management, Beijing University of Chinese Medicine, Beijing, China
| | - Yang Song
- School of Humanities, Beijing University of Chinese Medicine, Beijing, China
| | - Dongran Han
- School of Life and Science, Beijing University of Chinese Medicine, Beijing, China
- *Correspondence: Dongran Han, ; Yixing Liu,
| | - Yixing Liu
- School of Management, Beijing University of Chinese Medicine, Beijing, China
- *Correspondence: Dongran Han, ; Yixing Liu,
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20
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Luo J, Fang C, Huang S, Wu J, Liu B, Yu J, Xiao W, Ren Z. Effects of single session transcranial direct current stimulation on aerobic performance and one arm pull-down explosive force of professional rock climbers. Front Physiol 2023; 14:1153900. [PMID: 37089430 PMCID: PMC10117960 DOI: 10.3389/fphys.2023.1153900] [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: 01/30/2023] [Accepted: 03/28/2023] [Indexed: 04/25/2023] Open
Abstract
Objective: To explore the effects of single-session transcranial direct current stimulation (tDCS) on aerobic performance and explosive force in the one-arm pull-down of long-term trained rock climbers. Method: Twenty athletes (twelve male and eight female) from the Rock Climbing Team of Hunan province (Hunan, China) were selected for a randomized double-blind crossover study. After baseline tests, All subjects visited laboratories twice to randomly receive either sham or a-tDCS at a current intensity of 2 mA for 20 min. The two visits were more than 72 h apart. Immediately after each stimulation, subjects completed a 9-min 3-level-load aerobic test and a one-arm pull-down test. Results: Differences in the heart rate immediately after 9-min incremental aerobic exercises revealed no statistical significance between each group (p > 0.05). However, the decrease in heart rate per unit time after exercise after real stimulation was significantly better than before stimulation (p < 0.05), and no statistical significance was observed between after sham stimulation and before stimulation (p > 0.05). One-arm pull-down explosive force on both sides after real stimulation was improved by a-tDCS compared with before stimulation, but with no significant difference (p > 0.05). Real stimulation was significantly improved, compared with sham stimulation on the right side (p < 0.05). Conclusion: Single-session tDCS could potentially benefit sports performance in professional athletes.
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Affiliation(s)
- Jia Luo
- Key Laboratory of Kinesiology Evaluation and Recovery of General Administration of Sport of China, Sports Science Institute of Hunan, Changsha, China
| | - Caihua Fang
- Key Laboratory of Kinesiology Evaluation and Recovery of General Administration of Sport of China, Sports Science Institute of Hunan, Changsha, China
| | - Sen Huang
- Key Laboratory of Kinesiology Evaluation and Recovery of General Administration of Sport of China, Sports Science Institute of Hunan, Changsha, China
| | - Jinlong Wu
- College of Physical Education, Southwest University, Chongqing, China
| | - Bowen Liu
- College of Physical Education, Shenzhen University, Shenzhen, China
| | - Jingxuan Yu
- College of Physical Education, Shenzhen University, Shenzhen, China
| | - Wen Xiao
- College of Physical Education, Shenzhen University, Shenzhen, China
| | - Zhanbing Ren
- College of Physical Education, Shenzhen University, Shenzhen, China
- *Correspondence: Zhanbing Ren,
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Kamboj SK, Peniket M, Simeonov L. A bioelectronic route to compassion: Rationale and study protocol for combining transcutaneous vagus nerve stimulation (tVNS) with compassionate mental imagery. PLoS One 2023; 18:e0282861. [PMID: 36913378 PMCID: PMC10010509 DOI: 10.1371/journal.pone.0282861] [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: 08/26/2022] [Accepted: 02/19/2023] [Indexed: 03/14/2023] Open
Abstract
BACKGROUND The vagus nerve (VN) is a neural nexus between the brain and body, enabling bidirectional regulation of mental functioning and peripheral physiology. Some limited correlational findings suggest an association between VN activation and a particular form of self-regulation: compassionate responding. Interventions that are geared towards strengthening self-compassion in particular, can serve as an antidote to toxic shame and self-criticism and improve psychological health. OBJECTIVE We describe a protocol for examining the role of VN activation on 'state' self-compassion, self-criticism, and related outcomes. By combining transcutaneous vagus nerve stimulation (tVNS) with a brief imagery-based self-compassion intervention, we aim to preliminarily test additivity versus synergy between these distinct bottom-up and top-down methods for putatively regulating vagal activity. We also test whether the effects of VN stimulation accumulate with daily stimulation and daily compassionate imagery practice. METHODS Using a randomized 2 x 2 factorial (stimulation x imagery condition) design, healthy volunteers (n = 120) receive active (tragus) or sham (earlobe) tVNS plus standardized (audio-recorded) self-compassionate or sham mental imagery instructions. These interventions are delivered in a university-based psychological laboratory in two sessions, one week apart, as well as being self-administered between sessions by participants at home. Pre-stimulation, peri-stimulation and post-imagery measures of state self-compassion, self-criticism and related self-report outcomes are assessed in two lab sessions, separated by a week (Days 1 and 8). Heart rate variability is used as a physiological metric of vagal activity and an eye-tracking task assesses attentional bias to compassionate faces during the two lab sessions. On Days 2-7, participants continue their randomly assigned stimulation and imagery tasks at home, and complete state measures at the end of each remote session. DISCUSSION Demonstrating modulation of compassionate responding using tVNS would support a causal link between VN activation and compassion. This would provide a basis for future studies of bioelectronic approaches to augmenting therapeutic contemplative techniques. CLINICAL TRIALS REGISTRATION ClinicalTrials.gov, Identifier: NCT05441774 (Date: July 1st 2022). OSF REGISTRATION https://osf.io/4t9ha.
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Affiliation(s)
- Sunjeev K. Kamboj
- Clinical Psychopharmacology Unit, Research Department of Clinical, Educational and Health Psychology, University College London, London, United Kingdom
- * E-mail:
| | - Matthew Peniket
- Clinical Psychopharmacology Unit, Research Department of Clinical, Educational and Health Psychology, University College London, London, United Kingdom
| | - Louise Simeonov
- Clinical Psychopharmacology Unit, Research Department of Clinical, Educational and Health Psychology, University College London, London, United Kingdom
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22
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Gu Z, Chen W, Lu Q, Dai J, Hu S, Xu K, Geng Y, Zhu Y, Xu B, Dai W, Shen Y. Anodal high-definition transcranial direct current stimulation reduces heart rate and modulates heart-rate variability in healthy young people: A randomized cross-controlled trial. Front Cardiovasc Med 2022; 9:1070157. [PMID: 36531710 PMCID: PMC9755739 DOI: 10.3389/fcvm.2022.1070157] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 11/18/2022] [Indexed: 08/12/2023] Open
Abstract
OBJECTIVE To investigate whether anodal high-definition transcranial current stimulation (HD-tDCS) over the left dorsolateral pre-frontal cortex (DLPFC) could modulate the heart rate (HR) and heart-rate variability (HRV) in healthy young people. METHODS Forty healthy young people were enrolled in this randomized crossover trial. The participants were randomized to receive anodal HD-tDCS (n = 20) or sham HD-tDCS (n = 20) over the left DLPFC with a washout period of 1 week. Electrocardiogram (ECG) data were continuously recorded 20 min before the stimulation, during the session (20 min), and 20 min after the session. HR and the time- and frequency-domain indices of the HRV were measured to investigate the activity of the sympathetic and parasympathetic nervous systems. RESULTS Anodal HD-tDCS over the left DLPFC induced a significant decrease in HR and a significant increase in the average of normal-to-normal intervals (AVG NN), low-frequency (LF) power, total power (TP), and LF/high-frequency (HF) ratio in comparison with the sham stimulation and the baseline. However, sham HD-tDCS over the left DLPFC had no significant effect on HR or HRV. CONCLUSIONS Anodal HD-tDCS over the left DLPFC could reduce HR and modulate the HRV in healthy young people. HD-tDCS may show some potential for acutely modulating cardiovascular function.
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Affiliation(s)
- Zhongke Gu
- Department of Sport and Health Sciences, Nanjing Sport Institute, Nanjing, China
| | - Wenxiang Chen
- Department of Rehabilitation, Children's Hospital of Nanjing Medical University, Nanjing, China
| | - Qian Lu
- Department of Rehabilitation Medicine, The Affiliated Jiangsu Shengze Hospital of Nanjing Medical University, Suzhou, China
| | - Jiansong Dai
- Department of Sport and Health Sciences, Nanjing Sport Institute, Nanjing, China
| | - Shugang Hu
- Department of Rehabilitation, The Affiliated Jiangning Hospital With Nanjing Medical University, Nanjing, China
| | - Kai Xu
- Department of Sport and Health Sciences, Nanjing Sport Institute, Nanjing, China
| | - Yao Geng
- Rehabilitation Medicine Center, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Ye Zhu
- Rehabilitation Medicine Center, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Boqing Xu
- Rehabilitation Medicine Center, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Wenjun Dai
- Rehabilitation Medicine Center, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Ying Shen
- Rehabilitation Medicine Center, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
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23
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Sheen JZ, Miron JP, Mansouri F, Dunlop K, Russell T, Zhou R, Hyde M, Fox L, Voetterl H, Daskalakis ZJ, Griffiths JD, Blumberger DM, Downar J. Cardiovascular biomarkers of response to accelerated low frequency repetitive transcranial magnetic stimulation in major depression. J Affect Disord 2022; 318:167-174. [PMID: 36055538 DOI: 10.1016/j.jad.2022.08.105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 07/04/2022] [Accepted: 08/26/2022] [Indexed: 11/24/2022]
Abstract
BACKGROUND AND OBJECTIVE Repetitive transcranial magnetic stimulation (rTMS) is an effective and safe treatment for major depressive disorder (MDD). rTMS is in need of a reliable biomarker of treatment response. High frequency (HF) dorsolateral prefrontal cortex (DLPFC) rTMS has been reported to induce significant changes in the cardiac activity of MDD patients. Low frequency DLPFC rTMS has many advantages over HF-DLPFC rTMS and thus this study aims to further investigate the effect of low frequency 1 Hz right hemisphere (R)-DLPFC rTMS on the cardiac activity of MDD patients, as well as the potential of using electrocardiogram (ECG) parameters as biomarkers of treatment outcome. METHODS Baseline ECG sessions were performed for 19 MDD patients. All patients then underwent 40 sessions of accelerated 1 Hz R-DLPFC rTMS one week after the baseline session. RESULTS Heart rate (HR) significantly decreased from the resting period to the first and third minute of the 1 Hz R-DLPFC rTMS period. Resting HR was found to have a significant negative association with treatment outcome. Prior to Bonferroni correction, HR during stimulation and the degree of rTMS-induced HR reduction were significantly negatively associated with treatment outcome. No significant changes were observed for the heart rate variability (HRV) parameters. LIMITATIONS Sample size (n = 19); the use of electroencephalography equipment for ECG; lack of respiration monitoring; relatively short recording duration for HRV parameters. CONCLUSION This novel study provides further preliminary evidence that ECG may be utilized as a biomarker of rTMS treatment response in MDD. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT04376697.
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Affiliation(s)
- Jack Z Sheen
- Institute of Medical Science, University of Toronto, Toronto, Canada; Krembil Research Institute, University Health Network, Toronto, Canada
| | - Jean-Philippe Miron
- Institute of Medical Science, University of Toronto, Toronto, Canada; Department of Psychiatry, Faculty of Medicine, University of Toronto, Canada; Centre Hospitalier de l'Université de Montréal (CHUM), Centre de Recherche du CHUM (CRCHUM), Canada; Département de Psychiatrie, Faculté de Médecine, Université de Montréal, Montréal, QC, Canada
| | - Farrokh Mansouri
- Institute of Medical Science, University of Toronto, Toronto, Canada
| | - Katharine Dunlop
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Canada; Keenan Research Centre for Biomedical Science, St. Michael's Hospital, Unity Health Toronto, USA; Centre for Depression and Suicide Studies, St. Michael's Hospital, Unity Health Toronto, USA
| | - Thomas Russell
- Krembil Research Institute, University Health Network, Toronto, Canada
| | - Ryan Zhou
- Krembil Research Institute, University Health Network, Toronto, Canada
| | - Molly Hyde
- Institute of Medical Science, University of Toronto, Toronto, Canada; Krembil Research Institute, University Health Network, Toronto, Canada
| | - Linsay Fox
- Krembil Research Institute, University Health Network, Toronto, Canada
| | - Helena Voetterl
- Institute of Medical Science, University of Toronto, Toronto, Canada
| | - Zafiris J Daskalakis
- Institute of Medical Science, University of Toronto, Toronto, Canada; Department of Psychiatry, Faculty of Medicine, University of Toronto, Canada; Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, Canada; Department of Psychiatry, University of California San Diego, San Diego, CA, USA
| | - John D Griffiths
- Institute of Medical Science, University of Toronto, Toronto, Canada; Department of Psychiatry, Faculty of Medicine, University of Toronto, Canada; Krembil Centre for Neuroinformatics, Centre for Addiction and Mental Health, Toronto, Canada
| | - Daniel M Blumberger
- Institute of Medical Science, University of Toronto, Toronto, Canada; Department of Psychiatry, Faculty of Medicine, University of Toronto, Canada; Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, Canada
| | - Jonathan Downar
- Institute of Medical Science, University of Toronto, Toronto, Canada; Krembil Research Institute, University Health Network, Toronto, Canada; Department of Psychiatry, Faculty of Medicine, University of Toronto, Canada.
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24
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Cabral DF, Bigliassi M, Cattaneo G, Rundek T, Pascual-Leone A, Cahalin LP, Gomes-Osman J. Exploring the interplay between mechanisms of neuroplasticity and cardiovascular health in aging adults: A multiple linear regression analysis study. Auton Neurosci 2022; 242:103023. [PMID: 36087362 PMCID: PMC11012134 DOI: 10.1016/j.autneu.2022.103023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 06/13/2022] [Accepted: 09/05/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Neuroplasticity and cardiovascular health behavior are critically important factors for optimal brain health. OBJECTIVE To assess the association between the efficacy of the mechanisms of neuroplasticity and metrics of cardiovascular heath in sedentary aging adults. METHODS We included thirty sedentary individuals (age = 60.6 ± 3.8 y; 63 % female). All underwent assessments of neuroplasticity, measured by the change in amplitude of motor evoked potentials elicited by single-pulse Transcranial Magnetic Stimulation (TMS) at baseline and following intermittent Theta-Burst (iTBS) at regular intervals. Cardiovascular health measures were derived from the Incremental Shuttle Walking Test and included Heart Rate Recovery (HRR) at 1-min/2-min after test cessation. We also collected plasma levels of brain-derived neurotrophic factor (BDNF), vascular endothelial growth factor (VEGF), and c-reactive protein. RESULTS We revealed moderate but significant relationships between TMS-iTBS neuroplasticity, and the predictors of cardiovascular health (|r| = 0.38 to 0.53, p < .05). HRR1 was the best predictor of neuroplasticity (β = 0.019, p = .002). The best fit model (Likelihood ratio = 5.83, p = .016) of the association between neuroplasticity and HRR1 (β = 0.043, p = .002) was selected when controlling for demographics and health status. VEGF and BDNF plasma levels augmented the association between neuroplasticity and HRR1. CONCLUSIONS Our findings build on existing data demonstrating that TMS may provide insight into neuroplasticity and the role cardiovascular health have on its mechanisms. These implications serve as theoretical framework for future longitudinal and interventional studies aiming to improve cardiovascular and brain health. HRR1 is a potential prognostic measure of cardiovascular health and a surrogate marker of brain health in aging adults.
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Affiliation(s)
- Danylo F Cabral
- Department of Physical Therapy, University of Miami Miller School of Medicine, Coral Gables, FL, USA.
| | - Marcelo Bigliassi
- Department of Teaching and Learning, Florida International University, Miami, FL, USA
| | - Gabriele Cattaneo
- Institut Guttmann, Institut Universitari de Neurorehabilitació, Badalona, Spain; Department of Medicine, Universitat Autónoma de Barcelona, Bellaterra, Spain
| | - Tatjana Rundek
- Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, USA; Evelyn F. McKnight Brain Institute, University of Miami, Miami, FL, USA
| | - Alvaro Pascual-Leone
- Institut Guttmann, Institut Universitari de Neurorehabilitació, Badalona, Spain; Hinda and Arthur Marcus Institute for Aging Research and Deanna and Sidney Wolk Center for Memory Health, Hebrew SeniorLife, Boston, MA, USA; Department of Neurology, Harvard Medical School, Boston, MA, USA
| | - Lawrence P Cahalin
- Department of Physical Therapy, University of Miami Miller School of Medicine, Coral Gables, FL, USA
| | - Joyce Gomes-Osman
- Department of Physical Therapy, University of Miami Miller School of Medicine, Coral Gables, FL, USA; Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, USA.
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25
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Seligowski AV, Webber TK, Marvar PJ, Ressler KJ, Philip NS. Involvement of the brain-heart axis in the link between PTSD and cardiovascular disease. Depress Anxiety 2022; 39:663-674. [PMID: 35708302 PMCID: PMC9588548 DOI: 10.1002/da.23271] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 04/22/2022] [Accepted: 05/13/2022] [Indexed: 01/27/2023] Open
Abstract
Posttraumatic stress disorder (PTSD) has long been associated with a heightened risk of cardiovascular disease (CVD). A number of mechanisms have been implicated to underlie this brain-heart axis relationship, such as altered functioning of the autonomic nervous system and increased systemic inflammation. While neural alterations have repeatedly been observed in PTSD, they are rarely considered in the PTSD-CVD link. The brain-heart axis is a pathway connecting frontal and limbic brain regions to the brainstem and periphery via the autonomic nervous system and it may be a promising model for understanding CVD risk in PTSD given its overlap with PTSD neural deficits. We first provide a summary of the primary mechanisms implicated in the association between PTSD and CVD. We then review the brain-heart axis and its relevance to PTSD, as well as findings from PTSD trials demonstrating that a number of PTSD treatments have effects on areas of the brain-heart axis. Finally, we discuss sex considerations in the PTSD-CVD link. A critical next step in this study is to determine if PTSD treatments that affect the brain-heart axis (e.g., brain stimulation that improves autonomic function) also reduce the risk of CVD.
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Affiliation(s)
- Antonia V. Seligowski
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- McLean Hospital, Belmont, MA, USA
| | | | | | - Kerry J. Ressler
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- McLean Hospital, Belmont, MA, USA
| | - Noah S. Philip
- VA RR&D Center for Neurorestoration and Neurotechnology, Providence VA Medical Center, Providence, RI, USA
- Department of Psychiatry and Human Behavior, Alpert Medical School, of Brown University, Providence, RI, USA
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26
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Rodrigues GD, Gurgel JL, da Nobrega ACL, Soares PPDS. Orthostatic intolerance: a handicap of aging or physical deconditioning? Eur J Appl Physiol 2022; 122:2005-2018. [PMID: 35716190 DOI: 10.1007/s00421-022-04978-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Accepted: 05/27/2022] [Indexed: 11/24/2022]
Abstract
Despite several studies that have been investigated physical inactivity and age-related effects on orthostatic tolerance, impaired hemodynamics and postural balance responses to orthostatic stress are incorrectly attributed to aging or sedentarism alone. The isolated effects from aging and sedentarism should be investigated through comparative studies between senior athletes and age-matched controls, and physical activity assessments on aging follow-up studies. On the other hand, bed rest and space flight studies mimic accelerated physical inactivity or disuse, which is not the same physiological decline provoked by aging alone. Thus, the elementary question is: could orthostatic intolerance be attributed to aging or physical inactivity? The main purpose of this review is to provide an overview of possible mechanisms underlying orthostatic tolerance contrasting the paradigm of aging and/or physical inactivity. The key points of this review are the following: (1) to counterpoint all relevant literature on physiological aspects of orthostatic tolerance; (2) to explore the mechanistic aspects underneath the cerebrovascular, cardiorespiratory, and postural determinants of orthostatic tolerance; and (3) examine non-pharmacological interventions with the potential to counterbalance the physical inactivity and aging effects. To date, the orthostatic intolerance cannot be attributed exclusively with aging since physical inactivity plays an important role in postural balance, neurovascular and cardiorespiratory responses to orthostatic stress. These physiological determinates should be interpreted within an integrative approach of orthostatic tolerance, that considers the interdependence between physiological systems in a closed-loop model. Based on this multisystem approach, acute and chronic countermeasures may combat aging and sedentarism effects on orthostatic tolerance.
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Affiliation(s)
- Gabriel Dias Rodrigues
- Department of Physiology and Pharmacology, Fluminense Federal University, Niterói, Brazil.,Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.,National Institute for Science & Technology - INCT, (In)activity & Exercise, CNPq-Niterói (RJ), Rio de Janeiro, Brazil
| | - Jonas Lírio Gurgel
- Department of Physical Education and Sports, Fluminense Federal University, Niterói, Brazil
| | - Antonio Claudio Lucas da Nobrega
- Department of Physiology and Pharmacology, Fluminense Federal University, Niterói, Brazil.,National Institute for Science & Technology - INCT, (In)activity & Exercise, CNPq-Niterói (RJ), Rio de Janeiro, Brazil
| | - Pedro Paulo da Silva Soares
- Department of Physiology and Pharmacology, Fluminense Federal University, Niterói, Brazil. .,National Institute for Science & Technology - INCT, (In)activity & Exercise, CNPq-Niterói (RJ), Rio de Janeiro, Brazil.
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27
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Vieira L, Marques D, Bruscky I, Marques R. Safety of Repetitive Transcranial Magnetic Stimulation in Patients With Unruptured Intracranial Aneurysms. J ECT 2022; 38:e23-e24. [PMID: 35093972 DOI: 10.1097/yct.0000000000000825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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28
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Cosmo C, Seligowski AV, Aiken EM, Van't Wout-Frank M, Philip NS. Heart Rate Variability Features as Predictors of Intermittent Theta-Burst Stimulation Response in Posttraumatic Stress Disorder. Neuromodulation 2022; 25:588-595. [PMID: 35670065 PMCID: PMC8957628 DOI: 10.1111/ner.13529] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 07/22/2021] [Accepted: 08/09/2021] [Indexed: 01/20/2023]
Abstract
BACKGROUND Posttraumatic stress disorder (PTSD) is associated with autonomic dysfunction as indicated by deficits in the sympathetic and parasympathetic nervous systems. These abnormalities are expressed as elevated heart rate and reduced heart rate variability (HRV), respectively. Intermittent theta-burst stimulation (iTBS), a form of transcranial magnetic stimulation, has demonstrated effectiveness in PTSD. Nevertheless, it remains unclear whether HRV may be an iTBS biomarker for PTSD and whether iTBS impacts autonomic activity. MATERIALS AND METHODS Fifty veterans with PTSD participated in a randomized controlled trial, receiving ten daily sessions of sham-controlled iTBS (right dorsolateral prefrontal cortex, 1800 pulses/day, 80% active motor threshold, 9.5 min). With a usable dataset (N = 47), HRV parameters were assessed as predictors of clinical response immediately after stimulation. iTBS effects on autonomic response (mean RR interval, root mean square of successive differences [RMSSD], total power [TP], and low-frequency/high-frequency [LF/HF] ratio) were evaluated using an ultra-short approach. RESULTS TP and RMSSD were significant predictors of acute clinical response to iTBS. Individuals with higher TP had better response to iTBS with improved symptoms on the Clinician-Administered PTSD Scale (rs = -0.58, p = 0.004), and higher functionality on the Social and Occupational Function Scale (rs = 0.43, p = 0.04). Similarly, higher RMSSD was associated with superior outcomes (rs = -0.44, p = 0.04). No other significant changes in HRV metrics were observed (p ≥ 0.05). CONCLUSIONS Our findings indicate that autonomic activity is a potential low-cost and technically simple predictive biomarker of iTBS response in PTSD. Less autonomic dysfunction was associated with superior clinical improvements with iTBS. Future studies might consider HRV acquisition during iTBS, as well as prospective testing of these findings in patients with elevated hyperarousal.
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Affiliation(s)
- Camila Cosmo
- Department of Psychiatry and Human Behavior, The Warren Alpert Medical School, Brown University, Providence, RI, USA; VA RR&D Center for Neurorestoration and Neurotechnology, VA Providence Healthcare System, Providence, RI, USA.
| | - Antonia V Seligowski
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA; Division of Depression and Anxiety Disorders, McLean Hospital, Belmont, MA, USA
| | - Emily M Aiken
- VA RR&D Center for Neurorestoration and Neurotechnology, VA Providence Healthcare System, Providence, RI, USA
| | - Mascha Van't Wout-Frank
- Department of Psychiatry and Human Behavior, The Warren Alpert Medical School, Brown University, Providence, RI, USA; VA RR&D Center for Neurorestoration and Neurotechnology, VA Providence Healthcare System, Providence, RI, USA
| | - Noah S Philip
- Department of Psychiatry and Human Behavior, The Warren Alpert Medical School, Brown University, Providence, RI, USA; VA RR&D Center for Neurorestoration and Neurotechnology, VA Providence Healthcare System, Providence, RI, USA.
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29
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Schmaußer M, Hoffmann S, Raab M, Laborde S. The effects of noninvasive brain stimulation on heart rate and heart rate variability: A systematic review and meta-analysis. J Neurosci Res 2022; 100:1664-1694. [PMID: 35582757 DOI: 10.1002/jnr.25062] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 04/25/2022] [Accepted: 04/30/2022] [Indexed: 12/30/2022]
Abstract
Noninvasive brain stimulation (NIBS) techniques such as transcranial magnetic stimulation and transcranial direct current stimulation are widely used to test the involvement of specific cortical regions in various domains such as cognition and emotion. Despite the capability of stimulation techniques to test causal directions, this approach has been only sparsely used to examine the cortical regulation of autonomic nervous system (ANS) functions such as heart rate (HR) and heart rate variability (HRV) and to test current models in this regard. In this preregistered (PROSPERO) systematic review and meta-analysis, we aimed to investigate, based on meta-regression, whether NIBS represents an effective method for modulating HR and HRV measures, and to evaluate whether the ANS is modulated by cortical mechanisms affected by NIBS. Here we have adhered to the PRISMA guidelines. In a series of four meta-analyses, a total of 131 effect sizes from 35 sham-controlled trials were analyzed using robust variance estimation random-effects meta-regression technique. NIBS was found to effectively modulate HR and HRV with small to medium effect sizes. Moderator analyses yielded significant differences in effects between stimulation of distinct cortical areas. Our results show that NIBS is a promising tool to investigate the cortical regulation of ANS, which may add to the existing brain imaging and animal study literature. Future research is needed to identify further factors modulating the size of effects. As many of the studies reviewed were found to be at high risk of bias, we recommend that methods to reduce potential risk of bias be used in the design and conduct of future studies.
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Affiliation(s)
| | - Sven Hoffmann
- Institute of Psychology, University of Hagen, Hagen, Germany
| | - Markus Raab
- Institute of Psychology, German Sport University, Cologne, Germany.,School of Applied Sciences, London South Bank University, London, UK
| | - Sylvain Laborde
- Institute of Psychology, German Sport University, Cologne, Germany.,UFR STAPS, EA 4260, Université de Caen Normandie, Caen, France
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30
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Ferrulli A, Gandini S, Cammarata G, Redaelli V, Massarini S, Macrì C, Terruzzi I, Cannavaro D, Luzi F, Luzi L. Deep transcranial magnetic stimulation in combination with skin thermography in obesity: a window on sympathetic nervous system. Acta Diabetol 2022; 59:729-742. [PMID: 35174415 PMCID: PMC8995296 DOI: 10.1007/s00592-022-01859-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 01/24/2022] [Indexed: 12/26/2022]
Abstract
AIMS Obesity is known to be associated with an altered thermoregulation as well as a dysregulation of sympathetic nervous system (SNS). Considering the ability of deep transcranial magnetic stimulation (dTMS) to modulate the SNS, we hypothesized a potential role of dTMS in affecting thermoregulation in obesity. Aims of the study were to monitor the effect of a single session of dTMS on body temperature in subjects with obesity, and to correlate the dTMS-induced changes in body temperature with activation of the SNS (epinephrine and norepinephrine release). METHODS Twenty-nine subjects with obesity [5 M, 24 F; age 50 (IQR: 58, 38) yrs; BMI 36.1 (IQR: 33.9, 38.7) kg/m2] were randomized into 2 groups receiving a single session of high frequency stimulation (HF) or sham stimulation. Under neutral thermal conditions, infrared thermography was utilized to assess bilateral fingernail-beds and abdominal temperature. RESULTS During a single session HF, the average temperature of both fingernail-beds decreased. Right-hand temperature difference was statistically greater in HF vs Sham: median = - 1.45 (IQR: - 2.0, - 1.0) °C for HF, p = 0.009. While temperature variation in the fingernail-bed of left hand was not statistically significant in HF compared to Sham: median = - 1.26 (IQR: - 1.6, -0.5) °C, p = 0.064. Concurrently, when estimating the effect of norepinephrine variation on temperature change of fingernail-bed of left hand, a borderline significant positive association was estimated (beta = 1.09, p = 0.067) in HF. CONCLUSIONS Deep TMS revealed to be effective in modulating temperature in subjects with obesity, partially reversing obesity-induced alterations in heat production and dissipation with a potential SNS-mediated mechanism.
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Affiliation(s)
- Anna Ferrulli
- Department of Endocrinology, Nutrition and Metabolic Diseases, IRCCS MultiMedica, Via Milanese, N. 300, 20099, Sesto San Giovanni (MI), Italy
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Sara Gandini
- Department of Experimental Oncology, European Institute of Oncology IRCCS, Milan, Italy
| | - Giulio Cammarata
- Department of Experimental Oncology, European Institute of Oncology IRCCS, Milan, Italy
| | - Veronica Redaelli
- Department of Biomedical, Surgical and Dental Sciences - One Health Unit, University of Milan, Milan, Italy
| | - Stefano Massarini
- Department of Endocrinology, Nutrition and Metabolic Diseases, IRCCS MultiMedica, Via Milanese, N. 300, 20099, Sesto San Giovanni (MI), Italy
| | - Concetta Macrì
- Department of Endocrinology, Nutrition and Metabolic Diseases, IRCCS MultiMedica, Via Milanese, N. 300, 20099, Sesto San Giovanni (MI), Italy
| | - Ileana Terruzzi
- Department of Endocrinology, Nutrition and Metabolic Diseases, IRCCS MultiMedica, Via Milanese, N. 300, 20099, Sesto San Giovanni (MI), Italy
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Daniele Cannavaro
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Fabio Luzi
- Department of Biomedical, Surgical and Dental Sciences - One Health Unit, University of Milan, Milan, Italy
| | - Livio Luzi
- Department of Endocrinology, Nutrition and Metabolic Diseases, IRCCS MultiMedica, Via Milanese, N. 300, 20099, Sesto San Giovanni (MI), Italy.
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy.
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Sesa-Ashton G, Wong R, McCarthy B, Datta S, Henderson LA, Dawood T, Macefield VG. Stimulation of the dorsolateral prefrontal cortex modulates muscle sympathetic nerve activity and blood pressure in humans. Cereb Cortex Commun 2022; 3:tgac017. [PMID: 35559424 PMCID: PMC9086585 DOI: 10.1093/texcom/tgac017] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Revised: 04/06/2022] [Accepted: 04/09/2022] [Indexed: 11/13/2022] Open
Abstract
Introduction Muscle sympathetic nerve activity (MSNA) controls the diameter of arterioles in skeletalmuscle, contributing importantly to the beat-to-beat regulation of blood pressure (BP). Although brain imaging studies have shown that bursts of MSNA originate in the rostral ventrolateral medulla, other subcortical and cortical structures-including the dorsolateral prefrontal cortex (dlPFC)-contribute. Hypothesis We tested the hypothesis that MSNA and BP could be modulated by stimulating the dlPFC. Method dlPFC. In 22 individuals MSNA was recorded via microelectrodes inserted into the common peroneal nerve, together with continuous BP, electrocardiographic, and respiration.Stimulation of the right (n=22) or left dlPFC (n=10) was achieved using transcranial alternating current (tcACS; +2 to -2mA, 0.08 Hz,100 cycles), applied between the nasion and electrodes over the F3 or F4 EEG sites on the scalp. Results Sinusoidal stimulation of either dlPFC caused cyclicmodulation of MSNA, BP and heart rate, and a significant increase in BP. Conclusion We have shown, for the first time, that tcACS of the dlPFC in awake humans causes partial entrainment of MSNA, heart rate and BP, arguing for an important role of this higher-level cortical area in the control of cardiovascular function.
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Affiliation(s)
- Gianni Sesa-Ashton
- Baker Heart and Diabetes Institute, Human Autonomic Neurophysiology, 75 Commercial Road, Melbourne, VIC 3004, Australia
| | - Rebecca Wong
- Baker Heart and Diabetes Institute, Human Autonomic Neurophysiology, 75 Commercial Road, Melbourne, VIC 3004, Australia
- Baker Department of Cardiometabolic Health, The University of Melbourne, Parkville, VIC 3010, Australia
| | - Brendan McCarthy
- Baker Heart and Diabetes Institute, Human Autonomic Neurophysiology, 75 Commercial Road, Melbourne, VIC 3004, Australia
- Baker Department of Cardiometabolic Health, The University of Melbourne, Parkville, VIC 3010, Australia
| | - Sudipta Datta
- Baker Heart and Diabetes Institute, Human Autonomic Neurophysiology, 75 Commercial Road, Melbourne, VIC 3004, Australia
- Baker Department of Cardiometabolic Health, The University of Melbourne, Parkville, VIC 3010, Australia
| | - Luke A Henderson
- School of Medical Sciences (Neuroscience), Brain and Mind Centre, The University of Sydney, NSW 2050, Australia
| | - Tye Dawood
- Baker Heart and Diabetes Institute, Human Autonomic Neurophysiology, 75 Commercial Road, Melbourne, VIC 3004, Australia
- Baker Department of Cardiometabolic Health, The University of Melbourne, Parkville, VIC 3010, Australia
| | - Vaughan G Macefield
- Baker Heart and Diabetes Institute, Human Autonomic Neurophysiology, 75 Commercial Road, Melbourne, VIC 3004, Australia
- Baker Department of Cardiometabolic Health, The University of Melbourne, Parkville, VIC 3010, Australia
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Balint EM, Angerer P, Guendel H, Marten-Mittag B, Jarczok MN. Stress Management Intervention for Leaders Increases Nighttime SDANN: Results from a Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:3841. [PMID: 35409525 PMCID: PMC8997599 DOI: 10.3390/ijerph19073841] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 03/20/2022] [Accepted: 03/21/2022] [Indexed: 02/01/2023]
Abstract
Stress management interventions aim to reduce the disease risk that is heightened by work stress. Possible pathways of risk reduction include improvements in the autonomous nervous system, which is indexed by the measurement of heart rate variability (HRV). A randomized controlled trial on improving stress management skills at work was conducted to investigate the effects of intervention on HRV. A total of 174 lower management employees were randomized into either the waiting list control group (CG) or the intervention group (IG) receiving a 2-day stress management training program and another half-day booster after four and six months. In the trial, 24 h HRV was measured at baseline and after 12 months. Heart rate (HR), root mean square of successive differences (RMSSD), standard deviation of normal-to-normal intervals (SDNN), and standard deviation of the average of normal-to-normal intervals (SDANN) were calculated for 24 h and nighttime periods. Age-adjusted multilevel mixed effects linear regressions with unstructured covariance, time as a random coefficient, and time × group interaction with the according likelihood-ratio tests were calculated. The linear mixed-effect regression models showed neither group effects between IG and CG at baseline nor time effects between baseline and follow-up for SDANN (24 h), SDNN (24 h and nighttime), RMSSD (24 h and nighttime), and HR (24 h and nighttime). Nighttime SDANN significantly improved in the intervention group (z = 2.04, p = 0.041) compared to the control group. The objective stress axis measures (SDANN) showed successful stress reduction due to the training. Nighttime SDANN was strongly associated with minimum HR. Though the effects were small and only visible at night, it is highly remarkable that 3 days of intervention achieved a measurable effect considering that stress is only one of many factors that can influence HR and HRV.
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Affiliation(s)
- Elisabeth Maria Balint
- Department of Psychosomatic Medicine and Psychotherapy, Ulm University Medical Center, 89081 Ulm, Germany; (E.M.B.); (M.N.J.)
- Burnout Section, Privatklinik Meiringen, 3860 Meiringen, Switzerland
| | - Peter Angerer
- Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, Heinrich Heine University, 40204 Düsseldorf, Germany;
| | - Harald Guendel
- Department of Psychosomatic Medicine and Psychotherapy, Ulm University Medical Center, 89081 Ulm, Germany; (E.M.B.); (M.N.J.)
| | - Birgitt Marten-Mittag
- Department of Psychosomatic Medicine and Psychotherapy, Klinikum rechts der Isar, Technische Universität Muenchen, 81675 Munich, Germany;
| | - Marc N. Jarczok
- Department of Psychosomatic Medicine and Psychotherapy, Ulm University Medical Center, 89081 Ulm, Germany; (E.M.B.); (M.N.J.)
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Rodrigues B, Barboza CA, Moura EG, Ministro G, Ferreira-Melo SE, Castaño JB, Nunes WMS, Mostarda C, Coca A, Vianna LC, Moreno-Junior H. Acute and Short-Term Autonomic and Hemodynamic Responses to Transcranial Direct Current Stimulation in Patients With Resistant Hypertension. Front Cardiovasc Med 2022; 9:853427. [PMID: 35360028 PMCID: PMC8962672 DOI: 10.3389/fcvm.2022.853427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 02/18/2022] [Indexed: 12/03/2022] Open
Abstract
Previously, we demonstrated that acute transcranial direct current stimulation (tDCS) reduced blood pressure (BP) and improved autonomic modulation in hypertensives. We hypothesized that acute and short-term tDCS intervention can promote similar benefits in resistant hypertensive patients (RHT). We assessed the impact of one (acute intervention) and ten (short-term intervention) tDCS or SHAM (20 min, each) sessions on BP, pulse interval (PI) and systolic blood pressure variabilities, humoral mechanisms associated with BP regulation, and cytokines levels. True RHT subjects (n = 13) were randomly submitted to one and ten SHAM and tDCS crossing sessions (1 week of “washout”). Hemodynamic (Finometer®, Beatscope), office BP, and autonomic variables (accessed through spectral analysis of the pulse-to-pulse BP signal, in the time and frequency domain – Fast Fourrier Transform) were measured at baseline and after the short-term intervention. 24 h-ambulatory BP monitoring was measured after acute and short-term protocols. Acute intervention: tDCS reduced BP, cardiac output, and increase high-frequency band of PI (vagal modulation to the heart). Short-term protocol: tDCS did not change BP and cardiac output parameters. In contrast, central systolic BP (−12%), augmentation index (−31%), and pulse wave velocity (34%) were decreased by the short-term tDCS when compared to SHAM. These positive results were accompanied by a reduction in the low-frequency band (−37%) and an increase of the high-frequency band of PI (+62%) compared to SHAM. These findings collectively indicate that short-term tDCS concomitantly improves resting cardiac autonomic control and pulse wave behavior and reduces central BP in RHT patients, https://ensaiosclinicos.gov.br/rg/RBR-8n7c9p.
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Affiliation(s)
- Bruno Rodrigues
- Laboratory of Cardiovascular Investigation & Exercise, School of Physical Education, University of Campinas (UNICAMP), Campinas, Brazil
- Laboratory of Cardiovascular Pharmacology & Hypertension, School of Medical Sciences, University of Campinas (UNICAMP), Campinas, Brazil
- *Correspondence: Bruno Rodrigues
| | - Catarina A. Barboza
- Laboratory of Cardiovascular Investigation & Exercise, School of Physical Education, University of Campinas (UNICAMP), Campinas, Brazil
| | - Eliezer G. Moura
- Laboratory of Cardiovascular Investigation & Exercise, School of Physical Education, University of Campinas (UNICAMP), Campinas, Brazil
| | - Gabriela Ministro
- Laboratory of Cardiovascular Investigation & Exercise, School of Physical Education, University of Campinas (UNICAMP), Campinas, Brazil
| | - Silvia E. Ferreira-Melo
- Laboratory of Cardiovascular Pharmacology & Hypertension, School of Medical Sciences, University of Campinas (UNICAMP), Campinas, Brazil
| | - Javier B. Castaño
- Laboratory of Cardiovascular Investigation & Exercise, School of Physical Education, University of Campinas (UNICAMP), Campinas, Brazil
| | - Wilton M. S. Nunes
- Laboratory of Cardiovascular Investigation & Exercise, School of Physical Education, University of Campinas (UNICAMP), Campinas, Brazil
| | - Cristiano Mostarda
- Physical Education Department, Federal University of Maranhão (UFMA), São Luís, Brazil
| | - Antonio Coca
- Hypertension and Vascular Risk Unit, Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Lauro C. Vianna
- NeuroV̇ASQ̇ - Integrative Physiology Laboratory, Faculty of Physical Education, University of Brasília, Brasília, Brazil
| | - Heitor Moreno-Junior
- Laboratory of Cardiovascular Pharmacology & Hypertension, School of Medical Sciences, University of Campinas (UNICAMP), Campinas, Brazil
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Cappon D, den Boer T, Jordan C, Yu W, Metzger E, Pascual-Leone A. Transcranial magnetic stimulation (TMS) for geriatric depression. Ageing Res Rev 2022; 74:101531. [PMID: 34839043 PMCID: PMC8996329 DOI: 10.1016/j.arr.2021.101531] [Citation(s) in RCA: 32] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 11/04/2021] [Accepted: 11/22/2021] [Indexed: 02/03/2023]
Abstract
BACKGROUND The prevalence of treatment-resistant geriatric depression (GD) highlights the need for treatments that preserve cognitive functions and recognize polypharmacy in elderly, yet effectively reduce symptom burden. Transcranial magnetic stimulation (TMS) is a proven intervention for treatment-resistant depression in younger adults but the efficacy of TMS to treat depressed older adults is still unclear. This review provides an updated view on the efficacy of TMS treatment for GD, discusses methodological differences between trials in TMS application, and explores avenues for optimization of TMS treatment in the context of the ageing brain. METHODS A systematic review was conducted to identify published literature on the antidepressant efficacy of TMS for GD. Databases PubMed, Embase, and PsycINFO were searched for English language articles in peer-reviewed journals in March 2021. RESULTS Seven randomized controlled trials (RCTs) (total n = 260, active n = 148, control n = 112) and seven uncontrolled trials (total n = 160) were included. Overall, we found substantial variability in the clinical response, ranging from 6.7% to 54.3%. CONCLUSIONS The reviewed literature highlights large heterogeneity among studies both in terms of the employed TMS dosage and the observed clinical efficacy. This highlights the need for optimizing TMS dosage by recognizing the unique clinical features of GD. We showcase a set of novel approaches for the optimization of the TMS protocol for depression and discuss the possibility for a standardized TMS protocol tailored for the treatment of GD.
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Affiliation(s)
- Davide Cappon
- Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Boston, MA, USA; Deanna and Sidney Wolk Center for Memory Health, Hebrew SeniorLife, Boston, MA, USA; Department of Neurology, Harvard Medical School, Boston, MA, USA.
| | - Tim den Boer
- Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Boston, MA, USA
| | - Caleb Jordan
- Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Boston, MA, USA; Deanna and Sidney Wolk Center for Memory Health, Hebrew SeniorLife, Boston, MA, USA
| | - Wanting Yu
- Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Boston, MA, USA
| | - Eran Metzger
- Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Boston, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Alvaro Pascual-Leone
- Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Boston, MA, USA; Deanna and Sidney Wolk Center for Memory Health, Hebrew SeniorLife, Boston, MA, USA; Department of Neurology, Harvard Medical School, Boston, MA, USA; Guttmann Brain Health Institut, Guttmann Institut, Spain
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Oliveira Júnior FD, Pereira R, Silva A, Brito Alves JD, Costa-Silva J, Braga V, Balarini C. Different acquisition systems for heart rate variability analysis may lead to diverse outcomes. Braz J Med Biol Res 2022; 55:e11720. [PMID: 35137854 PMCID: PMC8852161 DOI: 10.1590/1414-431x2021e11720] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 11/26/2021] [Indexed: 12/14/2022] Open
Abstract
Heart rate variability (HRV) is a relevant physiological variable for the estimation of cardiac autonomic function. Although the gold standard for HRV registration is the electrocardiogram (ECG), several applications (APPs) have been increasingly developed. The evaluation carried out by these devices must be compatible with ECG standards. The aim of this study was to compare the data obtained simultaneously with ECG and APP with chest heart rate transmitters. Fifty-six healthy individuals (28 men and 28 women) were evaluated at rest through a short simultaneous HRV measurement with both devices. Data from both acquisition systems were analyzed separately using their own analysis software and exported and analyzed using a validated software. Signal recordings were compatible between the two acquisition systems (Pearson r=0.99; P<0.0001). Although a high correlation was found for the HRV variables obtained in the time domain (Spearman r=0.99; P<0.0001), the correlation decreased in the frequency domain (Pearson r=0.85; P<0.0001) when two software programs were used. Comparison of the averages of spectral analysis parameters also showed differences when HRV data were analyzed separately in each device for low-frequency (LF) and high-frequency (HF) bands. Although the portability of these mobile devices allows for optimal HRV evaluation, the direct analysis obtained from these devices must be carefully evaluated with respect to frequency domain parameters.
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Seligowski AV, Ressler KJ. Sex Differences in the Co-Occurrence of PTSD and Cardiovascular Disease. Psychiatr Ann 2022. [DOI: 10.3928/00485713-20211226-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Ministro G, Castaño JB, Barboza CA, Moura EG, Ferreira-Melo SE, Mostarda CT, Fattori A, Moreno-Junior H, Rodrigues B. ACUTE TRANSCRANIAL DIRECT CURRENT STIMULATION (tDCS) IMPROVES VENTILATORY VARIABILITY AND AUTONOMIC MODULATION IN RESISTANT HYPERTENSIVE PATIENTS. Respir Physiol Neurobiol 2021; 297:103830. [PMID: 34915178 DOI: 10.1016/j.resp.2021.103830] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 11/29/2021] [Accepted: 12/13/2021] [Indexed: 10/19/2022]
Abstract
Here, we assessed the impact of one session of transcranial direct current stimulation (tDCS) or SHAM (20 min, each) on ventilatory responses to cardiopulmonary exercise test, central and peripheral blood pressure (BP), and autonomic modulation in resistant hypertensive (RHT) patients. RHT subjects (n = 13) were randomly submitted to SHAM and tDCS crossing sessions (1 week of "washout"). Patients and a technician who set the tDCS/Sham room up were both blind. After brain stimulation, patients were submitted to a cardiopulmonary exercise test to evaluate ventilatory and cardiovascular response to exercise. Hemodynamic (Finometer®, Beatscope), and autonomic variables were measured at baseline (before tDCS/Sham) and after incremental exercise. RESULTS: Our study shows that tDCS condition improved heart rate recovery, VO2 peak, and vagal modulation (after cardiopulmonary exercise test); attenuated the ventilatory variability response, central and peripheral blood pressure well as sympathetic modulation (after cardiopulmonary exercise test) in comparison with SHAM. These data suggest that acute tDCS sessions prevented oscillatory ventilation behavior during the cardiopulmonary exercise test and mitigated the increase of systolic blood pressure in RHT patients. After the exercise test, tDCS promotes better vagal reentry and improved autonomic modulation, possibly reducing central blood pressure and aortic augmentation index compared to SHAM. Brazilian Registry of Clinical Trials (ReBEC): https://ensaiosclinicos.gov.br/rg/RBR-8n7c9p.
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Affiliation(s)
- Gabriela Ministro
- Laboratory of Cardiovascular Investigation & Exercise, School of Physical Education, University of Campinas (UNICAMP), Campinas, SP, Brazil
| | - Javier B Castaño
- Laboratory of Cardiovascular Investigation & Exercise, School of Physical Education, University of Campinas (UNICAMP), Campinas, SP, Brazil
| | - Catarina A Barboza
- Laboratory of Cardiovascular Investigation & Exercise, School of Physical Education, University of Campinas (UNICAMP), Campinas, SP, Brazil
| | - Eliezer G Moura
- Laboratory of Cardiovascular Investigation & Exercise, School of Physical Education, University of Campinas (UNICAMP), Campinas, SP, Brazil
| | - Silvia E Ferreira-Melo
- Laboratory of Cardiovascular Pharmacology & Hypertension, School of Medical Sciences, University of Campinas (UNICAMP), Campinas, SP, Brazil
| | | | - André Fattori
- Department of Clinical Medicine, University of Campinas (UNICAMP), Campinas, SP, Brazil
| | - Heitor Moreno-Junior
- Laboratory of Cardiovascular Pharmacology & Hypertension, School of Medical Sciences, University of Campinas (UNICAMP), Campinas, SP, Brazil
| | - Bruno Rodrigues
- Laboratory of Cardiovascular Investigation & Exercise, School of Physical Education, University of Campinas (UNICAMP), Campinas, SP, Brazil; Laboratory of Cardiovascular Pharmacology & Hypertension, School of Medical Sciences, University of Campinas (UNICAMP), Campinas, SP, Brazil.
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Vanderhasselt MA, Ottaviani C. Combining top-down and bottom-up interventions targeting the vagus nerve to increase resilience. Neurosci Biobehav Rev 2021; 132:725-729. [PMID: 34801258 DOI: 10.1016/j.neubiorev.2021.11.018] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 11/14/2021] [Indexed: 12/27/2022]
Abstract
Chronic stress has dramatically increased over the last years and is one of the major health concerns of the 21st century. Targeted interventions are traditionally based on inducing cognitive changes and enhancing control with the aim to promote adaptive emotion regulation, ultimately enhancing stress resilience. Crucially, bodily functions have received little attention in this quest, despite increasing evidence on the impact of mind-body interactions on resilience. An exemplary model is constituted by accumulating empirical support on the vagus nerve, which enables two-way communication between heart and brain, allowing to engage in an adaptive stress response in a context-appropriate manner. Yet, research on such bidirectional communication is mainly correlational. We propose to consider resonance breathing (bottom-up approach, heart > brain), and neuromodulation (top-down approach, brain > heart) as evidence-based ways to increase vagal nerve inhibitory control and hence increase stress resilience. These promising, likely cost-effective and easily employable techniques can be used alone or in combination, harnessing neurobiological scientific advances to select treatment options with the greatest likelihood of success.
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Affiliation(s)
- Marie-Anne Vanderhasselt
- Department of Head and Skin, Ghent University, Ghent, Belgium; Ghent Experimental Psychiatry (GHEP) Lab, Ghent University, Ghent, Belgium.
| | - Cristina Ottaviani
- Department of Psychology, Sapienza University of Rome, Rome, Italy; Neuroimaging Laboratory, IRCCS Santa Lucia Foundation, Rome, Italy.
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Infortuna C, Mineo L, Buffer S, Thomas FP, Muscatello MRA, Aguglia E, Bruno A, Zoccali RA, Sheikh A, Chusid E, Han Z, Battaglia F. Acute social and somatic stress alters cortical metaplasticity probed with non-invasive brain stimulation in humans. Int J Psychophysiol 2021; 170:1-5. [PMID: 34547303 DOI: 10.1016/j.ijpsycho.2021.09.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 09/08/2021] [Accepted: 09/14/2021] [Indexed: 11/30/2022]
Abstract
Studying the neuronal mechanisms that govern the cortical adaptations to acute stress is critical for understanding the development of neuropsychiatric diseases. Homeostatic plasticity stabilizes the neural activity in which a previous synaptic event drives subsequent synaptic plasticity. In this study, we evaluated the effect of acute stress induced with the socially evaluated cold pressor test (SECPT) on cortical metaplasticity in humans using a non-invasive brain stimulation protocol. After being exposed to the SECPT and control stress conditions, 30 healthy participants were tested for cortical metaplasticity assessed with changes in the amplitude of the motor evoked potential (MEP) induced by a single-pulse transcranial magnetic stimulation (TMS). Cortical metaplasticity was induced by combining priming with cathodal tDCS (cTDCS) followed by a sub-threshold 1-Hz repetitive stimulation (rTMS) test session. Our results showed that SECPT induced cardiovascular adaptations (increase in systolic, diastolic blood pressure, and heart rate), indicating that SECPT effectively induced acute stress. Also, in our experiments stimulation of subjects with 1-Hz rTMS after they had undergone the SECPT condition induced inhibition of MEP whereas 1-Hz rTMS administered after the control condition induced a facilitatory (physiologic) response pattern. Here we observed that acute stress impairs homeostatic metaplasticity. The dysfunctional regulation of cortical plastic changes after stress could play a pivotal role in the pathogenesis of neurological and psychiatric diseases.
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Affiliation(s)
- Carmenrita Infortuna
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Policlinico Universitario, University of Messina, Messina, Italy
| | - Ludovico Mineo
- Department of Clinical and Experimental Medicine, Psychiatry Unit, University of Catania, Italy
| | - Steven Buffer
- Department of Medical Sciences and Department of Neurology, Hackensack Meridian School of Medicine, Nutley, NJ, USA
| | - Florian P Thomas
- Department of Neurology, Hackensack University Medical Center, Hackensack Meridian School of Medicine, Hackensack, NJ, USA
| | - Maria Rosaria Anna Muscatello
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Policlinico Universitario, University of Messina, Messina, Italy
| | - Eugenio Aguglia
- Department of Clinical and Experimental Medicine, Psychiatry Unit, University of Catania, Italy
| | - Antonio Bruno
- Department of Clinical and Experimental Medicine, Psychiatry Unit, University of Catania, Italy
| | - Rocco Antonio Zoccali
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Policlinico Universitario, University of Messina, Messina, Italy
| | - Asad Sheikh
- Department of Pre-clinical Sciences, New York College of Podiatric Medicine, New York, USA
| | - Eileen Chusid
- Department of Pre-clinical Sciences, New York College of Podiatric Medicine, New York, USA
| | - Zhyiong Han
- Department of Neurology, Hackensack University Medical Center, Hackensack Meridian School of Medicine, Hackensack, NJ, USA
| | - Fortunato Battaglia
- Department of Neurology, Hackensack University Medical Center, Hackensack Meridian School of Medicine, Hackensack, NJ, USA.
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Metan J, Prasad A, Ananda Kumar K, Mathapati M, Patil KK. Cardiovascular MRI image analysis by using the bio inspired (sand piper optimized) fully deep convolutional network (Bio-FDCN) architecture for an automated detection of cardiac disorders. Biomed Signal Process Control 2021. [DOI: 10.1016/j.bspc.2021.103002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Lin FV, Heffner K, Gevirtz R, Zhang Z, Tadin D, Porsteinsson A. Targeting autonomic flexibility to enhance cognitive training outcomes in older adults with mild cognitive impairment: study protocol for a randomized controlled trial. Trials 2021; 22:560. [PMID: 34425878 PMCID: PMC8381519 DOI: 10.1186/s13063-021-05530-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 08/09/2021] [Indexed: 11/23/2022] Open
Abstract
Importance Cognitive training with components that can further enhance the transferred and long-term effects and slow the progress of dementia is needed for preventing dementia. Objective The goal of the study is to test whether improving autonomic nervous system (ANS) flexibility via a resonance frequency breathing (RFB) training will strengthen the effects of a visual speed of processing (VSOP) cognitive training on cognitive and brain function, and slow the progress of dementia in older adults with mild cognitive impairment (MCI). Design Stage II double-blinded randomized controlled trial. The study was prospectively registered at ClinicalTrials.gov, with registration approved on 21 August 2020 (No. NCT04522791). Setting Study-related appointments will be conducted on-site at University of Rochester Medical Center locations. Data collection will be conducted from August 2020 to February 2025. Participants Older adults with MCI (n = 114) will be randomly assigned to an 8-week combined intervention (RFB+VSOP), VSOP with guided imagery relaxation (IR) control, and a IR-only control, with periodical booster training sessions at follow-ups. Mechanistic and distal outcomes include ANS flexibility, measured by heart rate variability, and multiple markers of dementia progress. Data will be collected across a 14-month period. Discussion This will be among the first RCTs to examine in older persons with MCI a novel, combined intervention targeting ANS flexibility, an important contributor to overall environmental adaptation, with an ultimate goal for slowing neurodegeneration. Trial registration ClinicalTrials.gov NCT04522791. Registered on 21 August 2020 Protocol version: STUDY00004727; IRB protocol version 2, approved on 30 July 2020.
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Affiliation(s)
- Feng V Lin
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Stanford University, Stanford, USA.,Wu Tsai Neuroscience Institute, Stanford University, Stanford, USA.,Elaine C. Hubbard Center for Nursing Research on Aging, School of Nursing, University of Rochester Medical Center, Rochester, USA.,Department of Brain and Cognitive Sciences, University of Rochester, Rochester, USA
| | - Kathi Heffner
- Elaine C. Hubbard Center for Nursing Research on Aging, School of Nursing, University of Rochester Medical Center, Rochester, USA. .,Department of Medicine, School of Medicine and Dentistry, University of Rochester Medical Center, Rochester, USA. .,Department of Psychiatry, School of Medicine and Dentistry, University of Rochester Medical Center, Rochester, USA.
| | | | - Zhengwu Zhang
- University of North Carolina-Chapel Hill, Chapel Hill, USA
| | - Duje Tadin
- Department of Brain and Cognitive Sciences, University of Rochester, Rochester, USA.,Department of Neuroscience, School of Medicine and Dentistry, University of Rochester Medical Center, Rochester, USA
| | - Anton Porsteinsson
- Department of Psychiatry, School of Medicine and Dentistry, University of Rochester Medical Center, Rochester, USA
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Campana M, Wagner E, Wobrock T, Langguth B, Landgrebe M, Eichhammer P, Frank E, Cordes J, Wölwer W, Winterer G, Gaebel W, Hajak G, Ohmann C, Verde PE, Rietschel M, Malchow B, Ahmed R, Strube W, Häckert J, Schneider-Axmann T, Falkai P, Hasan A. Effects of high-frequency prefrontal rTMS on heart frequency rates and blood pressure in schizophrenia. J Psychiatr Res 2021; 140:243-249. [PMID: 34119909 DOI: 10.1016/j.jpsychires.2021.06.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 05/27/2021] [Accepted: 06/04/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND Repetitive transcranial magnetic stimulation (rTMS) is a safe non-invasive neuromodulation technique used for the treatment of various neuropsychiatric disorders. The effect of rTMS applied to the cortex on autonomic functions has not been studied in detail in patient cohorts, yet patients who receive rTMS may have disease-associated impairments in the autonomic system and may receive medication that may pronounce autonomic dysfunctions. METHODS Using data from the 'rTMS for the Treatment of Negative Symptoms in Schizophrenia' (RESIS) trial we evaluated the effect of rTMS applied to the left dorsolateral prefrontal cortex (DLPFC) on autonomic nervous system-related parameters such as blood pressure (BP) and heart rate (HR) in both reclining and standing postures from screening up to 105 days after intervention among patients with schizophrenia. RESULTS 157 patients received either active (n = 76) or sham (n = 81) rTMS treatment. Apart from gender no significant group differences were observed. During intervention, Linear Mixed Model (LMM) analyses showed no significant time × group interactions nor time effects for any of the variables (all p > 0.055). During the whole trial beside a significant time × group interaction for diastolic BP (p = 0.017) in the standing posture, no significant time × group interactions for other variables (all p > 0.140) were found. CONCLUSION These secondary analyses of the largest available rTMS trial on the treatment of negative symptoms in schizophrenia did not show a significant effect of active rTMS compared to sham rTMS on heart rate or blood pressure, neither during the intervention period nor during the follow-up period.
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Affiliation(s)
- Mattia Campana
- Department of Psychiatry and Psychotherapy, Klinikum der Universität München, Ludwig-Maximilians-University, München, Germany.
| | - Elias Wagner
- Department of Psychiatry and Psychotherapy, Klinikum der Universität München, Ludwig-Maximilians-University, München, Germany
| | - Thomas Wobrock
- Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Germany; County Hospitals Darmstadt-Dieburg, Groß-Umstadt, Germany
| | - Berthold Langguth
- Department of Psychiatry and Psychotherapy, University of Regensburg, Germany
| | - Michael Landgrebe
- Department of Psychiatry and Psychotherapy, University of Regensburg, Germany; Department of Psychiatry, Psychosomatics and Psychotherapy, Kbo-Lech-Mangfall-Klinik Agatharied, Germany
| | - Peter Eichhammer
- Department of Psychiatry and Psychotherapy, University of Regensburg, Germany
| | - Elmar Frank
- Department of Psychiatry and Psychotherapy, University of Regensburg, Germany
| | - Joachim Cordes
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany
| | - Wolfgang Wölwer
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany
| | - Georg Winterer
- Department of Anesthesiology and Operative Intensive Care Medicine (CCM, CVK), Charité- Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
| | - Wolfgang Gaebel
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany
| | - Göran Hajak
- Department of Psychiatry, Psychosomatics and Psychotherapy, Sozialstiftung Bamberg, Bamberg, Germany
| | | | - Pablo E Verde
- Coordination Centre for Clinical Trials, Heinrich-Heine University, Düsseldorf, Germany
| | - Marcella Rietschel
- Department of Genetic Epidemiology in Psychiatry, Institute of Central Mental Health, Medical Faculty Mannheim, University of Heidelberg, Germany
| | - Berend Malchow
- Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Germany
| | - Raees Ahmed
- University Medical Center, Goettingen, Germany
| | - Wolfgang Strube
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, University of Augsburg, BKH, Augsburg, Germany
| | - Jan Häckert
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, University of Augsburg, BKH, Augsburg, Germany
| | - Thomas Schneider-Axmann
- Department of Psychiatry and Psychotherapy, Klinikum der Universität München, Ludwig-Maximilians-University, München, Germany
| | - Peter Falkai
- Department of Psychiatry and Psychotherapy, Klinikum der Universität München, Ludwig-Maximilians-University, München, Germany
| | - Alkomiet Hasan
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, University of Augsburg, BKH, Augsburg, Germany
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Schumann A, de la Cruz F, Köhler S, Brotte L, Bär KJ. The Influence of Heart Rate Variability Biofeedback on Cardiac Regulation and Functional Brain Connectivity. Front Neurosci 2021; 15:691988. [PMID: 34267625 PMCID: PMC8275647 DOI: 10.3389/fnins.2021.691988] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 06/02/2021] [Indexed: 12/16/2022] Open
Abstract
Background Heart rate variability (HRV) biofeedback has a beneficial impact on perceived stress and emotion regulation. However, its impact on brain function is still unclear. In this study, we aimed to investigate the effect of an 8-week HRV-biofeedback intervention on functional brain connectivity in healthy subjects. Methods HRV biofeedback was carried out in five sessions per week, including four at home and one in our lab. A control group played jump‘n’run games instead of the training. Functional magnetic resonance imaging was conducted before and after the intervention in both groups. To compute resting state functional connectivity (RSFC), we defined regions of interest in the ventral medial prefrontal cortex (VMPFC) and a total of 260 independent anatomical regions for network-based analysis. Changes of RSFC of the VMPFC to other brain regions were compared between groups. Temporal changes of HRV during the resting state recording were correlated to dynamic functional connectivity of the VMPFC. Results First, we corroborated the role of the VMPFC in cardiac autonomic regulation. We found that temporal changes of HRV were correlated to dynamic changes of prefrontal connectivity, especially to the middle cingulate cortex, the left insula, supplementary motor area, dorsal and ventral lateral prefrontal regions. The biofeedback group showed a drop in heart rate by 5.2 beats/min and an increased SDNN as a measure of HRV by 8.6 ms (18%) after the intervention. Functional connectivity of the VMPFC increased mainly to the insula, the amygdala, the middle cingulate cortex, and lateral prefrontal regions after biofeedback intervention when compared to changes in the control group. Network-based statistic showed that biofeedback had an influence on a broad functional network of brain regions. Conclusion Our results show that increased heart rate variability induced by HRV-biofeedback is accompanied by changes in functional brain connectivity during resting state.
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Affiliation(s)
- Andy Schumann
- Lab for Autonomic Neuroscience, Imaging and Cognition (LANIC), Department of Psychosomatic Medicine and Psychotherapy, Jena University Hospital, Jena, Germany
| | - Feliberto de la Cruz
- Lab for Autonomic Neuroscience, Imaging and Cognition (LANIC), Department of Psychosomatic Medicine and Psychotherapy, Jena University Hospital, Jena, Germany
| | - Stefanie Köhler
- Lab for Autonomic Neuroscience, Imaging and Cognition (LANIC), Department of Psychosomatic Medicine and Psychotherapy, Jena University Hospital, Jena, Germany.,Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany
| | - Lisa Brotte
- Lab for Autonomic Neuroscience, Imaging and Cognition (LANIC), Department of Psychosomatic Medicine and Psychotherapy, Jena University Hospital, Jena, Germany.,Institute of Medical Psychology and Behavioral Immunobiology, Essen University Hospital, Essen, Germany
| | - Karl-Jürgen Bär
- Lab for Autonomic Neuroscience, Imaging and Cognition (LANIC), Department of Psychosomatic Medicine and Psychotherapy, Jena University Hospital, Jena, Germany
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44
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Jenkins ZM, Eikelis N, Phillipou A, Castle DJ, Wilding HE, Lambert EA. Autonomic Nervous System Function in Anorexia Nervosa: A Systematic Review. Front Neurosci 2021; 15:682208. [PMID: 34262430 PMCID: PMC8273292 DOI: 10.3389/fnins.2021.682208] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 05/18/2021] [Indexed: 12/31/2022] Open
Abstract
Background: Autonomic nervous system (ANS) dysfunction has been suggested to contribute to the high prevalence of cardiovascular complications in individuals with anorexia nervosa (AN), yet has not been thoroughly investigated. The current review aimed to synthesize the evidence of basal ANS function in individuals with a current diagnosis of AN and those with a previous diagnosis who had achieved weight restoration, as compared to controls. Methods: A systematic review of nine databases was conducted and studies that were published in a peer-review journal, in English, that included at least one assessment of ANS function in individuals with a current or previous diagnosis of AN were selected. Forty-six studies were included with a total of 811 participants with a current diagnosis of AN and 123 participants with a previous diagnosis of AN. Results: ANS function was assessed through heart rate variability (n = 27), orthostatic challenge, blood pressure variability or baroreflex sensitivity (n = 11), adrenergic activity (n = 14), skin conductance level (n = 4), and pupillometry (n = 1). Individuals with AN demonstrated increased parasympathetic activity and decreased sympathetic activity, suggestive of autonomic dysregulation. Following weight restoration, autonomic function trended toward, or was equivalent to, control levels. Discussion: Autonomic dysregulation is indicated through a range of assessments in individuals with AN. Future investigations should utilize a variety of assessments together in order to conclusively establish the nature of autonomic dysfunction in AN, and following extended weight restoration. Moreover, investigation into the co-occurrence of ANS function and cardiovascular risk is required.
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Affiliation(s)
- Zoe M. Jenkins
- Iverson Health Innovation Research Institute, Swinburne University of Technology, Melbourne, VIC, Australia
- Department of Mental Health, St Vincent's Hospital Melbourne, Fitzroy, VIC, Australia
- Department of Psychiatry, University of Melbourne, Melbourne, VIC, Australia
| | - Nina Eikelis
- Iverson Health Innovation Research Institute, Swinburne University of Technology, Melbourne, VIC, Australia
| | - Andrea Phillipou
- Department of Mental Health, St Vincent's Hospital Melbourne, Fitzroy, VIC, Australia
- Department of Psychiatry, University of Melbourne, Melbourne, VIC, Australia
- Centre for Mental Health, Swinburne University of Technology, Melbourne, VIC, Australia
- Department of Mental Health, Austin Health, Melbourne, VIC, Australia
| | - David J. Castle
- Department of Mental Health, St Vincent's Hospital Melbourne, Fitzroy, VIC, Australia
- Department of Psychiatry, University of Melbourne, Melbourne, VIC, Australia
| | - Helen E. Wilding
- Library Service, St Vincent's Hospital Melbourne, Fitzroy, VIC, Australia
| | - Elisabeth A. Lambert
- Iverson Health Innovation Research Institute, Swinburne University of Technology, Melbourne, VIC, Australia
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Smits FM, Schutter DJLG, van Honk J, Geuze E. Does non-invasive brain stimulation modulate emotional stress reactivity? Soc Cogn Affect Neurosci 2021; 15:23-51. [PMID: 31993648 PMCID: PMC7171378 DOI: 10.1093/scan/nsaa011] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Revised: 12/09/2019] [Accepted: 01/08/2020] [Indexed: 12/14/2022] Open
Abstract
Excessive emotional responses to stressful events can detrimentally affect psychological functioning and mental health. Recent studies have provided evidence that non-invasive brain stimulation (NBS) targeting the prefrontal cortex (PFC) can affect the regulation of stress-related emotional responses. However, the reliability and effect sizes have not been systematically analyzed. In the present study, we reviewed and meta-analyzed the effects of repetitive transcranial magnetic (rTMS) and transcranial direct current stimulation (tDCS) over the PFC on acute emotional stress reactivity in healthy individuals. Forty sham-controlled single-session rTMS and tDCS studies were included. Separate random effects models were performed to estimate the mean effect sizes of emotional reactivity. Twelve rTMS studies together showed no evidence that rTMS over the PFC influenced emotional reactivity. Twenty-six anodal tDCS studies yielded a weak beneficial effect on stress-related emotional reactivity (Hedges’ g = −0.16, CI95% = [−0.33, 0.00]). These findings suggest that a single session of NBS is insufficient to induce reliable, clinically significant effects but also provide preliminary evidence that specific NBS methods can affect emotional reactivity. This may motivate further research into augmenting the efficacy of NBS protocols on stress-related processes.
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Affiliation(s)
- Fenne M Smits
- Brain Research & Innovation Centre, Ministry of Defence, Lundlaan 1, 3584 EZ, Utrecht, The Netherlands.,Department of Psychiatry, UMC Utrecht Brain Center, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - Dennis J L G Schutter
- Experimental Psychology, Helmholtz Institute, Utrecht University, Heidelberglaan 1, 3584 CS, Utrecht, The Netherlands
| | - Jack van Honk
- Experimental Psychology, Helmholtz Institute, Utrecht University, Heidelberglaan 1, 3584 CS, Utrecht, The Netherlands.,Department of Psychiatry and Mental Health, University of Cape Town, Observatory, 7925, Cape Town, South Africa.,Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Observatory, 7925, Cape Town, South Africa
| | - Elbert Geuze
- Brain Research & Innovation Centre, Ministry of Defence, Lundlaan 1, 3584 EZ, Utrecht, The Netherlands.,Department of Psychiatry, UMC Utrecht Brain Center, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
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46
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Chou PH, Lin YF, Lu MK, Chang HA, Chu CS, Chang WH, Kishimoto T, Sack AT, Su KP. Personalization of Repetitive Transcranial Magnetic Stimulation for the Treatment of Major Depressive Disorder According to the Existing Psychiatric Comorbidity. CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE 2021; 19:190-205. [PMID: 33888649 PMCID: PMC8077054 DOI: 10.9758/cpn.2021.19.2.190] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 12/24/2020] [Indexed: 12/19/2022]
Abstract
Repetitive transcranial magnetic stimulation (rTMS) and intermittent theta-burst stimulation (iTBS) are evidenced-based treatments for patients with major depressive disorder (MDD) who fail to respond to standard first-line therapies. However, although various TMS protocols have been proven to be clinically effective, the response rate varies across clinical applications due to the heterogeneity of real-world psychiatric comorbidities, such as generalized anxiety disorder, posttraumatic stress disorder, panic disorder, or substance use disorder, which are often observed in patients with MDD. Therefore, individualized treatment approaches are important to increase treatment response by assigning a given patient to the most optimal TMS treatment protocol based on his or her individual profile. This literature review summarizes different rTMS or TBS protocols that have been applied in researches investigating MDD patients with certain psychiatric comorbidities and discusses biomarkers that may be used to predict rTMS treatment response. Furthermore, we highlight the need for the validation of neuroimaging and electrophysiological biomarkers associated with rTMS treatment responses. Finally, we discuss on which directions future efforts should focus for developing the personalization of the treatment of depression with rTMS or iTBS.
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Affiliation(s)
- Po-Han Chou
- Department of Psychiatry, China Medical University Hsinchu Hospital, China Medical University, Hsinchu, Taiwan.,Department of Psychiatry, China Medical University Hospital, China Medical University, Taichung, Taiwan.,Department of Biological Science and Technology, National Chiao Tung University, Hsinchu, Taiwan.,Taiwan Allied Clinics for Integrative TMS, Taipei, Taiwan
| | - Yen-Feng Lin
- Taiwan Allied Clinics for Integrative TMS, Taipei, Taiwan.,Center for Neuropsychiatric Research, National Health Research Institutes, Miaoli, Taiwan.,Department of Public Health & Medical Humanities, Faculty of Medicine, National Yang-Ming Chiao Tung University, Taipei, Taiwan.,Balance Psychiatric Clinic, Hsinchu, Taiwan
| | - Ming-Kuei Lu
- Ph.D. Program for Translational Medicine, College of Medicine, China Medical University, Taichung, Taiwan.,Department of Neurology, China Medical University Hospital, Taichung, Taiwan
| | - Hsin-An Chang
- Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Che-Sheng Chu
- Department of Psychiatry, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.,Center for Geriatric and Gerontology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.,Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, 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
| | - Taishiro Kishimoto
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Alexander T Sack
- Department of Cognitive Neuroscience, Faculty of Psychology and Neuroscience, Maastricht University, The Netherlands.,Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNs), Brain+Nerve Centre, Maastricht University Medical Centre+ (MUMC+), Maastricht, The Netherlands
| | - Kuan-Pin Su
- Department of Psychiatry, China Medical University Hospital, China Medical University, Taichung, Taiwan.,College of Medicine, China Medical University, Taichung, Taiwan.,Mind-Body Interface Laboratory (MBI-Lab), China Medical University Hospital, Taichung, Taiwan.,An-Nan Hospital, China Medical University, Tainan, Taiwan
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Rodrigues B, Barboza CA, Moura EG, Ministro G, Ferreira-Melo SE, Castaño JB, Ruberti OM, De Amorim RFB, Moreno H. Transcranial direct current stimulation modulates autonomic nervous system and reduces ambulatory blood pressure in hypertensives. Clin Exp Hypertens 2021; 43:320-327. [PMID: 33423544 DOI: 10.1080/10641963.2021.1871916] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Purpose: Transcranial direct current stimulation (tDCS) seems to positively modulate the autonomic nervous system in different clinical conditions and healthy subjects; however, its effects on hypertensive (HTN) patients are not completely known. This study aimed to evaluate the effects of a tDCS or SHAM session (20 min) on blood pressure (BP) and autonomic variables of HTN patients.Materials and Methods: Subjects (n = 13) were randomly submitted to SHAM and tDCS sessions (1 week of washout). Hemodynamic and autonomic variables were measured at baseline, during, and immediately after tDCS or SHAM stimulation (Finometer®, Beatscope). Ambulatory BP measurement (ABPM) was evaluated after the experimental period.Results: Hemodynamic variables were not changed by tDCS, except for the fall in peripheral vascular resistance (Δ = -1696.51 ± 204.65 dyn.s/cm5). After the tDCS, sympathetic modulation was decreased (-61.47%), and vagal modulation was increased (+38.09%). Such acute autonomic changes may have evoked positive results observed in 24 hs-systolic blood pressure (Δ = -8.4 ± 6.2; P = .0022) and 24hs-diastolic blood pressure (Δ = -5.4 ± 4.2; P = .0010) in tDCS subjects compared with that in SHAM.Conclusion: These findings suggest that the tDCS could promote positive acute adjustments on cardiac autonomic control and reduced values on 24-hs BP of HTN patients. More than a proof-of-concept, these results may point out to the future, where brain stimulation (tDCS) can be used to HTN syndromes, such as refractory HTN.
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Affiliation(s)
- Bruno Rodrigues
- School of Physical Education, Department of Adapted Physical Activity, University of Campinas (UNICAMP), Campinas, SP, Brazil.,Laboratory of Cardiovascular Pharmacology & Hypertension, School of Medical Sciences, University of Campinas (UNICAMP), Campinas, SP, Brazil
| | - Catarina A Barboza
- School of Physical Education, Department of Adapted Physical Activity, University of Campinas (UNICAMP), Campinas, SP, Brazil.,Laboratory of Cardiovascular Pharmacology & Hypertension, School of Medical Sciences, University of Campinas (UNICAMP), Campinas, SP, Brazil
| | - Eliezer G Moura
- School of Physical Education, Department of Adapted Physical Activity, University of Campinas (UNICAMP), Campinas, SP, Brazil.,Laboratory of Cardiovascular Pharmacology & Hypertension, School of Medical Sciences, University of Campinas (UNICAMP), Campinas, SP, Brazil
| | - Gabriela Ministro
- School of Physical Education, Department of Adapted Physical Activity, University of Campinas (UNICAMP), Campinas, SP, Brazil.,Laboratory of Cardiovascular Pharmacology & Hypertension, School of Medical Sciences, University of Campinas (UNICAMP), Campinas, SP, Brazil
| | - Silvia E Ferreira-Melo
- Laboratory of Cardiovascular Pharmacology & Hypertension, School of Medical Sciences, University of Campinas (UNICAMP), Campinas, SP, Brazil
| | - Javier B Castaño
- School of Physical Education, Department of Adapted Physical Activity, University of Campinas (UNICAMP), Campinas, SP, Brazil.,Laboratory of Cardiovascular Pharmacology & Hypertension, School of Medical Sciences, University of Campinas (UNICAMP), Campinas, SP, Brazil
| | - Olivia M Ruberti
- Laboratory of Vascular Biology, Department of Structural and Functional Biology, Institute of Biology, University of Campinas (UNICAMP), Campinas, SP, Brazil
| | | | - Heitor Moreno
- Laboratory of Cardiovascular Pharmacology & Hypertension, School of Medical Sciences, University of Campinas (UNICAMP), Campinas, SP, Brazil
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Deep Transcranial Magnetic Stimulation Affects Gut Microbiota Composition in Obesity: Results of Randomized Clinical Trial. Int J Mol Sci 2021; 22:ijms22094692. [PMID: 33946648 PMCID: PMC8125086 DOI: 10.3390/ijms22094692] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 04/25/2021] [Accepted: 04/26/2021] [Indexed: 02/07/2023] Open
Abstract
Growing evidence highlights the crucial role of gut microbiota in affecting different aspects of obesity. Considering the ability of deep transcranial magnetic stimulation (dTMS) to modulate the cortical excitability, the reward system, and, indirectly, the autonomic nervous system (ANS), we hypothesized a potential role of dTMS in affecting the brain-gut communication pathways, and the gut microbiota composition in obesity. In a hospital setting, 22 subjects with obesity (5 M, 17 F; 44.9 ± 2.2 years; BMI 37.5 ± 1.0 kg/m2) were randomized into three groups receiving 15 sessions (3 per week for 5 weeks) of high frequency (HF), low frequency (LF) dTMS, or sham stimulation. Fecal samples were collected at baseline and after 5 weeks of treatment. Total bacterial DNA was extracted from fecal samples using the QIAamp DNA Stool Mini Kit (Qiagen, Italy) and analyzed by a metagenomics approach (Ion Torrent Personal Genome Machine). After 5 weeks, a significant weight loss was found in HF (HF: −4.1 ± 0.8%, LF: −1.9 ± 0.8%, sham: −1.3 ± 0.6%, p = 0.042) compared to LF and sham groups, associated with a decrease in norepinephrine compared to baseline (HF: −61.5 ± 15.2%, p < 0.01; LF: −31.8 ± 17.1%, p < 0.05; sham: −35.8 ± 21.0%, p > 0.05). Furthermore, an increase in Faecalibacterium (+154.3% vs. baseline, p < 0.05) and Alistipes (+153.4% vs. baseline, p < 0.05) genera, and a significant decrease in Lactobacillus (−77.1% vs. baseline, p < 0.05) were found in HF. Faecalibacterium variations were not significant compared to baseline in the other two groups (LF: +106.6%, sham: +27.6%; p > 0.05) as well as Alistipes (LF: −54.9%, sham: −15.1%; p > 0.05) and Lactobacillus (LF: −26.0%, sham: +228.3%; p > 0.05) variations. Norepinephrine change significantly correlated with Bacteroides (r2 = 0.734; p < 0.05), Eubacterium (r2 = 0.734; p < 0.05), and Parasutterella (r2 = 0.618; p < 0.05) abundance variations in HF. In conclusion, HF dTMS treatment revealed to be effective in modulating gut microbiota composition in subjects with obesity, reversing obesity-associated microbiota variations, and promoting bacterial species representative of healthy subjects with anti-inflammatory properties.
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49
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Michael JA, Kaur M. The Heart-Brain Connection in Depression: Can it inform a personalised approach for repetitive transcranial magnetic stimulation (rTMS) treatment? Neurosci Biobehav Rev 2021; 127:136-143. [PMID: 33891972 DOI: 10.1016/j.neubiorev.2021.04.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 04/02/2021] [Accepted: 04/04/2021] [Indexed: 12/30/2022]
Abstract
There is growing enthusiasm into the frontal-vagal network theory of major depressive disorder (MDD) and the potential role of a frontal-vagal network in the therapeutic mechanism of repetitive transcranial magnetic stimulation (rTMS) treatment for MDD. A review of the autonomic nervous system (ANS) in MDD and its role in antidepressant treatment for MDD is timely. The literature supports the well-established notion of ANS dysfunction in MDD and the benign effect of selective serotonin reuptake inhibitors, but not tricyclic antidepressants, on perturbed ANS function in MDD. Notwithstanding, there is some evidence that ANS measures have the capacity to inform response to antidepressant medication treatment. While there is a paucity of studies on the effects of rTMS on the ANS, critically, there is preliminary support that rTMS may alleviate ANS dysfunction in MDD and that ANS measures are associated with rTMS treatment response. These observations are consistent with the frontal-vagal theory of depression and the emerging literature on the use of ANS measures for personalising and optimising rTMS treatment of MDD.
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Affiliation(s)
- Jessica A Michael
- Epworth Centre for Innovation in Mental Health, Epworth Healthcare and Department of Psychiatry, Monash University, Camberwell, Victoria, Australia
| | - Manreena Kaur
- Epworth Centre for Innovation in Mental Health, Epworth Healthcare and Department of Psychiatry, Monash University, Camberwell, Victoria, Australia; Neuroscience Research Australia, Sydney, New South Wales, Australia; School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia.
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50
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Hamasaki T, Yamakawa T, Fujiwara K, Harashima H, Nakamura K, Ikuta Y, Yamamoto T, Hasegawa Y, Takezaki T, Mukasa A. Sympathetic hyperactivity, hypertension, and tachycardia induced by stimulation of the ponto-medullary junction in humans. Clin Neurophysiol 2021; 132:1264-1273. [PMID: 33867252 DOI: 10.1016/j.clinph.2021.03.006] [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: 08/11/2020] [Revised: 02/01/2021] [Accepted: 03/06/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE The purpose of this study is to investigate changes in autonomic activities and systemic circulation generated by surgical manipulation or electrical stimulation to the human brain stem. METHODS We constructed a system that simultaneously recorded microsurgical field videos and heart rate variability (HRV) that represent autonomic activities. In 20 brain stem surgeries recorded, HRV features and sites of surgical manipulation were analyzed in 19 hypertensive epochs, defined as the periods with transient increases in the blood pressure. We analyzed the period during electrical stimulation to the ponto-medullary junction, performed for the purpose of monitoring a cranial nerve function. RESULTS In the hypertensive epoch, HRV analysis showed that sympathetic activity predominated over the parasympathetic activity. The hypertensive epoch was more associated with surgical manipulation of the area in the caudal pons or the rostral medulla oblongata compared to controls. During the period of electrical stimulation, there were significant increases in blood pressures and heart rates, accompanied by sympathetic overdrive. CONCLUSIONS Our results provide physiological evidence that there is an important autonomic center located adjacent to the ponto-medullary junction. SIGNIFICANCE A large study would reveal a candidate target of neuromodulation for disorders with autonomic imbalances such as drug-resistant hypertension.
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Affiliation(s)
- Tadashi Hamasaki
- Department of Neurosurgery, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto 860-8556, Japan.
| | - Toshitaka Yamakawa
- Priority Organization for Innovation and Excellence, Kumamoto University, 2-39-1 Kurokami, Chuo-ku, Kumamoto 860-0862, Japan
| | - Koichi Fujiwara
- Department of Material Engineering, Nagoya University, Furo-cho, Chikusa-ku, Nagoya, Aichi 464-8601, Japan
| | - Haruki Harashima
- Priority Organization for Innovation and Excellence, Kumamoto University, 2-39-1 Kurokami, Chuo-ku, Kumamoto 860-0862, Japan
| | - Kota Nakamura
- Priority Organization for Innovation and Excellence, Kumamoto University, 2-39-1 Kurokami, Chuo-ku, Kumamoto 860-0862, Japan
| | - Yoshihiro Ikuta
- Department of Anesthesiology, Kumamoto University Hospital, 1-1-1 Honjo, Chuo-ku, Kumamoto 860-8556, Japan
| | - Tatsuo Yamamoto
- Department of Anesthesiology, Kumamoto University Hospital, 1-1-1 Honjo, Chuo-ku, Kumamoto 860-8556, Japan
| | - Yu Hasegawa
- Department of Occupational Therapy, School of Health Sciences at Fukuoka, International University of Health and Welfare, 1-7-4 Momochihama, Sawara-ku, Fukuoka 814-0001, Japan
| | - Tatsuya Takezaki
- Department of Neurosurgery, Kumamoto University Hospital, 1-1-1 Honjo, Chuo-ku, Kumamoto 860-8556, Japan
| | - Akitake Mukasa
- Department of Neurosurgery, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto 860-8556, Japan
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