1
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Zhao W, Jiang B. Heart rate variability in patients with insomnia disorder: a systematic review and meta-analysis. Sleep Breath 2023; 27:1309-1313. [PMID: 36219384 DOI: 10.1007/s11325-022-02720-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 09/12/2022] [Accepted: 09/30/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Though logical inference based on small studies suggests that patients with insomnia have a blunted heart rate variability (HRV), this condition not been clearly shown. This meta-analysis aimed to determine whether or not HRV was impaired in patients with insomnia. MATERIALS AND METHODS We conducted a comprehensive literature search for studies that examined the association of HRV with insomnia disorder. HRV measures were extracted using the SDNN (time-domain measure, i.e., standard deviation of all NN intervals,) or the HF-norm (frequency-domain measure, i.e., high-frequency power normalized using total power). The effect size estimates of R_equivalent obtained from p values and sample size were synthesized. RESULTS We identified 17 studies with 921 participants. The pooled R_equivalent was 0.19 with 95% CI of 0.12 and 0.25 (p < 0.001), and there was no significant heterogeneity (I2 = 0.0%, p = 0.809). A p value of 0.075 corresponding to the R_equivalent of 0.19 was obtained, suggesting that blunted HRV was not significant in patients with insomnia disorder. CONCLUSION The current evidence did not confirm that HRV was reliably impaired in patients with insomnia disorder. Prospective studies using standard HRV measures are needed to clarify the HRV dynamics in different insomnia subtypes.
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Affiliation(s)
- Wen Zhao
- Department of Cardiology, Tianjin Fourth Central Hospital, The Fourth Central Hospital Affiliated to Nankai University, The Fourth Central Clinical College, Tianjin Medical University, Tianjin, 300140, China
| | - Binghu Jiang
- Department of Radiology, Nanchong Central Hospital, The Second Clinical Medical College, North Sichuan Medical College, No. 97 Renmin South Road, Shunqing District, Nanchong, 637000, Sichuan, China.
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2
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Shi Y, Lou H, Wang H, Zhou Y, Wang L, Li Y, Han D. Analysis of nasal resistance regulation mechanism during postural changes in patients with obstructive sleep apnea by measuring heart rate variability. J Clin Sleep Med 2023; 19:643-650. [PMID: 36661101 PMCID: PMC10071371 DOI: 10.5664/jcsm.10402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 11/12/2022] [Accepted: 11/14/2022] [Indexed: 01/21/2023]
Abstract
STUDY OBJECTIVES Changes in nasal resistance (NR) during postural changes are influenced by venous filling pressure and autonomic nervous system mediation, and heart rate variability (HRV) can reflect changes in the autonomic nervous system. This study aimed to explore the regulatory mechanisms of NR in patients with obstructive sleep apnea (OSA) during postural changes. METHODS Healthy controls (apnea-hypopnea index < 5 events/h) and patients with OSA were recruited. NR and electrocardiogram data were collected in sitting, supine, left-lateral, and right-lateral postures. HRV parameters were obtained by analyzing the electrocardiogram data from each posture. Subgroups were divided according to sitting-supine NR changes, and HRV parameters were compared between different postures and groups/subgroups. RESULTS In total, 34 healthy controls and 39 patients with OSA (mean apnea-hypopnea index 34.34 ± 22.44 events/h) were recruited. During sitting-supine postural changes, the NR increased in the control group but did not change significantly in the OSA group. None of the autonomic nervous system-related HRV parameters changed significantly. After the groups were divided into NR-elevated and NR-unchanged subgroups, sympathetic activity-related HRV parameters were higher in the NR-unchanged subgroup but only statistically significant in the OSA group. When comparing the left and right postures, there was no significant change in NR; however, the OSA group had lower parasympathetic activity-related HRV parameters when in the right posture. CONCLUSIONS During postural changes from the sitting to supine positions, the total NR increases, and this increment is smaller in patients with OSA. This is likely due to overregulation of sympathetic activity, which may occur in patients with OSA. CITATION Shi Y, Lou H, Wang H, et al. Analysis of nasal resistance regulation mechanism during postural changes in obstructive sleep apnea patients by measuring heart rate variability. J Clin Sleep Med. 2023;19(4):643-650.
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Affiliation(s)
- Yunhan Shi
- Department of Otolaryngology Head, and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Key Laboratory of Otolaryngology Head and Neck Surgery Capital Medical University, Beijing, China
- Obstructive Sleep Apnea-Hypopnea Syndrome Clinical Diagnosis and Therapy and Research Centre, Capital Medical University, Beijing, China
| | - Hongfei Lou
- Department of Otolaryngology Head, and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Key Laboratory of Otolaryngology Head and Neck Surgery Capital Medical University, Beijing, China
| | - Huijun Wang
- Department of Otolaryngology Head, and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Key Laboratory of Otolaryngology Head and Neck Surgery Capital Medical University, Beijing, China
- Obstructive Sleep Apnea-Hypopnea Syndrome Clinical Diagnosis and Therapy and Research Centre, Capital Medical University, Beijing, China
| | - Yi Zhou
- Department of Otolaryngology Head, and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Key Laboratory of Otolaryngology Head and Neck Surgery Capital Medical University, Beijing, China
| | - Li Wang
- Department of Otolaryngology Head, and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Key Laboratory of Otolaryngology Head and Neck Surgery Capital Medical University, Beijing, China
| | - Yanru Li
- Department of Otolaryngology Head, and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Key Laboratory of Otolaryngology Head and Neck Surgery Capital Medical University, Beijing, China
- Obstructive Sleep Apnea-Hypopnea Syndrome Clinical Diagnosis and Therapy and Research Centre, Capital Medical University, Beijing, China
| | - Demin Han
- Department of Otolaryngology Head, and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Key Laboratory of Otolaryngology Head and Neck Surgery Capital Medical University, Beijing, China
- Obstructive Sleep Apnea-Hypopnea Syndrome Clinical Diagnosis and Therapy and Research Centre, Capital Medical University, Beijing, China
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3
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Chen H, Comnick C, Norman GJ, Caplan DJ, Jin XX, Fillingim RB. Triad Multisystem Phenotype with High-risk for Developing Temporomandibular Disorders- Characteristics and Potential Pathophysiology Results from the OPPERA Dataset. Pain 2022; 164:1027-1038. [PMID: 36661844 DOI: 10.1097/j.pain.0000000000002797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 09/20/2022] [Indexed: 01/21/2023]
Abstract
ABSTRACT A multisystem phenotype with the Triad of bodily pain, psychological distress, and sleep disturbance was found to have high risk for developing initial onset of painful temporomandibular disorders (TMDs) in the multicenter Orofacial Pain: Prospective Evaluation and Risk Assessment (OPPERA) dataset. In this study, we systemically examined phenotypic characteristics and explored potential pathophysiology in quantitative sensory testing (QST) and autonomic nervous system (ANS) domains in this multisystem Triad phenotype. Secondary analysis was performed on 1199 non-Triad and 154 Triad TMD-free OPPERA enrollees at baseline. Results indicate that prior to developing TMDs, the Triad phenotype demonstrated both orofacial and systemic signs and symptoms that can only be captured through multisystem assessment. In addition, we found significantly lower resting heart rate variability and higher resting heart rate in the Triad phenotype as compared to the non-Triad group. However, pain sensitivity measured by QST was not different between groups. These findings highlight the importance of whole-person multisystem assessment at the stage prior to developing complex pain conditions such as TMDs, and suggest that, in addition to a "tissue damage monitor", pain should be considered in a broader context, such as a component within a "distress monitoring system" at the whole-person level when multisystem issues co-present. Therefore, the presence or absence of multisystem issues may carry critical information when searching for disease mechanisms and developing mechanism-based intervention and prevention strategies for TMDs and related pain conditions. Cardiovascular autonomic function should be further researched when multisystem issues co-present prior to developing TMDs.
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Affiliation(s)
- Hong Chen
- the University of Iowa College of Dentistry, Department of Preventive and Community Dentistry
| | - Carissa Comnick
- University of Iowa College of Dentistry, Division of Biostatistics & Computational Biology and University of Iowa College of Public Health, Department of Biostatistics
| | | | - Daniel J Caplan
- the University of Iowa College of Dentistry, Department of Preventive and Community Dentistry
| | - Xie Xian Jin
- University of Iowa College of Dentistry, Division of Biostatistics & Computational Biology and University of Iowa College of Public Health, Department of Biostatistics
| | - Roger B Fillingim
- University of Florida College of Dentistry, Department of Community Dentistry and Behavioral Science
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4
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Candia-Rivera D, Catrambone V, Valenza G. The role of electroencephalography electrical reference in the assessment of functional brain-heart interplay: From methodology to user guidelines. J Neurosci Methods 2021; 360:109269. [PMID: 34171310 DOI: 10.1016/j.jneumeth.2021.109269] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 06/16/2021] [Accepted: 06/18/2021] [Indexed: 12/25/2022]
Abstract
BACKGROUND The choice of EEG reference has been widely studied. However, the choice of the most appropriate re-referencing for EEG data is still debated. Moreover, the role of EEG reference in the estimation of functional Brain-Heart Interplay (BHI), together with different multivariate modelling strategies, has not been investigated yet. METHODS This study identifies the best methodology combining a proper EEG electrical reference and signal processing methods for an effective functional BHI assessment. The effects of the EEG reference among common average, mastoids average, Laplacian reference, Cz reference, and the reference electrode standardization technique (REST) were explored throughout different BHI methods including synthetic data generation (SDG) model, heartbeat-evoked potentials, heartbeat-evoked oscillations, and maximal information coefficient. RESULTS The SDG model exhibited high robustness between EEG references, whereas the maximal information coefficient method exhibited a high sensitivity. The common average and REST references for EEG showed a good consistency in the between-method comparisons. Laplacian, and Cz references significantly bias a BHI measurement. COMPARISON WITH EXISTING METHODS The use of EEG reference based on a common average outperforms on the use of other references for consistency in estimating directed functional BHI. We do not recommend the use of EEG references based on analytical derivations as the experimental conditions may not meet the requirements of their optimal estimation, particularly in clinical settings. CONCLUSION The use of a common average for EEG electrical reference is concluded to be the most appropriate choice for a quantitative, functional BHI assessment.
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Affiliation(s)
- Diego Candia-Rivera
- Bioengineering and Robotics Research Center E. Piaggio and the Department of Information Engineering, School of Engineering, University of Pisa, Pisa, Italy.
| | - Vincenzo Catrambone
- Bioengineering and Robotics Research Center E. Piaggio and the Department of Information Engineering, School of Engineering, University of Pisa, Pisa, Italy
| | - Gaetano Valenza
- Bioengineering and Robotics Research Center E. Piaggio and the Department of Information Engineering, School of Engineering, University of Pisa, Pisa, Italy
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5
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Guo X, Su T, Xiao H, Xiao R, Xiao Z. Using 24-h Heart Rate Variability to Investigate the Sleep Quality and Depression Symptoms of Medical Students. Front Psychiatry 2021; 12:781673. [PMID: 35058822 PMCID: PMC8763843 DOI: 10.3389/fpsyt.2021.781673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 12/06/2021] [Indexed: 11/13/2022] Open
Abstract
There have been numerous studies on the relationship between sleep and depression, as well as the relationship between sleep and depression, and heart rate variability (HRV), respectively. Even so, few studies have combined 24-h HRV analysis to study sleep quality and depressive symptoms. The purpose of this cross-sectional study was to investigate the relationship between depressed symptoms, sleep quality, and 24-h HRV in medical students. The particiants were all students at a medical university in Guangdong province, China. A total of 74 college students participated. They were asked to complete a questionnaire that included the Pittsburgh Sleep Quality Index (PSQI), the Beck Depression Inventory-II (BDI-II), the Positive and Negative Affect Scale (PANAS), and 24-h ECG monitoring. The results showed that 41.7% of the medical students had poor sleep quality, with higher levels of depressive symptoms and more negative emotions, and there was no difference in 24-h HRV indices between the low PSQI group and the high one. Correlation analysis showed that there was a significant relationship between sleep quality and depressive symptoms (r = 0.617), but the relationship between 24-h HRV indices and PSQI global scores, BDI scores were not significant. However, the correlation analysis of PSQI components and 24-h HRV showed that sleep disturbance was significantly negatively correlated with SDNN and LF in waking period (r = -0.285, -0.235), and with SDNN in sleeping period (r = -0.317). In general, the sleep disturbance in PSQI components can sensitively reflect the relationship between sleep quality and 24-h HRV of medical students. Individuals with higher sleep disturance may have lower SDNN during awake period and bedtime period, and lower LF in awake period. Twenty-four hour HRV has certain application value in clinical sleep quality monitoring, and its sensitivity and specificity in clinical application and daily life are still worth further investigation.
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Affiliation(s)
- Xiansheng Guo
- Department of Psychology, School of Public Health, Southern Medical University, Guangzhou, China.,Department of Physiology, School of Basic Medical Sciences, Southern Medical University, Guangzhou, China
| | - Tiehong Su
- Department of Psychology, School of Public Health, Southern Medical University, Guangzhou, China.,Department of Physiology, School of Basic Medical Sciences, Southern Medical University, Guangzhou, China
| | - Haoran Xiao
- Department of Psychology, School of Public Health, Southern Medical University, Guangzhou, China.,Department of Clinical Electrophysiology, The Seventh Affiliated Hospital, Southern Medical University, Foshan, China
| | - Rong Xiao
- Department of Psychology, School of Public Health, Southern Medical University, Guangzhou, China
| | - Zhongju Xiao
- Department of Psychology, School of Public Health, Southern Medical University, Guangzhou, China.,Department of Physiology, School of Basic Medical Sciences, Southern Medical University, Guangzhou, China.,Department of Clinical Electrophysiology, The Seventh Affiliated Hospital, Southern Medical University, Foshan, China
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6
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Catrambone V, Talebi A, Barbieri R, Valenza G. Time-resolved Brain-to-Heart Probabilistic Information Transfer Estimation Using Inhomogeneous Point-Process Models. IEEE Trans Biomed Eng 2021; 68:3366-3374. [DOI: 10.1109/tbme.2021.3071348] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Vincenzo Catrambone
- Research Center E. Piaggio, Information Engineering, University of Pisa, 9310 Pisa, Toscana, Italy, (e-mail: )
| | - Alireza Talebi
- Research Center E. Piaggio, Information Engineering, University of Pisa, 9310 Pisa, Toscana, Italy, (e-mail: )
| | | | - Gaetano Valenza
- Research Center E. Piaggio, Information Engineering, University of Pisa, 9310 Pisa, Toscana, Italy, (e-mail: )
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7
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Chang HA, Fang WH, Wan FJ, Tzeng NS, Liu YP, Shyu JF, Chang TC, Huang SY, Chang CC. Attenuated vagally-mediated heart rate variability at rest and in response to postural maneuvers in patients with generalized anxiety disorder. Psychol Med 2020; 50:1433-1441. [PMID: 31171043 DOI: 10.1017/s0033291719001302] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Altered heart rate variability (HRV), an index of autonomic nervous system function, has been reported in generalized anxiety disorder (GAD), but the results have been mixed. Thus, the present study, using a large sample size and better methodology, aims to examine whether GAD is associated with impaired HRV, both at rest and in response to posture challenges. METHODS In total, 1832 participants were recruited in this study, consisting of 682 patients with GAD (including 326 drug- and comorbidity-free GAD patients) and 1150 healthy controls. Short-term HRV was measured during the supine-standing-supine test (5-min per position). Propensity score matching (PSM), a relatively novel method, was used to control for potential confounders. RESULTS After PSM algorithm, drug- and comorbidity-free GAD patients had reductions in resting (baseline) high-frequency power (HF), an index for parasympathetic modulation, and increases in the low-frequency/HF ratio (LF/HF), an index for sympathovagal balance as compared to matched controls. Furthermore, the responses of HF and LF/HF to posture changes were all attenuated when compared with matched controls. Effect sizes, given by Cohen's d, for resting HF and HF reactivity were 0.42 and 0.36-0.42, respectively. CONCLUSIONS GAD is associated with altered sympathovagal balance, characterized by attenuation in both resting vagal modulation and vagal reactivity, with an almost medium effect size (Cohen's d ≈ 0.4), regardless of medication use or comorbidity status.
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Affiliation(s)
- Hsin-An Chang
- Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Wen-Hui Fang
- Department of Family and Community Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Fang-Jung Wan
- Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Nian-Sheng Tzeng
- Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Yia-Ping Liu
- Department of Psychiatry, Cheng Hsin General Hospital, Taipei, Taiwan
- Departments of Physiology and Psychiatry, Laboratory of Cognitive Neuroscience, National Defense Medical Center, Taipei, Taiwan
| | - Jia-Fwu Shyu
- Department of Biology and Anatomy, National Defense Medical Center, Taipei, Taiwan
| | - Tieh-Ching Chang
- Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - San-Yuan Huang
- Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Chuan-Chia Chang
- Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
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8
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Valenza G, Passamonti L, Duggento A, Toschi N, Barbieri R. Uncovering complex central autonomic networks at rest: a functional magnetic resonance imaging study on complex cardiovascular oscillations. J R Soc Interface 2020; 17:20190878. [PMID: 32183642 DOI: 10.1098/rsif.2019.0878] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
This study aims to uncover brain areas that are functionally linked to complex cardiovascular oscillations in resting-state conditions. Multi-session functional magnetic resonance imaging (fMRI) and cardiovascular data were gathered from 34 healthy volunteers recruited within the human connectome project (the '100-unrelated subjects' release). Group-wise multi-level fMRI analyses in conjunction with complex instantaneous heartbeat correlates (entropy and Lyapunov exponent) revealed the existence of a specialized brain network, i.e. a complex central autonomic network (CCAN), reflecting what we refer to as complex autonomic control of the heart. Our results reveal CCAN areas comprised the paracingulate and cingulate gyri, temporal gyrus, frontal orbital cortex, planum temporale, temporal fusiform, superior and middle frontal gyri, lateral occipital cortex, angular gyrus, precuneous cortex, frontal pole, intracalcarine and supracalcarine cortices, parahippocampal gyrus and left hippocampus. The CCAN visible at rest does not include the insular cortex, thalamus, putamen, amygdala and right caudate, which are classical CAN regions peculiar to sympatho-vagal control. Our results also suggest that the CCAN is mainly involved in complex vagal control mechanisms, with possible links with emotional processing networks.
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Affiliation(s)
- Gaetano Valenza
- Bioengineering and Robotics Research Centre 'E. Piaggio', University of Pisa, Pisa, Italy.,Deparment of Information Engineering, University of Pisa, Pisa, Italy
| | - Luca Passamonti
- Institute of Bioimaging and Molecular Physiology, National Research Council, Milano, Italy.,Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | - Andrea Duggento
- Department of Biomedicine and Prevention, University of Rome 'Tor Vergata', Rome, Italy
| | - Nicola Toschi
- Department of Biomedicine and Prevention, University of Rome 'Tor Vergata', Rome, Italy
| | - Riccardo Barbieri
- Department of Electronics, Informatics and Bioengineering, Politecnico di Milano, Milano, Italy
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9
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Malik M, Hnatkova K, Huikuri HV, Lombardi F, Schmidt G, Zabel M. CrossTalk proposal: Heart rate variability is a valid measure of cardiac autonomic responsiveness. J Physiol 2019; 597:2595-2598. [PMID: 31006862 DOI: 10.1113/jp277500] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Affiliation(s)
- Marek Malik
- National Heart and Lung Institute, Imperial College, London, UK
| | | | - Heikki V Huikuri
- Research Unit of Internal Medicine, University of Oulu and University Hospital, Oulu, Finland
| | | | - Georg Schmidt
- Klinik für Innere Medizin I, Technische Universität München, Munich, Germany
| | - Markus Zabel
- Department of Cardiology and Pneumology, Heart Center - University of Göttingen Medical Center, Göttingen, Germany
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10
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Nano MM, Fonseca P, Vullings R, Aarts RM. Measures of cardiovascular autonomic activity in insomnia disorder: A systematic review. PLoS One 2017; 12:e0186716. [PMID: 29059210 PMCID: PMC5653329 DOI: 10.1371/journal.pone.0186716] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Accepted: 10/08/2017] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Insomnia disorder is a widespread sleep disorder with a prevalence of approximately 10%. Even though the link between insomnia and cardiovascular activity is not exactly clear, it is generally assumed that cardiovascular autonomic modifications could occur as a result of sleeplessness, or, alternatively, that autonomic alterations could be an expression of a hyper-arousal state. This review investigates whether cardiovascular measures are different between insomniacs and controls. METHODS Electronic databases were systematically searched, and 34 studies were identified. Heart rate variability features, the association of cardiac and EEG activity, physiologic complexity measures, and cardiovascular activity, assessed by measures such as pre-ejection time, blood pressure, and heart rate dynamics were studied. Given the heterogeneity of the studies, a narrative synthesis of the findings was performed. RESULTS This review study found overall differences in cardiovascular activity between insomniacs and controls in most of the observational studies (21/26), while the expression of cardiovascular regulation varied between the examined insomniac groups. All the studies that investigated the association of cardiac activity and EEG power reported an altered relation between autonomic activity and EEG parameters in insomniacs. CONCLUSION Autonomic regulation tends to be consistent between insomniacs, as long as they are grouped according to their respective phenotype, as shown in the insomnia subgroup with objectively short sleep duration. Our hypothesis is that these differences in the expression of cardiovascular activity could be explained by the heterogeneity of the disorder. Therefore, the determination of insomnia phenotypes, and the study of cardiovascular measures, rather than heart rate variability alone, will give more insight into the link between insomnia and cardiovascular regulation. This study suggests that cardiovascular activity differs between insomniacs and controls. These new findings are of interest to clinicians and researchers for a more accurate insomnia assessment, and the development of personalized technological solutions in insomnia.
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Affiliation(s)
- Marina-Marinela Nano
- Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
- Sleep Medicine Centre Kempenhaeghe, Heeze, The Netherlands
- Philips Research, High Tech Campus, Eindhoven, The Netherlands
| | - Pedro Fonseca
- Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
- Philips Research, High Tech Campus, Eindhoven, The Netherlands
| | - Rik Vullings
- Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Ronald M. Aarts
- Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
- Philips Research, High Tech Campus, Eindhoven, The Netherlands
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11
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Heart rate variability in insomnia patients: A critical review of the literature. Sleep Med Rev 2017; 33:88-100. [DOI: 10.1016/j.smrv.2016.06.004] [Citation(s) in RCA: 63] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2016] [Revised: 06/02/2016] [Accepted: 06/12/2016] [Indexed: 01/05/2023]
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12
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Gentili C, Valenza G, Nardelli M, Lanatà A, Bertschy G, Weiner L, Mauri M, Scilingo EP, Pietrini P. Longitudinal monitoring of heartbeat dynamics predicts mood changes in bipolar patients: A pilot study. J Affect Disord 2017; 209:30-38. [PMID: 27870943 DOI: 10.1016/j.jad.2016.11.008] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2016] [Revised: 10/23/2016] [Accepted: 11/07/2016] [Indexed: 12/12/2022]
Abstract
OBJECTIVES Recent research indicates that Heart Rate Variability (HRV) is affected in Bipolar Disorders (BD) patients. To determine whether such alterations are a mere expression of the current mood state or rather contain longitudinal information on BD course, we examined the potential influence of states adjacent in time upon HRV features measured in a target mood state. METHODS Longitudinal evaluation of HRV was obtained in eight BD patients by using a wearable monitoring system developed within the PSYCHE project. We extracted time-domain, frequency-domain and non-linear HRV-features and trained a Support Vector Machine (SVM) to classify HRV-features according to mood state. To evaluate the influence of adjacent mood states, we trained SVM with different HRV-feature sets: 1) belonging to each mood state considered alone; 2) belonging to each mood state and normalized using information from the preceding mood state; 3) belonging to each mood state and normalized using information from the preceding and subsequent mood states; 4) belonging to each mood state and normalized using information from two randomly chosen states. RESULTS SVM classification accuracy within a target state was significantly greater when HRV-features from the previous and subsequent mood states were considered. CONCLUSIONS Although preliminary and in need of replications our results suggest for the first time that psychophysiological states in BD contain information related to the subsequent ones. Such characteristic may be used to improve clinical management and to develop algorithms to predict clinical course and mood switches in individual patients.
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Affiliation(s)
- Claudio Gentili
- Department of General Psychology, University of Padua, Via Venezia 8, 35139 Padua, Italy.
| | - Gaetano Valenza
- Department of Information Engineering & Research Centre "E. Piaggio", School of Engineering, University of Pisa, Italy
| | - Mimma Nardelli
- Department of Information Engineering & Research Centre "E. Piaggio", School of Engineering, University of Pisa, Italy
| | - Antonio Lanatà
- Department of Information Engineering & Research Centre "E. Piaggio", School of Engineering, University of Pisa, Italy
| | - Gilles Bertschy
- INSERM U1114, Fédération de Médecine Translationnelle de Strasbourg, Université de Strasbourg, Pôle de Psychiatrie et Santé Mentale des Hôpitaux Universitaires de Strasbourg, France
| | - Luisa Weiner
- INSERM U1114, Fédération de Médecine Translationnelle de Strasbourg, Université de Strasbourg, Pôle de Psychiatrie et Santé Mentale des Hôpitaux Universitaires de Strasbourg, France
| | - Mauro Mauri
- Section of Psychiatry, Department of Clinical and Experimental Medicine, University of Pisa, Italy
| | - Enzo Pasquale Scilingo
- Department of Information Engineering & Research Centre "E. Piaggio", School of Engineering, University of Pisa, Italy
| | - Pietro Pietrini
- IMT School for Advanced Studies, Piazza San Ponziano, 6 - 55100 Lucca, Italy.
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13
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Valenza G, Greco A, Gentili C, Lanata A, Sebastiani L, Menicucci D, Gemignani A, Scilingo EP. Combining electroencephalographic activity and instantaneous heart rate for assessing brain-heart dynamics during visual emotional elicitation in healthy subjects. PHILOSOPHICAL TRANSACTIONS. SERIES A, MATHEMATICAL, PHYSICAL, AND ENGINEERING SCIENCES 2016; 374:rsta.2015.0176. [PMID: 27044990 PMCID: PMC4822439 DOI: 10.1098/rsta.2015.0176] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/04/2016] [Indexed: 05/03/2023]
Abstract
Emotion perception, occurring in brain areas such as the prefrontal cortex and amygdala, involves autonomic responses affecting cardiovascular dynamics. However, how such brain-heart dynamics is further modulated by emotional valence (pleasantness/unpleasantness), also considering different arousing levels (the intensity of the emotional stimuli), is still unknown. To this extent, we combined electroencephalographic (EEG) dynamics and instantaneous heart rate estimates to study emotional processing in healthy subjects. Twenty-two healthy volunteers were elicited through affective pictures gathered from the International Affective Picture System. The experimental protocol foresaw 110 pictures, each of which lasted 10 s, associated to 25 different combinations of arousal and valence levels, including neutral elicitations. EEG data were processed using short-time Fourier transforms to obtain time-varying maps of cortical activation, whereas the associated instantaneous cardiovascular dynamics was estimated in the time and frequency domains through inhomogeneous point-process models. Brain-heart linear and nonlinear coupling was estimated through the maximal information coefficient (MIC). Considering EEG oscillations in theθband (4-8 Hz), MIC highlighted significant arousal-dependent changes between positive and negative stimuli, especially occurring at intermediate arousing levels through the prefrontal cortex interplay. Moreover, high arousing elicitations seem to mitigate changes in brain-heart dynamics in response to pleasant/unpleasant visual elicitation.
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Affiliation(s)
- G Valenza
- University of Pisa, Pisa, Italy Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA
| | - A Greco
- University of Pisa, Pisa, Italy
| | - C Gentili
- University of Pisa, Pisa, Italy University of Padua, Padua, Italy
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