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Zaccaro A, della Penna F, Mussini E, Parrotta E, Perrucci MG, Costantini M, Ferri F. Attention to cardiac sensations enhances the heartbeat-evoked potential during exhalation. iScience 2024; 27:109586. [PMID: 38623333 PMCID: PMC11016802 DOI: 10.1016/j.isci.2024.109586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 03/07/2024] [Accepted: 03/25/2024] [Indexed: 04/17/2024] Open
Abstract
Respiration and cardiac activity intricately interact through complex physiological mechanisms. The heartbeat-evoked potential (HEP) is an EEG fluctuation reflecting the cortical processing of cardiac signals. We recently found higher HEP amplitude during exhalation than inhalation during a task involving attention to cardiac sensations. This may have been due to reduced cardiac perception during inhalation and heightened perception during exhalation through attentional mechanisms. To investigate relationships between HEP, attention, and respiration, we introduced an experimental setup that included tasks related to cardiac and respiratory interoceptive and exteroceptive attention. Results revealed HEP amplitude increases during the interoceptive tasks over fronto-central electrodes. When respiratory phases were taken into account, HEP increases were primarily driven by heartbeats recorded during exhalation, specifically during the cardiac interoceptive task, while inhalation had minimal impact. These findings emphasize the role of respiration in cardiac interoceptive attention and could have implications for respiratory interventions to fine-tune cardiac interoception.
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Affiliation(s)
- Andrea Zaccaro
- Department of Psychological, Health and Territorial Sciences, “G. d’Annunzio” University of Chieti-Pescara, Chieti, Italy
| | - Francesca della Penna
- Department of Neuroscience, Imaging and Clinical Sciences, “G. d’Annunzio” University of Chieti-Pescara, Chieti, Italy
| | - Elena Mussini
- Department of Neuroscience, Imaging and Clinical Sciences, “G. d’Annunzio” University of Chieti-Pescara, Chieti, Italy
| | - Eleonora Parrotta
- Department of Neuroscience, Imaging and Clinical Sciences, “G. d’Annunzio” University of Chieti-Pescara, Chieti, Italy
| | - Mauro Gianni Perrucci
- Department of Neuroscience, Imaging and Clinical Sciences, “G. d’Annunzio” University of Chieti-Pescara, Chieti, Italy
- Institute for Advanced Biomedical Technologies, ITAB, “G. d’Annunzio” University of Chieti-Pescara, Chieti, Italy
| | - Marcello Costantini
- Department of Psychological, Health and Territorial Sciences, “G. d’Annunzio” University of Chieti-Pescara, Chieti, Italy
- Institute for Advanced Biomedical Technologies, ITAB, “G. d’Annunzio” University of Chieti-Pescara, Chieti, Italy
| | - Francesca Ferri
- Department of Neuroscience, Imaging and Clinical Sciences, “G. d’Annunzio” University of Chieti-Pescara, Chieti, Italy
- Institute for Advanced Biomedical Technologies, ITAB, “G. d’Annunzio” University of Chieti-Pescara, Chieti, Italy
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Hermann B, Candia‐Rivera D, Sharshar T, Gavaret M, Diehl J, Cariou A, Benghanem S. Aberrant brain-heart coupling is associated with the severity of post cardiac arrest brain injury. Ann Clin Transl Neurol 2024; 11:866-882. [PMID: 38243640 PMCID: PMC11021613 DOI: 10.1002/acn3.52000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 12/24/2023] [Indexed: 01/21/2024] Open
Abstract
OBJECTIVE To investigate autonomic nervous system activity measured by brain-heart interactions in comatose patients after cardiac arrest in relation to the severity and prognosis of hypoxic-ischemic brain injury. METHODS Strength and complexity of bidirectional interactions between EEG frequency bands (delta, theta, and alpha) and ECG heart rate variability frequency bands (low frequency, LF and high frequency, HF) were computed using a synthetic data generation model. Primary outcome was the severity of brain injury, assessed by (i) standardized qualitative EEG classification, (ii) somatosensory evoked potentials (N20), and (iii) neuron-specific enolase levels. Secondary outcome was the 3-month neurological status, assessed by the Cerebral Performance Category score [good (1-2) vs. poor outcome (3-4-5)]. RESULTS Between January 2007 and July 2021, 181 patients were admitted to ICU for a resuscitated cardiac arrest. Poor neurological outcome was observed in 134 patients (74%). Qualitative EEG patterns suggesting high severity were associated with decreased LF/HF. Severity of EEG changes were proportional to higher absolute values of brain-to-heart coupling strength (p < 0.02 for all brain-to-heart frequencies) and lower values of alpha-to-HF complexity (p = 0.049). Brain-to-heart coupling strength was significantly higher in patients with bilateral absent N20 and correlated with neuron-specific enolase levels at Day 3. This aberrant brain-to-heart coupling (increased strength and decreased complexity) was also associated with 3-month poor neurological outcome. INTERPRETATION Our results suggest that autonomic dysfunctions may well represent hypoxic-ischemic brain injury post cardiac arrest pathophysiology. These results open avenues for integrative monitoring of autonomic functioning in critical care patients.
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Affiliation(s)
- Bertrand Hermann
- Faculté de MédecineUniversité Paris CitéParisFrance
- Medical Intensive Care UnitHEGP Hospital, Assistance Publique ‐ Hôpitaux de Paris‐Centre (APHP.Centre)ParisFrance
- INSERM UMR 1266, Institut de Psychiatrie et Neurosciences de Paris (IPNP)Université Paris CitéParisFrance
| | - Diego Candia‐Rivera
- Sorbonne Université, Paris Brain Institute (ICM), INRIA, CNRS UMR 722, INSERM U1127, AP‐HP Hôpital Pitié‐SalpêtrièreParisFrance
| | - Tarek Sharshar
- Faculté de MédecineUniversité Paris CitéParisFrance
- INSERM UMR 1266, Institut de Psychiatrie et Neurosciences de Paris (IPNP)Université Paris CitéParisFrance
- GHU Paris Psychiatrie Neurosciences, Service hospitalo‐universitaire de Neuro‐anesthésie réanimationParisFrance
| | - Martine Gavaret
- Faculté de MédecineUniversité Paris CitéParisFrance
- INSERM UMR 1266, Institut de Psychiatrie et Neurosciences de Paris (IPNP)Université Paris CitéParisFrance
- Neurophysiology and Epileptology DepartmentGHU Paris Psychiatrie et NeurosciencesParisFrance
| | - Jean‐Luc Diehl
- Faculté de MédecineUniversité Paris CitéParisFrance
- Medical Intensive Care UnitHEGP Hospital, Assistance Publique ‐ Hôpitaux de Paris‐Centre (APHP.Centre)ParisFrance
- Université Paris Cité, INSERM, Innovative Therapies in HaemostasisParisFrance
- Biosurgical Research Lab (Carpentier Foundation)ParisFrance
| | - Alain Cariou
- Faculté de MédecineUniversité Paris CitéParisFrance
- Medical Intensive Care UnitCochin Hospital, Assistance Publique ‐ Hôpitaux de Paris‐Centre (APHP‐Centre)ParisFrance
- Paris‐Cardiovascular‐Research‐CenterINSERM U970ParisFrance
| | - Sarah Benghanem
- Faculté de MédecineUniversité Paris CitéParisFrance
- INSERM UMR 1266, Institut de Psychiatrie et Neurosciences de Paris (IPNP)Université Paris CitéParisFrance
- Medical Intensive Care UnitCochin Hospital, Assistance Publique ‐ Hôpitaux de Paris‐Centre (APHP‐Centre)ParisFrance
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Candia-Rivera D, Machado C. Reduced Heartbeat-Evoked Responses in a Near-Death Case Report. J Clin Neurol 2023; 19:581-588. [PMID: 37455508 PMCID: PMC10622722 DOI: 10.3988/jcn.2022.0415] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 12/30/2022] [Accepted: 01/25/2023] [Indexed: 07/18/2023] Open
Abstract
BACKGROUND AND PURPOSE Whether brain-heart communication continues under ventricular fibrillation (VF) remains to be determined. There is weak evidence of physiological changes in cortical activity under VF. Moreover, brain-heart communication has not previously been studied in this condition. We aimed to measure parallel changes in heart-rate variability (HRV), cortical activity, and brain-heart interactions in a patient who experienced VF. METHODS The EEG and EKG signals for the case report were acquired for approximately 20 h. We selected different 1-min-long segments based on the changes in the EKG waveform. We present the changes in heartbeat-evoked responses (HERs), HRV, and EEG power for each selected segment. RESULTS The overall physiological activity appeared to deteriorate as VF proceeded. Brain-heart interactions measured using HERs disappeared, with a few aberrant amplitudes appearing occasionally. The parallel changes in EEG and HRV were not pronounced, suggesting the absence of bidirectional neural control. CONCLUSIONS Our measurements of brain-heart interactions suggested that the evolving VF impairs communication between the central and autonomic nervous systems. These results may support that reduced brain-heart interactions reflect loss of consciousness and deterioration in the overall health state.
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Affiliation(s)
| | - Calixto Machado
- Department of Clinical Neurophysiology, Institute of Neurology and Neurosurgery, Havana, Cuba
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Kamp SM, Buntić N, Amtmann J, Scharpf A, Schönen A, Wagner L, Schulz A. Reduced concentration performance and heartbeat-evoked potential in individuals with a history of a SARS-CoV-2 infection. Neurosci Lett 2023; 814:137466. [PMID: 37652352 DOI: 10.1016/j.neulet.2023.137466] [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: 02/14/2023] [Revised: 07/20/2023] [Accepted: 08/28/2023] [Indexed: 09/02/2023]
Abstract
The goal of characterizing long-term psychological and neural consequences of a SARS-CoV-2 infection has recently gained importance. Here, we examined the effect of a prior SARS-CoV-2 infection on neural markers of exteroceptive (P300) and interoceptive (heartbeat-evoked potential; HEP) signal processing, as well as on neuropsychological tests of attention, inhibition and episodic memory, in 23 adults with a self-reported history of SARS-CoV-2 infection versus 23 healthy controls. We found that the group with a prior infection showed decreased HEP (but not P300) amplitudes, as well as reduced attention/concentration performance. These results suggest that SARS-CoV-2 may damage neural structures of cardiac interoception, thereby potentially contributing to cognitive and psychological long-term deficits. Modulations of interoceptive processing after a SARS-CoV-2 infection are thus a promising target for future research.
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Liu H, Liang H, Yu X, Wang G, Han Y, Yan M, Li S, Wang W. Enhanced external counterpulsation modulates the heartbeat evoked potential. Front Physiol 2023; 14:1144073. [PMID: 37078023 PMCID: PMC10106756 DOI: 10.3389/fphys.2023.1144073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 03/23/2023] [Indexed: 04/05/2023] Open
Abstract
Introduction: Accumulating evidence suggests that enhanced external counterpulsation (EECP) influences cardiac functions, hemodynamic characteristics and cerebral blood flow. However, little is known about whether or how the EECP affects the brain-heart coupling to produce these physiological and functional changes. We aimed to determine if the brain-heart coupling is altered during or after EECP intervention by assessing the heartbeat evoked potential (HEP) in healthy adults.Methods: Based on a random sham-controlled design, simultaneous electroencephalography and electrocardiography signals as well as blood pressure and flow status data were recorded before, during and after two consecutive 30-min EECP in 40 healthy adults (female/male: 17/23; age: 23.1 ± 2.3 years). HEP amplitude, frequency domain heart rate variability, electroencephalographic power and hemodynamic measurements of 21 subjects (female/male: 10/11; age: 22.7 ± 2.1 years) receiving active EECP were calculated and compared with those of 19 sham control subjects (female/male: 7/12; age: 23.6 ± 2.5 years).Results: EECP intervention caused immediate obvious fluctuations of HEP from 100 to 400 ms after T-peak and increased HEP amplitudes in the (155–169) ms, (354–389) ms and (367–387) ms time windows after T-peak in the region of the frontal pole lobe. The modifications in HEP amplitude were not associated with changes in the analyzed significant physiological measurements and hemodynamic variables.Discussion: Our study provides evidence that the HEP is modulated by immediate EECP stimuli. We speculate that the increased HEP induced by EECP may be a marker of enhanced brain-heart coupling. HEP may serve as a candidate biomarker for the effects and responsiveness to EECP.
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Affiliation(s)
- Hongyun Liu
- Research Center for Biomedical Engineering, Medical Innovation Research Division, Chinese PLA General Hospital, Beijing, China
- Key Laboratory of Biomedical Engineering and Translational Medicine, Ministry of Industry and Information Technology, Beijing, China
- *Correspondence: Hongyun Liu, ; Muyang Yan, ; Shijun Li, ; Weidong Wang,
| | - Hui Liang
- Department of Hyperbaric Oxygen, The First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Xiaohua Yu
- Research Center for Biomedical Engineering, Medical Innovation Research Division, Chinese PLA General Hospital, Beijing, China
- Key Laboratory of Biomedical Engineering and Translational Medicine, Ministry of Industry and Information Technology, Beijing, China
| | - Guojing Wang
- Research Center for Biomedical Engineering, Medical Innovation Research Division, Chinese PLA General Hospital, Beijing, China
- Key Laboratory of Biomedical Engineering and Translational Medicine, Ministry of Industry and Information Technology, Beijing, China
| | - Yi Han
- Research Center for Biomedical Engineering, Medical Innovation Research Division, Chinese PLA General Hospital, Beijing, China
- Key Laboratory of Biomedical Engineering and Translational Medicine, Ministry of Industry and Information Technology, Beijing, China
| | - Muyang Yan
- Department of Hyperbaric Oxygen, The First Medical Center, Chinese PLA General Hospital, Beijing, China
- *Correspondence: Hongyun Liu, ; Muyang Yan, ; Shijun Li, ; Weidong Wang,
| | - Shijun Li
- Department of Diagnostic Radiology, The First Medical Center, Chinese PLA General Hospital, Beijing, China
- *Correspondence: Hongyun Liu, ; Muyang Yan, ; Shijun Li, ; Weidong Wang,
| | - Weidong Wang
- Research Center for Biomedical Engineering, Medical Innovation Research Division, Chinese PLA General Hospital, Beijing, China
- Key Laboratory of Biomedical Engineering and Translational Medicine, Ministry of Industry and Information Technology, Beijing, China
- *Correspondence: Hongyun Liu, ; Muyang Yan, ; Shijun Li, ; Weidong Wang,
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Kumral D, Al E, Cesnaite E, Kornej J, Sander C, Hensch T, Zeynalova S, Tautenhahn S, Hagendorf A, Laufs U, Wachter R, Nikulin V, Villringer A. Attenuation of the Heartbeat-Evoked Potential in Patients With Atrial Fibrillation. JACC Clin Electrophysiol 2022; 8:1219-1230. [DOI: 10.1016/j.jacep.2022.06.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 06/28/2022] [Accepted: 06/28/2022] [Indexed: 11/26/2022]
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Brewer R, Murphy J, Bird G. Atypical interoception as a common risk factor for psychopathology: A review. Neurosci Biobehav Rev 2021; 130:470-508. [PMID: 34358578 PMCID: PMC8522807 DOI: 10.1016/j.neubiorev.2021.07.036] [Citation(s) in RCA: 52] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 07/09/2021] [Accepted: 07/31/2021] [Indexed: 02/06/2023]
Abstract
The inadequacy of a categorial approach to mental health diagnosis is now well-recognised, with many authors, diagnostic manuals and funding bodies advocating a dimensional, trans-diagnostic approach to mental health research. Variance in interoception, the ability to perceive one's internal bodily state, is reported across diagnostic boundaries, and is associated with atypical functioning across symptom categories. Drawing on behavioural and neuroscientific evidence, we outline current research on the contribution of interoception to numerous cognitive and affective abilities (in both typical and clinical populations), and describe the interoceptive atypicalities seen in a range of psychiatric conditions. We discuss the role that interoception may play in the development and maintenance of psychopathology, as well as the ways in which interoception may differ across clinical presentations. A number of important areas for further research on the role of interoception in psychopathology are highlighted.
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Affiliation(s)
- Rebecca Brewer
- Department of Psychology, Royal Holloway, University of London, United Kingdom
| | - Jennifer Murphy
- Department of Psychology, Royal Holloway, University of London, United Kingdom.
| | - Geoffrey Bird
- Department of Experimental Psychology, University of Oxford, United Kingdom; Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom
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Coll MP, Hobson H, Bird G, Murphy J. Systematic review and meta-analysis of the relationship between the heartbeat-evoked potential and interoception. Neurosci Biobehav Rev 2021; 122:190-200. [PMID: 33450331 DOI: 10.1016/j.neubiorev.2020.12.012] [Citation(s) in RCA: 86] [Impact Index Per Article: 28.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 12/11/2020] [Accepted: 12/13/2020] [Indexed: 02/07/2023]
Abstract
The Heartbeat Evoked Potential (HEP) has been proposed as a neurophysiological marker of interoceptive processing. Despite its use to validate interoceptive measures and to assess interoceptive functioning in clinical groups, the empirical evidence for a relationship between HEP amplitude and interoceptive processing, including measures of such processing, is scattered across several studies with varied designs. The aim of this systematic review and meta-analysis was to examine the body of HEP-interoception research, and consider the associations the HEP shows with various direct and indirect measures of interoception, and how it is affected by manipulations of interoceptive processing. Specifically, we assessed the effect on HEP amplitude of manipulating attention to the heartbeat; manipulating participants' arousal; the association between the HEP and behavioural measures of cardiac interoception; and comparisons between healthy and clinical groups. Following database searches and screening, 45 studies were included in the systematic review and 42 in the meta-analyses. We noted variations in the ways individual studies have attempted to address key confounds, particularly the cardiac field artefact. Meta-analytic summaries indicated there were moderate to large effects of attention, arousal, and clinical status on the HEP, and a moderate association between HEP amplitude and behavioural measures of interoception. Problematically, the reliability of the meta-analytic effects documented here remain unknown, given the lack of standardised protocols for measuring the HEP. Thus, it is possible effects are driven by confounds such as cardiac factors or somatosensory effects.
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Affiliation(s)
- Michel-Pierre Coll
- Department of Psychology, McGill University, 2001 McGill College, Montreal, H3A1G1, Canada.
| | - Hannah Hobson
- Department of Psychology, University of York, York, YO10 5DD, UK.
| | - Geoffrey Bird
- Department of Experimental Psychology, University of Oxford, Anna Watts Building, Radcliffe Observatory Quarter, Woodstock Road, Oxford, OX2, UK.
| | - Jennifer Murphy
- Department of Psychology, Royal Holloway, University of London, Egham, Surrey, TW20 0EX, UK.
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Schulz A, Schultchen D, Vögele C. Interoception, Stress, and Physical Symptoms in Stress-Associated Diseases. EUROPEAN JOURNAL OF HEALTH PSYCHOLOGY 2020. [DOI: 10.1027/2512-8442/a000063] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Abstract. The brain and peripheral bodily organs continuously exchange information. Exemplary, interoception refers to the processing and perception of ascending information from the body to the brain. Stress responses involve a neurobehavioral cascade, which includes the activation of peripheral organs via neural and endocrine pathways and can thus be seen as an example for descending information on the brain-body axis. Hence, the interaction of interoception and stress represents bi-directional communication on the brain-body axis. The main hypothesis underlying this review is that the dysregulation of brain-body communication represents an important mechanism for the generation of physical symptoms in stress-related disorders. The aims of this review are, therefore, (1) to summarize current knowledge on acute stress effects on different stages of interoceptive signal processing, (2) to discuss possible patterns of abnormal brain-body communication (i.e., alterations in interoception and physiological stress axes activation) in mental disorders and chronic physical conditions, and (3) to consider possible approaches to modify interoception. Due to the regulatory feedback loops underlying brain-body communication, the modification of interoceptive processes (ascending signals) may, in turn, affect physiological stress axes activity (descending signals), and, ultimately, also physical symptoms.
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Affiliation(s)
- André Schulz
- Research Group Self-Regulation and Health, Institute for Health and Behaviour, Department of Behavioural and Cognitive Sciences Faculty of Humanities, Education and Social Sciences, University of Luxembourg, Esch-sur-Alzette, Luxembourg
| | - Dana Schultchen
- Department of Clinical and Health Psychology, Ulm University, Germany
| | - Claus Vögele
- Research Group Self-Regulation and Health, Institute for Health and Behaviour, Department of Behavioural and Cognitive Sciences Faculty of Humanities, Education and Social Sciences, University of Luxembourg, Esch-sur-Alzette, Luxembourg
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Schulz A, Vögele C, Bertsch K, Bernard S, Münch EE, Hansen G, Naumann E, Schächinger H. Cardiac cycle phases affect auditory-evoked potentials, startle eye blink and pre-motor reaction times in response to acoustic startle stimuli. Int J Psychophysiol 2020; 157:70-81. [PMID: 32976890 DOI: 10.1016/j.ijpsycho.2020.08.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 07/20/2020] [Accepted: 08/14/2020] [Indexed: 11/16/2022]
Abstract
Startle stimuli evoke lower responses when presented during the early as compared to the late cardiac cycle phase, an effect that has been called 'cardiac modulation of startle' (CMS). The CMS effect may be associated with visceral-afferent neural traffic, as it is reduced in individuals with degeneration of afferent autonomic nerves. The aim of this study was to investigate whether the CMS effect is due a modulation of only early, automatic stages of stimulus processing by baro-afferent neural traffic, or if late stages are also affected. We, therefore, investigated early and late components of auditory-evoked potentials (AEPs) to acoustic startle stimuli (105, 100, 95 dB), which were presented during the early (R-wave +230 ms) or the late cardiac cycle phase (R +530 ms) in two studies. In Study 1, participants were requested to ignore (n = 25) or to respond to the stimuli with button-presses (n = 24). In Study 2 (n = 23), participants were asked to rate the intensity of the stimuli. We found lower EMG startle response magnitudes (both studies) and slower pre-motor reaction times in the early as compared to the late cardiac cycle phase (Study 1). We also observed lower N1 negativity (both studies), but higher P2 (Study 1) and P3 positivity (both studies) in response to stimuli presented in the early cardiac cycle phase. This AEP modulation pattern appears to be specific to the CMS effect, suggesting that early stages of startle stimulus processing are attenuated, whereas late stages are enhanced by baro-afferent neural traffic.
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Affiliation(s)
- André Schulz
- Clinical Psychophysiology Laboratory, Institute for Health and Behaviour, Department of Behavioural and Cognitive Sciences, Faculty of Humanities, Education and Social Sciences, University of Luxembourg, Esch-sur-Alzette, Luxembourg; Division of Clinical Psychophysiology, Institute of Psychobiology, University of Trier, Trier, Germany.
| | - Claus Vögele
- Clinical Psychophysiology Laboratory, Institute for Health and Behaviour, Department of Behavioural and Cognitive Sciences, Faculty of Humanities, Education and Social Sciences, University of Luxembourg, Esch-sur-Alzette, Luxembourg
| | - Katja Bertsch
- Division of Clinical Psychology and Psychotherapy, Ludwig-Maximilians-University Munich, Munich, Germany; Psychophysiological Laboratory, Department of Psychology, University of Trier, Trier, Germany
| | - Sam Bernard
- Clinical Psychophysiology Laboratory, Institute for Health and Behaviour, Department of Behavioural and Cognitive Sciences, Faculty of Humanities, Education and Social Sciences, University of Luxembourg, Esch-sur-Alzette, Luxembourg
| | - Eva E Münch
- Clinical Psychophysiology Laboratory, Institute for Health and Behaviour, Department of Behavioural and Cognitive Sciences, Faculty of Humanities, Education and Social Sciences, University of Luxembourg, Esch-sur-Alzette, Luxembourg
| | - Greta Hansen
- Clinical Psychophysiology Laboratory, Institute for Health and Behaviour, Department of Behavioural and Cognitive Sciences, Faculty of Humanities, Education and Social Sciences, University of Luxembourg, Esch-sur-Alzette, Luxembourg
| | - Ewald Naumann
- Psychophysiological Laboratory, Department of Psychology, University of Trier, Trier, Germany
| | - Hartmut Schächinger
- Division of Clinical Psychophysiology, Institute of Psychobiology, University of Trier, Trier, Germany
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Schulz A, Rost S, Flasinski T, Dierolf AM, Lutz APC, Münch EE, Mertens VC, Witthöft M, Vögele C. Distinctive body perception mechanisms in high versus low symptom reporters: A neurophysiological model for medically-unexplained symptoms. J Psychosom Res 2020; 137:110223. [PMID: 32866840 DOI: 10.1016/j.jpsychores.2020.110223] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 08/17/2020] [Accepted: 08/19/2020] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The neurophysiological processes involved in the generation of medically-unexplained symptoms (MUS) remain unclear. This study tested three assumptions of the perception-filter model contributing to MUS: (I.) increased bodily signal strength (II.) decreased filter function, (III.) increased perception. METHODS In this cross-sectional, observational study, trait MUS were assessed by a web-based survey (N = 486). The upper and lower decile were identified as extreme groups of high (HSR; n = 29; 26 women; Mage = 26.0 years) and low symptom reporters (LSR; n = 29; 21 women; Mage = 28.4 years). Mean heart rate (HR) and heart rate variability (HRV), and cortisol awakening response (CAR) were assessed as indicators of bodily signal strength (I.). Heartbeat-evoked potentials (HEPs) were assessed during rest and a heartbeat perception task. HEPs reflect attentional resources allocated towards heartbeats and served as index of filter function (II.). Interoceptive accuracy (IAc) in heartbeat perception was assessed as an indicator of perception (III.). RESULTS HSR showed higher HR and lower HRV (RMSSD) than LSR (I.), but no differences in CAR. HSR exhibited a stronger increase of HEPs when attention was focused on heartbeats than LSR (II.); there were no group differences in IAc (III.). CONCLUSIONS The perception-filter model was partially confirmed in that HSR showed altered bodily signals suggesting higher sympathetic activity (I.); higher HEP increases indicated increased filter function for bodily signals (II.). As more attentional resources are mobilized to process heartbeats, but perception accuracy remains unchanged (III.), this overflow could be responsible for detecting minor bodily changes associated with MUS.
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Affiliation(s)
- André Schulz
- Institute for Health and Behaviour, Department of Behavioural and Cognitive Sciences, University of Luxembourg, Esch-sur-Alzette, Luxembourg.
| | - Silke Rost
- Institute for Health and Behaviour, Department of Behavioural and Cognitive Sciences, University of Luxembourg, Esch-sur-Alzette, Luxembourg
| | - Tabea Flasinski
- Institute for Health and Behaviour, Department of Behavioural and Cognitive Sciences, University of Luxembourg, Esch-sur-Alzette, Luxembourg; Mental Health Research and Treatment Center, Faculty of Psychology, Ruhr University Bochum, Bochum, Germany
| | - Angelika M Dierolf
- Institute for Health and Behaviour, Department of Behavioural and Cognitive Sciences, University of Luxembourg, Esch-sur-Alzette, Luxembourg
| | - Annika P C Lutz
- Institute for Health and Behaviour, Department of Behavioural and Cognitive Sciences, University of Luxembourg, Esch-sur-Alzette, Luxembourg
| | - Eva E Münch
- Institute for Health and Behaviour, Department of Behavioural and Cognitive Sciences, University of Luxembourg, Esch-sur-Alzette, Luxembourg
| | - Vera-Christina Mertens
- Institute for Health and Behaviour, Department of Behavioural and Cognitive Sciences, University of Luxembourg, Esch-sur-Alzette, Luxembourg; HAN University of Applied Sciences, Nijmegen, The Netherlands
| | - Michael Witthöft
- Division of Clinical Psychology, Department of Psychology, Johannes Gutenberg University of Mainz, Mainz, Germany
| | - Claus Vögele
- Institute for Health and Behaviour, Department of Behavioural and Cognitive Sciences, University of Luxembourg, Esch-sur-Alzette, Luxembourg
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Salamone PC, Sedeño L, Legaz A, Bekinschtein T, Martorell M, Adolfi F, Fraile-Vazquez M, Rodríguez Arriagada N, Favaloro L, Peradejordi M, Absi DO, García AM, Favaloro R, Ibáñez A. Dynamic neurocognitive changes in interoception after heart transplant. Brain Commun 2020; 2:fcaa095. [PMID: 32954340 PMCID: PMC7472900 DOI: 10.1093/braincomms/fcaa095] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 06/12/2020] [Accepted: 06/18/2020] [Indexed: 12/20/2022] Open
Abstract
Heart–brain integration dynamics are critical for interoception (i.e. the sensing of body signals). In this unprecedented longitudinal study, we assessed neurocognitive markers of interoception in patients who underwent orthotopic heart transplants and matched healthy controls. Patients were assessed longitudinally before surgery (T1), a few months later (T2) and a year after (T3). We assessed behavioural (heartbeat detection) and electrophysiological (heartbeat evoked potential) markers of interoception. Heartbeat detection task revealed that pre-surgery (T1) interoception was similar between patients and controls. However, patients were outperformed by controls after heart transplant (T2), but no such differences were observed in the follow-up analysis (T3). Neurophysiologically, although heartbeat evoked potential analyses revealed no differences between groups before the surgery (T1), reduced amplitudes of this event-related potential were found for the patients in the two post-transplant stages (T2, T3). All these significant effects persisted after covariation with different cardiological measures. In sum, this study brings new insights into the adaptive properties of brain–heart pathways.
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Affiliation(s)
- Paula Celeste Salamone
- National Scientific and Technical Research Council (CONICET), Buenos Aires C1126AAB, Argentina
| | - Lucas Sedeño
- National Scientific and Technical Research Council (CONICET), Buenos Aires C1126AAB, Argentina
| | - Agustina Legaz
- National Scientific and Technical Research Council (CONICET), Buenos Aires C1126AAB, Argentina.,Cognitive Neuroscience Center (CNC), Universidad de San Andres, Buenos Aires B1644BID, Argentina
| | - Tristán Bekinschtein
- Consciousness and Cognition Lab, Department of Psychology, University of Cambridge, Cambridge CB2 3EB, UK
| | - Miguel Martorell
- National Scientific and Technical Research Council (CONICET), Buenos Aires C1126AAB, Argentina
| | - Federico Adolfi
- Cognitive Neuroscience Center (CNC), Universidad de San Andres, Buenos Aires B1644BID, Argentina.,Max-Planck Institute, Frankfurt 60438, Germany
| | - Matías Fraile-Vazquez
- Cognitive Neuroscience Center (CNC), Universidad de San Andres, Buenos Aires B1644BID, Argentina
| | | | - Liliana Favaloro
- University Hospital Fundación Favaloro, Buenos Aires C1093AAS, Argentina
| | | | - Daniel O Absi
- University Hospital Fundación Favaloro, Buenos Aires C1093AAS, Argentina
| | - Adolfo M García
- National Scientific and Technical Research Council (CONICET), Buenos Aires C1126AAB, Argentina.,Cognitive Neuroscience Center (CNC), Universidad de San Andres, Buenos Aires B1644BID, Argentina.,Faculty of Education, National University of Cuyo (UNCuyo), Centro Universitario, Mendoza M5502JMA, Argentina.,Departamento de Lingüística y Literatura, Facultad de Humanidades, Universidad de Santiago de Chile, Santiago, Chile.,Global Brain Health Institute (GBHI), University of California San Francisco (UCSF), San Francisco, 1701 CA 94115, USA
| | - Roberto Favaloro
- University Hospital Fundación Favaloro, Buenos Aires C1093AAS, Argentina
| | - Agustín Ibáñez
- National Scientific and Technical Research Council (CONICET), Buenos Aires C1126AAB, Argentina.,Cognitive Neuroscience Center (CNC), Universidad de San Andres, Buenos Aires B1644BID, Argentina.,Global Brain Health Institute (GBHI), University of California San Francisco (UCSF), San Francisco, 1701 CA 94115, USA.,Department of Psychology, Universidad Autónoma del Caribe, Barranquilla, Colombia.,Center for Social and Cognitive Neuroscience (CSCN), Universidad Adolfo Ibáñez, Santiago, Chile
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Towards a Pragmatic Approach to a Psychophysiological Unit of Analysis for Mental and Brain Disorders: An EEG-Copeia for Neurofeedback. Appl Psychophysiol Biofeedback 2020; 44:151-172. [PMID: 31098793 DOI: 10.1007/s10484-019-09440-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
This article proposes what we call an "EEG-Copeia" for neurofeedback, like the "Pharmacopeia" for psychopharmacology. This paper proposes to define an "EEG-Copeia" as an organized list of scientifically validated EEG markers, characterized by a specific association with an identified cognitive process, that define a psychophysiological unit of analysis useful for mental or brain disorder evaluation and treatment. A characteristic of EEG neurofeedback for mental and brain disorders is that it targets a EEG markers related to a supposed cognitive process, whereas conventional treatments target clinical manifestations. This could explain why EEG neurofeedback studies encounter difficulty in achieving reproducibility and validation. The present paper suggests that a first step to optimize EEG neurofeedback protocols and future research is to target a valid EEG marker. The specificity of the cognitive skills trained and learned during real time feedback of the EEG marker could be enhanced and both the reliability of neurofeedback training and the therapeutic impact optimized. However, several of the most well-known EEG markers have seldom been applied for neurofeedback. Moreover, we lack a reliable and valid EEG targets library for further RCT to evaluate the efficacy of neurofeedback in mental and brain disorders. With the present manuscript, our aim is to foster dialogues between cognitive neuroscience and EEG neurofeedback according to a psychophysiological perspective. The primary objective of this review was to identify the most robust EEG target. EEG markers linked with one or several clearly identified cognitive-related processes will be identified. The secondary objective was to organize these EEG markers and related cognitive process in a psychophysiological unit of analysis matrix inspired by the Research Domain Criteria (RDoC) project.
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RNAs in Brain and Heart Diseases. Int J Mol Sci 2020; 21:ijms21103717. [PMID: 32466222 PMCID: PMC7279324 DOI: 10.3390/ijms21103717] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 05/18/2020] [Accepted: 05/19/2020] [Indexed: 12/13/2022] Open
Abstract
In the era of single-cell analysis, one always has to keep in mind the systemic nature of various diseases and how these diseases could be optimally studied. Comorbidities of the heart in neurological diseases as well as of the brain in cardiovascular diseases are prevalent, but how interactions in the brain–heart axis affect disease development and progression has been poorly addressed. Several brain and heart diseases share common risk factors. A better understanding of the brain–heart interactions will provide better insights for future treatment and personalization of healthcare, for heart failure patients’ benefit notably. We review here emerging evidence that studying noncoding RNAs in the brain–heart axis could be pivotal in understanding these interactions. We also introduce the Special Issue of the International Journal of Molecular Sciences RNAs in Brain and Heart Diseases—EU-CardioRNA COST Action.
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