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Mörkl S, Oberascher A, Tatschl JM, Lackner S, Bastiaanssen TFS, Butler MI, Moser M, Frühwirth M, Mangge H, Cryan JF, Dinan TG, Holasek SJ. Cardiac vagal activity is associated with gut-microbiome patterns in women-An exploratory pilot study. DIALOGUES IN CLINICAL NEUROSCIENCE 2022; 24:1-9. [PMID: 36246995 PMCID: PMC9559470 DOI: 10.1080/19585969.2022.2128697] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Introduction A functional reciprocity between the gut microbiome and vagal nerve activity has been suggested, however, human studies addressing this phenomenon are limited. Methods Twenty-four-hour cardiac vagal activity (CVA) was assessed from 73 female participants (aged 24.5 ± 4.3 years). Additionally, stool samples were subjected to 16SrRNA gene analysis (V1–V2). Quantitative Insights Into Microbial Ecology (QIIME) was used to analyse microbiome data. Additionally, inflammatory parameters (such as CRP and IL-6) were derived from serum samples. Results Daytime CVA correlated significantly with gut microbiota diversity (rsp = 0.254, p = 0.030), CRP (rsp = −0.348, p = 0.003), and IL-6 (rsp = −0.320, p = 0.006). When the group was divided at the median of 24 h CVA (Mdn = 1.322), the following features were more abundant in the high CVA group: Clostridia (Linear discriminant analysis effect size (LDA) = 4.195, p = 0.029), Clostridiales (LDA = 4.195, p = 0.029), Lachnospira (LDA = 3.489, p = 0.004), Ruminococcaceae (LDA = 4.073, p = 0.010), Faecalibacterium (LDA = 3.982, p = 0.042), Lactobacillales (LDA = 3.317, p = 0.029), Bacilli (LDA = 3.294, p = 0.0350), Streptococcaceae (LDA = 3.353, p = 0.006), Streptococcus (LDA = 3.332, p = 0.011). Based on Dirichlet multinomial mixtures two enterotypes could be detected, which differed significantly in CVA, age, BMI, CRP, IL-6, and diversity. Conclusions As an indicator of gut-brain communication, gut microbiome analysis could be extended by measurements of CVA to enhance our understanding of signalling via microbiota-gut-brain-axis and its alterations through psychobiotics.
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Affiliation(s)
- Sabrina Mörkl
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Graz, Austria,CONTACT Sabrina Mörkl Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Auenbruggerplatz 31/1, Graz, 8036, Austria
| | - Andreas Oberascher
- Department of Psychiatry, Psychotherapy and Psychosomatics, Paracelsus Medical University of Salzburg, Salzburg, Austria,Division of Physiology, Otto Loewi Research Center (for Vascular Biology, Immunology and Inflammation), Medical University of Graz, Graz, Austria
| | | | - Sonja Lackner
- Division of Immunology and Pathophysiology, Otto Loewi Research Center (for Vascular Biology, Immunology and Inflammation), Medical University of Graz, Graz, Austria
| | | | - Mary I. Butler
- APC Microbiome Ireland, University College Cork, Cork, Ireland,Department of Psychiatry and Clinical Neuroscience, University College Cork, Cork, Ireland
| | - Maximilian Moser
- Division of Physiology, Otto Loewi Research Center (for Vascular Biology, Immunology and Inflammation), Medical University of Graz, Graz, Austria,Human Research Institute of Health Technology and Prevention Research, Weiz, Austria
| | - Matthias Frühwirth
- Human Research Institute of Health Technology and Prevention Research, Weiz, Austria
| | - Harald Mangge
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
| | - John F. Cryan
- APC Microbiome Ireland, University College Cork, Cork, Ireland
| | - Timothy G. Dinan
- APC Microbiome Ireland, University College Cork, Cork, Ireland,Department of Psychiatry and Clinical Neuroscience, University College Cork, Cork, Ireland
| | - Sandra J. Holasek
- Division of Immunology and Pathophysiology, Otto Loewi Research Center (for Vascular Biology, Immunology and Inflammation), Medical University of Graz, Graz, Austria
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Rosenblum M, Frühwirth M, Moser M, Pikovsky A. Dynamical disentanglement in an analysis of oscillatory systems: an application to respiratory sinus arrhythmia. PHILOSOPHICAL TRANSACTIONS. SERIES A, MATHEMATICAL, PHYSICAL, AND ENGINEERING SCIENCES 2019; 377:20190045. [PMID: 31656138 PMCID: PMC6834001 DOI: 10.1098/rsta.2019.0045] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/28/2019] [Indexed: 05/17/2023]
Abstract
We develop a technique for the multivariate data analysis of perturbed self-sustained oscillators. The approach is based on the reconstruction of the phase dynamics model from observations and on a subsequent exploration of this model. For the system, driven by several inputs, we suggest a dynamical disentanglement procedure, allowing us to reconstruct the variability of the system's output that is due to a particular observed input, or, alternatively, to reconstruct the variability which is caused by all the inputs except for the observed one. We focus on the application of the method to the vagal component of the heart rate variability caused by a respiratory influence. We develop an algorithm that extracts purely respiratory-related variability, using a respiratory trace and times of R-peaks in the electrocardiogram. The algorithm can be applied to other systems where the observed bivariate data can be represented as a point process and a slow continuous signal, e.g. for the analysis of neuronal spiking. This article is part of the theme issue 'Coupling functions: dynamical interaction mechanisms in the physical, biological and social sciences'.
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Affiliation(s)
- M. Rosenblum
- Institute of Physics and Astronomy, University of Potsdam, Karl-Liebknecht-Str. 24/25, 14476 Potsdam-Golm, Germany
- Control Theory Department, Institute of Information Technologies, Mathematics and Mechanics, Lobachevsky University Nizhny Novgorod, Nizhny Novgorod, Russia
| | - M. Frühwirth
- Human Research Institute of Health Technology and Prevention Research, Franz Pichler Street 30, 8160 Weiz, Austria
| | - M. Moser
- Human Research Institute of Health Technology and Prevention Research, Franz Pichler Street 30, 8160 Weiz, Austria
- Physiology Division, Otto Loewi Research Center for Vascular Biology, Immunology and Inflammation, Medical University of Graz, Neue Stiftingtalstr. 6/D05, 8010 Graz, Austria
| | - A. Pikovsky
- Institute of Physics and Astronomy, University of Potsdam, Karl-Liebknecht-Str. 24/25, 14476 Potsdam-Golm, Germany
- Control Theory Department, Institute of Information Technologies, Mathematics and Mechanics, Lobachevsky University Nizhny Novgorod, Nizhny Novgorod, Russia
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Grote V, Levnajić Z, Puff H, Ohland T, Goswami N, Frühwirth M, Moser M. Dynamics of Vagal Activity Due to Surgery and Subsequent Rehabilitation. Front Neurosci 2019; 13:1116. [PMID: 31827417 PMCID: PMC6849369 DOI: 10.3389/fnins.2019.01116] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Accepted: 10/02/2019] [Indexed: 12/16/2022] Open
Abstract
Background Vagal activity is critical for maintaining key body functions, including the stability of inflammatory control. Its weakening, such as in the aftermatch of a surgery, leaves the body vulnerable to diverse inflammatory conditions, including sepsis. Methods Vagal activity can be measured by the cardiorespiratory interaction known as respiratory sinus arrhythmia or high-frequency heart-rate variability (HRV). We examined the vagal dynamics before, during and after an orthopedic surgery. 39 patients had their HRV measured around the period of operation and during subsequent rehabilitation. Measurements were done during 24 h circadian cycles on ten specific days. For each patient, the circadian vagal activity was calculated from HRV data. Results Our results confirm the deteriorating effect of surgery on vagal activity. Patients with stronger pre-operative vagal activity suffer greater vagal withdrawal during the peri-operative phase, but benefit from stronger improvements during post-operative period, especially during the night. Rehabilitation seems not only to efficiently restore the vagal activity to pre-operative level, but in some cases to actually improve it. Discussion Our findings indicate that orthopedic rehabilitation has the potential to strengthen the vagal activity and hence boost inflammatory control. We conclude that providing a patient with a vagal reinforcement procedure prior to the surgery (“pre-habilitation”) might be a beneficial strategy against post-operative complications. The study also shows the clinical usefulness of quantifying the cardiorespiratory interactions.
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Affiliation(s)
- Vincent Grote
- Human Research Institute, Weiz, Austria.,Orthopedic Rehabilitation Center, Humanomed Center Althofen, Althofen, Austria.,Division of Physiology, Otto Loewi Research Center for Vascular Biology, Immunology and Inflammation, Medical University of Graz, Graz, Austria
| | - Zoran Levnajić
- Complex Systems and Data Science Lab, Faculty of Information Studies in Novo Mesto, Novo Mesto, Slovenia
| | - Henry Puff
- Orthopedic Rehabilitation Center, Humanomed Center Althofen, Althofen, Austria
| | - Tanja Ohland
- Orthopedic Rehabilitation Center, Humanomed Center Althofen, Althofen, Austria
| | - Nandu Goswami
- Division of Physiology, Otto Loewi Research Center for Vascular Biology, Immunology and Inflammation, Medical University of Graz, Graz, Austria
| | | | - Maximilian Moser
- Human Research Institute, Weiz, Austria.,Division of Physiology, Otto Loewi Research Center for Vascular Biology, Immunology and Inflammation, Medical University of Graz, Graz, Austria
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Martinez-Nicolas A, Madrid JA, García FJ, Campos M, Moreno-Casbas MT, Almaida-Pagán PF, Lucas-Sánchez A, Rol MA. Circadian monitoring as an aging predictor. Sci Rep 2018; 8:15027. [PMID: 30301951 PMCID: PMC6177481 DOI: 10.1038/s41598-018-33195-3] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Accepted: 09/25/2018] [Indexed: 12/14/2022] Open
Abstract
The ageing process is associated with sleep and circadian rhythm (SCR) frailty, as well as greater sensitivity to chronodisruption. This is essentially due to reduced day/night contrast, decreased sensitivity to light, napping and a more sedentary lifestyle. Thus, the aim of this study is to develop an algorithm to identify a SCR phenotype as belonging to young or aged subjects. To do this, 44 young and 44 aged subjects were recruited, and their distal skin temperature (DST), activity, body position, light, environmental temperature and the integrated variable TAP rhythms were recorded under free-living conditions for five consecutive workdays. Each variable yielded an individual decision tree to differentiate between young and elderly subjects (DST, activity, position, light, environmental temperature and TAP), with agreement rates of between 76.1% (light) and 92% (TAP). These decision trees were combined into a unique decision tree that reached an agreement rate of 95.3% (4 errors out of 88, all of them around the cut-off point). Age-related SCR changes were very significant, thus allowing to discriminate accurately between young and aged people when implemented in decision trees. This is useful to identify chronodisrupted populations that could benefit from chronoenhancement strategies.
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Affiliation(s)
- A Martinez-Nicolas
- Chronobiology Lab, Department of Physiology, College of Biology, University of Murcia, Mare Nostrum Campus, IUIE, IMIB-Arrixaca, Murcia, Spain
- Ciber Fragilidad y Envejecimiento Saludable (CIBERFES), Madrid, Spain
| | - J A Madrid
- Chronobiology Lab, Department of Physiology, College of Biology, University of Murcia, Mare Nostrum Campus, IUIE, IMIB-Arrixaca, Murcia, Spain
- Ciber Fragilidad y Envejecimiento Saludable (CIBERFES), Madrid, Spain
| | - F J García
- Ciber Fragilidad y Envejecimiento Saludable (CIBERFES), Madrid, Spain
- Geriatrics Section, Hospital Virgen del Valle, Toledo, Spain
| | - M Campos
- Department of Computer Science and Systems, University of Murcia, IMIB-Arrixaca, Murcia, Spain
| | - M T Moreno-Casbas
- Ciber Fragilidad y Envejecimiento Saludable (CIBERFES), Madrid, Spain
- Nursing and Healthcare Research Unit (Investén-isciii), Madrid, Spain
| | - P F Almaida-Pagán
- Chronobiology Lab, Department of Physiology, College of Biology, University of Murcia, Mare Nostrum Campus, IUIE, IMIB-Arrixaca, Murcia, Spain
- Ciber Fragilidad y Envejecimiento Saludable (CIBERFES), Madrid, Spain
| | - A Lucas-Sánchez
- Chronobiology Lab, Department of Physiology, College of Biology, University of Murcia, Mare Nostrum Campus, IUIE, IMIB-Arrixaca, Murcia, Spain
- Ciber Fragilidad y Envejecimiento Saludable (CIBERFES), Madrid, Spain
| | - M A Rol
- Chronobiology Lab, Department of Physiology, College of Biology, University of Murcia, Mare Nostrum Campus, IUIE, IMIB-Arrixaca, Murcia, Spain.
- Ciber Fragilidad y Envejecimiento Saludable (CIBERFES), Madrid, Spain.
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Topçu Ç, Frühwirth M, Moser M, Rosenblum M, Pikovsky A. Disentangling respiratory sinus arrhythmia in heart rate variability records. Physiol Meas 2018; 39:054002. [DOI: 10.1088/1361-6579/aabea4] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Moser M, Frühwirth M, Messerschmidt D, Goswami N, Dorfer L, Bahr F, Opitz G. Investigation of a Micro-test for Circulatory Autonomic Nervous System Responses. Front Physiol 2017; 8:448. [PMID: 28785223 PMCID: PMC5519958 DOI: 10.3389/fphys.2017.00448] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Accepted: 06/13/2017] [Indexed: 12/22/2022] Open
Abstract
Aims and Objectives: The autonomic nervous system plays an important role in homeostasis and organismic recreation, control of immune function, inflammation, and bone growth. It also regulates blood pressure and orthostasis via vagal and sympathetic pathways. Besides recording of heart rate variability (HRV), which characterizes medium (1–5 min) and long term (circadian) autonomic tone or modulation, no gentle tests of short-term autonomic reactivity and control are available. In 1976 Nogier described a short time cardiovascular response (“Réflexe Auriculo Cardiaque”, RAC) which could be used to investigate short term autonomic reactions without changing system characteristics and thus being repeatable in short intervals. In this paper, we investigated the possible application of the Nogier reaction as a micro-test for the identification of a disturbed sensitivity or reactivity of the autonomic nervous system. Methods: We statistically analyzed cardiovascular signals derived during the application of small repeated stimuli utilizing methods of signal averaging to characterize the physiological background. Specifically, the Nogier reaction was investigated using simultaneous recordings of ECG, pulse waves, and respiration. Results: Significant fast (delay 1–5 s) and slower (delay 6–12 s) cardio-autonomic responses to different stimuli which characterize short term were observed. From time characteristics and type of signals where they occur we deduce that fast changes observed in heart rate are vagal reactions to the small stimuli whereas slower changes observed in pulse waves stem from sympathetic nervous system responses. Conclusions: The investigated autonomic micro-test opens the possibility to differentially investigate both limbs of the autonomic nervous system with minimal stimuli. It can be performed within seconds and does not change the set point of the system in opposition to less subtle tests such as Valsalva maneuver. Therefore, it is well-suited for quick, repeated measurements of autonomic nervous system reactivity.
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Affiliation(s)
- Maximilian Moser
- Human Research Institute of Health Technology and Prevention ResearchWeiz, Austria.,Institute of Physiology, Medical University GrazGraz, Austria
| | - Matthias Frühwirth
- Human Research Institute of Health Technology and Prevention ResearchWeiz, Austria
| | | | - Nandu Goswami
- Institute of Physiology, Medical University GrazGraz, Austria
| | - Leopold Dorfer
- Austrian Society for Controlled AcupunctureGraz, Austria
| | - Frank Bahr
- German Academy for AcupunctureMunich, Germany
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Alvares GA, Quintana DS, Hickie IB, Guastella AJ. Autonomic nervous system dysfunction in psychiatric disorders and the impact of psychotropic medications: a systematic review and meta-analysis. J Psychiatry Neurosci 2016; 41:89-104. [PMID: 26447819 PMCID: PMC4764485 DOI: 10.1503/jpn.140217] [Citation(s) in RCA: 264] [Impact Index Per Article: 33.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Autonomic nervous system (ANS) dysfunction is a putative underlying mechanism for increased cardiovascular disease risk in individuals with psychiatric disorders. Previous studies suggest that this risk may be related to psychotropic medication use. In the present study we systematically reviewed and analyzed published studies of heart rate variability (HRV), measuring ANS output, to determine the effect of psychiatric illness and medication use. METHODS We searched for studies comparing HRV in physically healthy adults with a diagnosed psychiatric disorder to controls and comparing HRV pre- and post-treatment with a psychotropic medication. RESULTS In total, 140 case-control (mood, anxiety, psychosis, dependent disorders, k = 151) and 30 treatment (antidepressants, antipsychotics; k = 43) studies were included. We found that HRV was reduced in all patient groups compared to controls (Hedges g = -0.583) with a large effect for psychotic disorders (Hedges g = -0.948). Effect sizes remained highly significant for medication-free patients compared to controls across all disorders. Smaller and significant reductions in HRV were observed for specific antidepressants and antipsychotics. LIMITATIONS Study quality significantly moderated effect sizes in case-control analyses, underscoring the importance of assessing methodological quality when interpreting HRV findings. CONCLUSION Combined findings confirm substantial reductions in HRV across psychiatric disorders, and these effects remained significant even in medication-free individuals. Reductions in HRV may therefore represent a significant mechanism contributing to elevated cardiovascular risk in individuals with psychiatric disorders. The negative impact of specific medications on HRV suggest increased risk for cardiovascular disease in these groups, highlighting a need for treatment providers to consider modifiable cardiovascular risk factors to attenuate this risk.
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Affiliation(s)
| | | | | | - Adam J. Guastella
- Correspondence to: A.J. Guastella, Brain & Mind Centre, University of Sydney, 94 Mallett St, Camperdown NSW Australia;
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LeMoult J, Yoon KL, Joormann J. Rumination and Cognitive Distraction in Major Depressive Disorder: An Examination of Respiratory Sinus Arrhythmia. JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2015; 38:20-29. [PMID: 27199505 DOI: 10.1007/s10862-015-9510-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Difficulty regulating emotions following stressful events is a hallmark of Major Depressive Disorder (MDD). Although individuals' ability to regulate their emotions is believed to have direct consequences for both emotional and physical wellbeing, few studies have examined the cardiovascular effects of different emotion regulation strategies in MDD. To the best of our knowledge, the current study is the first to examine the effects of two emotion regulation strategies, cognitive distraction and rumination, on both self-reported sadness and respiratory sinus arrhythmia (RSA) in individuals with MDD and healthy controls (CTLs). Following a forced-failure stressor, participants were randomly assigned to a rumination or cognitive distraction condition. As expected, rumination increased sadness and triggered RSA withdrawal for both MDDs and CTLs. Interestingly, although cognitive distraction reduced sadness, it also triggered RSA withdrawal. Moreover, cognitive distraction was associated with greater RSA withdrawal for MDDs than CTLs. Thus, although depressed individuals are able to use cognitive distraction to emotionally recover from stress, it may be associated with greater cognitive effort. Adding low-cost physiological measures such as RSA into assessments has the potential to offer new and important information about the effects of emotion regulation on mental and physiological health.
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Grote V, Kelz C, Goswami N, Stossier H, Tafeit E, Moser M. Cardio-autonomic control and wellbeing due to oscillating color light exposure. Physiol Behav 2013; 114-115:55-64. [DOI: 10.1016/j.physbeh.2013.03.007] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2012] [Revised: 11/28/2012] [Accepted: 03/06/2013] [Indexed: 11/28/2022]
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Stapelberg NJ, Hamilton-Craig I, Neumann DL, Shum DHK, McConnell H. Mind and heart: heart rate variability in major depressive disorder and coronary heart disease - a review and recommendations. Aust N Z J Psychiatry 2012; 46:946-57. [PMID: 22528974 DOI: 10.1177/0004867412444624] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVE There is a reciprocal association between major depressive disorder (MDD) and coronary heart disease (CHD). These conditions are linked by a causal network of mechanisms. This causal network should be quantitatively studied and it is hypothesised that the investigation of vagal function represents a promising starting point. Heart rate variability (HRV) has been used to investigate cardiac vagal control in the context of MDD and CHD. This review aims to examine the relationship of HRV to both MDD and CHD in the context of vagal function and to make recommendations for clinical practice and research. METHODS The search terms 'heart rate variability', 'depression' and 'heart disease' were entered into an electronic multiple database search engine. Abstracts were screened for their relevance and articles were individually selected and collated. RESULTS Decreased HRV is found in both MDD and CHD. Both diseases are theorized to disrupt autonomic control feedback loops on the heart and are linked to vagal function. Existing theories link vagal function to both mood and emotion as well as cardiac function. However, several factors can potentially confound HRV measures and would thus impact on a complete understanding of vagal mechanisms in the link between MDD and CHD. CONCLUSIONS The quantitative investigation of vagal function using HRV represents a reasonable starting point in the study of the relationship between MDD and CHD. Many psychotropic and cardiac medications have effects on HRV, which may have clinical importance. Future studies of HRV in MDD and CHD should consider antidepressant medication, as well as anxiety, as potential confounders.
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Affiliation(s)
- Nicolas J Stapelberg
- Behavioural Basis of Health, Griffith Health Institute and School of Applied Psychology, Griffith University, Southport, Australia.
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11
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Cardiac vagal control in nonmedicated depressed women and nondepressed controls: impact of depression status, lifetime trauma history, and respiratory factors. Psychosom Med 2011; 73:336-43. [PMID: 21364194 PMCID: PMC3090496 DOI: 10.1097/psy.0b013e318213925d] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To evaluate the impact of acute stress and relationship-focused imagery on cardiac vagal control, as indicated by levels of respiratory sinus arrhythmia (RSA), in depressed and nondepressed women. Impairment in cardiac parasympathetic (vagal) control may confer risk for cardiac mortality in depressed populations. METHODS Electrocardiogram and respiratory rate were evaluated in 15 nonmedicated depressed women and 15 matched controls during two laboratory conditions: 1) a relationship-focused imagery designed to elicit vagal activation; and 2) a speech stressor designed to evoke vagal withdrawal. RESULTS As expected, the relationship-focused imagery increased RSA (F(3,66) = 3.79, p = .02) and the speech stressor decreased RSA (F(3,66) = 4.36, p = .02) across women. Depressed women exhibited lower RSA during the relationship-focused imagery, and this effect remained after control for respiratory rate and trauma history (F(1,21) = 5.65, p = .027). Depressed women with a trauma history exhibited the lowest RSA during the stress condition (F(1,22) = 9.61, p = .05). However, after controlling for respiratory rate, Trauma History × Task Order (p = .02) but not Trauma History × Depression Group (p = .12) accounted for RSA variation during the stress condition. CONCLUSION Depression in women is associated with lower RSA, particularly when women reflect on a close love relationship, a context expected to elicit vagal activation and hence increase RSA. In contrast, depression-related variation in stressor-evoked vagal activity seems to covary with women's trauma history. Associations between vagal activity and depression are complex and should be considered in view of the experimental conditions under which vagal control is assessed, as well as physiological and behavioral factors that may affect vagal function.
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12
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Comparison of respiratory rates derived from heart rate variability, ECG amplitude, and nasal/oral airflow. Ann Biomed Eng 2008; 36:2085-94. [PMID: 18855140 DOI: 10.1007/s10439-008-9580-2] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2008] [Accepted: 10/01/2008] [Indexed: 10/21/2022]
Abstract
It would often be desirable to obtain the respiratory rate during everyday conditions without obtaining an additional respiratory trace. This study investigates the agreement between respiratory rate assessed from the electrocardiogram (ECG) and the reference respiratory rate derived from a nasal/oral airflow (AF). Nasal/oral airflow and a Holter ECG were recorded in 52 healthy subjects (26 males, age range: 25.4-85.4 years) during everyday conditions for at least 10 h, including night-time sleep. The respiratory rate was assessed for each 5-min epoch (1) using respiratory sinus arrhythmia (RSA), (2) utilizing the respiration induced variations of the R-wave amplitude (ECG derived respiration (EDR)). The agreement with respect to AF was quantified using the average/std and the concordance correlation coefficient rho(c). For RSA and EDR the difference with respect to AF was 0.2 cpm (std: 0.6 cpm) during sleep and -0.2 cpm (std: 1.0 cpm) during wake time. During sleep the RSA-approach performed best for subjects < or =50 years (rho(c) = 0.79) and worst for subjects >50 years (rho(c) = 0.41). The correlation of the EDR-approach was rho(c) = 0.73 for both groups. In conclusion, the respiratory rate may be assessed with reasonable agreement by both methods in younger subjects, but EDR should be preferred in the elderly.
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Abstract
Cardiac vagal control, as measured by indices of respiratory sinus arrhythmia (RSA), has been investigated as a marker of impaired self-regulation in mental disorders, including depression. Past work in depressed samples has focused on deficits in resting RSA levels, with mixed results. This study tested the hypothesis that depression involves abnormal RSA fluctuation. RSA was measured in depressed and healthy control participants during rest and during two reactivity tasks, each followed by a recovery period. Relative to controls, depressed persons exhibited lower resting RSA levels as well as less RSA fluctuation, primarily evidenced by a lack of task-related vagal suppression. Group differences in RSA fluctuation were not accounted for by differences in physical health or respiration, whereas group differences in resting RSA level did not survive covariate analyses. Depression may involve multiple deficits in cardiac vagal control.
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Affiliation(s)
- Jonathan Rottenberg
- Mood and Emotion Laboratory, Department of Psychology, University of South Florida, 4202 E. Fowler Avenue, Tampa, FL 33620, USA.
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14
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Abstract
Rapidly developing research has found abnormal cardiac vagal control (CVC) in several physical and mental health conditions. CVC findings in depression are mixed, and the degree to which CVC is compromised in depression is unclear. A meta-analysis of 13 rigorous cross-sectional studies reveals that a diagnosis of depression exerts a small-to-medium effect size on CVC, and explains only about 2% of the overall variance in CVC. More robust data may emerge from alternative approaches to the depression-CVC relationship, such as the use of CVC to predict the course of the disorder. Despite the vigor of recent work on CVC and depression, overall findings are suggestive rather than conclusive. Methodological desiderata and priorities for future research are discussed, including the need to clarify the etiological significance of CVC.
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Affiliation(s)
- Jonathan Rottenberg
- Department of Psychology, University of South Florida, Tampa, FL 33620-7200, USA.
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Nahshoni E, Aizenberg D, Strasberg B, Dorfman P, Sigler M, Imbar S, Weizman A. QT dispersion in the surface electrocardiogram in elderly patients with major depression. J Affect Disord 2000; 60:197-200. [PMID: 11074108 DOI: 10.1016/s0165-0327(99)00142-1] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND QT dispersion (QTd) is a measure of interlead variations of QT interval of the surface 12-lead electrocardiogram (ECG). Increased QTd, found in various cardiac diseases, reflects cardiac instability and is associated with increased cardiac death. Major depressive disorder (MDD) was found to be associated with high cardiovascular mortality rates. This study compares QTd in elderly patients with MDD to normal controls. METHODS QTd and rate-corrected QTd of 18 physically healthy elderly patients (69.9 +/- 7.6 years) with MDD was compared to nine physically and mentally healthy age- and gender-matched controls (64.1 +/- 12.2 years). RESULTS QTd and rate-corrected QTd were significantly higher in MDD compared to controls (68 +/- 30 vs. 40 +/- 13 ms, P=0.002 and 81 +/- 39 vs. 43 +/- 13 ms, P=0.001, respectively). Intra- and inter- observer reproducibilities were highly correlated (r=0.96, P <0.0001; r=0.88, P <0.001, respectively). LIMITATIONS AND CONCLUSIONS The major limitations of this study are the small number of subjects and the fact that all the patients were maintained on antidepressant medication. However, it seems that QTd analysis might shed light on possible autonomic imbalance and also provide a novel cardiovascular risk factor for increased cardiac death in MDD.
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Affiliation(s)
- E Nahshoni
- Psychogeriatric Department and Research Unit, Geha Psychiatric Hospital and Felsenstein Medical Research Center, Petah Tiqva, Israel.
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