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Chong LS, Yeo AJ, Lin B. Childhood Family Stress and Women's Health: Parasympathetic Activity as a Risk and Resiliency Factor. Appl Psychophysiol Biofeedback 2024:10.1007/s10484-024-09661-2. [PMID: 39179946 DOI: 10.1007/s10484-024-09661-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/14/2024] [Indexed: 08/26/2024]
Abstract
Childhood family stress (CFS) exacerbates risk for physical health problems across the lifespan. Health risks associated with CFS are particularly relevant for women who tend to endorse more CFS than men. Importantly, some evidence suggests that individuals may vary in their susceptibility to CFS. Parasympathetic activity, which helps to regulate automatic bodily activity (e.g., breathing, digestion), has been proposed to represent a marker of plasticity to environmental exposure. However, no research to date has tested whether parasympathetic activity may modulate the impact of early adversity on health. We examined whether parasympathetic activity would moderate the link between CFS and health complaints in a sample of 68 undergraduate women (Mean age = 19.44). Participants self-reported CFS and health complaints. Parasympathetic activity was indexed using high-frequency heart rate variability (HF-HRV) and was evaluated by measuring changes in HF-HRV in response to and following a laboratory-based stress induction. Multiple regression analyses indicated that CFS was significantly associated with more health complaints. Further, HF-HRV in response to stress and during recovery relative to baseline significantly moderated relationship between CFS and health complaints. Specifically, more CFS was significantly associated with more health complaints among women who showed mean or greater decreases in HF-HRV in response to stress. Additionally, lower levels of CFS were associated with fewer health complaints among women who showed mean or greater HF-HRV during recovery relative to baseline. Findings highlight the importance of parasympathetic activity in modulating stress-health links.
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Affiliation(s)
- Li Shen Chong
- Department of Psychology, San Jose State University, San Jose, CA, 95192, USA.
| | - Anna J Yeo
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI, 02903, USA
- The Mirriam Hospital, Providence, RI, 02906, USA
| | - Betty Lin
- Department of Psychology, University at Albany, State University of New York, Albany, NY, 12222, USA
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Rudd KL, Alkon A, Abrams B, Bush NR. Infant weight-for-length gain associated with autonomic nervous system reactivity. Pediatr Res 2021; 90:472-478. [PMID: 33203965 PMCID: PMC8126564 DOI: 10.1038/s41390-020-01246-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 10/07/2020] [Accepted: 10/13/2020] [Indexed: 11/20/2022]
Abstract
BACKGROUND Research suggests that children's health and well-being are supported by core adaptive systems, including the autonomic nervous system (ANS). Despite evidence for the importance of adulthood ANS regulation in the development of disease, few studies have examined how early development may influence emerging ANS function. Therefore, we examined how infant adiposity gain during early infancy related to ANS regulation at 6 months. METHODS Infant weight and length were abstracted from birth records and measured during the 6-month assessment in a low-income, racially/ethnically diverse sample (N = 60). WHO-standardized weight-for-length-gain change was calculated across the first 6 months of life. ANS reactivity was measured as the combined sympathetic (i.e., pre-ejection period) and parasympathetic (i.e., respiratory sinus arrhythmia) nervous system responses during the developmentally challenging Still Face Paradigm (SFP). ANS "classic reactivity" response was characterized by paired sympathetic activation and parasympathetic withdrawal. RESULTS Lower weight-for-length gain in the first 6 months predicted classic reactivity during still face. However, greater weight-for-length gain predicted "classic reactivity" during the reunion, when infants were expected to recover, suggesting autonomic dysregulation. CONCLUSIONS These findings suggest an association between early life adiposity gain and the development of infant ANS regulation. IMPACT Adiposity gain during early infancy was associated with autonomic nervous system regulation at 6 months. This study identifies early adiposity gain (greater than average infant weight-for-length gain) as a risk for ANS dysregulation. This research focuses on a critical developmental period of ANS plasticity. If confirmed, findings can be used to inform early intervention programs targeting obesity prevention and to promote self-regulation.
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Affiliation(s)
- Kristen L Rudd
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, USA.
| | - Abbey Alkon
- Department of Family Health Care Nursing, University of California, San Francisco, San Francisco, CA, USA
| | - Barbara Abrams
- Division of Epidemiology, University of California, Berkeley, School of Public Health, Berkeley, CA, USA
| | - Nicole R Bush
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, USA
- Department of Pediatrics, University of California, San Francisco, San Francisco, CA, USA
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Stephens M, Bush N, Weiss S, Alkon A. Distribution, Stability, and Continuity of Autonomic Nervous System Responsivity at 18- and 36-Months of Age. Biol Res Nurs 2020; 23:208-217. [PMID: 32715727 DOI: 10.1177/1099800420943957] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Cardiac autonomic nervous system (ANS) measures, respiratory sinus arrhythmia (RSA) and preejection period (PEP), are valid and reliable indicators of children's sensitivity to their environment; however, there are few studies of ANS measures in children less than three years of age. This study's aim was to summarize the distributions, stability, and continuity of RSA and PEP measures during resting, challenge, and reactivity for children at 18- and 36-months. METHODS This was a cohort study of racially- and ethnically-diverse, low-income children who completed a developmentally challenging protocol while we simultaneously assessed their RSA and PEP at 18-months (N = 134) and 36-months (N = 102). RESULTS The ANS resting, challenge, and reactivity measures at 18- and 36-months of age were normally distributed. The RSA resting (r = 0.29), RSA challenge (r = 0.44), PEP resting (r = 0.55) and PEP challenge (r = 0.58) measures were moderately stable but RSA (r = 0.01) and PEP reactivity (r = 0.02) were not stable from 18- to 36-months of age. There was no continuity in the ANS measures from 18- to 36-months of age with statistically significant changes in sample means for all of the ANS measures. DISCUSSION These developmental changes in ANS are shown at the sample level but there are individual differences in ANS responses from 18- to 36-months that may be affected by adversity or protective factors experienced early in life.
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Affiliation(s)
- Michelle Stephens
- Department of Family Health Care Nursing, School of Nursing, 8785University of California, San Francisco (UCSF), CA, USA
| | - Nicole Bush
- Departments of Psychiatry and Pediatrics, 8785University of California, San Francisco (UCSF), CA, USA
| | - Sandra Weiss
- Department of Physiological Nursing, School of Nursing, 8785University of California, San Francisco (UCSF), CA, USA
| | - Abbey Alkon
- Department of Family Health Care Nursing, School of Nursing, 8785University of California, San Francisco (UCSF), CA, USA
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Shah P, Khaleel M, Thuptimdang W, Sunwoo J, Veluswamy S, Chalacheva P, Kato RM, Detterich J, Wood JC, Zeltzer L, Sposto R, Khoo MCK, Coates TD. Mental stress causes vasoconstriction in subjects with sickle cell disease and in normal controls. Haematologica 2019; 105:83-90. [PMID: 30975906 PMCID: PMC6939522 DOI: 10.3324/haematol.2018.211391] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Accepted: 04/05/2019] [Indexed: 01/02/2023] Open
Abstract
Vaso-occlusive crisis (VOC) is a hallmark of sickle cell disease (SCD) and occurs when deoxygenated sickled red blood cells occlude the microvasculature. Any stimulus, such as mental stress, which decreases microvascular blood flow will increase the likelihood of red cell entrapment resulting in local vaso-occlusion and progression to VOC. Neurally mediated vasoconstriction might be the physiological link between crisis triggers and vaso-occlusion. In this study, we determined the effect of mental stress on microvascular blood flow and autonomic nervous system reactivity. Sickle cell patients and controls performed mentally stressful tasks, including a memory task, conflict test and pain anticipation test. Blood flow was measured using photoplethysmography, autonomic reactivity was derived from electrocardiography and perceived stress was measured by the State-Trait Anxiety Inventory questionnaire. Stress tasks induced a significant decrease in microvascular blood flow, parasympathetic withdrawal and sympathetic activation in all subjects. Of the various tests, pain anticipation caused the highest degree of vasoconstriction. The magnitude of vasoconstriction, sympathetic activation and perceived stress was greater during the Stroop conflict test than during the N-back memory test, indicating the relationship between magnitude of experimental stress and degree of regional vasoconstriction. Baseline anxiety had a significant effect on the vasoconstrictive response in sickle cell subjects but not in controls. In conclusion, mental stress caused vasoconstriction and autonomic nervous system reactivity in all subjects. Although the pattern of responses was not significantly different between the two groups, the consequences of vasoconstriction can be quite significant in SCD because of the resultant entrapment of sickle cells in the microvasculature. This suggests that mental stress can precipitate a VOC in SCD by causing neural-mediated vasoconstriction.
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Affiliation(s)
- Payal Shah
- Division of Hematology, Children's Center for Cancer and Blood Diseases, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles
| | - Maha Khaleel
- Division of Hematology, Children's Center for Cancer and Blood Diseases, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles
| | - Wanwara Thuptimdang
- Biomedical Engineering, Viterbi School of Engineering, University of Southern California, Los Angeles
| | - John Sunwoo
- Biomedical Engineering, Viterbi School of Engineering, University of Southern California, Los Angeles
| | - Saranya Veluswamy
- Division of Hematology, Children's Center for Cancer and Blood Diseases, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles
| | - Patjanaporn Chalacheva
- Biomedical Engineering, Viterbi School of Engineering, University of Southern California, Los Angeles
| | - Roberta M Kato
- Division of Pulmonology, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles
| | - Jon Detterich
- Division of Cardiology, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles
| | - John C Wood
- Biomedical Engineering, Viterbi School of Engineering, University of Southern California, Los Angeles.,Division of Cardiology, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles
| | - Lonnie Zeltzer
- Pediatric Pain Program, David Geffen School of Medicine at UCLA, University of California, Los Angeles, CA, USA
| | - Richard Sposto
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Michael C K Khoo
- Biomedical Engineering, Viterbi School of Engineering, University of Southern California, Los Angeles
| | - Thomas D Coates
- Division of Hematology, Children's Center for Cancer and Blood Diseases, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles
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Coates TD, Chalacheva P, Zeltzer L, Khoo MC. Autonomic nervous system involvement in sickle cell disease. Clin Hemorheol Microcirc 2018; 68:251-262. [DOI: 10.3233/ch-189011] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Affiliation(s)
- Thomas D. Coates
- Section of Hematology, Children’s Center for Cancer and Blood Diseases, Children’s Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Patjanaporn Chalacheva
- Department of Biomedical Engineering, Viterbi School of Engineering, University of Southern California, Los Angeles, CA, USA
| | - Lonnie Zeltzer
- Department of Pediatrics, Pediatric Pain and Palliative Care Program Division of Hematology-Oncology, Department of Pediatrics, David Geffen School of Medicine at the University of California Los Angeles, Los Angeles, CA, USA
| | - Michael C.K. Khoo
- Department of Biomedical Engineering, Viterbi School of Engineering, University of Southern California, Los Angeles, CA, USA
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Bush NR, Caron ZK, Blackburn KS, Alkon A. Measuring Cardiac Autonomic Nervous System (ANS) Activity in Toddlers - Resting and Developmental Challenges. J Vis Exp 2016:53652. [PMID: 26967045 DOI: 10.3791/53652] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
The autonomic nervous system (ANS) consists of two branches, the parasympathetic and sympathetic nervous systems, and controls the function of internal organs (e.g., heart rate, respiration, digestion) and responds to everyday and adverse experiences (1). ANS measures in children have been found to be related to behavior problems, emotion regulation, and health (2-7). Therefore, understanding the factors that affect ANS development during early childhood is important. Both branches of the ANS affect young children's cardiovascular responses to stimuli and have been measured noninvasively, via external monitoring equipment, using valid and reliable measures of physiological change (8-11). However, there are few studies of very young children with simultaneous measures of the parasympathetic and sympathetic nervous systems, which limits understanding of the integrated functioning of the two systems. In addition, the majority of existing studies of young children report on infants' resting ANS measures or their reactivity to commonly used mother-child interaction paradigms, and less is known about ANS reactivity to other challenging conditions. We present a study design and standardized protocol for a non-invasive and rapid assessment of cardiac autonomic control in 18 month old children. We describe methods for continuous monitoring of the parasympathetic and sympathetic branches of the ANS under resting and challenge conditions during a home or laboratory visit and provide descriptive findings from our sample of 140 ethnically diverse toddlers using validated equipment and scoring software. Results revealed that this protocol can produce a range of physiological responses to both resting and developmentally challenging conditions, as indicated by changes in heart rate and indices of parasympathetic and sympathetic activity. Individuals demonstrated variability in resting levels, responses to challenges, and challenge reactivity, which provides additional evidence that this protocol is useful for the examination of ANS individual differences for toddlers.
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Affiliation(s)
- Nicole R Bush
- Department of Psychiatry, University of California, San Francisco; Department of Pediatrics, University of California, San Francisco
| | - Zoe K Caron
- Department of Psychiatry, University of California, San Francisco
| | | | - Abbey Alkon
- School of Nursing, University of California, San Francisco;
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Abaied JL, Wagner C, Sanders W. Parent socialization of coping in emerging adulthood: Moderation by respiratory sinus arrhythmia. JOURNAL OF APPLIED DEVELOPMENTAL PSYCHOLOGY 2014. [DOI: 10.1016/j.appdev.2014.06.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Abstract
Autonomic cardiac neurons have a common origin in the neural crest but undergo distinct developmental differentiation as they mature toward their adult phenotype. Progenitor cells respond to repulsive cues during migration, followed by differentiation cues from paracrine sources that promote neurochemistry and differentiation. When autonomic axons start to innervate cardiac tissue, neurotrophic factors from vascular tissue are essential for maintenance of neurons before they reach their targets, upon which target-derived trophic factors take over final maturation, synaptic strength and postnatal survival. Although target-derived neurotrophins have a central role to play in development, alternative sources of neurotrophins may also modulate innervation. Both developing and adult sympathetic neurons express proNGF, and adult parasympathetic cardiac ganglion neurons also synthesize and release NGF. The physiological function of these “non-classical” cardiac sources of neurotrophins remains to be determined, especially in relation to autocrine/paracrine sustenance during development.
Cardiac autonomic nerves are closely spatially associated in cardiac plexuses, ganglia and pacemaker regions and so are sensitive to release of neurotransmitter, neuropeptides and trophic factors from adjacent nerves. As such, in many cardiac pathologies, it is an imbalance within the two arms of the autonomic system that is critical for disease progression. Although this crosstalk between sympathetic and parasympathetic nerves has been well established for adult nerves, it is unclear whether a degree of paracrine regulation occurs across the autonomic limbs during development. Aberrant nerve remodeling is a common occurrence in many adult cardiovascular pathologies, and the mechanisms regulating outgrowth or denervation are disparate. However, autonomic neurons display considerable plasticity in this regard with neurotrophins and inflammatory cytokines having a central regulatory function, including in possible neurotransmitter changes. Certainly, neurotrophins and cytokines regulate transcriptional factors in adult autonomic neurons that have vital differentiation roles in development. Particularly for parasympathetic cardiac ganglion neurons, additional examinations of developmental regulatory mechanisms will potentially aid in understanding attenuated parasympathetic function in a number of conditions, including heart failure.
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Affiliation(s)
- Wohaib Hasan
- Knight Cardiovascular Institute; Oregon Health & Science University; Portland, OR USA
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L'Esperance VS, Cox SE, Simpson D, Gill C, Makani J, Soka D, Mgaya J, Kirkham FJ, Clough GF. Peripheral vascular response to inspiratory breath hold in paediatric homozygous sickle cell disease. Exp Physiol 2012; 98:49-56. [PMID: 22660812 PMCID: PMC4463767 DOI: 10.1113/expphysiol.2011.064055] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
New Findings • What is the central question of this study? Autonomic nervous dysfunction is implicated in complications of sickle cell anaemia (SCA). In healthy adults, a deep inspiratory breath hold (IBH) elicits rapid transient SNS- mediated vasoconstriction detectable using Laser Doppler Flux (LDF) assessment of the finger-tip cutaneous micovasculature. • What is the main finding and its importance? We demonstrate significantly increased resting peripheral blood flow and sympathetic activity in African children with SCA compared to sibling controls and increased sympathetic stimulation in response to vasoprovocation with DIG. This study is the first to observe an inverse association between resting peripheral blood flow and haemoglobin oxygen saturation (SpO2). These phenomena may be an adaptive response to the hypoxic exposure in SCA. There is increasing evidence that autonomic dysfunction in adults with homozygous sickle cell (haemoglobin SS) disease is associated with enhanced autonomic nervous system-mediated control of microvascular perfusion. However, it is unclear whether such differences are detectable in children with SS disease. We studied 65 children with SS disease [38 boys; median age 7.2 (interquartile range 5.1–10.6) years] and 20 control children without symptoms of SS disease [8 boys; 8.7 (5.5–10.8) years] and recorded mean arterial blood pressure (ABP) and daytime haemoglobin oxygen saturation (). Cutaneous blood flux at rest (RBF) and during the sympathetically activated vasoconstrictor response to inspiratory breath hold (IBH) were measured in the finger pulp of the non-dominant hand using laser Doppler fluximetry. Local factors mediating flow motion were assessed by power spectral density analysis of the oscillatory components of the laser Doppler signal. The RBF measured across the two study groups was negatively associated with age (r=−0.25, P < 0.0001), ABP (r=−0.27, P= 0.02) and daytime (r=−0.30, P= 0.005). Children with SS disease had a higher RBF (P= 0.005) and enhanced vasoconstrictor response to IBH (P= 0.002) compared with control children. In children with SS disease, higher RBF was associated with an increase in the sympathetic interval (r=−0.28, P= 0.022). The SS disease status, daytime and age explained 22% of the variance in vasoconstrictor response to IBH (P < 0.0001). Our findings suggest that blood flow and blood flow responses in the skin of young African children with SS disease differ from those of healthy control children, with increased resting peripheral blood flow and increased sympathetic stimulation from a young age in SS disease. They further suggest that the laser Doppler flowmetry technique with inspiratory breath hold manoeuvre appears to be robust for use in young children with SS disease, to explore interactions between , ABP and autonomic function with clinical complications, e.g. skin ulceration.
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Affiliation(s)
- Veline S L'Esperance
- Vascular Research Group, Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK
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Developmental changes in autonomic nervous system resting and reactivity measures in Latino children from 6 to 60 months of age. J Dev Behav Pediatr 2011; 32:668-77. [PMID: 22008788 DOI: 10.1097/dbp.0b013e3182331fa6] [Citation(s) in RCA: 66] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
OBJECTIVE : This study describes the developmental changes and individual stability in autonomic nervous system (ANS) resting and challenge responses for a cohort of primarily Latino, low-income children during the first 5 years of life. METHODS : ANS measures of the parasympathetic nervous system (respiratory sinus arrhythmia [RSA]) and sympathetic nervous system (preejection period [PEP]) were collected on a representative sample of the full cohort at 6, 12, 42, and 60 months of age (N = 378). The children participated in a standardized protocol to elicit ANS responses during resting and challenging states. Reactivity profiles were created to summarize each child's combined RSA and PEP reactivity (i.e., change in response to challenges compared to a resting state). RESULTS : Results showed developmental changes in ANS measures from 6 to 60 months: heart rate decreased, RSA increased, PEP increased, and frequency of classic reactivity profiles of reciprocal sympathetic activation and parasympathetic withdrawal increased. Correlations showed moderate stability for resting and challenging conditions but not reactivity. CONCLUSIONS : These findings suggest that low-income Latino children, from 6 to 60 months of age, showed ANS developmental changes and moderate individual stability for resting and challenge responses but not for reactivity. There was a significant shift in the frequency of children with the classic reactivity profile from 6 by 60 months of age. This is the first cohort study to show the developmental changes in ANS and young children's increase in their biologic sensitivity to the environment during the first 5 years of life.
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