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Seo D, Martins JS, Sinha R. Brain correlates and functional connectivity linking stress, autonomic dysregulation, and alcohol motivation. Neurobiol Stress 2024; 31:100645. [PMID: 38933283 PMCID: PMC11201348 DOI: 10.1016/j.ynstr.2024.100645] [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: 12/13/2023] [Revised: 04/22/2024] [Accepted: 05/19/2024] [Indexed: 06/28/2024] Open
Abstract
High stress is a key risk factor for alcohol use disorder (AUD) and often accompanied by physiological dysregulation including autonomic nervous system (ANS) disruptions. However, neural mechanisms underlying drinking behaviors associated with stress and ANS disruptions remain unclear. The current study aims to understand neural correlates of stress, ANS disruptions, and subsequent alcohol intake in social drinkers with risky drinking. Using functional magnetic resonance imaging (fMRI), we investigated brain and heart rate (HR) autonomic responses during brief exposure to stress, alcohol, and neutral cues utilizing a well-validated, individualized imagery paradigm in 48 social drinkers of which 26 reported high-risk drinking (HD) while 22 reported low-risk drinking (LD) patterns. Results indicated that HD individuals showed stress and ANS disruptions with increased basal HR, stress-induced craving, and decreased brain response to stress exposure in frontal-striatal regions including the ventromedial prefrontal cortex (VmPFC), anterior cingulate cortex, striatum, insula, and temporal gyrus. Furthermore, whole-brain correlation analysis indicated that greater basal HR was associated with hypoactive VmPFC, but hyperactive medulla oblongata (MOb) responses during stress, with an inverse association between activity in the VmPFC and Mob (whole-brain corrected (WBC), p < 0.05). Functional connectivity with the MOb as a seed to the whole brain indicated that HD versus LD had decreased functional connectivity between the VmPFC and MOb during stress (WBC, p < 0.05). In addition, those with more compromised functional connectivity between the VmPFC and MOb during stress consumed greater amount of alcohol beverage during an experimental alcohol taste test conducted on a separate day, as well as in their self-reported weekly alcohol intake. Together, these results indicate that stress-related, dysfunctional VmPFC control over brain regions of autonomic arousal contributes to greater alcohol motivation and may be a significant risk factor for hazardous alcohol use in non-dependent social drinkers. Findings also suggest that restoring VmPFC integrity in modulating autonomic arousal during stress may be critical for preventing the development of AUD.
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Affiliation(s)
- Dongju Seo
- Yale Stress Center, Department of Psychiatry, Yale University School of Medicine, 2 Church Street South, New Haven, CT, 06519, USA
| | - Jorge S. Martins
- William James Center for Research, ISPA-Instituto Universitário, Lisbon, Portugal
| | - Rajita Sinha
- Yale Stress Center, Department of Psychiatry, Yale University School of Medicine, 2 Church Street South, New Haven, CT, 06519, USA
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Sammito S, Thielmann B, Klussmann A, Deußen A, Braumann KM, Böckelmann I. Guideline for the application of heart rate and heart rate variability in occupational medicine and occupational health science. J Occup Med Toxicol 2024; 19:15. [PMID: 38741189 DOI: 10.1186/s12995-024-00414-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Accepted: 04/24/2024] [Indexed: 05/16/2024] Open
Abstract
This updated guideline replaces the "Guideline for the application of heart rate and heart rate variability in occupational medicine and occupational health science" first published in 2014. Based on the older version of the guideline, the authors have reviewed and evaluated the findings on the use of heart rate (HR) and heart rate variability (HRV) that have been published in the meantime and incorporated them into a new version of this guideline.This guideline was developed for application in clinical practice and research purposes in the fields of occupational medicine and occupational science to complement evaluation procedures with respect to exposure and risk assessment at the workplace by the use of objective physiological workload indicators. In addition, HRV is also suitable for assessing the state of health and for monitoring the progress of illnesses and preventive medical measures. It gives an overview of factors influencing the regulation of the HR and HRV at rest and during work. It further illustrates methods for measuring and analyzing these parameters under standardized laboratory and real workload conditions, areas of application as well as the quality control procedures to be followed during the recording and evaluation of HR and HRV.
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Affiliation(s)
- Stefan Sammito
- Department of Occupational Medicine, Medical Faculty, Otto-von-Guericke University Magdeburg, Magdeburg, Germany.
- German Air Force Centre of Aerospace Medicine, Experimental Aerospace Medicine Research, Flughafenstraße 1, Cologne, 51147, Germany.
| | - Beatrice Thielmann
- Department of Occupational Medicine, Medical Faculty, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
| | - Andre Klussmann
- Competence Centre Health (CCG), Department Health Sciences, University of Applied Sciences (HAW) Hamburg, Hamburg, Germany
| | - Andreas Deußen
- Department of Physiology, Medical Faculty, TU Dresden, Dresden, Germany
| | | | - Irina Böckelmann
- Department of Occupational Medicine, Medical Faculty, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
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Kim M, Kim J, Park H, Park JY, Lee D. Altered Low Frequency Heart Rate Variability Associated with Agoraphobia in Panic Disorder: A Retrospective Study. Yonsei Med J 2023; 64:670-678. [PMID: 37880848 PMCID: PMC10613766 DOI: 10.3349/ymj.2022.0592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 08/08/2023] [Accepted: 08/17/2023] [Indexed: 10/27/2023] Open
Abstract
PURPOSE This study aimed to compare the clinical features of panic disorder (PD) with comorbid agoraphobia to those of PD alone. We focused on autonomic nervous system (ANS) alterations reflected in heart rate variability (HRV) and executive function deficits reflected in the Stroop test. MATERIALS AND METHODS We retrospectively compared psychometric features, Stroop test results, and resting-state HRV across three groups: a subclinical group with anxiety attack history, a PD group without agoraphobia, and a PD group with agoraphobia. The subclinical group included 10 male and 34 female, the PD without agoraphobia group included 17 male and 19 female, and the PD with agoraphobia group included 11 male and 18 female. RESULTS The PD with agoraphobia group had higher Symptom Checklist-95 scores than the other groups. Both PD groups had longer reaction times in the Stroop test than the subclinical group. There were no significant differences in HRV parameters between the PD groups with and without agoraphobia. Compared with the subclinical group, the PD with agoraphobia group showed significantly lower values of the natural logarithm of low-frequency HRV. CONCLUSION Our results do not support that executive function deficits and ANS alterations are more pronounced with comorbid agoraphobia among PD groups. However, PD with agoraphobia patients showed more complex and severe clinical symptoms in their self-reports. Compared with the subclinical group, PD patients with agoraphobia showed specific features in the natural logarithm of low-frequency HRV. Our findings suggest that agoraphobia comorbidity should be considered when evaluating or treating patients with PD.
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Affiliation(s)
- Minjung Kim
- Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Jihye Kim
- Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Haein Park
- Department of Clinical Psychology, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Korea
| | - Jin Young Park
- Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Korea
- Department of Psychiatry, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Korea.
| | - Deokjong Lee
- Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Korea
- Department of Psychiatry, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Korea.
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Best LM, Hendershot CS, Buckman JF, Jagasar S, McPhee MD, Muzumdar N, Tyndale RF, Houle S, Logan R, Sanches M, Kish SJ, Le Foll B, Boileau I. Association Between Fatty Acid Amide Hydrolase and Alcohol Response Phenotypes: A Positron Emission Tomography Imaging Study With [ 11C]CURB in Heavy-Drinking Youth. Biol Psychiatry 2023; 94:405-415. [PMID: 36868890 DOI: 10.1016/j.biopsych.2022.11.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 11/18/2022] [Accepted: 11/30/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND Reductions in fatty acid amide hydrolase (FAAH), the catabolic enzyme for the endocannabinoid anandamide, may play a role in drinking behavior and risk for alcohol use disorder. We tested the hypotheses that lower brain FAAH levels in heavy-drinking youth are related to increased alcohol intake, hazardous drinking, and differential response to alcohol. METHODS FAAH levels in the striatum, prefrontal cortex, and whole brain were determined using positron emission tomography imaging of [11C]CURB in heavy-drinking youth (N = 31; 19-25 years of age). C385A FAAH genotype (rs324420) was determined. Behavioral (n = 29) and cardiovascular (n = 22) responses to alcohol were measured during a controlled intravenous alcohol infusion. RESULTS Lower [11C]CURB binding was not significantly related to frequency of use but was positively associated with hazardous drinking and reduced sensitivity to the negative effects of alcohol. During alcohol infusion, lower [11C]CURB binding related to greater self-reported stimulation and urges and lower sedation (p < .05). Lower heart rate variability was related to both greater alcohol-induced stimulation and lower [11C]CURB binding (p < .05). Family history of alcohol use disorder (n = 14) did not relate to [11C]CURB binding. CONCLUSIONS In line with preclinical studies, lower FAAH in the brain was related to a dampened response to the negative, impairing effects of alcohol, increased drinking urges, and alcohol-induced arousal. Lower FAAH might alter positive or negative effects of alcohol and increase urges to drink, thereby contributing to the addiction process. Determining whether FAAH influences motivation to drink through increased positive/arousing effects of alcohol or greater tolerance should be investigated.
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Affiliation(s)
- Laura M Best
- Brain Health Imaging Centre, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Addictions Division, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
| | - Christian S Hendershot
- Addictions Division, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Bowles Center for Alcohol Studies, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Jennifer F Buckman
- Department of Kinesiology and Health, Rutgers University, New Brunswick, New Jersey; Center of Alcohol and Substance Use Studies, Rutgers University, New Brunswick, New Jersey
| | - Samantha Jagasar
- Brain Health Imaging Centre, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Matthew D McPhee
- Addictions Division, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychological Clinical Science, University of Toronto, Toronto, Ontario, Canada
| | - Neel Muzumdar
- Department of Kinesiology and Health, Rutgers University, New Brunswick, New Jersey
| | - Rachel F Tyndale
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada; Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada
| | - Sylvain Houle
- Brain Health Imaging Centre, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Renee Logan
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Marcos Sanches
- Biostatistics Core, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Stephen J Kish
- Brain Health Imaging Centre, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada; Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada; Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
| | - Bernard Le Foll
- Brain Health Imaging Centre, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Addictions Division, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada; Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada; Department of Community and Family Medicine, University of Toronto, Toronto, Ontario, Canada; Waypoint Research Institute, Waypoint Centre for Mental Health Care, Penetanguishene, Ontario, Canada
| | - Isabelle Boileau
- Brain Health Imaging Centre, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Addictions Division, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada; Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada; Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada.
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Miller ML, Sanzari CM, Timko CA, Hormes JM. Impact of virtual adjunctive cognitive remediation therapy on cognitive flexibility and treatment outcomes in comorbid anorexia nervosa and exercise dependence as quantified using novel biomarkers: A stage 1 registered report. Int J Eat Disord 2023; 56:1449-1460. [PMID: 37464977 DOI: 10.1002/eat.23942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 03/04/2023] [Accepted: 03/15/2023] [Indexed: 07/20/2023]
Abstract
OBJECTIVE Anorexia nervosa (AN) is associated with significant individual mental and physical suffering and public health burden and fewer than half of patients recover fully with current treatments. Comorbid exercise dependence (ExD) is common in AN and associated with significantly worse symptom severity and treatment outcomes. Research points to cognitive inflexibility as a prominent executive function inefficiency and transdiagnostic etiologic and maintaining mechanism linking AN and ExD. This study will evaluate the initial efficacy of adjunctive Cognitive Remediation Therapy (CRT), which has been shown to produce cognitive improvements in adults with AN, in targeting cognitive inflexibility in individuals with comorbid AN and ExD. As an exploratory aim, this study also addresses the current lack of quick and cost-effective assessments of cognitive flexibility by establishing the utility of two proposed biomarkers, heart rate variability and salivary oxytocin. METHOD We will conduct a single-group, within-subjects trial of an established CRT protocol delivered remotely as an adjunct to inpatient or intensive outpatient treatment as usual (TAU) to adult patients (n = 42) with comorbid AN and ExD. Assessments, including self-report, neuropsychological, and biomarker measurements, will occur at three time points. RESULTS We expect CRT to increase cognitive flexibility transdiagnostically and consequently, along with TAU, positively impact AN and ExD compulsivity and symptom severity, including weight gain. DISCUSSION Findings will inform the development of more effective integrative interventions for AN and ExD targeting shared mechanisms and facilitate the routine assessment of cognitive flexibility as a transdiagnostic risk and maintaining factor across psychopathologies in clinical and research settings. PUBLIC SIGNIFICANCE Patients with anorexia nervosa often engage in excessive exercise, leading to harmful outcomes, including increased suicidal behavior. This study examines the preliminary efficacy of an intervention that fosters flexible and holistic thinking in patients with problematic eating and exercise to, along with routine treatment, decrease harmful exercise symptoms. This study also examines new biological markers of the inflexible thinking style thought to be characteristic of anorexia nervosa and exercise dependence.
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Affiliation(s)
- McKenzie L Miller
- Department of Psychology, University at Albany, Albany, New York, USA
| | | | - C Alix Timko
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Philadelphia, USA
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, The Children's Hospital of Philadelphia, Philadelphia, Philadelphia, USA
| | - Julia M Hormes
- Department of Psychology, University at Albany, Albany, New York, USA
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Ruyak S, Roberts MH, Chambers S, Ma X, DiDomenico J, De La Garza R, Bakhireva LN. The effect of the COVID-19 pandemic on substance use patterns and physiological dysregulation in pregnant and postpartum women. ALCOHOL, CLINICAL & EXPERIMENTAL RESEARCH 2023; 47:1088-1099. [PMID: 37526587 PMCID: PMC10394275 DOI: 10.1111/acer.15077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 02/19/2023] [Accepted: 03/25/2023] [Indexed: 08/02/2023]
Abstract
BACKGROUND The SARS-CoV-2/COVID-19 pandemic has been associated with increased stress levels and higher alcohol use, including in pregnant and postpartum women. In the general population, alcohol use is associated with dysregulation in the autonomic nervous system (ANS), which is indexed by heart rate variability (HRV). The objectives of this study were to: (1) characterize changes in substance use during the SARS-CoV-2/COVID-19 pandemic via a baseline self-report survey followed by mobile ecological momentary assessment (mEMA) of substance use; and (2) examine the associations between momentary substance use and ambulatory HRV measures in pregnant and postpartum women. METHODS Pregnant and postpartum women were identified from the ENRICH-2 prospective cohort study. Participants were administered a baseline structured phone interview that included the Coronavirus Perinatal Experiences (COPE) survey and ascertained the prevalence of substance use. Over a 14-day period, momentary substance use was assessed three times daily, and HRV measurements were captured via wearable electronics. Associations between momentary substance use and HRV measures (root mean square of successive differences [RMSSD] and low frequency/high frequency [LF/HF] ratio) were examined using a mixed effects model that included within-subject (WS) and between-subject (BS) effects and adjusted for pregnancy status and participant age. RESULTS The sample included 49 pregnant and 22 postpartum women. From a combination of a baseline and 14-day mEMA surveys, 21.2% reported alcohol use, 16.9% reported marijuana use, and 8.5% reported nicotine use. WS effects for momentary alcohol use were associated with the RMSSD (β = -0.14; p = 0.005) and LF/HF ratio (β = 0.14; p = 0.01) when controlling for pregnancy status and maternal age. No significant associations were observed between HRV measures and instances of marijuana or nicotine use. CONCLUSIONS These findings highlight the negative effect of the SARS-CoV-2/COVID-19 pandemic on the psychological health of pregnant and postpartum women associated with substance use, and in turn, ANS dysregulation, which potentially puts some women at risk of developing a substance use disorder.
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Affiliation(s)
- Sharon Ruyak
- College of Nursing, University of New Mexico, Albuquerque, New Mexico, USA
| | - Melissa H Roberts
- Substance Use Research and Education (SURE) Center, College of Pharmacy, University of New Mexico, Albuquerque, New Mexico, USA
| | - Stephanie Chambers
- Department of Family and Community Medicine, University of New Mexico, Albuquerque, New Mexico, USA
| | - Xingya Ma
- Substance Use Research and Education (SURE) Center, College of Pharmacy, University of New Mexico, Albuquerque, New Mexico, USA
| | - Jared DiDomenico
- Substance Use Research and Education (SURE) Center, College of Pharmacy, University of New Mexico, Albuquerque, New Mexico, USA
| | - Richard De La Garza
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, California, USA
| | - Ludmila N Bakhireva
- Substance Use Research and Education (SURE) Center, College of Pharmacy, University of New Mexico, Albuquerque, New Mexico, USA
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Tripska K, Draessler J, Pokladnikova J. Heart rate variability, perceived stress and willingness to seek counselling in undergraduate students. J Psychosom Res 2022; 160:110972. [PMID: 35728339 DOI: 10.1016/j.jpsychores.2022.110972] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 06/11/2022] [Accepted: 06/12/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The primary aim was to determine the level of stress in Czech pharmacy students using both subjective and physiological markers of stress throughout their study. The secondary aim was to investigate association of stress with sociodemographic and clinical characteristics, and to determine the predictors of the likelihood of enrolling in psychotherapy counselling. METHODS Design: A prospective observational study. SETTING Faculty of Pharmacy in Hradec Kralove, Czech Republic. SUBJECTS 175 s-year pharmacy students in 2016, 149 students in 2017, and 51 students in 2018. OUTCOME MEASURES Perceived stress scale (PSS-10), heart rate variability (HRV, emWavePro), a self-administered survey (sociodemographic and clinical data, likelihood of enrolling in psychotherapy counselling). RESULTS The average PSS score was 18.3 ± 6.7. There were no significant changes in PSS-10 and HRV parameters between 2016 and 2018. There was a significant negative correlation between PSS-10 and LF power (p = 0.012). Female gender and poor health status were more frequently observed among the respondents with impaired HRV (p = 0.026 for female gender and p = 0.025 and p = 0.042 for poor health status). Fifty-nine percent of students would be likely to enroll in psychotherapy counselling, with men being significantly less inclined to participate compared to women (p = 0.01). CONCLUSION Czech pharmacy students experience moderate levels of stress throughout their studies, which correlates with physiological markers of stress as well as their overall health. Push and pull factors of using mind-body interventions to manage stress should be further examined, especially in high risk groups.
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Affiliation(s)
- Katarina Tripska
- The Department of Biological and Medical Sciences, Faculty of Pharmacy in Hradec Kralove, Charles University, Czech Republic
| | - Jan Draessler
- The Department of Informatics and Quantitative Methods, Faculty of Informatics and Management, University of Hradec Kralove, Czech Republic
| | - Jitka Pokladnikova
- The Department of Social and Clinical Pharmacy, Faculty of Pharmacy in Hradec Kralove, Charles University, Czech Republic.
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Eckstein ML, Zimmermann P, Erlmann MP, Wachsmuth NB, Haupt S, Zimmer RT, Schierbauer J, Herz D, Aberer F, Sourij H, Obermayer-Pietsch B, Moser O. Glucose and Fructose Supplementation and Their Acute Effects on Electrocardiographic Time Intervals during Anaerobic Cycling Exercise in Healthy Individuals: A Secondary Outcome Analysis of a Double-Blind Randomized Crossover-Controlled Trial. Nutrients 2022; 14:nu14163257. [PMID: 36014763 PMCID: PMC9414006 DOI: 10.3390/nu14163257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 08/05/2022] [Accepted: 08/05/2022] [Indexed: 11/16/2022] Open
Abstract
The impact of glucose and fructose supplementation on acute cardiac effects during cardiopulmonary exercise testing (CPET) is a topic that is rarely investigated. The aim of the presented secondary outcome analysis of a double-blind, randomized crossover-controlled trial was to investigate the impact of glucose (Glu), fructose (Fru), glucose and fructose (GluFru), and sucralose on electrocardiogram (ECG), heart rate variability (HRV), premature ventricular complexes (PVCs), and heart rate turn points (HRTP) during CPET. Fourteen healthy individuals (age 25.4 ± 2.5 years, body mass index (BMI) 23.7 ± 1.7 kg/m2, body mass (BM) of 76.3 ± 12.3 kg) participated in this study, of which 12 were included for analysis. Participants received 1 g/kg BM of Glu, 1 g/kg BM of Fru, 0.5 g/kg BM of GluFru (each), and 0.2 g sucralose dissolved in 300 mL 30 min prior to each exercise session. No relevant clinical pathology or significant inter-individual differences between our participants could be revealed for baseline ECG parameters, such as heart rate (HR) (mean HR 70 ± 16 bpm), PQ interval (146 ± 20 ms), QRS interval (87 ± 16 ms) and the QT (405 ± 39 ms), and QTc interval (431 ± 15 ms). We found preserved cardiac autonomic function by analyzing the acute effects of different Glu, Fru, GluFru, or sucralose supplementation on cardiac autonomic function by Schellong-1 testing. SDNN and RMSSD revealed normal sympathetic and parasympathetic activities displaying a balanced system of cardiac autonomic regulation across our participating subjects with no impact on the metabolism. During CPET performance analyses, HRV values did not indicate significant changes between the ingested drinks within the different time points. Comparing the HRTP of the CPET with endurance testing by variable metabolic conditions, no significant differences were found between the HRTP of the CPET data (170 ± 12 bpm), Glu (171 ± 10 bpm), Fru (171 ± 9 bpm), GluFru (172 ± 9 bpm), and sucralose (170 ± 8 bpm) (p = 0.83). Additionally, the obtained time to reach HRTP did not significantly differ between Glu (202 ± 75 s), Fru (190 ± 88 s), GluFru (210 ± 89 s), and sucralose (190 ± 34 s) (p = 0.59). The significance of this study lies in evaluating the varying metabolic conditions on cardiac autonomic modulation in young healthy individuals. In contrast, our participants showed comparable cardiac autonomic responses determined by ECG and CPET.
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Affiliation(s)
- Max L. Eckstein
- Division of Exercise Physiology and Metabolism, BaySpo—Bayreuth Center of Sport Science, University of Bayreuth, 95440 Bayreuth, Germany
| | - Paul Zimmermann
- Division of Exercise Physiology and Metabolism, BaySpo—Bayreuth Center of Sport Science, University of Bayreuth, 95440 Bayreuth, Germany
- Department of Cardiology, Klinikum Bamberg, 96049 Bamberg, Germany
| | - Maximilian P. Erlmann
- Division of Exercise Physiology and Metabolism, BaySpo—Bayreuth Center of Sport Science, University of Bayreuth, 95440 Bayreuth, Germany
| | - Nadine B. Wachsmuth
- Division of Exercise Physiology and Metabolism, BaySpo—Bayreuth Center of Sport Science, University of Bayreuth, 95440 Bayreuth, Germany
| | - Sandra Haupt
- Division of Exercise Physiology and Metabolism, BaySpo—Bayreuth Center of Sport Science, University of Bayreuth, 95440 Bayreuth, Germany
| | - Rebecca T. Zimmer
- Division of Exercise Physiology and Metabolism, BaySpo—Bayreuth Center of Sport Science, University of Bayreuth, 95440 Bayreuth, Germany
| | - Janis Schierbauer
- Division of Exercise Physiology and Metabolism, BaySpo—Bayreuth Center of Sport Science, University of Bayreuth, 95440 Bayreuth, Germany
| | - Daniel Herz
- Division of Exercise Physiology and Metabolism, BaySpo—Bayreuth Center of Sport Science, University of Bayreuth, 95440 Bayreuth, Germany
| | - Felix Aberer
- Cardiovascular Diabetology Research Group, Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, 8036 Graz, Austria
| | - Harald Sourij
- Cardiovascular Diabetology Research Group, Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, 8036 Graz, Austria
| | - Barbara Obermayer-Pietsch
- Endocrinology Lab Platform, Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, 8036 Graz, Austria
| | - Othmar Moser
- Division of Exercise Physiology and Metabolism, BaySpo—Bayreuth Center of Sport Science, University of Bayreuth, 95440 Bayreuth, Germany
- Cardiovascular Diabetology Research Group, Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, 8036 Graz, Austria
- Correspondence: ; Tel.: +49-921-55-3465
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Zhao G, Ling Y, Su Y, Chen Z, Mathai CJ, Emeje O, Brown A, Alla DR, Huang J, Kim C, Chen Q, He X, Stalla D, Xu Y, Chen Z, Chen PY, Gangopadhyay S, Xie J, Yan Z. Laser-scribed conductive, photoactive transition metal oxide on soft elastomers for Janus on-skin electronics and soft actuators. SCIENCE ADVANCES 2022; 8:eabp9734. [PMID: 35731865 PMCID: PMC9216520 DOI: 10.1126/sciadv.abp9734] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 05/05/2022] [Indexed: 05/06/2023]
Abstract
Laser-assisted fabrication of conductive materials on flexible substrates has attracted intense interests because of its simplicity, easy customization, and broad applications. However, it remains challenging to achieve laser scribing of conductive materials on tissue-like soft elastomers, which can serve as the basis to construct bioelectronics and soft actuators. Here, we report laser scribing of metallic conductive, photoactive transition metal oxide (molybdenum dioxide) on soft elastomers, coated with molybdenum chloride precursors, under ambient conditions. Laser-scribed molybdenum dioxide (LSM) exhibits high electrical conductivity, biocompatibility, chemical stability, and compatibility with magnetic resonance imaging. In addition, LSM can be made on various substrates (polyimide, glass, and hair), showing high generality. Furthermore, LSM-based Janus on-skin electronics are developed to record information from human skin, human breath, and environments. Taking advantage of its outstanding photothermal effect, LSM-based soft actuators are developed to build light-driven reconfigurable three-dimensional architectures, reshapable airflow sensors, and smart robotic worms with bioelectronic sensors.
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Affiliation(s)
- Ganggang Zhao
- Department of Mechanical and Aerospace Engineering, University of Missouri, Columbia, MO, USA
| | - Yun Ling
- Department of Mechanical and Aerospace Engineering, University of Missouri, Columbia, MO, USA
| | - Yajuan Su
- Department of Surgery-Transplant and Mary and Dick Holland Regenerative Medicine Program, University of Nebraska Medical Center, Omaha, NE, USA
| | - Zanyu Chen
- Department of Mechanical and Aerospace Engineering, University of Missouri, Columbia, MO, USA
| | - Cherian J. Mathai
- Department of Electrical Engineering and Computer Science, University of Missouri, Columbia, MO, USA
| | - Ogheneobarome Emeje
- Department of Biomedical, Biological and Chemical Engineering, University of Missouri, Columbia, MO, USA
| | - Alexander Brown
- Cognitive Neuroscience Systems Core, University of Missouri, Columbia, MO, USA
| | - Dinesh Reddy Alla
- Department of Electrical and Computer Engineering, Missouri University of Science and Technology, Rolla, MO, USA
| | - Jie Huang
- Department of Electrical and Computer Engineering, Missouri University of Science and Technology, Rolla, MO, USA
| | - Chansong Kim
- Department of Materials Science and Engineering, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Qian Chen
- Department of Materials Science and Engineering, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Xiaoqing He
- Department of Mechanical and Aerospace Engineering, University of Missouri, Columbia, MO, USA
- Electron Microscopy Core, University of Missouri, Columbia, MO, USA
| | - David Stalla
- Electron Microscopy Core, University of Missouri, Columbia, MO, USA
| | - Yadong Xu
- Department of Biomedical, Biological and Chemical Engineering, University of Missouri, Columbia, MO, USA
| | - Zehua Chen
- Department of Biomedical, Biological and Chemical Engineering, University of Missouri, Columbia, MO, USA
| | - Pai-Yen Chen
- Department of Electrical and Computer Engineering, University of Illinois at Chicago, Chicago, IL, USA
| | - Shubhra Gangopadhyay
- Department of Electrical Engineering and Computer Science, University of Missouri, Columbia, MO, USA
| | - Jingwei Xie
- Department of Surgery-Transplant and Mary and Dick Holland Regenerative Medicine Program, University of Nebraska Medical Center, Omaha, NE, USA
| | - Zheng Yan
- Department of Mechanical and Aerospace Engineering, University of Missouri, Columbia, MO, USA
- Department of Biomedical, Biological and Chemical Engineering, University of Missouri, Columbia, MO, USA
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10
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Richesin MT, Baldwin DR, Wicks LAM. The Role of Contextual Information in a Virtual Trolly Problem: A Psychophysiological Investigation. Soc Neurosci 2022; 17:246-257. [PMID: 35536699 DOI: 10.1080/17470919.2022.2076733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Trolley problems have persisted as a popular method to examine moral decision-making in the face of many criticisms. One such criticism is that thought experiments provide unrealistically abundant contextual information, leading to mental simulation. Recent work utilizing virtual reality technology has reduced contextual information with mixed results. However, this work has not departed entirely from the thought experiment tradition, often providing written or verbal descriptions of the trolley problem before or during the simulation. This approach may still allow for mental simulation prior to decision-making. The goal of the current study is to examine whether or not this criticism is relevant for the classic version of the trolley problem. One hundred and nineteen participants were randomly assigned to either receive prior contextual information about the trolley problem or receive no information. All participants then entered a virtual reality simulation of the classic trolley problem. We examined decision-making from an affective and autonomic nervous system perspective. We found no effect on any measure in response to the reduction of contextual information. There were, however, surprising gender differences in decision-making and autonomic response. Further, we discuss how these findings relate to competing dual-process models of moral decision-making.
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Affiliation(s)
- Matthew T Richesin
- Department of Psychology, College of Arts and Sciences, The University of Tennessee Knoxville, 1404 Circle Dr, Knoxville, Tennessee, 37916, USA
| | - Debora R Baldwin
- Department of Psychology, College of Arts and Sciences, The University of Tennessee Knoxville, 1404 Circle Dr, Knoxville, Tennessee, 37916, USA
| | - Lahai A M Wicks
- Department of Psychology, College of Arts and Sciences, The University of Tennessee Knoxville, 1404 Circle Dr, Knoxville, Tennessee, 37916, USA
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11
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Golder S, McCambridge J. Alcohol, cardiovascular disease and industry funding: A co-authorship network analysis of systematic reviews. Soc Sci Med 2021; 289:114450. [PMID: 34607052 PMCID: PMC8586735 DOI: 10.1016/j.socscimed.2021.114450] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 09/14/2021] [Accepted: 09/29/2021] [Indexed: 12/18/2022]
Abstract
BACKGROUND Alcohol's effects on heart health is the site of a major scientific controversy. We conducted a co-authorship network analysis of systematic reviews on the impacts on alcohol on cardiovascular disease (CVD) in order to investigate patterns of co-authorship in the literature, with particular attention given to industry funding. METHODS We used Epistemonikos to identify systematic reviews. Review characteristics, influential authors, co-authorship subnetworks, prior histories of alcohol industry funding, study outcomes and citations were investigated. RESULTS 60 systematic reviews with 231 unique authors met our inclusion criteria. 14 systematic reviews were undertaken by authors with histories of alcohol industry funding, including 5 that were funded directly by the alcohol industry itself. All 14 such reviews identified a cardioprotective effect of alcohol. These formed distinct co-authorship subnetworks within the literature. Of reviews by authors with no prior histories of alcohol industry funding, the findings were mixed, with 54% (25/46) concluding there was evidence of health protective effects. These two groups of reviews differed in other respects. Those with industry funding were more likely to study broader outcomes such as 'cardiovascular disease' or 'coronary heart disease' as opposed to specific CVD issues such as hypertension or stroke (93% [13/14] versus 41% [19/46]) (chi-squared 12.4, p < 0.001) and have more included studies (mean of 29 versus 20). They were also more widely cited by others. Over time the proportions of systematic reviews on CVD and alcohol undertaken by authors with no prior histories of alcohol industry funding has increased. CONCLUSIONS Systematic reviews undertaken by authors with histories of alcohol industry funding were more likely to study broader outcomes, and be cited more widely, and exclusively reported favorable conclusions.
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Affiliation(s)
- Su Golder
- Department of Health Sciences, University of York, York, United Kingdom.
| | - Jim McCambridge
- Department of Health Sciences, University of York, York, United Kingdom
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12
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Strüven A, Holzapfel C, Stremmel C, Brunner S. Obesity, Nutrition and Heart Rate Variability. Int J Mol Sci 2021; 22:ijms22084215. [PMID: 33921697 PMCID: PMC8072942 DOI: 10.3390/ijms22084215] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 04/12/2021] [Accepted: 04/13/2021] [Indexed: 12/15/2022] Open
Abstract
Heart rate variability (HRV) represents the activity and balance of the autonomic nervous system and its capability to react to internal and external stimuli. As a measure of general body homeostasis, HRV is linked to lifestyle factors and it is associated with morbidity and mortality. It is easily accessible by heart rate monitoring and gains interest in the era of smart watches and self-monitoring. In this review, we summarize effects of weight loss, training, and nutrition on HRV with a special focus on obesity. Besides weight reduction, effects of physical activity and dietary intervention can be monitored by parameters of HRV, including its time and frequency domain components. In the future, monitoring of HRV should be included in any weight reduction program as it provides an additional tool to analyze the effect of body weight on general health and homeostasis. HRV parameters could, for example, be monitored easily by implementation of an electrocardiogram (ECG) every two to four weeks during weight reduction period. Indices presumibly showing beneficial changes could be a reduction in heart rate and the number of premature ventricular complexes as well as an increase in standard deviation of normal-to-normal beat intervals (SDNN), just to name some.
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Affiliation(s)
- Anna Strüven
- Department of Medicine I, University Hospital Munich, Ludwig Maximilians University Munich, Marchioninistr. 15, 81377 Munich, Germany; (A.S.); (C.S.)
- German Center for Cardiovascular Research (DZHK), Partner Site: Munich Heart Alliance, Marchioninistr. 15, 81377 Munich, Germany
| | - Christina Holzapfel
- Institute for Nutritional Medicine, School of Medicine, Technical University of Munich, Ismaninger Strasse 22, 81675 Munich, Germany;
| | - Christopher Stremmel
- Department of Medicine I, University Hospital Munich, Ludwig Maximilians University Munich, Marchioninistr. 15, 81377 Munich, Germany; (A.S.); (C.S.)
- German Center for Cardiovascular Research (DZHK), Partner Site: Munich Heart Alliance, Marchioninistr. 15, 81377 Munich, Germany
| | - Stefan Brunner
- Department of Medicine I, University Hospital Munich, Ludwig Maximilians University Munich, Marchioninistr. 15, 81377 Munich, Germany; (A.S.); (C.S.)
- German Center for Cardiovascular Research (DZHK), Partner Site: Munich Heart Alliance, Marchioninistr. 15, 81377 Munich, Germany
- Department of Medicine I, University Hospital Munich, Ziemssenstrasse 1, 80336 Munich, Germany
- Correspondence: ; Tel.: +49-89-4400-52248; Fax: +49-89-4400-75251
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13
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Heiss S, Vaschillo B, Vaschillo EG, Timko CA, Hormes JM. Heart rate variability as a biobehavioral marker of diverse psychopathologies: A review and argument for an "ideal range". Neurosci Biobehav Rev 2020; 121:144-155. [PMID: 33309905 DOI: 10.1016/j.neubiorev.2020.12.004] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Accepted: 12/02/2020] [Indexed: 01/21/2023]
Abstract
Heart rate variability (HRV), a measure of the variability in intervals between subsequent heart beats, is now widely considered an index of emotion regulatory capacity and the ability to adapt flexibly to changing environmental demands. Abnormalities in HRV are implicated in a host of psychopathologies, making it a potentially powerful transdiagnostic biobehavioral change mechanism in treatment interventions. While most mental illnesses are associated with low HRV, eating disorders have been linked to elevated HRV. We examined 62 research articles on HRV in psychopathology to test the hypothesis that there is an "ideal range" of HRV that predicts optimal functioning. Relationships between symptom severity and parameters that quantify HRV were examined graphically. More extreme time-domain HRV measures, both high and low, were associated with psychopathology, whereas healthy controls displayed mid-range values. Findings preliminarily support the hypothesis that there is an "ideal range" of HRV that could be targeted in biofeedback interventions.
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Affiliation(s)
- Sydney Heiss
- Department of Psychology, University at Albany, State University of New York, USA.
| | - Bronya Vaschillo
- Department of Kinesiology and Health, Rutgers, The State University of New Jersey, USA
| | - Evgeny G Vaschillo
- Department of Kinesiology and Health, Rutgers, The State University of New Jersey, USA
| | - C Alix Timko
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, The Children's Hospital of Philadelphia, USA
| | - Julia M Hormes
- Department of Psychology, University at Albany, State University of New York, USA
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14
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Tremblay M, Albert WJ, Fischer SL, Beairsto E, Johnson MJ. Exploration of the health status of experienced New Brunswick paramedics. Work 2020; 66:461-473. [PMID: 32568159 DOI: 10.3233/wor-203185] [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: 11/15/2022] Open
Abstract
BACKGROUND Literature reports that paramedics represent an at-risk occupation for the development of health problems. At least half of the paramedic population presents at least one risk factor associated with a negative health condition. These reports may suffer a "mono-method bias" where most reported outcomes are based on a single screening tool approach (may attenuate or inflate the prevalence). OBJECTIVE The current study characterizes the health status of a cohort of twenty-five experienced New Brunswick (Canadian province) paramedics. METHODS To understand possible limitations of past research, health status was characterized using four different methods: two methods using only one health measure and two were combined methods, integrating outcomes from at least two health measures to determine the prevalence of a given health status. RESULTS Mono-bias was observed when using the single health measure methods. The difference among the four methods highlighted that a third of the cohort seemed unaware of their health condition. This result shed additional light on paramedics' health, where a high proportion of paramedics worked without knowledge of their health conditions. Based on a two health measures combined method, it was observed that only two-fifths of the current sample had no health conditions or could otherwise be considered as a "healthy". CONCLUSIONS Because the literature has focused on single screening methods, our results were difficult to compare. However, there was a consensus that paramedics represent an at-risk occupation comprised of health problems. This study was exploratory and should be the basis for further research.
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Affiliation(s)
- Mathieu Tremblay
- Occupational Performance Lab, Faculty of Kinesiology, University of New Brunswick, Fredericton (NB), Canada.,Department of Health Sciences, Université du Québec à Rimouski, Rimouski (QC), Canada
| | - Wayne J Albert
- Occupational Performance Lab, Faculty of Kinesiology, University of New Brunswick, Fredericton (NB), Canada
| | - Steven L Fischer
- Department of Kinesiology, University of Waterloo, Waterloo (ON), Canada
| | - Eric Beairsto
- New Brunswick EMS, Medavie Health Services, Moncton (NB), Canada
| | - Michel J Johnson
- School of Kinesiology and Leisure, Université de Moncton, Moncton (NB), Canada
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15
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Evoked K-complexes and altered interaction between the central and autonomic nervous systems during sleep in alcohol use disorder. Alcohol 2020; 84:1-7. [PMID: 31539623 PMCID: PMC10005844 DOI: 10.1016/j.alcohol.2019.09.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Revised: 09/11/2019] [Accepted: 09/11/2019] [Indexed: 12/11/2022]
Abstract
There is evidence for impairment in both central nervous system (CNS) and autonomic nervous system (ANS) function with prolonged alcohol use. While these impairments persist into abstinence, partial recovery of function has been demonstrated in both systems during sleep. To investigate potential ANS dysfunction associated with cortical CNS responses (impairment in CNS-ANS coupling), we assessed phasic heart rate (HR) fluctuation associated with tones that did and those that did not elicit a K-complex (KC) during stable N2 non-rapid eye movement (NREM) sleep in a group of 16 recently abstinent alcohol use disorder (AUD) patients (41.6 ± 8.5 years) and a group of 13 sex- and age-matched control participants (46.6 ± 9.3 years). Electroencephalogram (EEG) and electrocardiogram (ECG) data were recorded throughout the night. Alcohol consumption questionnaires were also administered to the AUD patients. AUD patients had elevated HR compared to controls at baseline prior to tone presentation. The HR fluctuation associated with KCs elicited by tone presentation was significantly smaller in amplitude, and tended to be delayed in time, in the AUD group compared with the control group, and the subsequent deceleration was also smaller in AUD patients. In both groups, the increase in HR was larger and occurred earlier when KCs were produced than when they were not, and there was no difference in the magnitude of the KC effect between groups. Phasic HR changes associated with KCs elicited by tones are impaired in AUD participants, reflecting ANS dysfunction possibly caused by an alteration of cardiac vagal trafficking. However, only the timing of the HR response was found to relate to estimated lifetime alcohol consumption in AUD. The clinical meaning and implications of these novel findings need to be determined.
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16
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Dietary and Lifestyle Patterns are Associated with Heart Rate Variability. J Clin Med 2020; 9:jcm9041121. [PMID: 32295262 PMCID: PMC7230664 DOI: 10.3390/jcm9041121] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 03/31/2020] [Accepted: 04/10/2020] [Indexed: 12/28/2022] Open
Abstract
Assessment of heart rate variability (HRV) and cardiac ectopic beats is a clinically relevant topic. The present exploratory observational study aimed to inspect the relationships of lifestyle, dietary patterns, and anthropometrics with HRV, premature ventricular complexes (PVCs), and supraventricular premature complexes (SVPCs). A cross-sectional study enrolling subjects undergoing Holter monitoring was performed. Sociodemographic and clinical characteristics, body composition (full-body bio-impedentiometry), dietary patterns (validated food frequency questionnaire and 24 h dietary recall), and quality of life were assessed. Generalized additive models were estimated to evaluate the relationships between outcomes of interest and variables collected. The study enrolled 121 consecutive patients undergoing 24 h Holter monitoring. Upon univariable analysis, HRV was found to have an inverse association with mass of body fat (MBF) (p-value 0.015), while doing physical activity was associated with a significantly higher HRV (p-value 0.036). Upon multivariable analysis, fruit consumption in the 24 h dietary recall was found to be directly associated with HRV (p-value 0.044). The present findings might be useful for improving the management of patients attending cardiac rhythm labs, and to tailor ad hoc prevention strategies (modification of lifestyle and eating habits) based on Holter parameters.
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17
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Lozupone M, La Montagna M, D'Urso F, Daniele A, Greco A, Seripa D, Logroscino G, Bellomo A, Panza F. The Role of Biomarkers in Psychiatry. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2019; 1118:135-162. [PMID: 30747421 DOI: 10.1007/978-3-030-05542-4_7] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Psychiatric illnesses are cognitive and behavioral disorders of the brain. At present, psychiatric diagnosis is based on DSM-5 criteria. Even if endophenotype specificity for psychiatric disorders is discussed, it is difficult to study and identify psychiatric biomarkers to support diagnosis, prognosis, or clinical response to treatment. This chapter investigates the innovative biomarkers of psychiatric diseases for diagnosis and personalized treatment, in particular post-genomic data and proteomic analyses.
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Affiliation(s)
- Madia Lozupone
- Neurodegenerative Disease Unit, Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari Aldo Moro, Bari, Italy
| | - Maddalena La Montagna
- Psychiatric Unit, Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Francesca D'Urso
- Psychiatric Unit, Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Antonio Daniele
- Institute of Neurology, Catholic University of Sacred Heart, Rome, Italy.,Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Antonio Greco
- Geriatric Unit, Fondazione IRCCS Casa Sollievo della Sofferenza, Foggia, Italy
| | - Davide Seripa
- Geriatric Unit, Fondazione IRCCS Casa Sollievo della Sofferenza, Foggia, Italy
| | - Giancarlo Logroscino
- Neurodegenerative Disease Unit, Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari Aldo Moro, Bari, Italy.,Department of Clinical Research in Neurology, University of Bari Aldo Moro, Lecce, Italy
| | - Antonello Bellomo
- Psychiatric Unit, Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Francesco Panza
- Neurodegenerative Disease Unit, Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari Aldo Moro, Bari, Italy. .,Geriatric Unit, Fondazione IRCCS Casa Sollievo della Sofferenza, Foggia, Italy. .,Department of Clinical Research in Neurology, University of Bari Aldo Moro, Lecce, Italy.
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18
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Romero-Martínez Á, Vitoria-Estruch S, Moya-Albiol L. Emotional and autonomic dysregulation in abstinent alcoholic men: An idiosyncratic profile? Alcohol 2019; 77:155-162. [PMID: 30664984 DOI: 10.1016/j.alcohol.2019.01.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Revised: 01/03/2019] [Accepted: 01/14/2019] [Indexed: 01/29/2023]
Abstract
Men who misuse alcohol tend to experience negative affect, which may entail difficulties in regulating emotions to cope effectively with stressful or anxiety-provoking situations, thus increasing the risk of alcohol relapse. This dysphoric state has been associated with alexithymia, which compromises an individual's abilities to acknowledge, recognize, and regulate emotional states. A physiological correlate of emotional regulation is autonomic flexibility, as shown by emotional dysregulation in men who misuse alcohol being correlated with reduced parasympathetic activation to control heart rate variability during stress and/or conflict situations. Hence, the main aim of this study was to investigate whether long-term abstinent alcoholic (LTAA) men exhibit higher levels of negative affect and sympathetic activation (cardiovascular and electrodermal) in response to acute standardized laboratory stress than non-alcoholic controls. In addition, we hypothesized that the higher the alexithymic traits, the greater would be the increase in negative affect and sympathetic activation in response to stress, especially in LTAAs. Our data demonstrated that LTAAs experienced slightly greater increases in anxiety, states of anger, and worsening of mood than controls. Moreover, they exhibited lower high-frequency heart rate variability, respiratory sinus arrhythmia values, shorter pre-ejection periods, and higher respiratory rates than controls. Finally, alexithymic traits imply greater worsening of mood and sympathetic predominance (shorter pre-ejection periods and smaller magnitude of response), with the associations being stronger in LTAAs. These findings indicate a different emotional and cardiovascular response to psychosocial stress in LTAA than non-alcoholic men. Improving our knowledge of the way this population reacts to stress may help identify risk factors for alcohol relapse.
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19
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Ralevski E, Petrakis I, Altemus M. Heart rate variability in alcohol use: A review. Pharmacol Biochem Behav 2018; 176:83-92. [PMID: 30529588 DOI: 10.1016/j.pbb.2018.12.003] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Revised: 10/24/2018] [Accepted: 12/05/2018] [Indexed: 12/17/2022]
Abstract
BACKGROUND Prior studies have shown that resting heart rate variability (HRV) is reduced in those with alcohol use disorders (AUD). However, HRV following an acute stressful stimulus (reactive HRV), and the relationship between resting or reactive HRV and drinking, craving and relapse in AUD have received less attention. METHODS Studies using HRV in relationship to acute or chronic alcohol consumption were included in this review. Manuscripts that related to alcohol in the context of cardiovascular disease were excluded. RESULTS Thirty-three articles were included and findings are presented in healthy social drinkers, moderate/heavy drinkers without AUD and individuals with AUD. Results on resting and reactive HRV were presented separately. Acute alcohol reduced resting HRV in healthy subjects but healthy controls had higher resting HRV then AUD subjects and moderate/heavy drinkers (in some studies). Resting HRV improved in AUD subjects only after at least 4 months of abstinence. AUD subjects had higher reactive HRV scores when compared to controls. In AUD subjects increased reactivity was related to more craving, faster relapse and more negative mood. Reactive HRV showed slower improvement with abstinence in AUD subjects. CONCLUSIONS Chronic, heavy alcohol has a negative effect on the autonomic nervous system and may be a sensitive biomarker of craving and relapse.
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Affiliation(s)
| | - Ismene Petrakis
- Yale University School of Medicine, United States of America
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20
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Vitoria-Estruch S, Romero-Martínez Á, Lila M, Moya-Albiol L. Could Alcohol Abuse Drive Intimate Partner Violence Perpetrators' Psychophysiological Response to Acute Stress? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15122729. [PMID: 30513964 PMCID: PMC6313658 DOI: 10.3390/ijerph15122729] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Revised: 11/28/2018] [Accepted: 11/29/2018] [Indexed: 01/15/2023]
Abstract
Proactively aggressive individuals have been shown to present a different pattern of autonomic nervous system (ANS) dysregulation from that of individuals characterized by reactive violence. Although attempts have been made to classify intimate partner violence (IPV) perpetrators based on ANS reactivity to acute stress, subsequent studies have failed to replicate this classification. Notably, the proposed classification neglected the role of chronic alcohol abuse in ANS dysregulation and the fact that this dysregulation entails an abnormal stress response. The aim of the present study was to analyze the response profile (psychological state and ANS response) of groups of IPV perpetrators with high (n = 27) and low (n = 33)-risk alcohol use to an acute stressor, compared to controls (n = 35). All IPV perpetrators scored higher on executive dysfunctions and impulsivity and showed larger decreases in positive affect, less satisfaction, and a higher external locus of control after the stressor than controls. IPV perpetrators with low-risk alcohol use had higher skin conductance levels and breathing reactivity than controls, especially during preparatory, task, and recovery periods. This information could help to develop methods for increasing batterers’ behavioral self-regulation, thus decreasing IPV recidivism risk.
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Affiliation(s)
| | | | - Marisol Lila
- Department of Social Psychology, University of Valencia, 46010 Valencia, Spain.
| | - Luis Moya-Albiol
- Department of Psychobiology, University of Valencia, 46010 Valencia, Spain.
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21
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Oshri A, Liu S, Duprey EB, MacKillop J. Child Maltreatment, Delayed Reward Discounting, and Alcohol and Other Drug Use Problems: The Moderating Role of Heart Rate Variability. Alcohol Clin Exp Res 2018; 42:2033-2046. [PMID: 30152855 PMCID: PMC6584053 DOI: 10.1111/acer.13858] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Accepted: 07/26/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND Child maltreatment (CM) is robustly associated with youth risk for addictive behaviors, and recent findings suggest that this may be mediated through impulsive discounting of future rewards. However, research indicates that youth self-regulation (emotional and cognitive), particularly in peer contexts, is critical to consider in the study of decision making. This study aimed to examine the indirect link between CM and alcohol and other drug use problems, through delayed reward discounting (DRD), among a community sample of emerging adults. Further, this investigation aimed to examine whether this indirect link was moderated by heart rate variability (HRV), a physiological proxy for regulation of stress reactivity. METHODS A sample of emerging adults (N = 225; Mage = 21.56; SDage = 2.24; 52.9% female) was assessed at 2 time points, with 1 year between assessments. The sample was comprised of rural emerging adults from lower socioeconomic backgrounds. DRD was examined using a monetary choice task, and HRV reactivity was derived during a social stress task. RESULTS Increased CM experiences were significantly linked to riskier DRD. HRV reactivity amplified the indirect effect between CM and alcohol use problems via riskier DRD. CONCLUSIONS The results demonstrate that the connection between CM and alcohol use problems via impulsive decision making is modulated by acute stress response reactivity, as indexed by HRV.
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Affiliation(s)
- Assaf Oshri
- Department of Human Development and Family Science, University of Georgia
| | - Sihong Liu
- Department of Human Development and Family Science, University of Georgia
| | | | - James MacKillop
- Department of Psychiatry & Behavioral Neurosciences, McMaster University/St. Joseph’s Healthcare Hamilton
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22
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Cardiac vagal dysfunction moderates patterns of craving across the day in moderate to heavy consumers of alcohol. PLoS One 2018; 13:e0200424. [PMID: 30016350 PMCID: PMC6049906 DOI: 10.1371/journal.pone.0200424] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Accepted: 06/26/2018] [Indexed: 01/09/2023] Open
Abstract
Background Alcohol craving, a known correlate of vulnerability to Alcohol Use Disorder (AUD), has been found to be inversely related to cardiac vagal tone (CVT). Here we examine how resting CVT, CVT reactivity to a postural challenge, and their interaction influence craving during imposed alcohol abstinence and their usual drinking among moderate to heavy drinkers. Methods Participants were recruited from the local community (final n = 29) and assessed for CVT functioning via respiratory sinus arrhythmia (RSA) at rest (RSA-rest) and during a postural challenge (RSA-react). Craving intensity was assessed throughout the day during 3-day periods of imposed alcohol abstinence (abstained days) and drinking as usual (normal days) via Ecological Momentary Assessment (EMA). Multilevel statistical modeling assessed relationships between patterns of CVT and diurnal craving. The primary hypothesis of interest was that the interaction of RSA-rest with RSA-react would be significantly associated with increased craving across the day. Results Overall, craving increased throughout the day and significantly decreased after drinking (p < 0.001). There was a significant interaction between RSA-rest and RSA-react with plots revealing that this effect was driven by an aberrant craving pattern among participants with higher RSA-rest and a sluggish vagal brake in response to a postural shift—atypical RSA-react. Conclusion Although additional research is needed to corroborate these findings, our results suggest that moderate-heavy drinkers characterized by higher RSA-rest and atypical RSA-react exhibit aberrant patterns of craving across the day that may represent a risk factor for AUD.
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Ferreri F, Bourla A, Mouchabac S, Karila L. e-Addictology: An Overview of New Technologies for Assessing and Intervening in Addictive Behaviors. Front Psychiatry 2018; 9:51. [PMID: 29545756 PMCID: PMC5837980 DOI: 10.3389/fpsyt.2018.00051] [Citation(s) in RCA: 64] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Accepted: 02/06/2018] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND New technologies can profoundly change the way we understand psychiatric pathologies and addictive disorders. New concepts are emerging with the development of more accurate means of collecting live data, computerized questionnaires, and the use of passive data. Digital phenotyping, a paradigmatic example, refers to the use of computerized measurement tools to capture the characteristics of different psychiatric disorders. Similarly, machine learning-a form of artificial intelligence-can improve the classification of patients based on patterns that clinicians have not always considered in the past. Remote or automated interventions (web-based or smartphone-based apps), as well as virtual reality and neurofeedback, are already available or under development. OBJECTIVE These recent changes have the potential to disrupt practices, as well as practitioners' beliefs, ethics and representations, and may even call into question their professional culture. However, the impact of new technologies on health professionals' practice in addictive disorder care has yet to be determined. In the present paper, we therefore present an overview of new technology in the field of addiction medicine. METHOD Using the keywords [e-health], [m-health], [computer], [mobile], [smartphone], [wearable], [digital], [machine learning], [ecological momentary assessment], [biofeedback] and [virtual reality], we searched the PubMed database for the most representative articles in the field of assessment and interventions in substance use disorders. RESULTS We screened 595 abstracts and analyzed 92 articles, dividing them into seven categories: e-health program and web-based interventions, machine learning, computerized adaptive testing, wearable devices and digital phenotyping, ecological momentary assessment, biofeedback, and virtual reality. CONCLUSION This overview shows that new technologies can improve assessment and interventions in the field of addictive disorders. The precise role of connected devices, artificial intelligence and remote monitoring remains to be defined. If they are to be used effectively, these tools must be explained and adapted to the different profiles of physicians and patients. The involvement of patients, caregivers and other health professionals is essential to their design and assessment.
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Affiliation(s)
- Florian Ferreri
- Sorbonne Université, UPMC, Department of Adult Psychiatry and Medical Psychology, APHP, Saint-Antoine Hospital, Paris, France
| | - Alexis Bourla
- Sorbonne Université, UPMC, Department of Adult Psychiatry and Medical Psychology, APHP, Saint-Antoine Hospital, Paris, France
| | - Stephane Mouchabac
- Sorbonne Université, UPMC, Department of Adult Psychiatry and Medical Psychology, APHP, Saint-Antoine Hospital, Paris, France
| | - Laurent Karila
- Université Paris Sud - INSERM U1000, Addiction Research and Treatment Center, APHP, Paul Brousse Hospital, Villejuif, France
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Sarlon J, Plaszczyk S, Engel S, Oertel-Knöchel V. Electrophysiological parameters as biomarkers for psychiatry: Intra-individual variability and influencing factors. Int J Psychophysiol 2017; 123:42-47. [PMID: 29155050 DOI: 10.1016/j.ijpsycho.2017.11.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2017] [Revised: 10/21/2017] [Accepted: 11/15/2017] [Indexed: 12/22/2022]
Affiliation(s)
- Jan Sarlon
- Laboratory for Neuroimaging, Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe University, Heinrich-Hoffmann-Str. 10, 60528 Frankfurt am Main, Germany; Psychiatric Hospital, Oberbergkliniken, Oberberg 1, 78132 Hornberg, Germany.
| | - Simone Plaszczyk
- Laboratory for Neuroimaging, Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe University, Heinrich-Hoffmann-Str. 10, 60528 Frankfurt am Main, Germany
| | - Sinah Engel
- Laboratory for Neuroimaging, Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe University, Heinrich-Hoffmann-Str. 10, 60528 Frankfurt am Main, Germany; Department of Neurology, University of Mainz, Langenbeckstr. 1, 55131 Mainz, Germany
| | - Viola Oertel-Knöchel
- Laboratory for Neuroimaging, Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe University, Heinrich-Hoffmann-Str. 10, 60528 Frankfurt am Main, Germany
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Khanade K, Sasangohar F. Efficacy of Using Heart Rate Measurements as an Indicator to Monitor Anxiety Disorders: A Scoping Literature Review. ACTA ACUST UNITED AC 2017. [DOI: 10.1177/1541931213601927] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Post-traumatic stress disorder (PTSD) is a prevalent disorder affecting veterans, first responders, children and others who have experienced traumatic events. Heart rate measures like resting heart rates along with heart rate accelerations are important measures to monitor the changes in the state of PTSD and other related disorders. A scoping review was conducted to investigate the efficacy of using heart rate (HR) measurements as reliable indicator for assessment of PTSD and other anxiety-related disorders. Findings show that while Heart Rate Variability (HRV) may provide a more robust measurement of PTSD and other anxiety-related symptoms, heart rate accelerations in response to traumatic reminders are reliable indicators. Changes in resting or basal heart rates show promise in long-term monitoring of PTSD symptoms.
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Affiliation(s)
- Kunal Khanade
- Department of Industrial and Systems Engineering, Texas A&M University, College Station, TX
| | - Farzan Sasangohar
- Department of Industrial and Systems Engineering, Texas A&M University, College Station, TX
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26
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Alcohol Use Disorder Moderates the Effect of Age on Heart Rate Variability in Veterans With Posttraumatic Stress Disorder. J Nerv Ment Dis 2017; 205:793-800. [PMID: 28727660 DOI: 10.1097/nmd.0000000000000718] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Research on heart rate variability (HRV) in posttraumatic stress disorder (PTSD) and comorbid alcohol use disorder (AUD) is limited despite its use as a biomarker of both disorders. This study examined whether AUD comorbidity contributes an additive effect on HRV for veterans with PTSD. HRV was assessed in 70 male Operation Enduring Freedom/Operation Iraqi Freedom veterans with PTSD, including 32 with co-occurring AUD. Mean HRV values for both groups were below the mean for healthy adults, but additive effects of PTSD and AUD on HRV were not observed. Consistent with prior studies, hierarchical regressions showed that HRV decreased with age in the PTSD-only group. However, HRV increased slightly with age among veterans with both PTSD and AUD. This interaction remained significant after controlling for common HRV covariates. These findings support HRV as a biomarker of PTSD and extend research by demonstrating the complex relationship between PTSD and HRV in the context of co-occurring AUD.
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Stevenson JR, Young KA, Bohidar AE, Francomacaro LM, Fasold TR, Buirkle JM, Ndem JR, Christian SC. Alcohol Consumption Decreases Oxytocin Neurons in the Anterior Paraventricular Nucleus of the Hypothalamus in Prairie Voles. Alcohol Clin Exp Res 2017; 41:1444-1451. [PMID: 28617958 DOI: 10.1111/acer.13430] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2016] [Accepted: 06/05/2017] [Indexed: 12/22/2022]
Abstract
BACKGROUND Alcohol use disorders are associated with dysfunctional social relationships and stress responses. The neuropeptides oxytocin (OT) and vasopressin (AVP) are known to orchestrate or mediate many aspects of social behavior, stress responses, and ingestive behaviors. Because of the overlap between the effects of alcohol and the roles of OT and AVP, we sought to determine whether alcohol consumption altered expression of OT and AVP in the paraventricular nucleus (PVN) of the hypothalamus, one of the key sites for OT and AVP synthesis. METHODS Pair-housed adult male prairie voles were allowed to consume 15% ethanol versus water in the home cage continuously (Continuous-Access [CA] group) or every other day for 4 hours (Intermittent-Access [IA] group). Control animals never had access to alcohol. After 7 weeks, animals were sacrificed and their brains were removed and immunohistochemical analysis of OT- and AVP-immunopositive neurons was performed. RESULTS OT-immunopositive neurons were significantly decreased in the anterior PVN in the CA but not IA group, relative to Control animals, suggesting that continuous alcohol consumption decreases the number of OT neurons. There was no effect of alcohol consumption on posterior PVN OT neurons, and no effect on PVN AVP neurons. CONCLUSIONS These data show that continuous-access voluntary alcohol consumption is associated with decreased OT neurons in the anterior PVN, suggesting that alcohol-induced alterations in the OT system should be investigated as a mechanism for alcohol-related changes in social behavior, stress responses, and exacerbation of alcohol use disorders.
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Affiliation(s)
- Jennie R Stevenson
- Department of Psychology, Bucknell University, Lewisburg, Pennsylvania.,Program in Neuroscience, Bucknell University, Lewisburg, Pennsylvania.,Program in Animal Behavior, Bucknell University, Lewisburg, Pennsylvania
| | - Katelyn A Young
- Department of Psychology, Bucknell University, Lewisburg, Pennsylvania.,Program in Neuroscience, Bucknell University, Lewisburg, Pennsylvania.,Program in Animal Behavior, Bucknell University, Lewisburg, Pennsylvania
| | - Amelia E Bohidar
- Department of Psychology, Bucknell University, Lewisburg, Pennsylvania.,Program in Neuroscience, Bucknell University, Lewisburg, Pennsylvania.,Program in Animal Behavior, Bucknell University, Lewisburg, Pennsylvania
| | - Lisa M Francomacaro
- Department of Psychology, Bucknell University, Lewisburg, Pennsylvania.,Program in Neuroscience, Bucknell University, Lewisburg, Pennsylvania.,Program in Animal Behavior, Bucknell University, Lewisburg, Pennsylvania
| | - Terra R Fasold
- Department of Psychology, Bucknell University, Lewisburg, Pennsylvania.,Program in Neuroscience, Bucknell University, Lewisburg, Pennsylvania.,Program in Animal Behavior, Bucknell University, Lewisburg, Pennsylvania
| | - Julia M Buirkle
- Department of Psychology, Bucknell University, Lewisburg, Pennsylvania.,Program in Neuroscience, Bucknell University, Lewisburg, Pennsylvania.,Program in Animal Behavior, Bucknell University, Lewisburg, Pennsylvania
| | - Jackie R Ndem
- Department of Psychology, Bucknell University, Lewisburg, Pennsylvania.,Program in Neuroscience, Bucknell University, Lewisburg, Pennsylvania.,Program in Animal Behavior, Bucknell University, Lewisburg, Pennsylvania
| | - Sara C Christian
- Department of Psychology, Bucknell University, Lewisburg, Pennsylvania.,Program in Neuroscience, Bucknell University, Lewisburg, Pennsylvania.,Program in Animal Behavior, Bucknell University, Lewisburg, Pennsylvania
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Muehlhan M, Höcker A, Höfler M, Wiedemann K, Barnow S, Schäfer I. Stress-related salivary alpha-amylase (sAA) activity in alcohol dependent patients with and without a history of childhood maltreatment. Psychopharmacology (Berl) 2017; 234:1901-1909. [PMID: 28314952 DOI: 10.1007/s00213-017-4595-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2016] [Accepted: 03/11/2017] [Indexed: 12/30/2022]
Abstract
RATIONALE Alcohol-dependent (AD) patients with a history of childhood maltreatment (CM) have shown a more severe clinical profile and a higher risk of relapse than those without CM. It was hypothesized that stress responsivity plays an important role in moderating the relationship between CM and AD. Surprisingly, systematic investigations about the stress responsivity in AD patients with CM are rare. OBJECTIVE This study compared physiological and subjective stress responses in AD patients with and without CM as well as in healthy controls with and without CM. METHODS A total of 130 participants performed the Trier Social Stress Test (TSST). Physiological stress reactivity related to the noradrenergic system was assessed by salivary alpha-amylase (sAA) activity. Subjective ratings of anxiety, nervousness, distress, and mood were rated on visual analogue scales. RESULTS AD patients showed significantly lower stress-related sAA activity than healthy controls (p ≤ 0.024; z ≥ 1.97). A different pattern was found in the subjective ratings. In particular, anticipatory anxiety revealed a clear effect of CM (p ≤ 0.005; z ≥ 2.43) but no difference between AD patients and healthy controls (p > 0.05). After the TSST, distress ratings differed between AD patients with CM and AD patients without CM (p ≤ 0.009; z ≥ 2.61). CONCLUSION The discrepancy between physiological responsivity and subjective stress experiences may account for an increased inability to cope with stressful situations, which in turn might explain the enhanced risk of relapse in AD patients with a history of CM during early abstinence.
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Affiliation(s)
- Markus Muehlhan
- Department of Psychology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Chemnitzer Str. 46, 01187, Dresden, Germany.
- Department of Psychology, Faculty of Human Science, Medical School Hamburg, Hamburg, Germany.
| | - Anja Höcker
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg-Eppendorf, Germany
| | - Michael Höfler
- Department of Psychology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Chemnitzer Str. 46, 01187, Dresden, Germany
| | - Klaus Wiedemann
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg-Eppendorf, Germany
| | - Sven Barnow
- Department of Clinical Psychology and Psychotherapy, Ruprecht-Karls-University Heidelberg, Heidelberg, Germany
| | - Ingo Schäfer
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg-Eppendorf, Germany
- Center for Interdisciplinary Addiction Research, University of Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg-Eppendorf, Germany
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Moss D, Shaffer F. The Application of Heart Rate Variability Biofeedback to Medical and Mental Health Disorders. ACTA ACUST UNITED AC 2017. [DOI: 10.5298/1081-5937-45.1.03] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Heart rate variability (HRV) is a medical index for morbidity and wellness. Lower HRV accompanies many illnesses; high HRV accompanies healthy states, resilience, and optimal functioning. Heart rate variability biofeedback (HRVB) uses real-time electronic feedback of the moment-to-moment changes in HRV to train patients to produce increases in HRV. Outcome studies on HRVB have shown therapeutic benefit for a wide variety of medical and mental health disorders. Lehrer and colleagues have published evidence-based protocols for HRV assessment and HRV treatment. Here, the authors review outcome studies on a sampling of common disorders: asthma, chronic muscle pain, depression, heart failure, hypertension, and posttraumatic stress disorder. HRVB offers promising therapeutic benefit for any medical or mental health disorder known to be accompanied by autonomic nervous system dysregulation.
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Affiliation(s)
- Donald Moss
- College of Integrative Medicine and Health Sciences, Saybrook University, Oakland, CA
| | - Fredric Shaffer
- Department of Psychology, Truman State University, Kirksville, MO
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Young HA, Cousins AL, Watkins HT, Benton D. Is the link between depressed mood and heart rate variability explained by disinhibited eating and diet? Biol Psychol 2016; 123:94-102. [PMID: 27939700 DOI: 10.1016/j.biopsycho.2016.12.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Revised: 12/03/2016] [Accepted: 12/07/2016] [Indexed: 12/16/2022]
Abstract
Consistently it has been reported that a depressed mood and low heart rate variability (HRV) are linked. However, studies have not considered that the association might be explained by dietary behaviour. The resting inter-beat interval data of 266 adults (Study 1: 156 (51M), Study 2: 112 (38M)) were recorded for six minutes and quantified using linear (HF power: 0.15-0.4Hz) and nonlinear indices (Sample entropy). Participants also completed the Profile of Mood States and the Three Factor Eating questionnaires. The Alternative Healthy Eating Index was used to quantify diet quality. In study 1 mood was associated with HRV; an effect partially mediated by diet. Study 2 replicated the finding: disinhibited eating (the tendency to lose control over one's eating) and diet sequentially mediated the association between mood and HRV. Diet plays a role in the link between mood and HRV and studies should consider the influence of this factor.
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Affiliation(s)
- Hayley A Young
- Department of Psychology, Swansea University, Swansea SA2 8PP, Wales, UK.
| | - Alecia L Cousins
- Department of Psychology, Swansea University, Swansea SA2 8PP, Wales, UK
| | - Heather T Watkins
- Department of Psychology, Swansea University, Swansea SA2 8PP, Wales, UK
| | - David Benton
- Department of Psychology, Swansea University, Swansea SA2 8PP, Wales, UK
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Price CJ, Crowell SE. Respiratory sinus arrhythmia as a potential measure in substance use treatment--outcome studies. Addiction 2016; 111:615-25. [PMID: 26567088 PMCID: PMC4801752 DOI: 10.1111/add.13232] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Revised: 05/13/2015] [Accepted: 11/06/2015] [Indexed: 12/23/2022]
Abstract
BACKGROUND AND AIMS Dysfunction of physiological regulation systems may underlie the disrupted emotional and self-regulatory processes among people with substance use disorder (SUD). This paper reviews evidence as to whether or not respiratory sinus arrhythmia (RSA), as a psychophysiological index of emotional regulation, could provide useful information in treatment-outcome research to provide insights into recovery processes. METHODS We reviewed the use of RSA in clinical research and studies on SUD treatment. Search terms for the review of RSA in clinical research included respiratory sinus arrhythmia, heart rate variability, vagal, cardiac vagal control, psychophysiology, intervention, treatment, mindfulness, mind-body, mental health, substance use, chemical dependence, regulation and emotion regulation. For the review of RSA in intervention studies, we included only those that provided adequate description of psychophysiological methods, and examined RSA in the context of an intervention study. RESULTS RSA appears to be able to provide an index of self-regulatory capacity; however, it has been little used in either intervention or treatment research. Of the four intervention studies included in this review, all were mindfulness-based interventions. Two studies were with substance-using samples, and both showed pre-post increases in RSA and related improved substance use outcomes. Two of the three studies were randomized controlled trials (RCTs), and both showed significant increases in RSA in the experimental compared to comparison condition. CONCLUSION Respiratory sinus arrhythmia may be a useful index of emotional regulation in people with substance use disorder, and a potential measure of underlying mechanisms for SUD treatment studies, particularly mindfulness-based interventions.
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Affiliation(s)
- Cynthia J. Price
- Box 357266, Biobehavioral Nursing, University of Washington, Seattle WA 98195
| | - Sheila E. Crowell
- 380 South 1530 East, Department of Psychology. University of Utah, Salt Lake City, UT 84112
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Jochum T, Hoyme J, Schulz S, Weißenfels M, Voss A, Bär KJ. Diverse autonomic regulation of pupillary function and the cardiovascular system during alcohol withdrawal. Drug Alcohol Depend 2016; 159:142-51. [PMID: 26790823 DOI: 10.1016/j.drugalcdep.2015.12.030] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Revised: 12/07/2015] [Accepted: 12/08/2015] [Indexed: 11/28/2022]
Abstract
BACKGROUND Previous research indicated the complexity of autonomic dysfunction during acute alcohol withdrawal. This study aimed to investigate the pupillary light reflex as an indicator of midbrain and brainstem regulatory systems in relation to cardiovascular autonomic function. METHODS Thirty male patients were included in the study. They were investigated during acute alcohol withdrawal syndrome and 24h later during clomethiazole treatment and compared to healthy controls. Parameters of pupillary light reflex of both eyes as well as heart rate variability, blood pressure variability and baroreflex sensitivity (BRS) were studied. RESULTS We observed significantly reduced sympathetic (small diameter, e.g., left eye: 5.00 in patients vs. 5.91 mm in controls) and vagal modulation (e.g., prolonged latencies, left eye: 0.28 vs. 0.26 ms) regarding both pupils during acute alcohol withdrawal syndrome. Cardiovascular parameters showed reduced vagal modulation (e.g., b-slope of BRS: 7. 57 vs. 13.59 ms/mm Hg) and mixed results for sympathetic influence. After 24h, autonomic dysfunction improved significantly, both for the pupils (e.g., left diameter: 5.38 mm) and the heart (e.g., b-slope of BRS: 9.34 ms/mm Hg). While parameters obtained from the pupil correlated with cardiac autonomic function (e.g, BRS and left diameter: r=0.564) in healthy controls, no such pattern was observed in patients. CONCLUSION Results obtained from the pupil during acute alcohol withdrawal do not simply mirror autonomic dysfunction regarding the heart. Pupillary and cardiovascular changes after 24h indicate state dependencies of the results. The findings are discussed with respect to autonomic mechanisms and potentially involved brain regions.
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Affiliation(s)
- Thomas Jochum
- Psychiatric Brain & Body Research Group Jena, Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany
| | - Johannes Hoyme
- Psychiatric Brain & Body Research Group Jena, Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany
| | - Steffen Schulz
- Department of Medical Engineering and Biotechnology, Ernst-Abbe-Hochschule Jena, University of Applied Sciences, Jena, Germany
| | - Markus Weißenfels
- Psychiatric Brain & Body Research Group Jena, Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany
| | - Andreas Voss
- Department of Medical Engineering and Biotechnology, Ernst-Abbe-Hochschule Jena, University of Applied Sciences, Jena, Germany
| | - Karl-Jürgen Bär
- Psychiatric Brain & Body Research Group Jena, Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany.
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Cardiovascular disease risks in adult Native and Mexican Americans with a history of alcohol use disorders: association with cardiovascular autonomic control. Clin Auton Res 2016; 26:87-95. [PMID: 26758567 DOI: 10.1007/s10286-015-0333-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2015] [Accepted: 12/08/2015] [Indexed: 12/11/2022]
Abstract
Hypertension and obesity are serious health problems that have been associated with an increased risk of cardiovascular disease (CVD). We recently showed a relationship between hypertension, obesity and cardiovagal control in a sample of Native and Mexican Americans at high risk of alcohol use disorders (AUD). While studies have shown that Native and Mexican Americans exhibit high rates of AUD, the consequences of AUD on CVD risk factors and their relationship with cardiovascular autonomic control is not well understood in these ethnic groups. This study investigated whether an association could be demonstrated between cardiovascular autonomic control and several CVD risk factors in Native and Mexican American men and women (n = 228) who are literate in English and are residing legally in San Diego County. Participants with lifetime history of AUD showed higher rates of systolic and diastolic hypertension and obesity than participants without lifetime AUD. Lifetime AUD was significantly associated with reduced HR response to deep breathing (HRDB) measure of cardiovagal control, higher current drinking quantity, and obesity. Reduced HRDB was also associated with increased systolic pre-hypertension or hypertension (pre-/hypertension) and with higher diastolic blood pressure in a linear regression model that included several diagnostic and demographic variables. HRDB and time- and frequency-domain measures of cardiovagal control were significantly reduced in participants with diastolic pre-/hypertension. These data suggest that lower cardiovagal control may play a role in the prevalence of systolic and diastolic pre-/hypertension in a community sample with a history of alcohol and substance use disorders.
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Chen TY, Chang CC, Tzeng NS, Kuo TBJ, Huang SY, Lu RB, Chang HA. Different Patterns of Heart Rate Variability During Acute Withdrawal in Alcohol Dependent Patients With and Without Comorbid Anxiety and/or Depression. J PSYCHOPHYSIOL 2015. [DOI: 10.1027/0269-8803/a000139] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Abstract. The aim of the present study was to examine cardiac autonomic function during acute alcohol withdrawal (AW) in two clinical subgroups with alcohol dependence. To this end we compared 24 patients with pure alcohol dependence (Pure ALC) with 24 alcohol-dependent patients who had comorbid symptoms of anxiety and/or depression (ANX/DEP ALC) on their mean heart rate and several (spectral) measures of heart rate variability (HRV) obtained from the patients when they were withdrawn from alcohol. To elucidate the contribution of anxiety and depression to the cardiac measures we moreover compared these groups to 120 non-comorbid patients with major depressive disorder (MDD), 24 patients with anxiety disorders and 120 matched controls. The Hamilton Depression Rating Scale (HAM-D) and the Hamilton Anxiety Rating Scale (HAM-A) were employed for the clinical symptom ratings. The cardiac measures were found to significantly discriminate among the groups (Hotelling-Lawley F = 3.18, p < .001). Post hoc testing revealed that total HRV (variance in interbeat intervals) was reduced in Pure ALC (p = .033, Cohen’s d = −0.51), ANX/DEP ALC (p < .001, Cohen’s d = −1.33), MDD (p < .001, Cohen’s d = −0.66), and anxiety disorders (p = .002, Cohen’s d = −0.69), relative to controls. When these comparisons were adjusted for smoking history in pack-years, the results were unchanged. The ANX/DEP ALC patients showed significantly greater reduction in total HRV and high frequency (HF)-HRV compared with the Pure ALC patients. Both anxiety and depression moderated the influence of alcohol use and withdrawal on resting HRV. Our results suggest that compared to Pure ALC, ANX/DEP ALC presents a subtype of alcohol dependence with higher vulnerability to reduced HRV during acute AW. Implications for cardiovascular risk are discussed.
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Affiliation(s)
- Tien-Yu Chen
- Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Chuan-Chia Chang
- Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Nian-Sheng Tzeng
- Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
- Student Counseling Center, National Defense Medical Center, Taipei, Taiwan
| | - Terry B. J. Kuo
- Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan
| | - San-Yuan Huang
- Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Ru-Band Lu
- Institute of Behavioral Medicine and Department of Psychiatry, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Hsin-An Chang
- Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
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de Zambotti M, Willoughby AR, Baker FC, Sugarbaker DS, Colrain IM. Cardiac autonomic function during sleep: effects of alcohol dependence and evidence of partial recovery with abstinence. Alcohol 2015; 49:409-15. [PMID: 25957854 DOI: 10.1016/j.alcohol.2014.07.023] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2014] [Revised: 07/24/2014] [Accepted: 07/25/2014] [Indexed: 02/03/2023]
Abstract
Chronic alcoholism is associated with the development of cardiac and peripheral autonomic nervous system (ANS) pathology. The aim of the present study was to evaluate the extent to which recovery in ANS function could be demonstrated over the first 4 months of abstinence. Fifteen alcoholics (7 women) were studied on three occasions: within a month of detoxification, at approximately 2 months post-detox, and at 4 months post-detox. Thirteen control subjects (6 women) were also studied on three occasions with inter-study intervals matching those of the alcoholics. Six alcoholics relapsed, 48.7 ± 27.9 days following the initial PSG session. ANS function was assessed in the first part of stable non-rapid eye movement sleep. Frequency-domain power spectral analysis of heart rate variability (HRV) produced variables including: heart rate (HR), total power (TP; an index representing total HR variability), High Frequency power (HFa; an index reflecting cardiac vagal modulation), HF proportion of total power (HFprop sympathovagal balance), and HF peak frequency (HFpf; an index reflecting respiration rate). Overall, high total and high frequency variability and low sympathovagal balance and myocardial contractility are considered as desired conditions to promote cardiovascular health. At initial assessment, alcoholics had a higher HR (p < 0.001) and respiratory rate (p < 0.01), and lower vagal activity (HFa; p < 0.01) than controls. Alcoholics showed evidence of recovery in HR (p = 0.039) and HFa (p = 0.031) with 4 months of abstinence. Alcoholics with higher TP at the initial visit showed a greater improvement in TP from the initial to the 4 month follow-up session (r = 0.75, p < 0.05). Alcoholics showed substantial recovery in HR and vagal modulation of HRV with 4 months of abstinence, with evidence that the extent of recovery in HRV may be partially determined by the extent of alcohol dependence-related insult to the cardiac ANS system. These data support other studies showing recovery in a number of ANS, central nervous system, and behavioral domains with abstinence, even in those with long-term dependence.
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Affiliation(s)
| | | | - Fiona C Baker
- Center for Health Sciences, SRI International, Menlo Park, CA, USA; Brain Function Research Group, School of Physiology, University of the Witwatersrand, Johannesburg, South Africa
| | | | - Ian M Colrain
- Center for Health Sciences, SRI International, Menlo Park, CA, USA; Melbourne School of Psychological Sciences, University of Melbourne, Parkville, Victoria, Australia.
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Sawyer KS, Poey A, Ruiz SM, Marinkovic K, Oscar-Berman M. Measures of skin conductance and heart rate in alcoholic men and women during memory performance. PeerJ 2015; 3:e941. [PMID: 26020002 PMCID: PMC4435500 DOI: 10.7717/peerj.941] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2014] [Accepted: 04/16/2015] [Indexed: 11/20/2022] Open
Abstract
We examined abnormalities in physiological responses to emotional stimuli associated with long-term chronic alcoholism. Skin conductance responses (SCR) and heart rate (HR) responses were measured in 32 abstinent alcoholic (ALC) and 30 healthy nonalcoholic (NC) men and women undergoing an emotional memory task in an MRI scanner. The task required participants to remember the identity of two emotionally-valenced faces presented at the onset of each trial during functional magnetic resonance imaging (fMRI) scanning. After viewing the faces, participants saw a distractor image (an alcoholic beverage, nonalcoholic beverage, or scrambled image) followed by a single probe face. The task was to decide whether the probe face matched one of the two encoded faces. Skin conductance measurements (before and after the encoded faces, distractor, and probe) were obtained from electrodes on the index and middle fingers on the left hand. HR measurements (beats per minute before and after the encoded faces, distractor, and probe) were obtained by a pulse oximeter placed on the little finger on the left hand. We expected that, relative to NC participants, the ALC participants would show reduced SCR and HR responses to the face stimuli, and that we would identify greater reactivity to the alcoholic beverage stimuli than to the distractor stimuli unrelated to alcohol. While the beverage type did not differentiate the groups, the ALC group did have reduced skin conductance and HR responses to elements of the task, as compared to the NC group.
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Affiliation(s)
- Kayle S. Sawyer
- Boston University School of Medicine, Boston, MA, USA
- VA Boston Healthcare System, Boston, MA, USA
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Boston, MA, USA
| | - Alan Poey
- Boston University School of Medicine, Boston, MA, USA
- VA Boston Healthcare System, Boston, MA, USA
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Boston, MA, USA
| | - Susan Mosher Ruiz
- Boston University School of Medicine, Boston, MA, USA
- VA Boston Healthcare System, Boston, MA, USA
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Boston, MA, USA
| | - Ksenija Marinkovic
- University of California at San Diego, CA, USA
- Psychology Department, San Diego State University, CA, USA
| | - Marlene Oscar-Berman
- Boston University School of Medicine, Boston, MA, USA
- VA Boston Healthcare System, Boston, MA, USA
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Boston, MA, USA
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Tremblay M, Gallant F, Lavallière M, Chiasson M, Silvey D, Behm D, Albert WJ, Johnson MJ. Driving performance on the descending limb of blood alcohol concentration (BAC) in undergraduate students: a pilot study. PLoS One 2015; 10:e0118348. [PMID: 25723618 PMCID: PMC4344323 DOI: 10.1371/journal.pone.0118348] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2014] [Accepted: 01/14/2015] [Indexed: 12/05/2022] Open
Abstract
Young drivers are overrepresented in collisions resulting in fatalities. It is not uncommon for young drivers to socially binge drink and decide to drive a vehicle a few hours after consumption. To better understand the risks that may be associated with this behaviour, the present study has examined the effects of a social drinking bout followed by a simulated drive in undergraduate students on the descending limb of their BAC (blood alcohol concentration) curve. Two groups of eight undergraduate students (n = 16) took part in this study. Participants in the alcohol group were assessed before drinking, then at moderate and low BAC as well as 24 hours post-acute consumption. This group consumed an average of 5.3 ± 1.4 (mean ± SD) drinks in an hour in a social context and were then submitted to a driving and a predicted crash risk assessment. The control group was assessed at the same time points without alcohol intake or social context.; at 8 a.m., noon, 3 p.m. and 8 a.m. the next morning. These multiple time points were used to measure any potential learning effects from the assessment tools (i.e. driving simulator and useful field of view test (UFOV)). Diminished driving performance at moderate BAC was observed with no increases in predicted crash risk. Moderate correlations between driving variables were observed. No association exists between driving variables and UFOV variables. The control group improved measures of selective attention after the third asessement. No learning effect was observed from multiple sessions with the driving simulator. Our results show that a moderate BAC, although legal, increases the risky behaviour. Effects of alcohol expectancy could have been displayed by the experimental group. UFOV measures and predicted crash risk categories were not sentitive enough to predict crash risk for young drivers, even when intoxicated.
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Affiliation(s)
- Mathieu Tremblay
- Faculty of Kinesiology, University of New Brunswick, Fredericton, Canada
- Healthy Driver Research Group, Université de Moncton, Moncton, Canada
| | - François Gallant
- École de kinésiologie et de loisir, Université de Moncton, Moncton, Canada
- Healthy Driver Research Group, Université de Moncton, Moncton, Canada
| | - Martin Lavallière
- MIT (Massachusetts Institute of Technology) AgeLab & New England University Transportation Center, Cambridge, United States of America
| | - Martine Chiasson
- Faculty of Kinesiology, University of New Brunswick, Fredericton, Canada
- Healthy Driver Research Group, Université de Moncton, Moncton, Canada
| | - Dustin Silvey
- School of Human Kinetics and Recreation, Memorial University of Newfoundland, St John’s, Canada
| | - David Behm
- School of Human Kinetics and Recreation, Memorial University of Newfoundland, St John’s, Canada
| | - Wayne J. Albert
- Faculty of Kinesiology, University of New Brunswick, Fredericton, Canada
| | - Michel J. Johnson
- École de kinésiologie et de loisir, Université de Moncton, Moncton, Canada
- Healthy Driver Research Group, Université de Moncton, Moncton, Canada
- * E-mail:
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Vatsalya V, Momenan R, Hommer DW, Ramchandani VA. Cardiac reactivity during the ascending phase of acute intravenous alcohol exposure and association with subjective perceptions of intoxication in social drinkers. Alcohol Clin Exp Res 2014; 38:1247-54. [PMID: 24655119 PMCID: PMC4022188 DOI: 10.1111/acer.12377] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2013] [Accepted: 01/14/2014] [Indexed: 12/17/2022]
Abstract
BACKGROUND The aim of this study was to characterize cardiac reactivity measures, heart rate (HR), and heart rate variability (HRV), following acute intravenous (IV) alcohol administration and their association with subjective responses in social drinkers. METHODS Twenty-four subjects (11 females) received IV alcohol infusions to attain and clamp the breath alcohol concentration (BrAC) at 50 mg% or placebo in separate sessions. Serial 5-minute cardiac recordings at baseline and during the infusion were analyzed to obtain frequency and time domain cardiac measures. Self-reported subjective perceptions were also obtained at the same time points. RESULTS HR showed significant decreases from baseline, while the HRV measure pNN50 showed steady increases during the ascending phase of alcohol infusion. HR was inversely correlated with pNN50 across time and treatment. There was a significant association of HR with subjective feelings of high, intoxication, feeling drug effects, and liking drug effects across time during the ascending phase. CONCLUSIONS Acute IV alcohol resulted in decreases in HR and increases in HRV consistent with autonomic parasympathetic activation. The association of these changes with subjective responses suggests that cardiac reactivity may serve as a physiological marker of subjective alcohol effects. This study broadens the understanding of acute cardiovascular effects of alcohol and clinically significant cardiac conditions such as arrhythmia and cardiomyopathy associated with chronic alcohol drinking.
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Affiliation(s)
- Vatsalya Vatsalya
- Section on Human Psychopharmacology , Laboratory of Clinical and Translational Studies, National Institute on Alcohol Abuse and Alcoholism, Bethesda, Maryland
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