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Piccirillo G, Moscucci F, Mezzadri M, Caltabiano C, Cisaria G, Vizza G, De Santis V, Giuffrè M, Stefano S, Scinicariello C, Carnovale M, Corrao A, Lospinuso I, Sciomer S, Rossi P. Artificial Intelligence Applied to Electrical and Non-Invasive Hemodynamic Markers in Elderly Decompensated Chronic Heart Failure Patients. Biomedicines 2024; 12:716. [PMID: 38672072 PMCID: PMC11048014 DOI: 10.3390/biomedicines12040716] [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: 02/04/2024] [Revised: 03/16/2024] [Accepted: 03/18/2024] [Indexed: 04/28/2024] Open
Abstract
OBJECTIVES The first aim of this study was to assess the predictive power of Tend interval (Te) and non-invasive hemodynamic markers, based on bioimpedance in decompensated chronic heart failure (CHF). The second one was to verify the possible differences in repolarization and hemodynamic data between CHF patients grouped by level of left ventricular ejection fraction (LVEF). Finally, we wanted to check if repolarization and hemodynamic data changed with clinical improvement or worsening in CHF patients. METHODS Two hundred and forty-three decompensated CHF patients were studied by 5 min ECG recordings to determine the mean and standard deviation (TeSD) of Te (first study). In a subgroup of 129 patients (second study), non-invasive hemodynamic and repolarization data were recorded for further evaluation. RESULTS Total in-hospital and cardiovascular mortality rates were respectively 19 and 9%. Te was higher in the deceased than in surviving subjects (Te: 120 ± 28 vs. 100 ± 25 ms) and multivariable logistic regression analysis reported that Te was related to an increase of total (χ2: 35.45, odds ratio: 1.03, 95% confidence limit: 1.02-1.05, p < 0.001) and cardiovascular mortality (χ2: 32.58, odds ratio: 1.04, 95% confidence limit: 1.02-1.06, p < 0.001). Subjects with heart failure with reduced ejection fraction (HFrEF) reported higher levels of repolarization and lower non-invasive systolic hemodynamic data in comparison to those with preserved ejection fraction (HFpEF). In the subgroup, patients with the NT-proBNP reduction after therapy showed a lower rate of Te, heart rate, blood pressures, contractility index, and left ventricular ejection time in comparison with the patients without NT-proBNP reduction. CONCLUSION Electrical signals from ECG and bioimpedance were capable of monitoring the patients with advanced decompensated CHF. These simple, inexpensive, non-invasive, easily repeatable, and transmissible markers could represent a tool to remotely monitor and to intercept the possible worsening of these patients early by machine learning and artificial intelligence tools.
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Affiliation(s)
- Gianfranco Piccirillo
- Department of Internal and Clinical Medicine, Anesthesiology and Cardiovascular Sciences, Policlinico Umberto I, “Sapienza” University of Rome, 00185 Rome, Italy; (G.P.); (M.M.); (C.C.); (G.C.); (G.V.); (V.D.S.); (M.G.); (S.S.); (C.S.); (M.C.); (A.C.); (S.S.)
| | - Federica Moscucci
- Department of Internal Medicine and Medical Specialties, Policlinico Umberto I, Viale del Policlinico, 155, 00161 Rome, Italy;
| | - Martina Mezzadri
- Department of Internal and Clinical Medicine, Anesthesiology and Cardiovascular Sciences, Policlinico Umberto I, “Sapienza” University of Rome, 00185 Rome, Italy; (G.P.); (M.M.); (C.C.); (G.C.); (G.V.); (V.D.S.); (M.G.); (S.S.); (C.S.); (M.C.); (A.C.); (S.S.)
| | - Cristina Caltabiano
- Department of Internal and Clinical Medicine, Anesthesiology and Cardiovascular Sciences, Policlinico Umberto I, “Sapienza” University of Rome, 00185 Rome, Italy; (G.P.); (M.M.); (C.C.); (G.C.); (G.V.); (V.D.S.); (M.G.); (S.S.); (C.S.); (M.C.); (A.C.); (S.S.)
| | - Giovanni Cisaria
- Department of Internal and Clinical Medicine, Anesthesiology and Cardiovascular Sciences, Policlinico Umberto I, “Sapienza” University of Rome, 00185 Rome, Italy; (G.P.); (M.M.); (C.C.); (G.C.); (G.V.); (V.D.S.); (M.G.); (S.S.); (C.S.); (M.C.); (A.C.); (S.S.)
| | - Guendalina Vizza
- Department of Internal and Clinical Medicine, Anesthesiology and Cardiovascular Sciences, Policlinico Umberto I, “Sapienza” University of Rome, 00185 Rome, Italy; (G.P.); (M.M.); (C.C.); (G.C.); (G.V.); (V.D.S.); (M.G.); (S.S.); (C.S.); (M.C.); (A.C.); (S.S.)
| | - Valerio De Santis
- Department of Internal and Clinical Medicine, Anesthesiology and Cardiovascular Sciences, Policlinico Umberto I, “Sapienza” University of Rome, 00185 Rome, Italy; (G.P.); (M.M.); (C.C.); (G.C.); (G.V.); (V.D.S.); (M.G.); (S.S.); (C.S.); (M.C.); (A.C.); (S.S.)
| | - Marco Giuffrè
- Department of Internal and Clinical Medicine, Anesthesiology and Cardiovascular Sciences, Policlinico Umberto I, “Sapienza” University of Rome, 00185 Rome, Italy; (G.P.); (M.M.); (C.C.); (G.C.); (G.V.); (V.D.S.); (M.G.); (S.S.); (C.S.); (M.C.); (A.C.); (S.S.)
| | - Sara Stefano
- Department of Internal and Clinical Medicine, Anesthesiology and Cardiovascular Sciences, Policlinico Umberto I, “Sapienza” University of Rome, 00185 Rome, Italy; (G.P.); (M.M.); (C.C.); (G.C.); (G.V.); (V.D.S.); (M.G.); (S.S.); (C.S.); (M.C.); (A.C.); (S.S.)
| | - Claudia Scinicariello
- Department of Internal and Clinical Medicine, Anesthesiology and Cardiovascular Sciences, Policlinico Umberto I, “Sapienza” University of Rome, 00185 Rome, Italy; (G.P.); (M.M.); (C.C.); (G.C.); (G.V.); (V.D.S.); (M.G.); (S.S.); (C.S.); (M.C.); (A.C.); (S.S.)
| | - Myriam Carnovale
- Department of Internal and Clinical Medicine, Anesthesiology and Cardiovascular Sciences, Policlinico Umberto I, “Sapienza” University of Rome, 00185 Rome, Italy; (G.P.); (M.M.); (C.C.); (G.C.); (G.V.); (V.D.S.); (M.G.); (S.S.); (C.S.); (M.C.); (A.C.); (S.S.)
| | - Andrea Corrao
- Department of Internal and Clinical Medicine, Anesthesiology and Cardiovascular Sciences, Policlinico Umberto I, “Sapienza” University of Rome, 00185 Rome, Italy; (G.P.); (M.M.); (C.C.); (G.C.); (G.V.); (V.D.S.); (M.G.); (S.S.); (C.S.); (M.C.); (A.C.); (S.S.)
| | - Ilaria Lospinuso
- Department of Internal Medicine and Medical Specialties, Policlinico Umberto I, Viale del Policlinico, 155, 00161 Rome, Italy;
| | - Susanna Sciomer
- Department of Internal and Clinical Medicine, Anesthesiology and Cardiovascular Sciences, Policlinico Umberto I, “Sapienza” University of Rome, 00185 Rome, Italy; (G.P.); (M.M.); (C.C.); (G.C.); (G.V.); (V.D.S.); (M.G.); (S.S.); (C.S.); (M.C.); (A.C.); (S.S.)
| | - Pietro Rossi
- Arrhythmology Unit, Fatebenefratelli Hospital, Isola Tiberina-Gemelli Isola, 00186 Rome, Italy;
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Dimitriev D, Indeykina O, Dimitriev A. The Effect of Auditory Stimulation on the Nonlinear Dynamics of Heart Rate: The Impact of Emotional Valence and Arousal. Noise Health 2023; 25:165-175. [PMID: 37815078 PMCID: PMC10747806 DOI: 10.4103/nah.nah_15_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 05/01/2023] [Accepted: 05/11/2023] [Indexed: 10/11/2023] Open
Abstract
Background Although it is known that sound exposure evokes changes in autonomic activity, the effects of noise and music on the nonlinear behavior of heart rate fluctuations remain poorly understood and controversial. This study aims to assess the influence of sound subjective emotional valence and arousal on the nonlinear characteristics of the autonomic nervous system during passive listening. Methods In this study, 42 subjects listened to four sounds: (1) white noise, (2) road traffic noise, (3) excitatory music, and (4) a lullaby. The experiment consisted of two consecutive sessions: 5 minutes of rest, followed by 5 minutes of listening. RR intervals were recorded during both sessions. The following linear and nonlinear heart rate variability (HRV) indices were computed: Standard deviation of NN (SDNN), The root mean square of successive differences between normal heartbeats (RMSSD), F, high frequency (HF), approximate entropy (ApEn) and sample entropy (SampEn), correlation dimension (D2), Poincaré plot indices (SD1, SD2), fractal scaling exponents (alpha1, alpha2), and recurrence plot indices (mean line length [Lmean], maximum line length [Lmax], determinism [DET], laminarity [LAM], maximal vertical length [Vmax], trapping time [TT], Shannon entropy of line length distribution [ShanEn]). Results Excitatory music was associated with a significant decrease in SDNN (from 47.3 ± 3.59 to 38.31 ± 3.16, P < 0.01), RMSSD (from 51.07 ± 4.75 to 42.53 ± 3.9, P < 0.05), HF (from 1516.26 ± 245.74 to 884.07 ± 183.44, P < 0.001), and low frequency (LF; from 973.33 ± 176.09 to 760.28 ± 150.35, P < 0.05). Excitatory music exposure induced significant increases in DET (P < 0.01), SD1 (P < 0.05), and SD2 (P < 0.05), but changes in detrended fluctuation analysis (DFA), SampEn, and D2 were nonsignificant. Traffic noise, white noise, and the lullaby did not cause significant changes in the measures of HRV. Conclusion Presentation of excitatory music that evokes strong negative emotions elicits a prominent decrease in respiratory sinus arrhythmia. Poincaré plot and recurrence plot measures possess high sensitivity to excitatory music. Contrary to previous studies, we did not find the effects of relaxing music on HRV.
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Affiliation(s)
- Dmitri Dimitriev
- Department of Biology, Chuvash I. Yakovlev State Pedagogical University, Cheboksary, Chuvashia Republic, Russia
| | - Olga Indeykina
- Department of Biology, Chuvash I. Yakovlev State Pedagogical University, Cheboksary, Chuvashia Republic, Russia
| | - Aleksey Dimitriev
- Cheboksary Cooperative Institute of the Russian University of Cooperation, Cheboksary, Chuvashia Republic, Russia
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Egana-delSol P, Sun X, Sajda P. Neurophysiological markers of emotion regulation predict efficacy of entrepreneurship education. Sci Rep 2023; 13:7206. [PMID: 37137955 PMCID: PMC10156692 DOI: 10.1038/s41598-023-34148-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 04/25/2023] [Indexed: 05/05/2023] Open
Abstract
Recent evidence shows that programs targeting the socio-emotional dimensions of entrepreneurship-e.g., resilience, personal initiative, and empathy-are more highly correlated with success along with key business metrics, such as sales and survival, than programs with a narrow, technical bent-e.g., accounting and finance. We argue that programs designed to foster socio-emotional skills are effective in improving entrepreneurship outcomes because they improve the students' ability to regulate their emotions. They enhance the individuals' disposition to make more measured, rational decisions. We test this hypothesis studying a randomized controlled trial (RCT, RCT ID: AEARCTR-0000916) of an entrepreneurship program in Chile. We combine administrative data, surveys, and neuro-psychological data from lab-in-the-field measurements. A key methodological contribution of this study is the use of the electroencephalogram (EEG) to quantify the impact of emotional responses. We find that the program has a positive and significant impact on educational outcomes and, in line with the findings of other studies in the literature, we find no impact on self-reported measures of socio-emotional skills (e.g., grit and locus of control) and creativity. Our novel insight comes from the finding that the program has a significant impact on neurophysiological markers, decreasing arousal (a proxy of alertness), valence (a proxy for withdrawal from or approachability to an event or stimuli), and neuro-psychological changes to negative stimuli.
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Affiliation(s)
- Pablo Egana-delSol
- School of Business, Universidad Adolfo Ibáñez, Santiago, Viña del Mar, Chile.
- Millennium Nucleus on the Evolution of Work (MNEW), Santiago, Chile.
| | - Xiaoxiao Sun
- Department of Biomedical Engineering, Columbia University, New York, NY, 10027, USA
| | - Paul Sajda
- Department of Biomedical Engineering, Columbia University, New York, NY, 10027, USA
- Department of Radiology, Columbia University Irving Medical Center, New York, NY, 10032, USA
- Department of Electrical Engineering, Columbia University, New York, NY, 10027, USA
- Data Science Institute, Columbia University, New York, NY, 10027, USA
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Raglio A, Maestri R, Robbi E, Pierobon A, La Rovere MT, Pinna GD. Effect of Algorithmic Music Listening on Cardiac Autonomic Nervous System Activity: An Exploratory, Randomized Crossover Study. J Clin Med 2022; 11:jcm11195738. [PMID: 36233606 PMCID: PMC9571939 DOI: 10.3390/jcm11195738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Revised: 09/21/2022] [Accepted: 09/25/2022] [Indexed: 11/16/2022] Open
Abstract
It is proven that music listening can have a therapeutic impact in many clinical fields. However, to assume a curative value, musical stimuli should have a therapeutic logic. This study aimed at assessing short-term effects of algorithmic music on cardiac autonomic nervous system activity. Twenty-two healthy subjects underwent a crossover study including random listening to relaxing and activating algorithmic music. Electrocardiogram (ECG) and non-invasive arterial blood pressure were continuously recorded and were later analyzed to measure Heart Rate (HR) mean, HR variability and baroreflex sensitivity (BRS). Statistical analysis was performed using a general linear model, testing for carryover, period and treatment effects. Relaxing tracks decreased HR and increased root mean square of successive squared differences of normal-to-normal (NN) intervals, proportion of interval differences of successive NN intervals greater than 50 ms, low-frequency (LF) and high-frequency (HF) power and BRS. Activating tracks caused almost no change or an opposite effect in the same variables. The difference between the effects of the two stimuli was statistically significant in all these variables. No difference was found in the standard deviation of normal-to-normal RR intervals, LFpower in normalized units and LFpower/HFpower variables. The study suggests that algorithmic relaxing music increases cardiac vagal modulation and tone. These results open interesting perspectives in various clinical areas.
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Affiliation(s)
- Alfredo Raglio
- Music Therapy Research Laboratory, Istituti Clinici Scientifici Maugeri IRCCS, 27100 Pavia, Italy
- Correspondence: ; Tel.: +39-03825901
| | - Roberto Maestri
- Laboratory for the Study of Ventilatory Instability, Department of Biomedical Engineering, Istituti Clinici Scientifici Maugeri IRCCS, 27040 Montescano, Italy
| | - Elena Robbi
- Laboratory for the Study of the Autonomic Nervous System and Cardiorespiratory Activity, Department of Cardiology, Istituti Clinici Scientifici Maugeri IRCCS, 27040 Montescano, Italy
| | - Antonia Pierobon
- Psychology Unit, Istituti Clinici Scientifici Maugeri IRCCS, 27040 Montescano, Italy
| | - Maria Teresa La Rovere
- Laboratory for the Study of the Autonomic Nervous System and Cardiorespiratory Activity, Department of Cardiology, Istituti Clinici Scientifici Maugeri IRCCS, 27040 Montescano, Italy
| | - Gian Domenico Pinna
- Laboratory for the Study of Ventilatory Instability, Department of Biomedical Engineering, Istituti Clinici Scientifici Maugeri IRCCS, 27040 Montescano, Italy
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Walter Y, Altorfer A. Physiological Foundations for Religious Experiences in Devotional Worship Practices with Music Using Heart Rate and Respiration Rate Analyses. Eur J Investig Health Psychol Educ 2022; 12:127-143. [PMID: 35200234 PMCID: PMC8871314 DOI: 10.3390/ejihpe12020011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Revised: 01/19/2022] [Accepted: 01/25/2022] [Indexed: 11/20/2022] Open
Abstract
The present study investigates the psychophysiological activation patterns of religious experiences in worship practices using Heart Rate (HR) and Respiratory Rate (RR) analyses. For this, 60 evangelical individuals participated in an experiment where they worshipped to six selected conditions and continuously indicated how strongly they sensed what they believed to be the presence of God. These ratings were correlated with the biometric data to indicate whether the experience has an activating effect on the believer’s vegetative system (activation hypothesis) or a soothing effect thereupon (pacification hypothesis). Statistical analyses showed that the psychological disposition during the religious worship experience speeds up the physiological responses, which was indicated by increases in HR and RR. Hence, the activation hypothesis was accepted, and the pacification hypothesis was rejected.
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Affiliation(s)
- Yoshija Walter
- Laboratory for Cognitive Neurosciences, University of Fribourg, 1700 Fribourg, Switzerland
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy UPD, University of Bern, 3000 Bern, Switzerland;
- Institute for Management and Digitalization, Kalaidos University of Applied Sciences Zurich, 8050 Zurich, Switzerland
- Correspondence:
| | - Andreas Altorfer
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy UPD, University of Bern, 3000 Bern, Switzerland;
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Raglio A, De Maria B, Perego F, Galizia G, Gallotta M, Imbriani C, Porta A, Dalla Vecchia LA. Effects of Algorithmic Music on the Cardiovascular Neural Control. J Pers Med 2021; 11:jpm11111084. [PMID: 34834436 PMCID: PMC8618683 DOI: 10.3390/jpm11111084] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 10/22/2021] [Accepted: 10/22/2021] [Indexed: 12/21/2022] Open
Abstract
Music influences many physiological parameters, including some cardiovascular (CV) control indices. The complexity and heterogeneity of musical stimuli, the integrated response within the brain and the limited availability of quantitative methods for non-invasive assessment of the autonomic function are the main reasons for the scarcity of studies about the impact of music on CV control. This study aims to investigate the effects of listening to algorithmic music on the CV regulation of healthy subjects by means of the spectral analysis of heart period, approximated as the time distance between two consecutive R-wave peaks (RR), and systolic arterial pressure (SAP) variability. We studied 10 healthy volunteers (age 39 ± 6 years, 5 females) both while supine (REST) and during passive orthostatism (TILT). Activating and relaxing algorithmic music tracks were used to produce possible contrasting effects. At baseline, the group featured normal indices of CV sympathovagal modulation both at REST and during TILT. Compared to baseline, at REST, listening to both musical stimuli did not affect time and frequency domain markers of both SAP and RR, except for a significant increase in mean RR. A physiological TILT response was maintained while listening to both musical tracks in terms of time and frequency domain markers, compared to baseline, an increase in mean RR was again observed. In healthy subjects featuring a normal CV neural profile at baseline, algorithmic music reduced the heart rate, a potentially favorable effect. The innovative music approach of this study encourages further research, as in the presence of several diseases, such as ischemic heart disease, hypertension, and heart failure, a standardized musical stimulation could play a therapeutic role.
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Affiliation(s)
- Alfredo Raglio
- IRCCS Istituti Clinici Scientifici Maugeri, 27100 Pavia, Italy; (A.R.); (C.I.)
| | - Beatrice De Maria
- IRCCS Istituti Clinici Scientifici Maugeri, 20138 Milan, Italy; (B.D.M.); (F.P.); (M.G.)
| | - Francesca Perego
- IRCCS Istituti Clinici Scientifici Maugeri, 20138 Milan, Italy; (B.D.M.); (F.P.); (M.G.)
| | | | - Matteo Gallotta
- IRCCS Istituti Clinici Scientifici Maugeri, 20138 Milan, Italy; (B.D.M.); (F.P.); (M.G.)
| | - Chiara Imbriani
- IRCCS Istituti Clinici Scientifici Maugeri, 27100 Pavia, Italy; (A.R.); (C.I.)
| | - Alberto Porta
- Department of Biomedical Sciences for Health, University of Milan, 20133 Milan, Italy;
- Department of Cardiothoracic, Vascular Anesthesia and Intensive Care, IRCCS Policlinico San Donato, San Donato Milanese, 20097 Milan, Italy
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Abstract
Although music is predominantly utilized for religious, enjoyment or entertainment purposes, it is gradually emerging as a promising non-pharmacological intervention for improving health outcomes in both healthy and diseased populations, especially in those with cardiovascular diseases. As such, music of various genres and types has been postulated to possess features that stimulate or inhibit the autonomic nervous system, which leads to variable effects on cardiovascular function. However, music intervention has not been adequately explored as a cardiovascular therapeutic modality due to the lack of extensive studies with quality methodology. Thus, the aim of this systematic review is to explore the available literature on the effect of music on the cardiovascular system, discuss the limitations of current research, and suggest future directions in this field.
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Ruiz-Blais S, Orini M, Chew E. Heart Rate Variability Synchronizes When Non-experts Vocalize Together. Front Physiol 2020; 11:762. [PMID: 33013429 PMCID: PMC7506073 DOI: 10.3389/fphys.2020.00762] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 06/11/2020] [Indexed: 11/13/2022] Open
Abstract
Singing and chanting are ubiquitous across World cultures. It has been theorized that such practices are an adaptive advantage for humans because they facilitate bonding and cohesion between group members. Investigations into the effects of singing together have so far focused on the physiological effects, such as the synchronization of heart rate variability (HRV), of experienced choir singers. Here, we study whether HRV synchronizes for pairs of non-experts in different vocalizing conditions. Using time-frequency coherence (TFC) analysis, we find that HRV becomes more coupled when people make long (> 10 s) sounds synchronously compared to short sounds (< 1 s) and baseline measurements (p < 0.01). Furthermore, we find that, although most of the effect can be attributed to respiratory sinus arrhythmia, some HRV synchronization persists when the effect of respiration is removed: long notes show higher partial TFC than baseline and breathing (p < 0.05). In addition, we observe that, for most dyads, the frequency of the vocalization onsets matches that of the peaks in the TFC spectra, even though these frequencies are above the typical range of 0.04–0.4 Hz. A clear correspondence between high HRV coupling and the subjective experience of “togetherness" was not found. These results suggest that since autonomic physiological entrainment is observed for non-expert singing, it may be exploited as part of interventions in music therapy or social prescription programs for the general population.
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Affiliation(s)
- Sebastian Ruiz-Blais
- School of Electronic Engineering and Computer Science, Queen Mary University of London, London, United Kingdom
- *Correspondence: Sebastian Ruiz-Blais
| | - Michele Orini
- Department of Clinical Science, Institute of Cardiovascular Science, University College London, London, United Kingdom
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