Heart Rate Variability and Decision-Making: Autonomic Responses in Making Decisions

Do Decision-Making Styles Predict Vagal Control? The Role of Resting Heart Rate Variability

Decision-making styles are a habit-based propensity that drive behavior and affect daily life. Rational and intuitive decision-making styles have been associated with good mental health. However, the underlying mechanisms are not clear. In the last decade, high basal levels of heart rate variability (HRV) have been proposed as an index of health and emotional control, and this could be one of the variables involved in the effects of decision making on health. Therefore, the aim of this study is to analyze the capability of decision-making styles to predict resting HRV. A cross-sectional study was conducted in a sample of 199 (119 women) young university students, and a resting ECG was recorded to extract frequency domain HRV variables. Subsequently, participants completed sociodemographic data and the General Decision-Making Style questionnaire (GDMS). Results showed that the intuitive style predicted high-frequency HRV, while the avoidant style predicted less low-frequency HRV. This study presents new data on the relationship between decision-making style and HRV, suggesting that the intuitive style has a cardioprotective effect, while the avoidant style is related to lower HRV, which has been associated with health vulnerability. In conclusion, this study contributes to the understanding of HRV and its potential as a biomarker for cognitive styles that may improve health.

Neurophysiological and Autonomic Correlates of Metacognitive Control of and Resistance to Distractors in Ecological Setting: A Pilot Study

In organisational contexts, professionals are required to decide dynamically and prioritise unexpected external inputs deriving from multiple sources. In the present study, we applied a multimethodological neuroscientific approach to investigate the ability to resist and control ecological distractors during decision-making and to explore whether a specific behavioural, neurophysiological (i.e., delta, theta, alpha and beta EEG band), or autonomic (i.e., heart rate-HR, and skin conductance response-SCR) pattern is correlated with specific personality profiles, collected with the 10-item Big Five Inventory. Twenty-four participants performed a novel Resistance to Ecological Distractors (RED) task aimed at exploring the ability to resist and control distractors and the level of coherence and awareness of behaviour (metacognition ability), while neurophysiological and autonomic measures were collected. The behavioural results highlighted that effectiveness in performance did not require self-control and metacognition behaviour and that being proficient in metacognition can have an impact on performance. Moreover, it was shown that the ability to resist ecological distractors is related to a specific autonomic profile (HR and SCR decrease) and that the neurophysiological and autonomic activations during task execution correlate with specific personality profiles. The agreeableness profile was negatively correlated with the EEG theta band and positively with the EEG beta band, the conscientiousness profile was negatively correlated with the EEG alpha band, and the extroversion profile was positively correlated with the EEG beta band. Taken together, these findings describe and disentangle the hidden relationship that lies beneath individuals' decision to inhibit or activate intentionally a specific behaviour, such as responding, or not, to an external stimulus, in ecological conditions.

Autonomic brain functioning and age-related health concerns

The autonomic nervous system (ANS) regulates involuntary bodily functions such as blood pressure, heart rate, breathing, and digestion, in addition to controlling motivation and behavior. In older adults, the ANS is dysregulated, which changes the ability of the ANS to respond to physiological signals, regulate cardiovascular autonomic functionality, diminish gastric motility, and exacerbate sleep problems. For example, a decrease in heart rate variability, or the variation in the interval between heartbeats, is one of the most well-known alterations in the ANS associated with health issues, including cardiovascular diseases and cognitive decline. The inability to perform fundamental activities of daily living and compromising the physiological reactivity or motivational responses of older adults to moving toward or away from specific environmental stimuli are significant negative consequences of chronic and geriatric conditions that pose grave threats to autonomy, health, and well-being. The most updated research has investigated the associations between the action responsiveness of older adults and the maintenance of their physiological and physical health or the development of mental and physical health problems. Once autonomic dysfunction may significantly influence the development of different age-related diseases, including ischemic stroke, cardiovascular disease, and autoimmune diseases, this review aimed to assess the relationship between aging and autonomic functions. The review explored how motivational responses, physiological reactivity, cognitive processes, and lifelong developmental changes associated with aging impact the ANS and contribute to the emergence of health problems.

The use of heart rate variability in esports: A systematic review

Heart rate variability (HRV) is a psychophysiological measure of particular interest in esports due to its potential to monitor player self-regulation. This study aimed to systematically review the utilisation of HRV in esports. Consideration was given to the methodological and theoretical underpinnings of previous works to provide recommendations for future research. The protocol was made available on the Open Science Framework. Inclusion criteria were empirical studies, examining HRV in esports, using esports players, published in English. Exclusion criteria were non-peer-reviewed studies, populations with pre-existing clinical illness other than Internet Gaming Disorder (IGD), opinion pieces or review papers. In November 2022 a search of Web of Science, PubMed, and EBSCOHost identified seven studies using HRV in esports. Risk of bias was assessed using the Mixed Methods Appraisal Tool. Narrative review identified two primary uses of HRV in esports; stress response and IGD. A lack of theoretical and methodological underpinning was identified as a major limitation of current literature. Further investigation is necessary before making recommendations regarding the use of HRV in esports. Future research should employ sound theoretical underpinning such as the use of vagally mediated HRV and the robust application of supporting methodological guidelines when investigating HRV in esports.

Decision-making under ambiguity and risk and executive functions in Parkinson's disease patients: A scoping review of the studies investigating the Iowa Gambling Task and the Game of Dice

Evidence shows that patients affected by Parkinson's disease (PD) display the tendency toward making risky choices. This is due, at least in part, to the pathophysiological characteristics of the disease that affects neural areas underlying decision making (DM), in which a pivotal role is played by nonmotor corticostriatal circuits and dopamine. Executive functions (EFs), which can be impaired by PD as well, may sustain optimal choices in DM processes. However, few studies have investigated whether EFs can support PD patients to make good decisions. Adopting the scoping review approach, the present article is designed to deepen the cognitive mechanisms of DM under conditions of ambiguity and risk (that are conditions common to everyday life decisions) in PD patients without impulse control disorders. We focused our attention on the Iowa Gambling Task and the Game of Dice Task, because they are the most commonly used and reliable tasks to assess DM under ambiguity and under risk, respectively, and analyzed the performances in such tasks and their relationships with EFs tests in PD patients. The analysis supported the relationships between EFs and DM performance, especially when a higher cognitive load is required to make optimal decisions, as it happens under conditions of risk. Possible knowledge gaps and further research directions are suggested to better understand DM mechanisms in PD sustaining patients' cognitive functioning and preventing negative consequences in everyday life derived from suboptimal decisions.

Inhibition and Heart Rate Variability in Experimentally Induced Pain

Introduction

Pain is a complex experience that requires executive functions (EFs) to be processed. The autonomic outcome of the neural networks involved in the cognitive evaluation of pain is reflected by heart rate variability (HRV), an index of self-regulation abilities. Although some results suggest a relationship between HRV, EFs, and pain, studies focusing on this three-way relationship are still scarce.

Objective

This study aims to investigate the relationship between pain, cognitive, and autonomic mechanisms, hypothesizing an association between resting HRV and both cognitive and motor inhibition as indices of executive functioning. This relationship was investigated after an experimental-induced pain.

Methods

Seventy-six young adults were exposed to the Cold Pressure Arm Warp to induce experimental pain. HRV was collected, and cognitive tasks were administered to assess executive performance.

Results

The results showed that (1) HRV indices significantly increased during pain stimulation, (2) cognitive inhibition was positively correlated with vagal indices and with pain parameters, (3) both inhibition tasks significantly predicted pain threshold while the performance on the Stroop Task predicted pain tolerance.

Conclusion

Results suggest a three-way relationship. Further research would focus on the role of HRV and cognitive strategies in pain management in chronic pain conditions.

Three weeks of mental training changes physiological outcomes during a time trial to exhaustion

Mental training (MT) can increase endurance performance. The purpose of this study was to examine the minimum dose of mental training needed to increase performance and elucidate the physiological mechanisms underlying this improvement. In a randomized between groups pre-test-post-test design, 33 participants visited the lab on 6 separate days. A VO2peak with ventilatory threshold (VT) was performed on day 1. The subsequent visits consisted of time trials to exhaustion (TTE) performed at 10% above VT. Between visit 3 and 6, the MT group (n = 16) watched a video for 10-15 min each day for 3 weeks, while the control group (CON; n = 17) did no mental training. Heart rate (HR), rate of perceived exertion (RPE), VAS scores for pain and fatigue, electromyography, and metabolic and neuromuscular data were collected and recorded during the time trials. The GRIT-S and CD-RISC 10 surveys were completed before study days 3 and 6. TTE increased significantly for MT beginning after 2 weeks (10.0 ± 13.1%) with no further change after 3 weeks (10.4 ± 13.2). TTE also significantly decreased during the last TTE for CON (-10.3 ± 12.7). VO2, ventilation, and frequency of breathing were significantly reduced in the latter stages of the TTE for MT. EMG was also significantly decreased for MT as compared for CON throughout the trial. Three weeks of mental training improves performance by reducing EMG, decreasing activation of the muscle and reducing metabolic factors during the latter stages of exercise.

Self-Awareness of Goals Task (SAGT) and Planning Skills: The Neuroscience of Decision Making

A goal's self-awareness and the planning to achieve it drive decision makers. Through a neuroscientific approach, this study explores the self-awareness of goals by analyzing the explicit and implicit processes linked to the ability to self-represent goals and sort them via an implicit dominant key. Thirty-five professionals performed a novel and ecological decision-making task, the Self-Awareness of Goals Task (SAGT), aimed at exploring the (i) self-representation of the decision-making goals of a typical working day; (ii) self-representation of how these goals were performed in order of priority; (iii) temporal sequence; and (iv) in terms of their efficacy. Electrophysiological (i.e., alpha, beta, and gamma band), autonomic, behavioral, and self-report data (General Decision Making Style and Big Five Inventory) are collected. Higher self-awareness of goals by time as well as efficacy and the greater activation of alpha, beta, and gamma bands in the temporoparietal brain area were found. Correlations reported positive associations between the self-awareness of goals via a time and dependent decision-making style and a conscientious personality, but also between the self-awareness of goals via an efficacy and rational decision-making style. The results obtained in this study suggest that the SAGT could activate recursive thinking in the examinee and grasp individual differences in self-representation and aware identification of decision-making goals.

A Comparative Cross-Sectional Study of Cardiac Autonomic Status by Five Minute Heart Rate Variability among Type 2 Diabetics, Hypertensives and Normotensive-Nondiabetics

Background

Diabetes and hypertension are known to co-exist frequently as adverse cardiovascular risk factors. Both can produce cardiac autonomic neuropathythat can be measured by ECG RR interval-based heart rate variability (HRV). We compared 5 minutes HRV in four groups based on diabetes and hypertension.

Methodology

A cross sectional study was done on 203 participants divided into four groups- diabetics, hypertensives, diabetic-hypertensives and normotensive-nondiabetics. They were evaluated for current disease control and five minutes HRV was done in supine condition following standard protocols by Variowin HR Software. HRV parameters of time domain, frequency domain and Poincare plot were compared between groups and associated with gender, glycaemic control and blood pressure control. Statistical significance was set at p<0.05.

Results

Three diseasedgroups had mean age in mid-fifties, mean duration of disease > 6 years, comparable BMI, poor glycaemic and blood pressure control. As compared to normal groups, three diseased groups exhibit reduced HRV with respect to all three domains of HRV with varying statistical significance. Among diseased groups, HRV was associated with blood pressure control better than glycaemic control but not with gender. LF /HF ratio was the most consistent HRV parameter showing statistical significance in tests.

Conclusion

HRV is reduced in both diabetics more than hypertensives; related to blood pressure control more than glycaemic control. It points altered cardiac autonomic balance, and possibility of cardiovascular risk and early detection of it with timely intervention. It also calls for investigation of same for reinforcement of our observations and further exploration.

Reducing decision-making deficits in patients with brain injury: effect of slow-paced breathing

Impairments in decision-making have been reported in brain-damaged (stroke/traumatic brain injury) patients with a wide range of lesion sites. Here, we propose that the performances of patients in complex sequential decision-making (DM) tasks can be explained by their negative affectivity, leading to deliberative processing associated with poor DM performances. We assumed that a slow-paced breathing (SPB) training, by reducing negative affectivity would improve performances in a complex DM task. For 24 days, 34 brain-damaged patients (16 males and 18 females; 12 had a hemorrhagic stroke, 17 with an ischemic stroke and 5 with a TBI), practiced either daily SPB or sham trainings for five min, three times a day. Before and after training, we assessed their vagal tone (electrocardiogram-ECG), affectivity (Positive and Negative Affect Schedule-PANAS) and certainty level (Dimensional Ratings Questionnaire-DRQ) and their performance on the Iowa Gambling Task. All participants showed initial weak performance, which improved only for patients in the SPB training condition. These results suggest that DM disorders in brain-damaged patients can be the consequence of their poor information processing strategy rather than an impairment in their DM abilities. Second, we showed that SPB could be efficient to normalize DM processes in brain injury patients.

Is there a link between heart rate variability and cognitive decline? A cross-sectional study on patients with mild cognitive impairment and cognitively healthy controls

BACKGROUND

Given that, up to date, there is no effective strategy to treat dementia, a timely start of interventions in a prodromal stage such as mild cognitive impairment (MCI) is considered an important option to lower the overall societal burden. Although autonomic functions have been related to cognitive performance, both aspects have rarely been studied simultaneously in MCI.

OBJECTIVE

The aim of the present study was to investigate cardiac autonomic control in older adults with and without MCI.

METHODS

Cardiac autonomic control was assessed by means of heart rate variability (HRV) at resting state and during cognitive tasks in 22 older adults with MCI and 29 healthy controls (HCs). Resting HRV measurement was performed for 5 minutes during a sitting position. Afterwards, participants performed three PC-based tasks to probe performance in executive functions and language abilities (i.e., Stroop, N-back, and a verbal fluency task).

RESULTS

Participants with MCI showed a significant reduction of HRV in the frequency-domain (high frequency power) and nonlinear indices (SD2, D2, and DFA1) during resting state compared to HCs. Older individuals with MCI exhibited decreases in RMSSD and increases in DFA1 from resting state to Stroop and N-back tasks, reflecting strong vagal withdrawal, while this parameter remained stable in HCs.

CONCLUSION

The results support the presence of autonomic dysfunction at the early stage of cognitive impairment. Heart rate variability could help in the prediction of cognitive decline as a noninvasive biomarker or as a tool to monitor the effectiveness of therapy and prevention of neurodegenerative diseases.

The heart to make the right choice: Vagal (re)activity and recovery predict advantageous decision-making

From simple everyday choices to life-altering decisions, decision-making is a crucial cognitive process in our daily life. Psychophysiological theories of heart-brain interactions involvement in cognition predict that general self-regulation capacities underlie cognitive processes including decision-making. Yet, in the context of decision-making, the somatic maker hypothesis postulates that the adaptability of the current physiological state should be the best predictor of advantageous decision-making. The present study tests compare self-regulation in general (indexed by resting vagal activity) and in a specific decisional context (vagal reactivity and recovery) to explain advantageous decision-making. Young adults (n = 54) completed a decision-making task while wearing a heart rate monitor. Bayesian regressions show that vagal reactivity and recovery combined is the preferred statistical model to explain advantageous decision-making (BF₁₀ = 163.85). Those findings 1) support the somatic marker hypothesis highlighting the key role of in situ self-regulation in decision-making processes and 2) show that the popular and often used index of general self-regulation, resting vagal activity, is not the best predictor of decision-making performance, and perhaps even for other cognitive functions. A next step could be interventional studies to test whether vagal modulation of heart rate underlies decision-making through interventions that influence vagal activity, which could provide relevant clinical leads.

Case Study of the Psychophysical State of Student-Operators During UAVO Training, Based on Heart Rate Parameter

This article focuses on the human factor in UAV operations. In the manuscript, research on the psychophysical state of student-operators under the license of UAVO VLOS <4 kg. For the analysis of the psychophysical state, the pulse parameter was used, which is one of the values that describe the work of the cardiovascular system and is one for the objective methods of assessing the psychophysical state of a human being. The data collected were analyzed using the STATISTICA software. The article focuses on the above aspect and analyzes the psychophysical state of the student-operator during flight training. The obtained results were also related to research on similar topics in the chapter discussion section.

Quantitative analysis of heart rate variability parameter and mental stress index

Background

Cardiovascular disease not only occurs in the elderly but also tends to become a common social health problem. Considering the fast pace of modern life, quantified heart rate variability (HRV) indicators combined with the convenience of wearable devices are of great significance for intelligent telemedicine. To quantify the changes in human mental state, this article proposes an improved differential threshold algorithm for R-wave detection and recognition of electrocardiogram (ECG) signals.

Methods

HRV is a specific quantitative indicator of autonomic nerve regulation of the heart. The recognition rate is increased by improving the starting position of R wave and the time-window function of the traditional differential threshold method. The experimental platform is a wearable sign monitoring system constructed based on body area networks (BAN) technology. Analytic hierarchy process (AHP) is used to construct the mental stress assessment model, the weight judgment matrix is constructed according to the influence degree of HRV analysis parameters on mental stress, and the consistency check is carried out to obtain the weight value of the corresponding HRV analysis parameters.

Results

Experimental results show that the recognition rate of R wave of real-time 5 min ECG data collected by this algorithm is >99%. The comprehensive index of HRV based on weight matrix can greatly reduce the deviation caused by the measurement error of each parameter. Compared with traditional characteristic wave recognition algorithms, the proposed algorithm simplifies the process, has high real-time performance, and is suitable for wearable analysis devices with low-configuration requirements.

Conclusion

Our algorithm can describe the mental stress of the body quantitatively and meet the requirements of application demonstration.

Investigating the Role of Insight, Decision-Making and Mentalizing in Functional Outcome in Schizophrenia: A Cross-Sectional Study

Background: Recovery has become a priority in schizophrenia spectrum disorders (SSDs). This study aimed to investigate predictors of objective—general functioning and disability—and subjective—quality of life (QoL)—measures of functional outcomes in SSD. Methods: Sample: n = 77 SSD outpatients (age 18–64, IQ > 70) participating in a randomised controlled trial. Baseline data were used to build three multivariable linear regression models on: (i) general functioning—General Assessment of Functioning (GAF); (ii) disability—the World Health Organization Disability Assessment Schedule (WHODAS-2.0); and (iii) QoL—Satisfaction Life Domains Scale (SLDS). Results: Young age and being employed (R² change = 0.211; p = 0.001), late adolescence premorbid adjustment (R² change = 0.049; p = 0.0050), negative symptoms and disorganization (R² change = 0.087; p = 0.025) and Theory of Mind (R² change = 0.066, p = 0.053) predicted general functioning. Previous suicidal behaviour (R² change = 0.068; p = 0.023) and negative and depressive symptoms (R² change = 0.167; p = 0.001) were linked with disability. Previous suicidal behaviour (R² change = 0.070, p = 0.026), depressive symptoms (R² change = 0.157; p < 0.001) and illness recognition (R² change = 0.046, p = 0.044) predicted QoL. Conclusions: Negative, disorganization and depressive symptoms, older age, unemployment, poor premorbid adjustment, previous suicide attempts and illness awareness appear to underlie a poor global functional outcome in SSD. Achieving recovery in SSD appears to require both symptomatic remission (e.g., through antipsychotics) and measures to improve mastery and relieve low mood.

High-Level Executive Functions: A Possible Role of Sex and Weight Condition in Planning and Decision-Making Performances

Evidence indicates an association between executive functioning and increased weight, with different patterns ascribed to individual differences (sex, age, lifestyles). This study reports on the relationship between high-level executive functions and body weight. Sixty-five young adults participated in the study: 29 participants (14 males, 15 females) in the normal weight range; 36 participants (18 males, 18 females) in the overweight range. The Iowa Gambling Task (IGT) and Tower of London Task were administered to assess decision making and planning. Planning did not differ in individuals in the normal-weight and overweight groups, and no difference emerged between females and males. However, normal and overweight males and females had different patterns in decision making. On the long-term consequences index of the IGT, females reported lower scores than males. Males in the overweight range had a lower long-term consequences index on the IGT than normal-weight males, while this pattern did not emerge in females. These findings suggest that decision-making responses may differ in the overweight relative to healthy weight condition, with a different expression in males and females. This pattern should be considered in weight loss prevention strategies, possibly adopting different approaches in males and females.

Heart Rate Variability and Pain: A Systematic Review

Background and Objective: Heart rate variability (HRV) as an index of the autonomic nervous system appears to be related to reactivity to experimental pain stimuli. HRV could better explain the contributions of sympathetic and parasympathetic activity response to nociceptive stimulation. The aim of this study was to systematically review and synthesize the current evidence on HRV in relation to the experience of pain in experimental tasks. Databases and Data Treatment: Studies indexed in the PubMed, PsycINFO, MEDLINE, WebOfScience, and Scopus databases were reviewed for eligibility. Studies on the autonomic response (i.e., HRV) to experimentally induced pain in healthy adults were included. Different methods of pain induction were considered (e.g., thermal, pressure, and electrical). Data were synthesized considering the association between HRV and both pain induction and subjective measures of pain. Results: Seventy-one studies were included. The results underline significant change in both the sympathetic and parasympathetic autonomic nervous systems during the painful stimulation independent of the pain induction method. The autonomic reaction to pain could be affected by several factors, such as sex, age, body mass index, breathing patterns, the intensity of the stimulation, and the affective state. Moreover, an association between the autonomic nervous system and the subjective experience of pain was found. Higher parasympathetic activity was associated with better self-regulation capacities and, accordingly, a higher pain inhibition capacity. Conclusions: HRV appears to be a helpful marker to evaluate nociceptive response in experimentally induced pain. Future studies are also needed in clinical samples to understand better the interindividual changes of autonomic response due to pain stimuli.

The complex burden of determining prevalence rates of mild cognitive impairment: A systematic review

Mild cognitive impairment (MCI) is a syndrome characterized by a decline in cognitive performance greater than expected for an individual's age and education level, but that does not interfere much with daily life activities. Establishing the prevalence of MCI is very important for both clinical and research fields. In fact, in a certain percentage of cases, MCI represents a prodromal condition for the development of dementia. Accordingly, it is important to identify the characteristics of MCI that allow us to predict the development of dementia. Also, initial detection of cognitive decline can allow the early implementation of prevention programs aimed at counteracting or slowing it down. To this end, it is important to have a clear picture of the prevalence of MCI and, consequently, of the diagnostic criteria used. According to these issues, this systematic review aims to analyze MCI prevalence, exploring the methods for diagnosing MCI that determine its prevalence. The review process was conducted according to the PRISMA statement. Three thousand one hundred twenty-one international articles were screened, and sixty-six were retained. In these studies, which involved 157,035 subjects, the prevalence of MCI ranged from 1.2 to 87%. The review results showed a large heterogeneity among studies due to differences in the subjects' recruitment, the diagnostic criteria, the assessed cognitive domains, and other methodological aspects that account for a higher range of MCI prevalence. This large heterogeneity prevents drawing any firm conclusion about the prevalence of MCI.

Moral Judgement along the Academic Training

Moral reasoning and consequent decision making are central in the everyday life of all people, independent of their profession. It is undoubtedly crucial in the so-called "helping professions", when the professional through his/her decisions can support or not support others. Our study aimed to investigate whether academic training can play an essential role in influencing moral reasoning. We used three different conditions: 20 moral personal, 20 moral impersonal, and 20 nonmoral dilemmas to assessed differences in moral judgement between students of Economics, Medicine, and Psychology at their first year and at the end of university training. We observed a difference between school and year of course: psychology students showing more time when asked to read and answer the proposed questions. Moreover, medical students showed a significant increase in sensitiveness to moral issues as a function of academic ageing, whereas such a moral sense regressed from the first to the fifth year of academic training in other students. Gender was also relevant, with women showing an increased response and reading times compared to than men when asked to cope with moral decisions. This study shows that the main factor driving moral decision making is the faculty to which one is enrolled, significantly modulated by sex and academic seniority.

Decision Making: a Theoretical Review

Decision-making is a crucial skill that has a central role in everyday life and is necessary for adaptation to the environment and autonomy. It is the ability to choose between two or more options, and it has been studied through several theoretical approaches and by different disciplines. In this overview article, we contend a theoretical review regarding most theorizing and research on decision-making. Specifically, we focused on different levels of analyses, including different theoretical approaches and neuropsychological aspects. Moreover, common methodological measures adopted to study decision-making were reported. This theoretical review emphasizes multiple levels of analysis and aims to summarize evidence regarding this fundamental human process. Although several aspects of the field are reported, more features of decision-making process remain uncertain and need to be clarified. Further experimental studies are necessary for understanding this process better and for integrating and refining the existing theories.

Heart Rate Variability in Insulo-Opercular Epilepsy

Background: We aimed to evaluate heart rate variability (HRV) changes in insulo-opercular epilepsy (IOE) and after insulo-opercular surgery. Methods: We analyzed 5-min resting HRV of IOE patients before and after surgery. Patients’ SUDEP-7 risk inventory scores were also calculated. Results were compared with age- and sex-matched patients with temporal lobe epilepsy (TLE) and healthy individuals. Results: There were no differences in HRV measurements between IOE, TLE, and healthy control groups (and within each IOE group and TLE group) in preoperative and postoperative periods. In IOE patients, the SUDEP-7 score was positively correlated with pNN50 (percentage of successive RR intervals that differ by more than 50 ms) (p = 0.008) and RMSSD (root mean square of successive RR interval differences) (p = 0.019). We stratified IOE patients into those whose preoperative RMSSD values were below (Group 1a = 7) versus above (Group 1b = 9) a cut-off threshold of 31 ms (median value of a healthy population from a previous study). In group 1a, all HRV values significantly increased after surgery. In group 1b, time-domain parameters significantly decreased postoperatively. Conclusions: Our results suggest that in IOE, HRV may be either decreased in parasympathetic tone or increased globally in both sympathetic and parasympathetic tones. We found no evidence that insulo-opercular surgeries lead to major autonomic dysfunction when a good seizure outcome is reached. The increase in parasympathetic tone observed preoperatively may be of clinical concern, as it was positively correlated with the SUDEP-7 score.

Modeling Skin Conductance Response Time Series during Consecutive Rapid Decision-Making under Concurrent Temporal Pressure and Information Ambiguity

Emergency situations promote risk-taking behaviors associated with anxiety reactivity. A previous study using the Iowa Gambling Task (IGT) has demonstrated that prespecified state anxiety predicts moderate risk-taking (middle-risk/high-return) after salient penalty events under temporal pressure and information ambiguity. Such moderate risk-taking can be used as a behavioral background in the case of fraud damage. We conducted two psychophysiological experiments using the IGT and used a psychophysiological modeling approach to examine how moderate risk-taking under temporal pressure and information ambiguity is associated with automatic physiological responses, such as a skin conductance response (SCR). The first experiment created template SCR functions under concurrent temporal pressure and information ambiguity. The second experiment produced a convolution model using the SCR functions and fitted the model to the SCR time series recorded under temporal pressure and no temporal pressure, respectively. We also collected the participants’ anxiety profiles before the IGT experiment. The first finding indicated that participants with higher state anxiety scores yielded better model fitting (that is, event-related physiological responses) under temporal pressure. The second finding demonstrated that participants with better model fitting made consecutive Deck A selections under temporal pressure more frequently. In summary, a psychophysiological modeling approach is effective for capturing overlapping SCRs and moderate risk-taking under concurrent temporal pressure and information ambiguity is associated with automatic physiological and emotional reactivity.

Anxiety and Attentional Processes: The Role of Resting Heart Rate Variability

Individuals with high anxiety preferentially focus attention on emotional information. The autonomic nervous system (ANS) plays an important role in modulating both anxiety and attentional processes. Despite many studies having evaluated attentional bias in anxious people, few of them have investigated the change blindness phenomenon associated with the attentional response toward salient stimuli, considering the role of the ANS. This study aimed to examine the role of heart rate variability (HRV) in trait anxiety and top-down and bottom-up attentional processes toward emotional stimuli. Seventy-five healthy university students were divided into high (N = 39) and low (N = 36) trait anxiety groups and completed a change detection flicker task with neutral, positive, and negative stimuli. The results evidenced a different attentional pattern between people with high and low anxiety considering both the two attentional processes and the valence of the stimuli. Specifically, individuals with high anxiety showed a bias in elaborating emotional stimuli related to their salience (i.e., negative stimuli were faster elaborated than neutral and positive stimuli when top-down attentional mechanisms were involved, while slower performances were highlighted considering bottom-up attentional mechanisms in response to emotional stimuli compared to neutral stimuli). Moreover, an association between HRV, trait anxiety levels, and change blindness phenomenon was confirmed. These results underline the role of HRV as a possible predictor of the alteration of attentional mechanism in anxiety.