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Saito R, Yoshida K, Sawamura D, Watanabe A, Tokikuni Y, Sakai S. Effects of Heart Rate Variability Biofeedback Training on Anxiety Reduction and Brain Activity: a Randomized Active-Controlled Study Using EEG. Appl Psychophysiol Biofeedback 2024:10.1007/s10484-024-09650-5. [PMID: 38888656 DOI: 10.1007/s10484-024-09650-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/08/2024] [Indexed: 06/20/2024]
Abstract
Heart rate variability biofeedback (HRVBF) is a promising anxiety-reducing intervention that increases vagally-mediated heart rate variability (vmHRV) through slow-paced breathing and feedback of heart rhythm. Several studies have reported the anxiety-reducing effects of HRVBF; however, some studies have reported such training as ineffective. Furthermore, the effects of training and underlying brain activity changes remain unclear. This study examined the anxiety-reducing effects of HRVBF training and related brain activity changes by randomly assigning participants, employing an active control group, and measuring anxiety-related attentional bias using the emotional Stroop task and electroencephalography (EEG). Fifty-five healthy students with anxiety were randomly assigned to the HRVBF or control groups, and 21 in the HRVBF group and 19 in the control group were included in the analysis. Both groups performed 10 training sessions of 20 min each within 3 weeks. They were assessed using resting vmHRV, event-related potential (ERP), time-frequency EEG, attentional bias, and the State-Trait Anxiety Inventory-JYZ (STAI-JYZ) before and after training. The results demonstrated increased resting vmHRV in the HRVBF group compared to the control group after training. However, no differences were observed in ERP, time-frequency EEG, attentional bias, and STAI-JYZ. Participants with higher pre-training resting vmHRV achieved higher heart rhythm coherence in HRVBF training and had reduced attentional bias. This study suggests that individuals with higher resting vmHRV are more likely to be proficient in HRVBF training and benefit from its anxiety-reducing effects. The findings contribute to participant selection to benefit from HRVBF training and modification of the training protocols for non-responders.Clinical trial registrationOrganization: University Hospital Medical Information Network Clinical Trials Registry (UMIN-CTR), JapanRegistration number: UMIN000047096Registration date: March 6, 2022.
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Affiliation(s)
- Ryuji Saito
- Graduate School of Health Sciences, Hokkaido University, Sapporo, Japan
| | - Kazuki Yoshida
- Department of Rehabilitation Science, Faculty of Health Sciences, Hokkaido University, Sapporo, Japan.
| | - Daisuke Sawamura
- Department of Rehabilitation Science, Faculty of Health Sciences, Hokkaido University, Sapporo, Japan
| | - Akihiro Watanabe
- Graduate School of Health Sciences, Hokkaido University, Sapporo, Japan
| | - Yukina Tokikuni
- Graduate School of Health Sciences, Hokkaido University, Sapporo, Japan
| | - Shinya Sakai
- Department of Rehabilitation Science, Faculty of Health Sciences, Hokkaido University, Sapporo, Japan
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Galin S, Keren H. The Predictive Potential of Heart Rate Variability for Depression. Neuroscience 2024; 546:88-103. [PMID: 38513761 DOI: 10.1016/j.neuroscience.2024.03.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 02/29/2024] [Accepted: 03/16/2024] [Indexed: 03/23/2024]
Abstract
Heart rate variability (HRV),a measure of the fluctuations in the intervals between consecutive heartbeats, is an indicator of changes in the autonomic nervous system. A chronic reduction in HRV has been repeatedly linked to clinical depression. However, the chronological and mechanistic aspects of this relationship, between the neural, physiological, and psychopathological levels, remain unclear. In this review we present evidence by which changes in HRV might precede the onset of depression. We describe several pathways that can facilitate this relationship. First, we examine a theoretical model of the impact of autonomic imbalance on HRV and its role in contributing to mood dysregulation and depression. We then highlight brain regions that are regulating both HRV and emotion, suggesting these neural regions, and the Insula in particular, as potential mediators of this relationship. We also present additional possible mediating mechanisms involving the immune system and inflammation processes. Lastly, we support this model by showing evidence that modification of HRV with biofeedback leads to an improvement in some symptoms of depression. The possibility that changes in HRV precede the onset of depression is critical to put to the test, not only because it could provide insights into the mechanisms of the illness but also because it may offer a predictive anddiagnosticphysiological marker for depression. Importantly, it could also help to develop new effective clinical interventions for treating depression.
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Affiliation(s)
- Shir Galin
- Azrieli Faculty of Medicine, Bar Ilan University, Safed, Israel; Gonda Interdisciplinary Brain Research Center, Bar Ilan University, Ramat Gan, Israel
| | - Hanna Keren
- Azrieli Faculty of Medicine, Bar Ilan University, Safed, Israel; Gonda Interdisciplinary Brain Research Center, Bar Ilan University, Ramat Gan, Israel.
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Luo X, Wang R, Zhou Y, Xie W. The relationship between emotional disorders and heart rate variability: A Mendelian randomization study. PLoS One 2024; 19:e0298998. [PMID: 38451975 PMCID: PMC10919610 DOI: 10.1371/journal.pone.0298998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 02/04/2024] [Indexed: 03/09/2024] Open
Abstract
OBJECTIVE Previous studies have shown that emotional disorders are negatively associated with heart rate variability (HRV), but the potential causal relationship between genetic susceptibility to emotional disorders and HRV remains unclear. We aimed to perform a Mendelian randomization (MR) study to investigate the potential association between emotional disorders and HRV. METHODS The data used for this study were obtained from publicly available genome-wide association study datasets. Five models, including the inverse variance weighted model (IVW), the weighted median estimation model (WME), the weighted model-based method (WM), the simple model (SM) and the MR-Egger regression model (MER), were utilized for MR. The leave-one-out sensitivity test, MR pleiotropy residual sum and outlier test (MR-PRESSO) and Cochran's Q test were used to confirm heterogeneity and pleiotropy. RESULTS MR analysis revealed that genetic susceptibility to broad depression was negatively correlated with HRV (pvRSA/HF) (OR = 0.380, 95% CI 0.146-0.992; p = 0.048). However, genetic susceptibility to irritability was positively correlated with HRV (pvRSA/HF, SDNN) (OR = 2.017, 95% CI 1.152-3.534, p = 0.008) (OR = 1.154, 95% CI 1.000-1.331, p = 0.044). Genetic susceptibility to anxiety was positively correlated with HRV (RMSSD) (OR = 2.106, 95% CI 1.032-4.299; p = 0.041). No significant directional pleiotropy or heterogeneity was detected. The accuracy and robustness of these findings were confirmed through a sensitivity analysis. CONCLUSIONS Our MR study provides genetic support for the causal effects of broad depression, irritable mood, and anxiety on HRV.
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Affiliation(s)
- Xu Luo
- College of Clinical Medicine, University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Rui Wang
- College of Clinical Medicine, University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - YunXiang Zhou
- College of Clinical Medicine, University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Wen Xie
- College of Clinical Medicine, University of Traditional Chinese Medicine, Chengdu, Sichuan, China
- Department of Cardiology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
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Radimecká M, Látalová A, Lamoš M, Jáni M, Bartys P, Damborská A, Theiner P, Linhartová P. Facial emotion processing in patients with borderline personality disorder as compared with healthy controls: an fMRI and ECG study. Borderline Personal Disord Emot Dysregul 2024; 11:4. [PMID: 38360712 PMCID: PMC10870473 DOI: 10.1186/s40479-024-00245-4] [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] [Received: 08/16/2023] [Accepted: 01/08/2024] [Indexed: 02/17/2024] Open
Abstract
BACKGROUND Maladaptive behaviors and interpersonal difficulties in patients with borderline personality disorder (BPD) seem connected to biased facial emotion processing. This bias is often accompanied by heightened amygdala activity in patients with BPD as compared to healthy controls. However, functional magnetic resonance imaging (fMRI) studies exploring differences between patients and healthy controls in facial emotion processing have produced divergent results. The current study explored fMRI and heart rate variability (HRV) correlates of negative facial emotion processing in patients with BPD and healthy controls. METHODS The study included 30 patients with BPD (29 females; age: M = 24.22, SD = 5.22) and 30 healthy controls (29 females; M = 24.66, SD = 5.28). All participants underwent the "faces" task, an emotional face perception task, in an fMRI session simultaneously with ECG. In this task, participants are presented with emotional expressions of disgust, sadness, and fear (as a negative condition) and with the same pictures in a scrambled version (as a neutral condition). RESULTS We found no differences in brain activity between patients with BPD and healthy controls when processing negative facial expressions as compared to neutral condition. We observed activation in large-scale brain areas in both groups when presented with negative facial expressions as compared to neutral condition. Patients with BPD displayed lower HRV than healthy controls in both conditions. However, there were no significant associations between HRV and amygdala activity and BPD symptoms. CONCLUSION The results of this study indicate no abnormal brain activity during emotional facial processing in patients with BPD. This result contrasts with previous studies and more studies are needed to clarify the relationship between facial emotion processing and brain activity in patients with BPD. Possible reasons for the absence of brain activity differences are discussed in the study. Consistent with previous findings, patients showed lower HRV than healthy controls. However, HRV was not associated with amygdala activity and BPD symptoms.
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Affiliation(s)
- Monika Radimecká
- Department of Psychiatry, University Hospital Brno and Faculty of Medicine, Masaryk University, Jihlavská 340/20, Brno, 625 00, Czech Republic.
| | - Adéla Látalová
- Department of Psychiatry, University Hospital Brno and Faculty of Medicine, Masaryk University, Jihlavská 340/20, Brno, 625 00, Czech Republic
| | - Martin Lamoš
- Brain and Mind Research Program, Central European Institute of Technology, Masaryk University, Brno, Czech Republic
| | - Martin Jáni
- Department of Psychiatry, University Hospital Brno and Faculty of Medicine, Masaryk University, Jihlavská 340/20, Brno, 625 00, Czech Republic
| | - Patrik Bartys
- Department of Psychiatry, University Hospital Brno and Faculty of Medicine, Masaryk University, Jihlavská 340/20, Brno, 625 00, Czech Republic
| | - Alena Damborská
- Department of Psychiatry, University Hospital Brno and Faculty of Medicine, Masaryk University, Jihlavská 340/20, Brno, 625 00, Czech Republic
| | - Pavel Theiner
- Department of Psychiatry, University Hospital Brno and Faculty of Medicine, Masaryk University, Jihlavská 340/20, Brno, 625 00, Czech Republic
| | - Pavla Linhartová
- Department of Psychiatry, University Hospital Brno and Faculty of Medicine, Masaryk University, Jihlavská 340/20, Brno, 625 00, Czech Republic
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Kulakova E, Graumann L, Cho AB, Deuter CE, Wolf OT, Roepke S, Otte C, Wingenfeld K. Evidence of deviant parasympathetic response to social exclusion in women with borderline personality disorder. Eur Arch Psychiatry Clin Neurosci 2024; 274:129-138. [PMID: 37650962 PMCID: PMC10786993 DOI: 10.1007/s00406-023-01678-8] [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: 02/13/2023] [Accepted: 08/08/2023] [Indexed: 09/01/2023]
Abstract
Stressful social situations like social exclusion are particularly challenging for patients with borderline personality disorder (BPD) and often lead to dysfunctional reactive behaviour of aggression and withdrawal. The autonomous signature of these core symptoms of BPD remains poorly understood. The present study investigated the parasympathetic response to social exclusion in women with BPD (n = 62) and healthy controls (HC; n = 87). In a between-subjects design, participants experienced objective social exclusion or overinclusion in the Cyberball task, a virtual ball-tossing game. Need threat scores served as individual measures of perceived exclusion and the resulting frustration of cognitive-emotional needs. Five-minute measurements of high-frequency heart rate variability (HF-HRV) at three time points (before, during, after Cyberball) indicated parasympathetic tone and regulation. We observed a trend towards lowered baseline HF-HRV in BPD vs. HC in line with previous findings. Interestingly, the parasympathetic response of patients with BPD to objective and perceived social exclusion fundamentally differed from HC: higher exclusion was associated with increased parasympathetic activation in HC, while this autonomic response was reversed and blunted in BPD. Our findings suggest that during social stress, the parasympathetic nervous system fails to display an adaptive regulation in patients with BPD, but not HC. Understanding the autonomous signature of the stress response in BPD allows the formulation of clinically relevant and biologically plausible interventions to counteract parasympathetic dysregulation in this clinical group.
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Affiliation(s)
- Eugenia Kulakova
- Department of Psychiatry and Neurosciences, Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin, Hindenburgdamm 30, 12203, Berlin, Germany.
| | - Livia Graumann
- Department of Psychiatry and Neurosciences, Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin, Hindenburgdamm 30, 12203, Berlin, Germany
| | - An Bin Cho
- Department of Psychiatry and Neurosciences, Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin, Hindenburgdamm 30, 12203, Berlin, Germany
| | - Christian Eric Deuter
- Department of Psychiatry and Neurosciences, Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin, Hindenburgdamm 30, 12203, Berlin, Germany
| | - Oliver T Wolf
- Department of Cognitive Psychology, Institute of Cognitive Neuroscience, Ruhr University, Bochum, Germany
| | - Stefan Roepke
- Department of Psychiatry and Neurosciences, Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin, Hindenburgdamm 30, 12203, Berlin, Germany
| | - Christian Otte
- Department of Psychiatry and Neurosciences, Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin, Hindenburgdamm 30, 12203, Berlin, Germany
| | - Katja Wingenfeld
- Department of Psychiatry and Neurosciences, Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin, Hindenburgdamm 30, 12203, Berlin, Germany
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Fallata EO, Bashekah KA, Alqahtani RM, Althagafi SE, Bardesi MH, Adnan AM, Alfaqih MA, Aljifri AM, Aljifri HM. Interoceptive Awareness Among the General Public in Saudi Arabia: A Cross-Sectional Study. Cureus 2023; 15:e49771. [PMID: 38161562 PMCID: PMC10757733 DOI: 10.7759/cureus.49771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/30/2023] [Indexed: 01/03/2024] Open
Abstract
Background Interoception refers to the cognitive process of perceiving internal bodily states. This encompasses various physiological indicators, including heart rate fluctuations, stomach distention, internal temperature, hydration levels, sensory input from free nerve terminals in the fascia and muscles, as well as hormonal, stretch, and pain receptors. This study aimed to examine the interoceptive awareness among the general public in Saudi Arabia. Methods A cross-sectional online survey was undertaken in Saudi Arabia to investigate the level of interoceptive awareness within the overall population of the country in October 2023. This research used a previously developed questionnaire named the Multidimensional Assessment of Interoceptive Awareness, version 2 (MAIA-2). In a binary logistic regression analysis, the mean interoceptive awareness score of the participants was utilized as the dummy variable to determine the variables that influence interoceptive awareness. Results A total of 814 participants were involved in this study. Overall, the study participants demonstrated a marginal level of interoceptive awareness with a mean score of 94.3 (standard deviation (SD): 29.3) out of 185 (representing 51.0% of the maximum attainable score). The mean interoceptive score was not consistent across different subscales and ranged between 37.7% and 63.3%. The highest mean interoceptive score was observed for the Trusting subscale (9.5 (SD: 4.5) out of 15) (representing 63.3% of the maximum attainable score for this subscale). The lowest mean interoceptive score was observed for the Not-Distracting subscale (11.3 (SD: 6.9) out of 30) (representing 37.7% of the maximum attainable score for this subscale). Binary logistic regression analysis did not identify any statistically significant difference in the likelihood of having a higher level of interoceptive awareness among the participants based on their demographic characteristics (p>0.05). Conclusion The participants in our research demonstrated a modest degree of interoceptive awareness. The study's results suggest that the participants demonstrated a heightened inclination towards internal experiences rather than being attentive to their bodily sensations. Further investigation is required to examine interoceptive awareness across various cohorts.
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Affiliation(s)
- Ebtihaj Omar Fallata
- Department of Psychiatry, Eradah and Mental Health Complex, Saudi Ministry of Health, Jeddah, SAU
| | - Kadeja Abdulrahman Bashekah
- Department of Diabetes and Endocrinology, Endocrine and Diabetes Center, Saudi Ministry of Health, Jeddah, SAU
| | | | | | | | | | - Mohammed Ali Alfaqih
- Department of Psychiatry, Faculty of Medicine, King Abdulaziz University, Jeddah, SAU
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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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Zhang X, Wang S, Sun Y, Ding Y. Gender moderates the association between resting vagally mediated heart rate variability and attentional control. Front Psychiatry 2023; 14:1165467. [PMID: 37654989 PMCID: PMC10466397 DOI: 10.3389/fpsyt.2023.1165467] [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] [Received: 02/14/2023] [Accepted: 07/12/2023] [Indexed: 09/02/2023] Open
Abstract
Background Women typically exhibit weaker attentional control ability than men. Lower resting vagally mediated heart rate variability (vmHRV) is thought to reflect the poorer function of the neurophysiological pathways underlying attentional control and thus, poorer attentional control ability. However, existing findings are inconsistent regarding the relationship between vmHRV and attentional control. Gender may be an important moderator. Objective To examine whether gender moderates the relationship between resting vmHRV and attentional control, and to provide neurophysiological evidence for elucidating gender differences in attentional control ability. Methods Two hundred and twenty college students completed the Attentional Control Scale to evaluate their attentional control ability. Resting vmHRV was assessed during a 5 min baseline period using an electrocardiographic amplifier (ECG100C) of the Biopac MP150 physiological recorder. Results (1) There was no significant difference in the total scores of the Attentional Control Scale between men and women (t = 0.498, p > 0.05), but the scores of the attentional shifting dimension of women were significantly lower than those of men (t = 1.995, p < 0.05); (2) Resting vmHRV was significantly negatively correlated with attentional control in women(r = -0.233, p < 0.01), whereas the correlation was not significant in men; (3) Gender significantly moderated the relationship between resting vmHRV and attentional control (B = -3.088, 95% boot CI [-5.431, -0.745], t = -2.598, p < 0.05); (4) Among participants with lower resting vmHRV, there was no significant difference in attentional control between men and women (B = 2.284, 95% boot CI [-0.748, 5.310], p > 0.05), but among participants with higher resting vmHRV, men scored significantly higher than women in attentional control (B = -3.377, 95% boot CI [-6.406, -0.348], p < 0.05). Conclusion Gender moderates the relationship between resting vmHRV and attentional control, with higher resting vmHRV in women reflecting a compensatory response to deficits in attentional control.
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Affiliation(s)
- Xiaocong Zhang
- Department of Psychology, School of Medicine and Holistic Integrated Medicine, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
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9
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Andorfer A, Kraler S, Kaufmann P, Pollheimer E, Spah C, Fuchshuber J, Rominger C, Traunmüller C, Schwerdtfeger A, Unterrainer HF. Psychophysiological stress response after a 6-week Mindful Self-Compassion training in psychiatric rehabilitation inpatients: a randomized post-test only study. Front Psychiatry 2023; 14:1098122. [PMID: 37533890 PMCID: PMC10391549 DOI: 10.3389/fpsyt.2023.1098122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 06/30/2023] [Indexed: 08/04/2023] Open
Abstract
Objectives Mindfulness-based interventions (including self-compassion interventions) are effective in improving stress management at psychological and physical levels. Mindful Self-Compassion (MSC) is a newly developed program particularly aimed at increasing self-compassion. The main objective of this study was to determine whether the psychophysiological stress response during a social-evaluative speaking task differs in inpatients participating in the MSC or the Progressive Muscle Relaxation (PMR) program at the end of their 6-week psychiatric rehabilitation stay (i.e., post-test only design). Method Data from 50 inpatients (25 MSC, 25 PMR, 35 female) aged 19 to 76 years (M = 47.22, SD = 12.44) were analyzed in terms of psychophysiological stress response. For this purpose, heart rate variability, heart rate, and blood pressure were assessed together with several psychometric variables: positive and negative affect (PANAS), subjective stress perception (Visual Analog Scale), self-compassion (Self-Compassion Scale), cognitive reappraisal and suppression (Emotion Regulation Questionnaire), psychological distress (Brief Symptom Inventory-18), and appraisal and rumination (selected items). Results After correction for alpha inflation no differences in the psychophysiological stress response and psychometric parameters between the MSC and PMR group were found. Discussion In general, our results indicate that MSC is not superior to PMR training. However, more research with clinical randomized controlled trials investigating larger samples are needed to further affirm these initial findings.
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Affiliation(s)
- Andrea Andorfer
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Graz, Austria
- CIAR: Center for Integrative Addiction Research, Grüner Kreis Society, Vienna, Austria
| | - Sabina Kraler
- Institute of Psychology, University of Graz, Graz, Austria
| | - Paul Kaufmann
- Center for Psychosocial Health, Sonnenpark Neusiedlersee, Rust, Austria
| | - Ewald Pollheimer
- Center for Psychosocial Health, Sonnenpark Neusiedlersee, Rust, Austria
| | - Christoph Spah
- Center for Psychosocial Health, Sonnenpark Neusiedlersee, Rust, Austria
| | - Jürgen Fuchshuber
- CIAR: Center for Integrative Addiction Research, Grüner Kreis Society, Vienna, Austria
- Department of Psychoanalysis and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | | | | | | | - Human-Friedrich Unterrainer
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Graz, Austria
- CIAR: Center for Integrative Addiction Research, Grüner Kreis Society, Vienna, Austria
- Institute of Psychology, University of Graz, Graz, Austria
- Department of Religious Studies, University of Vienna, Vienna, Austria
- Faculty of Psychotherapy Science, Sigmund Freud University, Vienna, Austria
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Fiskum C, Eik-Nes TT, Abdollahpour Ranjbar H, Andersen J, Habibi Asgarabad M. Interoceptive awareness in a Norwegian population: psychometric properties of the Multidimensional Assessment of Interoceptive Awareness (MAIA) 2. BMC Psychiatry 2023; 23:489. [PMID: 37430262 DOI: 10.1186/s12888-023-04946-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Accepted: 06/09/2023] [Indexed: 07/12/2023] Open
Abstract
BACKGROUND Interoception plays a vital role in human cognition and emotion and is an increasingly important part of clinical studies of mind-body approaches and mental health. Interoceptive awareness (IA) encompasses numerous mind-body components and can be assessed by employing a self-report measure such as the Multidimensional Assessment of Interoceptive Awareness (MAIA), which has been adapted and validated across several countries and is used in experimental and clinical settings. In this study, the MAIA-2, which was developed due to the psychometric shortages of MAIA, was thoroughly translated, and its psychometric features were examined in a sample of 306 Norwegian-speaking participants (81% females, ages 16 through 66 plus). METHODS The participants completed the MAIA-2 Norwegian version (MAIA-2-N) and the COOP/WONCA Functional Assessment Charts measuring psychological, physical, and overall health. The following psychometric qualities of the MAIA-2 were investigated: factor structure, internal consistency, and the moderating role of gender. RESULTS Confirmatory Factor Analysis (CFA) revealed that an 8-factor model of MAIA-2-N provided the best fit. Also, a bifactor model revealed a proper fit. Good internal consistency and a moderating role of gender, age, and education on the relationships between certain MAIA-2-N factors and health were observed. CONCLUSIONS The MAIA-2-N is an adequate measure of IA in Norwegian-speaking individuals. The factor-structure corresponds with the original MAIA-2 and it shows good internal consistency. Some moderating effects of gender were observed, particularly related to the relationship between IA and physical and psychological state, with the physical state/fitness more closely linked to IA in males and psychological state in females.
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Affiliation(s)
- Charlotte Fiskum
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway.
| | - Trine Tetlie Eik-Nes
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway
- Stjørdal Community Mental Health Centre, Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
| | | | | | - Mojtaba Habibi Asgarabad
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
- Health Promotion Research Center, Iran University of Medical Sciences, Tehran, Iran
- Department of Health Psychology, School of Behavioral Sciences and Mental Health (Tehran Institute of Psychiatry), Iran University of Medical Sciences, Tehran, Iran
- Center of Excellence in Cognitive Neuropsychology, Institute for Cognitive and Brain Sciences, Shahid Beheshti University, Tehran, Iran
- Positive Youth Development Lab, Human Development & Family Sciences, Texas Tech University, Texas, USA
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11
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Agorastos A, Mansueto AC, Hager T, Pappi E, Gardikioti A, Stiedl O. Heart Rate Variability as a Translational Dynamic Biomarker of Altered Autonomic Function in Health and Psychiatric Disease. Biomedicines 2023; 11:1591. [PMID: 37371686 DOI: 10.3390/biomedicines11061591] [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: 03/17/2023] [Revised: 04/13/2023] [Accepted: 05/24/2023] [Indexed: 06/29/2023] Open
Abstract
The autonomic nervous system (ANS) is responsible for the precise regulation of tissue functions and organs and, thus, is crucial for optimal stress reactivity, adaptive responses and health in basic and challenged states (survival). The fine-tuning of central ANS activity relies on the internal central autonomic regulation system of the central autonomic network (CAN), while the peripheral activity relies mainly on the two main and interdependent peripheral ANS tracts, the sympathetic nervous system (SNS) and the parasympathetic nervous system (PNS). In disease, autonomic imbalance is associated with decreased dynamic adaptability and increased morbidity and mortality. Acute or prolonged autonomic dysregulation, as observed in stress-related disorders, affects CAN core centers, thereby altering downstream peripheral ANS function. One of the best established and most widely used non-invasive methods for the quantitative assessment of ANS activity is the computerized analysis of heart rate variability (HRV). HRV, which is determined by different methods from those used to determine the fluctuation of instantaneous heart rate (HR), has been used in many studies as a powerful index of autonomic (re)activity and an indicator of cardiac risk and ageing. Psychiatric patients regularly show altered autonomic function with increased HR, reduced HRV and blunted diurnal/circadian changes compared to the healthy state. The aim of this article is to provide basic knowledge on ANS function and (re)activity assessment and, thus, to support a much broader use of HRV as a valid, transdiagnostic and fully translational dynamic biomarker of stress system sensitivity and vulnerability to stress-related disorders in neuroscience research and clinical psychiatric practice. In particular, we review the functional levels of central and peripheral ANS control, the main neurobiophysiologic theoretical models (e.g., polyvagal theory, neurovisceral integration model), the precise autonomic influence on cardiac function and the definition and main aspects of HRV and its different measures (i.e., time, frequency and nonlinear domains). We also provide recommendations for the proper use of electrocardiogram recordings for HRV assessment in clinical and research settings and highlight pathophysiological, clinical and research implications for a better functional understanding of the neural and molecular mechanisms underlying healthy and malfunctioning brain-heart interactions in individual stress reactivity and psychiatric disorders.
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Affiliation(s)
- Agorastos Agorastos
- II. Department of Psychiatry, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 56430 Thessaloniki, Greece
| | - Alessandra C Mansueto
- Center for Neurogenomics and Cognitive Research, Vrije Universiteit (VU) Amsterdam, 1081 HV Amsterdam, The Netherlands
- Centre for Urban Mental Health, University of Amsterdam, 1081 HV Amsterdam, The Netherlands
| | - Torben Hager
- Center for Neurogenomics and Cognitive Research, Vrije Universiteit (VU) Amsterdam, 1081 HV Amsterdam, The Netherlands
| | - Eleni Pappi
- Faculty of Health Sciences, School of Medicine, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Angeliki Gardikioti
- Faculty of Health Sciences, School of Medicine, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Oliver Stiedl
- Center for Neurogenomics and Cognitive Research, Vrije Universiteit (VU) Amsterdam, 1081 HV Amsterdam, The Netherlands
- Department of Health, Safety and Environment, Vrije Universiteit (VU) Amsterdam, 1081 HZ Amsterdam, The Netherlands
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12
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Impact of maternal emotional state during pregnancy on fetal heart rate variability. COMPREHENSIVE PSYCHONEUROENDOCRINOLOGY 2023; 14:100181. [PMID: 36911250 PMCID: PMC9995932 DOI: 10.1016/j.cpnec.2023.100181] [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: 02/27/2023] [Accepted: 02/27/2023] [Indexed: 03/04/2023] Open
Abstract
Background The fetal autonomic nervous system (ANS) is believed to be negatively affected by maternal adverse emotional states. In this study, we evaluated how depression, anxiety and stress during pregnancy are related to fetal heart rate variability (HRV) as recorded with magnetocardiography (MCG). We also considered metabolic factors such as maternal adiposity and circulating levels of cortisol during gestation. Furthermore, we followed up these fetuses after birth, recording HRV and saliva levels of cortisol in these infants to establish any effects postpartum. Methods We calculated HRV in spontaneous MCG recordings from 32 healthy fetuses between 32 and 38 weeks of gestational age. Maternal emotional state was assessed using standardized questionnaires about anxiety, depression and stress. An overall indicator of maternal well-being was calculated by z-scoring each individual questionnaire and summation. We used a median split to divide the group into high and low z-scores (HZS and LZS), respectively. Standard HRV measures were determined in the time and frequency domain. T-test analyses were performed between LZS and HZS, with the HRV and the metabolic measures as the dependent variables. Results We found an impaired HRV in the HZS group both during pregnancy and after birth. No differences were observed between LZS and HZS for metabolic factors. Depression and anxiety symptoms seem to affect HRV differently. No relationship was found between maternal and infant cortisol levels. Conclusions On the basis of our results on different HRV parameters, we propose that maternal emotional state might affect the development of the fetal nervous system in utero.
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13
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Rassler B, Blinowska K, Kaminski M, Pfurtscheller G. Analysis of Respiratory Sinus Arrhythmia and Directed Information Flow between Brain and Body Indicate Different Management Strategies of fMRI-Related Anxiety. Biomedicines 2023; 11:biomedicines11041028. [PMID: 37189642 DOI: 10.3390/biomedicines11041028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 03/20/2023] [Accepted: 03/22/2023] [Indexed: 03/29/2023] Open
Abstract
Background: Respiratory sinus arrhythmia (RSA) denotes decrease of cardiac beat-to-beat intervals (RRI) during inspiration and RRI increase during expiration, but an inverse pattern (termed negative RSA) was also found in healthy humans with elevated anxiety. It was detected using wave-by-wave analysis of cardiorespiratory rhythms and was considered to reflect a strategy of anxiety management involving the activation of a neural pacemaker. Results were consistent with slow breathing, but contained uncertainty at normal breathing rates (0.2–0.4 Hz). Objectives and methods: We combined wave-by-wave analysis and directed information flow analysis to obtain information on anxiety management at higher breathing rates. We analyzed cardiorespiratory rhythms and blood oxygen level-dependent (BOLD) signals from the brainstem and cortex in 10 healthy fMRI participants with elevated anxiety. Results: Three subjects with slow respiratory, RRI, and neural BOLD oscillations showed 57 ± 26% negative RSA and significant anxiety reduction by 54 ± 9%. Six participants with breathing rate of ~0.3 Hz showed 41 ± 16% negative RSA and weaker anxiety reduction. They presented significant information flow from RRI to respiration and from the middle frontal cortex to the brainstem, which may result from respiration-entrained brain oscillations, indicating another anxiety management strategy. Conclusion: The two analytical approaches applied here indicate at least two different anxiety management strategies in healthy subjects.
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Yoo SD, Park EJ. Association of Depressive and Somatic Symptoms with Heart Rate Variability in Patients with Traumatic Brain Injury. J Clin Med 2022; 12:jcm12010104. [PMID: 36614905 PMCID: PMC9821673 DOI: 10.3390/jcm12010104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 12/19/2022] [Accepted: 12/19/2022] [Indexed: 12/24/2022] Open
Abstract
Depressive and somatic symptoms are common after traumatic brain injury (TBI). Depression after TBI can relate to worsened cognitive functioning, functional impairment, higher rates of suicide attempts, and larger health care costs. Heart rate variability (HRV) represents the activity of the autonomic nervous system (ANS), which regulates almost all vascular, visceral, and metabolic functions. Several studies show a correlation between HRV, depression, and somatic symptoms in other diseases. However, studies on autonomic dysfunction, depression, and somatic symptoms in TBI patients are lacking. This study investigated the association between reduced ANS function, depression, and somatic symptoms in TBI patients. We retrospectively recruited 136 TBI patients who underwent 24 h ambulatory Holter electrocardiography to measure autonomic dysfunction within 1 month of onset. Patients who used BDI and PHQ-15 to evaluate depressive and somatic symptoms were included. Using Pearson's correlation analysis and multiple linear regression, the association between HRV parameters and BDI and PHQ-15 was determined. The HRV parameters and BDI and PHQ-15 showed statistical significance. In addition, HRV was shown to be a significantly associated factor of BDI and PHQ-15. HRV was associated with depressive and somatic symptom severity in TBI patients. Additionally, autonomic dysfunction may serve as an associated factor of depressive and somatic symptoms in patients with TBI.
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Affiliation(s)
| | - Eo Jin Park
- Correspondence: ; Tel.: +82-2-440-7246; Fax: +82-2-440-7171
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Dell’Acqua C, Mura F, Messerotti Benvenuti S, Patron E, Palomba D. Reduced heart rate variability and expressive suppression interact to prospectively predict COVID-19 pandemic-related post-traumatic stress symptoms. Sci Rep 2022; 12:21311. [PMID: 36494439 PMCID: PMC9734110 DOI: 10.1038/s41598-022-25915-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 12/07/2022] [Indexed: 12/13/2022] Open
Abstract
The COVID-19 pandemic is a unique period of stress that, in some cases, led to post-traumatic stress symptoms (PTSSs). Emotion regulation strategies are known to modulate the emotional response to stressful events. Expressive suppression (ES) is a maladaptive strategy related to the exacerbation of the physiological stress response. Heart rate variability (HRV), an index of cardiac autonomic balance strictly related to ES, was also shown to predict PTSSs. This was the first study to investigate whether the pre-pandemic ES use and resting-state HRV predicted pandemic-related PTSSs. Before the pandemic, 83 (58 females) university students completed the Emotion Regulation Questionnaire (ERQ), self-report measures of anxiety and depressive symptoms, and a three-minute resting-state electrocardiogram recording. After 12 months, 61 (45 females) participants completed a self-report measure of pandemic-related PTSSs and repeated the self-report psychological measures. Pre-pandemic anxiety symptoms prospectively predicted greater PTSSs. Moreover, a significant interaction between HRV and ES in predicting PTSSs emerged, whereby those who had higher levels of ES and reduced HRV showed higher PTSSs. These findings suggest that an integrated assessment of HRV and ES might be useful for identifying individuals who are more vulnerable to the development of PTSSs during crises.
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Affiliation(s)
- Carola Dell’Acqua
- grid.5608.b0000 0004 1757 3470Department of General Psychology, University of Padua, Via Venezia, 8, 35131 Padua, Italy ,grid.5608.b0000 0004 1757 3470Padova Neuroscience Center (PNC), University of Padua, Padua, Italy
| | - Francesca Mura
- grid.5608.b0000 0004 1757 3470Department of General Psychology, University of Padua, Via Venezia, 8, 35131 Padua, Italy ,grid.5608.b0000 0004 1757 3470Padova Neuroscience Center (PNC), University of Padua, Padua, Italy
| | - Simone Messerotti Benvenuti
- grid.5608.b0000 0004 1757 3470Department of General Psychology, University of Padua, Via Venezia, 8, 35131 Padua, Italy ,grid.5608.b0000 0004 1757 3470Padova Neuroscience Center (PNC), University of Padua, Padua, Italy ,grid.411474.30000 0004 1760 2630Hospital Psychology Unit, Padua University Hospital, Padua, Italy
| | - Elisabetta Patron
- grid.5608.b0000 0004 1757 3470Department of General Psychology, University of Padua, Via Venezia, 8, 35131 Padua, Italy
| | - Daniela Palomba
- grid.5608.b0000 0004 1757 3470Department of General Psychology, University of Padua, Via Venezia, 8, 35131 Padua, Italy ,grid.5608.b0000 0004 1757 3470Padova Neuroscience Center (PNC), University of Padua, Padua, Italy
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Tonhajzerova I, Visnovcova Z, Ondrejka I, Funakova D, Hrtanek I, Ferencova N. Major depressive disorder at adolescent age is associated with impaired cardiovascular autonomic regulation and vasculature functioning. Int J Psychophysiol 2022; 181:14-22. [PMID: 36029918 DOI: 10.1016/j.ijpsycho.2022.08.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 08/15/2022] [Accepted: 08/18/2022] [Indexed: 11/09/2022]
Abstract
Cardiovascular adverse complications represent a risk factor for increased cardiovascular morbidity and mortality in patients with major depressive disorder (MDD). However, there is little knowledge of adolescent MDD. We aimed to study complex cardiovascular autonomic regulation and early atherosclerotic damage with a focus on an analysis of heart rate variability (HRV), blood pressure variability (BPV), systolic time intervals, and measures of early atherosclerotic changes in adolescent MDD. Ninety depressive adolescents (34 boys, age 15.8 ± 1.3 yrs.) and 90 age-/gender-matched controls were examined. Evaluated parameters: HRV - time and spectral parameters, BPV - mean, systolic, and diastolic blood pressure, spectral systolic parameters; haemodynamic indices - stroke volume, cardiac output, total peripheral resistance, systolic time intervals - left ventricular ejection time, pre-ejection period; atherosclerotic indices - ankle-brachial index (ABI), pulse wave velocity, brachial-ankle pulse wave velocity, cardio-ankle vascular index; growth factors - epidermal growth factor (EGF), vascular endothelial growth factor associated with monocyte chemoattractant protein-1. Our results showed that the MDD group had significantly reduced HRV and higher BPV measures, shortened systolic time intervals, lower ABI, and higher EGF compared to controls. Concluding, our study revealed that adolescent MDD is associated with cardiovascular dysregulation and early vasculature dysfunction as preclinical markers of higher risk for cardiovascular morbidity, thus adolescence seems to represent an important age period for early diagnosis and prevention of later MDD-linked cardiovascular diseases manifesting in adulthood.
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Affiliation(s)
- Ingrid Tonhajzerova
- Department of Physiology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Mala Hora 4C, 036 01 Martin, Slovak Republic.
| | - Zuzana Visnovcova
- Biomedical Centre Martin, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Mala Hora 4D, 036 01 Martin, Slovak Republic.
| | - Igor Ondrejka
- Psychiatric Clinic, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, University Hospital Martin, Kollarova 2, 036 59 Martin, Slovak Republic.
| | - Dana Funakova
- Psychiatric Clinic, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, University Hospital Martin, Kollarova 2, 036 59 Martin, Slovak Republic.
| | - Igor Hrtanek
- Psychiatric Clinic, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, University Hospital Martin, Kollarova 2, 036 59 Martin, Slovak Republic.
| | - Nikola Ferencova
- Biomedical Centre Martin, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Mala Hora 4D, 036 01 Martin, Slovak Republic.
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Predicting Psychopathological Onset: Early Signs of Neuropsychiatric Diseases. J Pers Med 2022; 12:jpm12050778. [PMID: 35629200 PMCID: PMC9146207 DOI: 10.3390/jpm12050778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 05/08/2022] [Accepted: 05/09/2022] [Indexed: 12/10/2022] Open
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Sousa R, Ribeiro da Silva D, Petrocchi N, Gilbert P, Rijo D. At the heart of change: Differences in young offenders' HRV patterns after the delivery of the PSYCHOPATHY.COMP program. Front Psychiatry 2022; 13:1032011. [PMID: 36704737 PMCID: PMC9872126 DOI: 10.3389/fpsyt.2022.1032011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 12/19/2022] [Indexed: 01/11/2023] Open
Abstract
INTRODUCTION Literature has pointed the need for intervention programs specifically tailored to target the treatment needs of young offenders, as well as the need to test the efficacy of such programs through physiological indexes of emotion regulation (e.g., heart rate variability; HRV), complementing self-reports typically used as outcome measures. The PSYCHOPATHY.COMP is a 20-session individual intervention program based on Compassion Focused Therapy aiming to reduce psychopathic traits and disruptive behavior among young offenders through the development of a compassionate motivation, while stimulating the soothing system as a strategy to improve emotion regulation. Previous research with young offenders has shown decreases in vagally mediated HRV (vmHRV) when the soothing system is activated. This physiological pattern seems to mirror threat-like responses that contrast with relaxed states. METHODS To test the efficacy of the PSYCHOPATHY.COMP, a clinical trial was implemented encompassing a treatment (n = 56) and a control group (n = 53). Treatment participants attended the PSYCHOPATHY.COMP, while controls received the Treatment As Usual (TAU) delivered in Portuguese juvenile detention facilities. HRV data was collected throughout a standardized procedure (encompassing resting, reactivity and recovery phases) specifically designed to trigger the soothing system. Participants were assessed at pre-treatment, post-treatment and 6-months follow-up. RESULTS Although treatment participants continued to process the soothing system as unpleasant (with decreased vmHRV), they seem to become able to adaptively recover from the stimuli without avoiding it or resorting to maladaptive coping strategies. The physiological pattern was in line with participants' decreases in difficulties in emotion regulation across the assessment periods. In contrast, controls seemed to have actively employed coping strategies associated with increases in vmHRV not only when the soothing system was triggered, but also when recovering from the stimuli. Congruently, for controls, increases in difficulties in emotion regulation were found, with increases in the lack of emotional clarity across the assessment periods. DISCUSSION Findings offer new evidence for the efficacy of the PSYCHOPATHY.COMP program in improving emotion regulation in young offenders, assessed through both self-report and physiological measures. Additionally, findings support the assessment of the autonomic balance as a treatment efficacy index in future research, targeting the rehabilitation of these youth. CLINICAL TRIAL REGISTRATION ClinicalTrials.gov, identifier NCT03971682.
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Affiliation(s)
- Rúben Sousa
- Center for Research in Neuropsychology and Cognitive Behavioral Intervention, Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal
| | - Diana Ribeiro da Silva
- Center for Research in Neuropsychology and Cognitive Behavioral Intervention, Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal
| | - Nicola Petrocchi
- Department of Economics and Social Sciences, John Cabot University, Rome, Italy
| | - Paul Gilbert
- School of Allied Health and Social Care, College of Health and Social Care, University of Derby, Derby, United Kingdom
| | - Daniel Rijo
- Center for Research in Neuropsychology and Cognitive Behavioral Intervention, Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal
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Deng S, Wang Q, Fan J, Yang X, Mei J, Lu J, Chen G, Yang Y, Liu W, Wang R, Han Y, Sheng R, Wang W, Ba L, Ding F. Correlation of Circadian Rhythms of Heart Rate Variability Indices with Stress, Mood, and Sleep Status in Female Medical Workers with Night Shifts. Nat Sci Sleep 2022; 14:1769-1781. [PMID: 36225321 PMCID: PMC9549795 DOI: 10.2147/nss.s377762] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 09/12/2022] [Indexed: 12/02/2022] Open
Abstract
PURPOSE Heart rate variability (HRV) indices have been used as stress indicators. Rare studies investigated the associations of circadian rhythms of the HRV indices with the stress, mood, and sleep conditions in populations under stress. METHODS In total 257 female participants (203 shift workers and 54 non-shift workers) were included. All the participants completed a structured questionnaire to assess the stress, mood, and sleep conditions and performed 24-hour Holter electrocardiogram monitoring on the day away from shifts. Using epochs of 1-min or 5-min beat-to-beat intervals, the HRV indices (SDNN, RMSSD, LF, HF, LF/HF, and LFnu, SD1, SD2, SD1/SD2) were plotted as a function of time and fitted into cosine periodic curves, respectively. Three mathematical parameters based on the cosine periodic curves were extracted, MESOR (M, overall averages of the cosine curve), amplitude (A, amplitude of the peak of the cosine curve), and acrophase (θ, latency to the peak) to quantify the circadian rhythms of the HRV indices. Multivariable linear regression models were used to reveal the associations of these parameters with the clinical assessments of stress, mood, or sleep conditions, as well as with the 24-h averages of the HRV indices. RESULTS The parameters M and A of SDNN, RMSSD, LF, and HF, and θ of LF/HF and LFnu significantly differ between shift and non-shift workers. The parameter θ of LF/HF positively correlates with the severity of stress and anxiety. The parameter A of LF/HF and LFnu also positively correlates with daytime sleepiness and sleep fragmentation. In addition, the parameters M and A instead of θ of SDNN, RMSSD, LF, LF/HF, and LFnu significantly correlate with the 24-h averages of HRV indices. CONCLUSION The circadian rhythms of the HRV indices over 24 hours can, to some extent, predict the severity of stress, emotion and sleep conditions in female populations under stress.
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Affiliation(s)
- Saiyue Deng
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, People's Republic of China
| | - Quan Wang
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430000, People's Republic of China
| | - Jingjing Fan
- Cardiac Unit, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, People's Republic of China
| | - Xiaoyun Yang
- Cardiac Unit, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, People's Republic of China
| | - Junhua Mei
- Department of Neurology, Wuhan No.1 Hospital, Wuhan, 430022, People's Republic of China
| | - Jiajia Lu
- Cardiac Unit, Wuhan No.1 Hospital, Wuhan, 430022, People's Republic of China
| | - Guohua Chen
- Department of Neurology, Wuhan No.1 Hospital, Wuhan, 430022, People's Republic of China
| | - Yuan Yang
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, People's Republic of China
| | - Wenhua Liu
- Department of Clinical Research Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430000, People's Republic of China
| | - Runsen Wang
- Huawei Technologies Co, Shenzhen, People's Republic of China
| | - Yujia Han
- Huawei Technologies Co, Shenzhen, People's Republic of China
| | - Rong Sheng
- Huawei Technologies Co, Shenzhen, People's Republic of China
| | - Wei Wang
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, People's Republic of China
| | - Li Ba
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, People's Republic of China
| | - Fengfei Ding
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, People's Republic of China.,Department of Pharmacology, Shanghai Medical College, Fudan University, Shanghai, 200032, People's Republic of China
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