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Benouar S, Kedir-Talha M, Seoane F. Time-series NARX feedback neural network for forecasting impedance cardiography ICG missing points: a predictive model. Front Physiol 2023; 14:1181745. [PMID: 37346485 PMCID: PMC10280448 DOI: 10.3389/fphys.2023.1181745] [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: 03/07/2023] [Accepted: 05/15/2023] [Indexed: 06/23/2023] Open
Abstract
One of the crucial steps in assessing hemodynamic parameters using impedance cardiography (ICG) is the detection of the characteristic points in the dZ/dt ICG complex, especially the X point. The most often estimated parameters from the ICG complex are stroke volume and cardiac output, for which is required the left ventricular pre-ejection time. Unfortunately, for beat-to-beat calculations, the accuracy of detection is affected by the variability of the ICG complex subtypes. Thus, in this work, we aim to create a predictive model that can predict the missing points and decrease the previous work percentages of missing points to support the detection of ICG characteristic points and the extraction of hemodynamic parameters according to several existing subtypes. Thus, a time-series non-linear autoregressive model with exogenous inputs (NARX) feedback neural network approach was implemented to forecast the missing ICG points according to the different existing subtypes. The NARX was trained on two different datasets with an open-loop mode to ensure that the network is fed with correct feedback inputs. Once the training is satisfactory, the loop can be closed for multi-step prediction tests and simulation. The results show that we can predict the missing characteristic points in all the complexes with a success rate ranging between 75% and 88% in the evaluated datasets. Previously, without the NARX predictive model, the successful detection rate was 21%-30% for the same datasets. Thus, this work indicates a promising method and an accuracy increase in the detection of X, Y, O, and Z points for both datasets.
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Affiliation(s)
- Sara Benouar
- Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
- Laboratory of Instrumentation, Department of Instrumentation and Automatics, Institute of Electrical Engineering, University of Sciences and Technology Houari Boumediene, Bab Ezzouar, Algeria
| | - Malika Kedir-Talha
- Laboratory of Instrumentation, Department of Instrumentation and Automatics, Institute of Electrical Engineering, University of Sciences and Technology Houari Boumediene, Bab Ezzouar, Algeria
| | - Fernando Seoane
- Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
- Department of Medical Technology, Karolinska University Hospital, Stockholm, Sweden
- Department of Clinical Physiology, Karolinska University Hospital, Stockholm, Sweden
- Department of Textile Technology, University of Borås, Borås, Sweden
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2
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van der Mee DJ, Gevonden MJ, Westerink JHDM, de Geus EJC. Cardiorespiratory fitness, regular physical activity, and autonomic nervous system reactivity to laboratory and daily life stress. Psychophysiology 2023; 60:e14212. [PMID: 36379911 DOI: 10.1111/psyp.14212] [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] [Received: 06/07/2022] [Revised: 09/21/2022] [Accepted: 10/21/2022] [Indexed: 11/17/2022]
Abstract
The cross-stressor adaptation hypothesis-which posits that adjustment to physical stress as a result of regular physical activity and its effects on fitness crosses over to psychological stress reactivity-has been around for over four decades. However, the literature has been plagued by heterogeneities preventing definitive conclusions. We address these heterogeneity issues in a combined laboratory and daily life study of 116 young adults (M = 22.48 SD = 3.56, 57.76% female). The exposure, i.e., the potential driver of adaptation, was defined in three ways. First, a submaximal test was performed to obtain aerobic fitness measured as the VO2 max (kg/ml/min). Second, leisure time exercise behavior, and third, overall moderate-to-vigorous physical activity (MVPA), were obtained from a structured interview. Outcomes were autonomic nervous system (ANS) reactivity and affective responsiveness to stressors. ANS activity was measured continuously and expressed as inter-beat-interval (IBI), pre-ejection-period (PEP), respiratory sinus arrythmia (RSA), and non-specific Skin Conductance Responses (ns.SCR). Negative and positive affect were recorded after each experimental condition in the laboratory and hourly in daily life with a nine-item digital questionnaire. Linear regressions were performed between the three exposure measures as predictors and the various laboratory and daily life stress measurements as outcomes. Our results support the resting heart rate reducing effect of aerobic fitness and total MVPA in both the laboratory and daily life. We did not find evidence for the cross-stressor adaptation hypothesis, irrespective of ANS or affective outcome measure or whether the exposure was defined as exercise/MVPA or aerobic fitness.
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Affiliation(s)
| | - Martin J Gevonden
- Department of Biological Psychology, VU University Amsterdam, Amsterdam, The Netherlands
| | - Joyce H D M Westerink
- Industrial Engineering and Innovation Sciences, Eindhoven University of Technology, Eindhoven, The Netherlands
- Philips Research, Eindhoven, The Netherlands
| | - Eco J C de Geus
- Department of Biological Psychology, VU University Amsterdam, Amsterdam, The Netherlands
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3
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Wardenaar KJ, Riese H, Giltay EJ, Eikelenboom M, van Hemert AJ, Beekman AF, Penninx BWJH, Schoevers RA. Common and specific determinants of 9-year depression and anxiety course-trajectories: A machine-learning investigation in the Netherlands Study of Depression and Anxiety (NESDA). J Affect Disord 2021; 293:295-304. [PMID: 34225209 DOI: 10.1016/j.jad.2021.06.029] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 06/15/2021] [Accepted: 06/17/2021] [Indexed: 01/06/2023]
Abstract
BACKGROUND Given the strong relationship between depression and anxiety, there is an urge to investigate their shared and specific long-term course determinants. The current study aimed to identify and compare the main determinants of the 9-year trajectories of combined and pure depression and anxiety symptom severity. METHODS Respondents with a 6-month depression and/or anxiety diagnosis (n=1,701) provided baseline data on 152 sociodemographic, clinical and biological variables. Depression and anxiety symptom severity assessed at baseline, 2-, 4-, 6- and 9-year follow-up, were used to identify data-driven course-trajectory subgroups for general psychological distress, pure depression, and pure anxiety severity scores. For each outcome (class-probability), a Superlearner (SL) algorithm identified an optimally weighted (minimum mean squared error) combination of machine-learning prediction algorithms. For each outcome, the top determinants in the SL were identified by determining variable-importance and correlations between each SL-predicted and observed outcome (ρpred) were calculated. RESULTS Low to high prediction correlations (ρpred: 0.41-0.91, median=0.73) were found. In the SL, important determinants of psychological distress were age, young age of onset, respiratory rate, participation disability, somatic disease, low income, minor depressive disorder and mastery score. For course of pure depression and anxiety symptom severity, similar determinants were found. Specific determinants of pure depression included several types of healthcare-use, and of pure-anxiety course included somatic arousal and psychological distress. LIMITATIONS Limited sample size for machine learning. CONCLUSIONS The determinants of depression- and anxiety-severity course are mostly shared. Domain-specific exceptions are healthcare use for depression and somatic arousal and distress for anxiety-severity course.
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Affiliation(s)
- Klaas J Wardenaar
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), Groningen, The Netherlands.
| | - Harriëtte Riese
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), Groningen, The Netherlands
| | - Erik J Giltay
- Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands
| | - Merijn Eikelenboom
- Amsterdam UMC, Vrije Universiteit, Psychiatry, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Albert J van Hemert
- Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands
| | - Aartjan F Beekman
- Amsterdam UMC, Vrije Universiteit, Psychiatry, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Brenda W J H Penninx
- Amsterdam UMC, Vrije Universiteit, Psychiatry, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Robert A Schoevers
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), Groningen, The Netherlands
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Xie Y, Song R, Yang D, Yu H, Sun C, Xie Q, Xu RX. Motion robust ICG measurements using a two-step spectrum denoising method. Physiol Meas 2021; 42. [PMID: 34433135 DOI: 10.1088/1361-6579/ac2131] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Accepted: 08/25/2021] [Indexed: 11/11/2022]
Abstract
Objective. Impedance cardiography (ICG) is a noninvasive and continuous method for evaluating stroke volume and cardiac output. However, the ICG measurement is easily interfered due to respiration and body movements. Taking into consideration about the spectral correlations between the simultaneously collected ICG, electrocardiogram (ECG), and acceleration signals, this paper introduces a two-step spectrum denoising method to remove motion artifacts of ICG measurements in both resting and exercising scenarios.Approach. First, the major motion artifacts of ECG and ICG are separately suppressed by the spectral subtraction with respect to acceleration signals. The obtained ECG and ICG are further decomposed into two sets of intrinsic mode functions (IMFs) through the ensemble empirical mode decomposition. We then extract the shared spectral information between the two sets of IMFs using the canonical correlation analysis in a spectral domain. Finally, the ICG signal is reconstructed using those canonical variates with largest spectral correlations with ECG IMFs.Main results. The denoising method was evaluated for 30 subjects under both resting and cycling scenarios. Experimental results show that the beat contribution factor of ICG signals increases from its original 80.1%-97.4% after removing the motion artifacts.Significance. The proposed denoising scheme effectively improves the reliability of diagnosis and analysis on cardiovascular diseases relying on ICG signals.
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Affiliation(s)
- Yao Xie
- School of Engineering Science, University of Science and Technology of China, Hefei, 230027, People's Republic of China.,Anhui Tongling Bionic Technology Co. Ltd, No. 5089, Wangjiang West Road, Hefei, People's Republic of China
| | - Rencheng Song
- Department of Biomedical Engineering, Hefei University of Technology, Hefei, 230009, People's Republic of China
| | - Dong Yang
- Anhui Tongling Bionic Technology Co. Ltd, No. 5089, Wangjiang West Road, Hefei, People's Republic of China
| | - Honglong Yu
- Department of Biomedical Engineering, Hefei University of Technology, Hefei, 230009, People's Republic of China
| | - Cuimin Sun
- School of Engineering Science, University of Science and Technology of China, Hefei, 230027, People's Republic of China
| | - Qilian Xie
- Anhui Tongling Bionic Technology Co. Ltd, No. 5089, Wangjiang West Road, Hefei, People's Republic of China.,Anhui Medical University, Hefei, 230032, People's Republic of China
| | - Ronald X Xu
- School of Engineering Science, University of Science and Technology of China, Hefei, 230027, People's Republic of China
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5
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Benouar S, Hafid A, Kedir-Talha M, Seoane F. Classification of impedance cardiography dZ/dt complex subtypes using pattern recognition artificial neural networks. ACTA ACUST UNITED AC 2021; 66:515-527. [PMID: 34162027 DOI: 10.1515/bmt-2020-0267] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Accepted: 06/09/2021] [Indexed: 11/15/2022]
Abstract
In impedance cardiography (ICG), the detection of dZ/dt signal (ICG) characteristic points, especially the X point, is a crucial step for the calculation of hemodynamic parameters such as stroke volume (SV) and cardiac output (CO). Unfortunately, for beat-to-beat calculations, the accuracy of the detection is affected by the variability of the ICG complex subtypes. Thus, in this work, automated classification of ICG complexes is proposed to support the detection of ICG characteristic points and the extraction of hemodynamic parameters according to several existing subtypes. A novel pattern recognition artificial neural network (PRANN) approach was implemented, and a divide-and-conquer strategy was used to identify the five different waveforms of the ICG complex waveform with output nodes no greater than 3. The PRANN was trained, tested and validated using a dataset from four volunteers from a measurement of eight electrodes. Once the training was satisfactory, the deployed network was validated on two other datasets that were completely different from the training dataset. As an additional performance validation of the PRANN, each dataset included four volunteers for a total of eight volunteers. The results show an average accuracy of 96% in classifying ICG complex subtypes with only a decrease in the accuracy to 83 and 80% on the validation datasets. This work indicates that the PRANN is a promising method for automated classification of ICG subtypes, facilitating the investigation of the extraction of hemodynamic parameters from beat-to-beat dZ/dt complexes.
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Affiliation(s)
- Sara Benouar
- Laboratory of Instrumentation, University of Sciences and Technology Houari Boumediene, Algiers, Algeria.,Department of Textile Technology, University of Borås, Borås, Sweden
| | - Abdelakram Hafid
- Laboratory of Instrumentation, University of Sciences and Technology Houari Boumediene, Algiers, Algeria.,Department of Textile Technology, University of Borås, Borås, Sweden
| | - Malika Kedir-Talha
- Laboratory of Instrumentation, University of Sciences and Technology Houari Boumediene, Algiers, Algeria
| | - Fernando Seoane
- Department for Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.,The Department of Medical Technology, Karolinska University Hospital, Stockholm,Sweden.,The Swedish School of Textiles, University of Borås, Borås, Sweden
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Groenendaal W, Lee S, van Hoof C. Wearable Bioimpedance Monitoring: Viewpoint for Application in Chronic Conditions. JMIR BIOMEDICAL ENGINEERING 2021; 6:e22911. [PMID: 38907374 PMCID: PMC11041432 DOI: 10.2196/22911] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 03/01/2021] [Accepted: 04/06/2021] [Indexed: 01/20/2023] Open
Abstract
Currently, nearly 6 in 10 US adults are suffering from at least one chronic condition. Wearable technology could help in controlling the health care costs by remote monitoring and early detection of disease worsening. However, in recent years, there have been disappointments in wearable technology with respect to reliability, lack of feedback, or lack of user comfort. One of the promising sensor techniques for wearable monitoring of chronic disease is bioimpedance, which is a noninvasive, versatile sensing method that can be applied in different ways to extract a wide range of health care parameters. Due to the changes in impedance caused by either breathing or blood flow, time-varying signals such as respiration and cardiac output can be obtained with bioimpedance. A second application area is related to body composition and fluid status (eg, pulmonary congestion monitoring in patients with heart failure). Finally, bioimpedance can be used for continuous and real-time imaging (eg, during mechanical ventilation). In this viewpoint, we evaluate the use of wearable bioimpedance monitoring for application in chronic conditions, focusing on the current status, recent improvements, and challenges that still need to be tackled.
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Affiliation(s)
| | - Seulki Lee
- Imec the Netherlands / Holst Centre, Eindhoven, Netherlands
| | - Chris van Hoof
- Imec, Leuven, Belgium
- One Planet Research Center, Wageningen, Netherlands
- Department of Engineering Science, KU Leuven, Leuven, Belgium
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Lindeboom L, Lee S, Wieringa F, Groenendaal W, Basile C, van der Sande F, Kooman J. On the potential of wearable bioimpedance for longitudinal fluid monitoring in end-stage kidney disease. Nephrol Dial Transplant 2021; 37:2048-2054. [PMID: 33544863 DOI: 10.1093/ndt/gfab025] [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: 10/16/2020] [Indexed: 11/12/2022] Open
Abstract
Bioimpedance spectroscopy (BIS) has proven to be a promising non-invasive technique for fluid monitoring in HD patients. While current BIS-based monitoring of pre- and post-dialysis fluid status utilizes benchtop devices, designed for intramural use, advancements in micro-electronics have enabled the development of wearable bioimpedance systems. Wearable systems meanwhile can offer a similar frequency range for current injection as commercially available benchtop devices. This opens opportunities for unobtrusive longitudinal fluid status monitoring, including transcellular fluid shifts, with the ultimate goal of improving fluid management, thereby lowering mortality and improving quality of life for HD patients. Ultra-miniaturized wearable devices can also offer simultaneous acquisition of multiple other parameters, including hemodynamic parameters. Combination of wearable BIS and additional longitudinal multiparametric data may aid in the prevention of both hemodynamic instability as well as fluid overload. The opportunity to also acquire data during interdialytic periods using wearable devices likely will give novel pathophysiological insights and the development of smart (predicting) algorithms could contribute to personalizing dialysis schemes and ultimately to autonomous (nocturnal) home dialysis. This review provides an overview of current research regarding wearable bioimpedance, with special attention to applications in ESKD patients. Furthermore, we present an outlook on the future use of wearable bioimpedance within dialysis practice.
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Affiliation(s)
- Lucas Lindeboom
- imec The Netherlands/Holst Centre, Health Research, High Tech Campus 31, Eindhoven, The Netherlands
| | - Seulki Lee
- imec The Netherlands/Holst Centre, Health Research, High Tech Campus 31, Eindhoven, The Netherlands
| | - Fokko Wieringa
- imec The Netherlands/Holst Centre, Health Research, High Tech Campus 31, Eindhoven, The Netherlands.,Department of Nephrology, University Medical Center Utrecht, The Netherlands
| | - Willemijn Groenendaal
- imec The Netherlands/Holst Centre, Health Research, High Tech Campus 31, Eindhoven, The Netherlands
| | - Carlo Basile
- Division of Nephrology, Miulli General Hospital, Acquaviva delle Fonti, Italy
| | - Frank van der Sande
- Division of Nephrology, Department of Internal Medicine, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Jeroen Kooman
- Division of Nephrology, Department of Internal Medicine, Maastricht University Medical Center, Maastricht, The Netherlands
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8
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Harteveld LM, Nederend I, Ten Harkel ADJ, Schutte NM, de Rooij SR, Vrijkotte TGM, Oldenhof H, Popma A, Jansen LMC, Suurland J, Swaab H, de Geus EJC. Maturation of the Cardiac Autonomic Nervous System Activity in Children and Adolescents. J Am Heart Assoc 2021; 10:e017405. [PMID: 33525889 PMCID: PMC7955328 DOI: 10.1161/jaha.120.017405] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Background Despite the increasing interest in cardiac autonomic nervous activity, the normal development is not fully understood. The main aim was to determine the maturation of different cardiac sympathetic‐(SNS) and parasympathetic nervous system (PNS) activity parameters in healthy patients aged 0.5 to 20 years. A second aim was to determine potential sex differences. Methods and Results Five studies covering the 0.5‐ to 20‐year age range provided impedance‐ and electrocardiography recordings from which heart rate, different PNS‐parameters (eg, respiratory sinus arrhythmia) and an SNS‐parameter (pre‐ejection period) were collected. Age trends were computed in the mean values across 12 age‐bins and in the age‐specific variances. Age was associated with changes in mean and variance of all parameters. PNS‐activity followed a cubic trend, with an exponential increase from infancy, a plateau phase during middle childhood, followed by a decrease to adolescence. SNS‐activity showed a more linear trend, with a gradual decrease from infancy to adolescence. Boys had higher SNS‐activity at ages 11 to 15 years, while PNS‐activity was higher at 5 and 11 to 12 years with the plateau level reached earlier in girls. Interindividual variation was high at all ages. Variance was reasonably stable for SNS‐ and the log‐transformed PNS‐parameters. Conclusions Cardiac PNS‐ and SNS‐activity in childhood follows different maturational trajectories. Whereas PNS‐activity shows a cubic trend with a plateau phase during middle childhood, SNS‐activity shows a linear decrease from 0.5 to 20 years. Despite the large samples used, clinical use of the sex‐specific centile and percentile normative values is modest in view of the large individual differences, even within narrow age bands.
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Affiliation(s)
- Lisette M Harteveld
- Department of Pediatric Cardiology Leiden University Medical Center Leiden The Netherlands
| | - Ineke Nederend
- Department of Pediatric Cardiology Leiden University Medical Center Leiden The Netherlands.,Department of Biological Psychology Faculty of Human Behavioral and Movement Sciences Vrije Universiteit AmsterdamAmsterdam Public Health Research Institute Amsterdam The Netherlands
| | - Arend D J Ten Harkel
- Department of Pediatric Cardiology Leiden University Medical Center Leiden The Netherlands
| | - Nienke M Schutte
- Department of Biological Psychology Faculty of Human Behavioral and Movement Sciences Vrije Universiteit AmsterdamAmsterdam Public Health Research Institute Amsterdam The Netherlands
| | - Susanne R de Rooij
- Department of Clinical Epidemiology, Biostatistics and Bioinformatics Amsterdam University Medical CenterAcademic Medical Center Amsterdam The Netherlands.,Department of Public Health Amsterdam Public Health Research InstituteAmsterdam University Medical CenterUniversity of Amsterdam Amsterdam The Netherlands
| | - Tanja G M Vrijkotte
- Department of Public Health Amsterdam Public Health Research InstituteAmsterdam University Medical CenterUniversity of Amsterdam Amsterdam The Netherlands
| | - Helena Oldenhof
- Department of Child and Adolescent Psychiatry Amsterdam University Medical CenterVU University Medical Centre Amsterdam The Netherlands
| | - Arne Popma
- Department of Child and Adolescent Psychiatry Amsterdam University Medical CenterVU University Medical Centre Amsterdam The Netherlands
| | - Lucres M C Jansen
- Department of Child and Adolescent Psychiatry Amsterdam University Medical CenterVU University Medical Centre Amsterdam The Netherlands
| | - Jill Suurland
- Department of Clinical Child and Adolescent Studies and Leiden Institute for Brain and Cognition Leiden University Leiden The Netherlands
| | - Hanna Swaab
- Department of Clinical Child and Adolescent Studies and Leiden Institute for Brain and Cognition Leiden University Leiden The Netherlands
| | - Eco J C de Geus
- Department of Biological Psychology Faculty of Human Behavioral and Movement Sciences Vrije Universiteit AmsterdamAmsterdam Public Health Research Institute Amsterdam The Netherlands
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Individual Differences in Cross-System Physiological Activity at Rest and in Response to Acute Social Stress. Psychosom Med 2021; 83:138-148. [PMID: 33395213 DOI: 10.1097/psy.0000000000000901] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
OBJECTIVE Individual differences in long-term cardiovascular disease risk are related to physiological responses to psychological stress. However, little is known about specific physiological response profiles in young adults that may set the stage for long-term increased cardiovascular disease risk. We investigated individual differences in profiles of resting cardiovascular physiology and stress reactivity, combining parasympathetic, sympathetic, and hemodynamic measures. METHODS Participants (n = 744, 71% women, mean [standard deviation] age = 20.1 [2.4] years) underwent the Trier Social Stress Test, while blood pressure (systolic blood pressure, diastolic blood pressure), electrocardiograms (interbeat interval), and impedance cardiograms (preejection period, left ventricular ejection time) were recorded. Respiratory sinus arrhythmia was derived from the combination of the electrocardiogram and the impedance cardiogram. A three-step latent profile analysis (LPA) was performed on resting and reactivity values to derive clusters of individual physiological profiles. We also explored demographic and health behavioral correlates of the observed latent clusters. RESULTS For resting physiology, LPA revealed five different resting physiology profiles, which were related to sex, usual physical activity levels, and body mass index. Five cardiovascular stress reactivity profiles were identified: a reciprocal/moderate stress response (Cr1; 29%), and clusters characterized by high blood pressure reactivity (Cr2: 22%), high vagal withdrawal (Cr3; 22%), autonomic coactivation (parasympathetic nervous system and sympathetic nervous system; Cr4; 13%), and overall high reactivity (Cr5; 12%). Men were more likely to belong to the high reactivity (Cr5) cluster, whereas women were more likely to have autonomic coactivation (Cr4). CONCLUSIONS We identified five cardiovascular physiological reactivity profiles, with individuals displaying generalized hyperreactivity, predominant vagal withdrawal, autonomic coactivation, or blood pressure-specific hyperreactivity. Longitudinal studies are needed to determine whether these profiles are useful in early detection of individuals at high risk for cardiovascular disease.
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10
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Evaluation of dZ/dt Complex Subtypes vs Ensemble Averaging Method for Estimation of Left Ventricular Ejection Time from ICG Recording. ACTA ACUST UNITED AC 2020. [DOI: 10.1007/978-3-030-64610-3_57] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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11
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Psychophysiological responses underlying unresolved loss and trauma in the Adult Attachment Interview. Dev Psychopathol 2020; 34:197-212. [PMID: 33168119 DOI: 10.1017/s0954579420001492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Unresolved loss/trauma in the context of the Adult Attachment Interview (AAI) has been theorised to result from dissociative processing of fear-related memories and ideas. To examine the plausibility of this model, this study tested hypothesised associations between unresolved loss/trauma and indicators of autonomic nervous system (ANS) reactivity. First-time pregnant women (N = 235) participated in the AAI while heart rate (interbeat interval; IBI) and indicators of parasympathetic reactivity (respiratory sinus arrhythmia; RSA) and sympathetic reactivity (pre-ejection period; PEP, skin conductance level; SCL) were recorded. Using multilevel modelling, ANS reactivity was examined in relation to topic (loss/trauma versus other questions); discussion of actual loss/trauma; classification of unresolved/disorganised; and unresolved responses during the interview. Responses to loss/trauma questions and discussion of loss were associated with respectively larger and smaller IBIs. There was no moderation by unresolved/disorganised status. Unresolved responses about loss were associated with smaller IBIs. Participants classified as unresolved/disorganised showed decreasing PEP and blunted SCL throughout the whole interview. The findings suggest that unresolved speech about loss co-occurs with physiological arousal, although the inconclusive findings regarding parasympathetic and sympathetic nervous system responses fail to clearly support the role of fear.
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12
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Ali Sheikh SA, Shah A, Levantsevych O, Soudan M, Alkhalaf J, Bahrami Rad A, Inan OT, Clifford GD. An open-source automated algorithm for removal of noisy beats for accurate impedance cardiogram analysis. Physiol Meas 2020; 41:075002. [PMID: 32784269 DOI: 10.1088/1361-6579/ab9b71] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVE The impedance cardiogram (ICG) is a non-invasive sensing modality for assessing the mechanical aspects of cardiac function, but is sensitive to artifacts from respiration, speaking, motion, and electrode displacement. Electrocardiogram (ECG)-synchronized ensemble averaging of ICG (conventional ensemble averaging method) partially mitigates these disturbances, as artifacts from intra-subject variability (ISVar) of ICG morphology and event latency remain. This paper describes an automated algorithm for removing noisy beats for improved artifact suppression in ensemble-averaged (EA) ICG beats. APPROACH Synchronized ECG and ICG signals from 144 male subjects at rest in different psychological conditions were recorded. A 'three-stage EA ICG beat' was formed by passing 60-seconds non-overlapping ECG-synchronized ICG signals through three filtering stages. The amplitude filtering stage removed spikes/noisy beats with amplitudes outside of normal physiological ranges. Cross-correlation was applied to remove noisy beats in coarse and fine filtering stages. The accuracy of the algorithm-detected artifacts was measured with expert-identified artifacts. Agreement between the expert and the algorithm was assessed using intraclass correlation coefficients (ICC) and Bland-Altman plots. The ISVar of the cardiac parameters was evaluated to quantify improvement in these estimates provided by the proposed method. MAIN RESULTS The proposed algorithm yielded an accuracy of 96.3% and high inter-rater reliability (ICC > 0.997). Bland-Altman plots showed consistently accurate results across values. The ISVar of the cardiac parameters derived using the proposed method was significantly lower than those derived via conventional ensemble averaging method (p < 0.0001). Enhancement in resolution of fiducial points and smoothing of higher-order time derivatives of the EA ICG beats were observed. SIGNIFICANCE The proposed algorithm provides a robust framework for removal of noisy beats and accurate estimation of ICG-based parameters. Importantly, the methodology reduced the ISVar of cardiac parameters. An open-source toolbox has been provided to enable other researchers to readily reproduce and improve upon this work.
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Affiliation(s)
- Shafa-At Ali Sheikh
- Department of Biomedical Informatics, Emory University, Atlanta, GA, United States of America. School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, GA, United States of America
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Busscher B, Spinhoven P, de Geus EJC. Synchronous change in subjective and physiological reactivity during flight as an indicator of treatment outcome for aviophobia: A longitudinal study with 3-year follow-up. J Behav Ther Exp Psychiatry 2020; 67:101443. [PMID: 30583795 DOI: 10.1016/j.jbtep.2018.12.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2018] [Revised: 11/02/2018] [Accepted: 12/14/2018] [Indexed: 01/04/2023]
Abstract
BACKGROUND AND OBJECTIVES Emotion can be seen as the organizing process that coordinates response systems to deal effectively with challenges and opportunities. Synchronous change in subjective and physiological reactivity is regarded as an indication of this organizing process. Synchrony is expected to increase with the intensity of emotional stimuli. Conversely, adaptive emotional functioning could be indicated by progressive synchrony upon increasing demands, and the magnitude of synchrony could be an indication of progress during therapy. METHODS We examined whether synchronous change in subjective and physiological reactivity over repeated exposures increased from watching a flight video through simulated flight to actual flight, and whether the magnitude of synchronous change predicted favourable short- and long-term treatment outcome within a group of 77 aviophobic participants during CBT. RESULTS Results did not show a relationship between the intensity of the phobic stimuli and the magnitude of synchronous change in subjective and physiological reactivity. Moreover, synchronous change across both response systems did not predict treatment outcome. LIMITATIONS By design this study had no control group. Additional treatment or life events between end of treatment and 3-year follow-up were not assessed. CONCLUSION The results provide only weak support for the functionalistic view that successful treatment of anxiety disorders is indicated by synchronous change in reactivity across emotional response systems. The relationship between these systems is likely to be affected by many intervening variables including higher order cognitive processes.
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Affiliation(s)
- Bert Busscher
- VALK Foundation, Postbox 110, 2300, AC, Leiden, the Netherlands; Institute of Psychology, Leiden University, the Netherlands.
| | - Philip Spinhoven
- Institute of Psychology, Leiden University, the Netherlands; Department of Psychiatry, Leiden University Medical Center, the Netherlands
| | - Eco J C de Geus
- Department of Biological Psychology, Vrije Universiteit, Amsterdam, the Netherlands
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14
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Noten MMPG, van der Heijden KB, Huijbregts SCJ, van Goozen SHM, Swaab H. Infant emotional responses to challenge predict empathic behavior in toddlerhood. Dev Psychobiol 2020; 62:454-470. [PMID: 31489632 PMCID: PMC7217152 DOI: 10.1002/dev.21903] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Revised: 06/28/2019] [Accepted: 07/07/2019] [Indexed: 11/10/2022]
Abstract
Although emotional responses are theorized to be important in the development of empathy, findings regarding the prediction of early empathic behavior by infant behavioral and physiological responses are mixed. This study examined whether behavioral and physiological responses to mild emotional challenge (still face paradigm and car seat task) in 118 infants at age 6 months predicted empathic distress and empathic concern in response to an empathy-evoking task (i.e, experimenter's distress simulation) at age 20 months. Correlation analyses, corrected for sex and baseline levels of physiological arousal, showed that stronger physiological and behavioral responses to emotional challenge at age 6 months were positively related to observed empathic distress, but not empathic concern, at age 20 months. Linear regression analyses indicated that physiological and behavioral responses to challenge at 6 months independently predicted empathic distress at 20 months, which suggests an important role for both physiological and behavioral emotional responses in empathy development. In addition, curvilinear regression analyses showed quadratic associations between behavioral responses at 6 months, and empathic distress and empathic concern at 20 months, which indicates that moderate levels of behavioral responsivity predict the highest levels of empathic distress and empathic concern.
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Affiliation(s)
- Malou M. P. G. Noten
- Department of Clinical Neurodevelopmental SciencesLeiden UniversityLeidenThe Netherlands
- Leiden Institute for Brain and CognitionLeiden UniversityLeidenThe Netherlands
| | - Kristiaan B. van der Heijden
- Department of Clinical Neurodevelopmental SciencesLeiden UniversityLeidenThe Netherlands
- Leiden Institute for Brain and CognitionLeiden UniversityLeidenThe Netherlands
| | - Stephan C. J. Huijbregts
- Department of Clinical Neurodevelopmental SciencesLeiden UniversityLeidenThe Netherlands
- Leiden Institute for Brain and CognitionLeiden UniversityLeidenThe Netherlands
| | - Stephanie H. M. van Goozen
- Department of Clinical Neurodevelopmental SciencesLeiden UniversityLeidenThe Netherlands
- School of PsychologyCardiff UniversityCardiffUnited Kingdom
| | - Hanna Swaab
- Department of Clinical Neurodevelopmental SciencesLeiden UniversityLeidenThe Netherlands
- Leiden Institute for Brain and CognitionLeiden UniversityLeidenThe Netherlands
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15
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Forouzanfar M, Baker FC, Colrain IM, de Zambotti M. Automatic Artifact Detection in Impedance Cardiogram Using Pulse Similarity Index. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2020; 2019:2629-2632. [PMID: 31946435 DOI: 10.1109/embc.2019.8856542] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Impedance cardiography (ICG) is a noninvasive technique for evaluation of cardiac hemodynamic parameters such as cardiac output and pre-ejection period. However, the sensitivity of the technique to motion artifact, electrode displacement, and cardiovascular pathologies can severely impact the accuracy of hemodynamic parameter estimates. In this paper, we proposed a new algorithm for the automatic detection and exclusion of corrupted ICG cardiac cycles by defining a pulse similarity index that quantifies the level of pulse corruption and its diversion from a typical-shaped pulse. The index considers different features (activity, structure, shape, and pattern) of the ICG cardiac cycles. The algorithm is compared on sleep data collected from 20 participants against expert identified corrupted cycles. The artifact rejection algorithm achieved a high accuracy of 96% in detection of expert-identified corrupted ICG cycles, including those with normal amplitude as well as out-of-range values, and was robust to different types and levels of artifact. The algorithm shows promise toward applications requiring accurate and reliable automatic measurement of cardiac hemodynamic parameters from prolonged data sets.
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16
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Forouzanfar M, Baker FC, Colrain IM, Goldstone A, de Zambotti M. Automatic analysis of pre-ejection period during sleep using impedance cardiogram. Psychophysiology 2019; 56:e13355. [PMID: 30835856 PMCID: PMC6824194 DOI: 10.1111/psyp.13355] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2018] [Revised: 12/19/2018] [Accepted: 01/31/2019] [Indexed: 12/17/2022]
Abstract
The pre-ejection period (PEP) is a valid index of myocardial contractility and beta-adrenergic sympathetic control of the heart defined as the time between electrical systole (ECG Q wave) to the initial opening of the aortic valve, estimated as the B point on the impedance cardiogram (ICG). B-point detection accuracy can be severely impacted if ICG cardiac cycles corrupted by motion artifact, noise, or electrode displacement are included in the analyses. Here, we developed new algorithms to detect and exclude corrupted ICG cycles by analyzing their level of activity. PEP was then estimated and analyzed on ensemble-averaged clean ICG cycles using an automatic algorithm previously developed by the authors for the detection of B point in awake individuals. We investigated the algorithms' performance relative to expert visual scoring on long-duration data collected from 20 participants during overnight recordings, where the quality of ICG could be highly affected by movement artifacts and electrode displacements and the signal could also vary according to sleep stage and time of night. The artifact rejection algorithm achieved a high accuracy of 87% in detection of expert-identified corrupted ICG cycles, including those with normal amplitude as well as out-of-range values, and was robust to different types and levels of artifact. Intraclass correlations for concurrent validity of the B-point detection algorithm in different sleep stages and in-bed wakefulness exceeded 0.98, indicating excellent agreement with the expert. The algorithms show promise toward sleep applications requiring accurate and reliable automatic measurement of cardiac hemodynamic parameters.
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Affiliation(s)
- Mohamad Forouzanfar
- Human Sleep Research Program, Center for Health Sciences, SRI International, Menlo Park, California
| | - Fiona C Baker
- Human Sleep Research Program, Center for Health Sciences, SRI International, Menlo Park, California
| | - Ian M Colrain
- Human Sleep Research Program, Center for Health Sciences, SRI International, Menlo Park, California
| | - Aimée Goldstone
- Human Sleep Research Program, Center for Health Sciences, SRI International, Menlo Park, California
| | - Massimiliano de Zambotti
- Human Sleep Research Program, Center for Health Sciences, SRI International, Menlo Park, California
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17
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Smarius LJCA, Strieder TGA, Doreleijers TAH, Vrijkotte TGM, Zafarmand MH, de Rooij SR. Common oxytocin polymorphisms interact with maternal verbal aggression in early infancy impacting blood pressure at age 5-6: The ABCD study. PLoS One 2019; 14:e0216035. [PMID: 31233509 PMCID: PMC6590781 DOI: 10.1371/journal.pone.0216035] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Accepted: 04/12/2019] [Indexed: 11/19/2022] Open
Abstract
Early life stress has been shown to contribute to alterations in biobehavioral regulation. Genetic make-up, especially related to social sensitivity, might affect the child’s vulnerability to these alterations. This study examined whether maternal verbally aggressive behavior in early infancy interacts with oxytocin polymorphisms in changing resting cardiovascular outcomes at age 5–6. In the Amsterdam-Born-Children-and-their-Development-(ABCD)-study, a large prospective, observational, population-based birth cohort, maternal verbally aggressive behavior was assessed in the 13th postnatal week (range 11–25 weeks, SD 2 weeks) by a questionnaire (maternal self-report). Indicators of resting cardiac autonomic nervous system activity (sympathetic drive by pre-ejection period, parasympathetic drive by respiratory sinus arrhythmia), heart rate, and blood pressure were measured at age 5–6 years. Data on oxytocin receptor gene polymorphisms rs53576, rs2268498 and oxytocin polymorphisms rs2740210, rs4813627, were collected (N = 966 included). If the child was carrier of the rs53576 GG variant, exposure to maternal verbally aggressive behavior (10.6%) was associated with increased systolic blood pressure at age 5–6 (B = 4.9 mmHg,95% CI[2.2;7.7]). If the child was carrier of the rs2268498 TT/TC variant, exposure to maternal verbally aggressive behavior was associated with increased systolic blood pressure at age 5–6 (B = 3.0 mmHg,95%CI[1.0:5.0]). No significant interactions of maternal verbally aggressive behavior with oxytocin gene polymorphisms on heart rate or cardiac autonomic nervous system activity were found. In conclusion, oxytocin receptor gene polymorphisms may partly determine a child’s vulnerability to develop increased systolic blood pressure after being exposed to maternal verbally aggressive behavior in early infancy.
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Affiliation(s)
- Laetitia J. C. A. Smarius
- Department of Public Health, Amsterdam Public Health Research Institute, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
- Academic Center for Child and Adolescent Psychiatry de Bascule, Amsterdam, The Netherlands
- Department of Child and Adolescent Psychiatry, VU University Medical Center, Amsterdam, The Netherlands
- * E-mail:
| | | | - Theo A. H. Doreleijers
- Department of Child and Adolescent Psychiatry, VU University Medical Center, Amsterdam, The Netherlands
| | - Tanja G. M. Vrijkotte
- Department of Public Health, Amsterdam Public Health Research Institute, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - M. H. Zafarmand
- Department of Public Health, Amsterdam Public Health Research Institute, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Susanne R. de Rooij
- Department of Public Health, Amsterdam Public Health Research Institute, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
- Department of Clinical Epidemiology, Biostatistics and Bio-informatics, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
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18
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Suurland J, van der Heijden KB, Huijbregts SCJ, van Goozen SHM, Swaab H. Infant Parasympathetic and Sympathetic Activity during Baseline, Stress and Recovery: Interactions with Prenatal Adversity Predict Physical Aggression in Toddlerhood. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2019; 46:755-768. [PMID: 28782091 PMCID: PMC5899751 DOI: 10.1007/s10802-017-0337-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Exposure to prenatal adversity is associated with aggression later in life. Individual differences in autonomic nervous system (ANS) functioning, specifically nonreciprocal activation of the parasympathetic (PNS) and sympathetic (SNS) nervous systems, increase susceptibility to aggression, especially in the context of adversity. Previous work examining interactions between early adversity and ANS functioning in infancy is scarce and has not examined interaction between PNS and SNS. This study examined whether the PNS and SNS moderate the relation between cumulative prenatal risk and early physical aggression in 124 children (57% male). Cumulative risk (e.g., maternal psychiatric disorder, substance (ab)use, and social adversity) was assessed during pregnancy. Parasympathetic respiratory sinus arrhythmia (RSA) and sympathetic pre-ejection period (PEP) at baseline, in response to and during recovery from emotional challenge were measured at 6 months. Physical aggression and non-physical aggression/oppositional behavior were measured at 30 months. The results showed that cumulative prenatal risk predicted elevated physical aggression and non-physical aggression/oppositional behavior in toddlerhood; however, the effects on physical aggression were moderated by PNS and SNS functioning. Specifically, the effects of cumulative risk on physical aggression were particularly evident in children characterized by low baseline PNS activity and/or by nonreciprocal activity of the PNS and SNS, characterized by decreased activity (i.e., coinhibition) or increased activity (i.e., coactivation) of both systems at baseline and/or in response to emotional challenge. These findings extend our understanding of the interaction between perinatal risk and infant ANS functioning on developmental outcome.
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Affiliation(s)
- J Suurland
- Department of Clinical Child and Adolescent Studies, Leiden University, Wassenaarseweg 52, Room 4A03, Box 9555, 2300, RB, Leiden, The Netherlands. .,Leiden Institute for Brain and Cognition, Leiden University, Leiden, The Netherlands.
| | - K B van der Heijden
- Department of Clinical Child and Adolescent Studies, Leiden University, Wassenaarseweg 52, Room 4A03, Box 9555, 2300, RB, Leiden, The Netherlands.,Leiden Institute for Brain and Cognition, Leiden University, Leiden, The Netherlands
| | - S C J Huijbregts
- Department of Clinical Child and Adolescent Studies, Leiden University, Wassenaarseweg 52, Room 4A03, Box 9555, 2300, RB, Leiden, The Netherlands.,Leiden Institute for Brain and Cognition, Leiden University, Leiden, The Netherlands
| | - S H M van Goozen
- Department of Clinical Child and Adolescent Studies, Leiden University, Wassenaarseweg 52, Room 4A03, Box 9555, 2300, RB, Leiden, The Netherlands.,School of Psychology, Cardiff University, Cardiff, UK
| | - H Swaab
- Department of Clinical Child and Adolescent Studies, Leiden University, Wassenaarseweg 52, Room 4A03, Box 9555, 2300, RB, Leiden, The Netherlands.,Leiden Institute for Brain and Cognition, Leiden University, Leiden, The Netherlands
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19
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The impact of childhood trauma and psychophysiological reactivity on at-risk women's adjustment to parenthood. Dev Psychopathol 2018; 31:127-141. [PMID: 30585566 DOI: 10.1017/s0954579418001591] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Adverse childhood experiences (ACEs) have an impact on women's adaptation to parenthood, but mechanisms are poorly understood. Autonomic nervous system reactivity was tested as a potential mediating mechanism in a sample of 193 at-risk primiparous women. ACEs were measured retrospectively during pregnancy. A baby cry-response task was administered during pregnancy while indicators of sympathetic reactivity (pre-ejection period; PEP) and parasympathetic reactivity (respiratory sinus arrhythmia; RSA) were recorded. Parenting self-efficacy, anxiety, and depressive symptoms were measured during pregnancy and 1 year after giving birth. Harsh discipline was measured 2 years after giving birth. Structural equation modeling was employed to test whether baseline PEP and RSA and reactivity mediated links between ACEs and postnatal outcomes, adjusted for prenatal variables. High ACEs predicted less RSA reactivity (p = .02), which subsequently predicted increases in depressive symptoms (p = .03). The indirect effect was not significant (p = .06). There was no indirect link between high ACEs and harsh parenting through PEP nor RSA (n = 98). The parasympathetic nervous system may be involved in negative affective responses in the transition to parenthood among women exposed to childhood trauma.
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20
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Hafid A, Benouar S, Kedir-Talha M, Attari M, Seoane F. Simultaneous Recording of ICG and ECG Using Z-RPI Device with Minimum Number of Electrodes. JOURNAL OF SENSORS 2018; 2018:1-7. [DOI: 10.1155/2018/3269534] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
Abstract
Impedance cardiography (ICG) is a noninvasive method for monitoring mechanical function of the heart with the use of electrical bioimpedance measurements. This paper presents the feasibility of recording an ICG signal simultaneously with electrocardiogram signal (ECG) using the same electrodes for both measurements, for a total of five electrodes rather than eight electrodes. The device used is the Z-RPI. The results present good performance and show waveforms presenting high similarity with the different signals reported using different electrodes for acquisition; the heart rate values were calculated and they present accurate evaluation between the ECG and ICG heart rates. The hemodynamics and cardiac parameter results present similitude with the physiological parameters for healthy people reported in the literature. The possibility of reducing number of electrodes used for ICG measurement is an encouraging step to enabling wearable and personal health monitoring solutions.
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Affiliation(s)
- Abdelakram Hafid
- Laboratory of Instrumentation, University of Sciences and Technology Houari Boumediene, Algiers, Algeria
| | - Sara Benouar
- Laboratory of Instrumentation, University of Sciences and Technology Houari Boumediene, Algiers, Algeria
| | - Malika Kedir-Talha
- Laboratory of Instrumentation, University of Sciences and Technology Houari Boumediene, Algiers, Algeria
| | - Mokhtar Attari
- Laboratory of Instrumentation, University of Sciences and Technology Houari Boumediene, Algiers, Algeria
| | - Fernando Seoane
- Swedish School of Textiles, University of Borås, 50190 Borås, Sweden
- The Department for Clinical Science, Intervention and Technology, Karolinska Institutet, 14186 Stockholm, Sweden
- Department Biomedical Engineering, Karolinska University Hospital, 14186 Stockholm, Sweden
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21
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Hafid A, Benouar S, Kedir-Talha M, Abtahi F, Attari M, Seoane F. Full Impedance Cardiography Measurement Device Using Raspberry PI3 and System-on-Chip Biomedical Instrumentation Solutions. IEEE J Biomed Health Inform 2018; 22:1883-1894. [DOI: 10.1109/jbhi.2017.2783949] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
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22
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Schäflein E, Sattel HC, Pollatos O, Sack M. Disconnected - Impaired Interoceptive Accuracy and Its Association With Self-Perception and Cardiac Vagal Tone in Patients With Dissociative Disorder. Front Psychol 2018; 9:897. [PMID: 29997537 PMCID: PMC6031288 DOI: 10.3389/fpsyg.2018.00897] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Accepted: 05/17/2018] [Indexed: 11/13/2022] Open
Abstract
Patients suffering from dissociative disorders are characterized by an avoidance of aversive stimuli. This includes the avoidance of emotions and, in particular, bodily perceptions. In the present pilot study, we explored the potential interoceptive accuracy deficit of patients suffering from dissociative disorders in a heartbeat detection task. Moreover, we investigated the impact of facial mirror-confrontation on interoceptive accuracy and the potential association between cardiac vagal tone derived from heart rate variability and interoceptive accuracy. Eighteen patients suffering from dissociative disorders and 18 healthy controls were assessed with the Mental Tracking Paradigm by Schandry for heartbeat detection at baseline and after confrontations exposing them to their own faces in a mirror (2 min each, accompanied by a negative or positive cognition). During the experiment, cardiac vagal tone was assessed. We used Pearson correlations to calculate potential associations between cardiac vagal tone and interoceptive accuracy. Patients performed significantly worse than the healthy controls in the heartbeat detection task at baseline. They displayed no significant increase in interoceptive accuracy following facial mirror-confrontation. In the patient group, higher cardiac vagal tone was associated with a more precise heartbeat detection performance. Dissociative disorder patients showed a considerable deficit in interoceptive accuracy. Our results fit with the assumption that highly dissociative patients tend to tune out the perceiving of bodily signals. To the extent that bodily signal perception may play a causal role in these disorders, therapeutic approaches enhancing interoceptive accuracy and cardiac vagal tone may be considered important and practicable steps to improve the therapy outcome of this patient group.
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Affiliation(s)
- Eva Schäflein
- Department of Psychosomatic Medicine and Psychotherapy, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
| | - Heribert C Sattel
- Department of Psychosomatic Medicine and Psychotherapy, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
| | - Olga Pollatos
- Department of Clinical and Health Psychology, Institute of Psychology and Education, Ulm University, Ulm, Germany
| | - Martin Sack
- Department of Psychosomatic Medicine and Psychotherapy, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
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23
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Effect of excessive infant crying on resting BP, HRV and cardiac autonomic control in childhood. PLoS One 2018; 13:e0197508. [PMID: 29851997 PMCID: PMC5979019 DOI: 10.1371/journal.pone.0197508] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Accepted: 05/03/2018] [Indexed: 11/19/2022] Open
Abstract
Objective Early life stress has been shown to influence the developing autonomic nervous system. Stressors in infancy may program the autonomic nervous system resting state set point, affecting cardiovascular function in later life. Excessive crying may be an indicator of increased stress arousal in infancy. We hypothesized that excessive infant crying is related to altered cardiac autonomic nervous system activity and increased blood pressure at age 5–6 years. Methods In the Amsterdam Born Children and their Development study, excessive crying, maternal burden of infant care and maternal aggressive behavior in the 13th week after birth (range 11–16 weeks) were reported using questionnaires. Blood pressure, heart rate, heart rate variability and indicators of cardiac autonomic nervous system activity (sympathetic drive by pre-ejection period, parasympathetic drive by respiratory sinus arrhythmia) were measured at age 5–6 years during rest. Inclusion criteria were singleton birth, term-born, and no reported congenital or cardiovascular problems (N = 2153 included). Results Excessive crying (2.8%) was not associated with resting heart rate, heart rate variability, pre-ejection period, respiratory sinus arrhythmia nor with blood pressure at age 5–6 years. Conclusions Excessive infant crying as an indicator of increased stress arousal does not seem to be related to resting activity of the autonomic nervous system or blood pressure at age 5–6. Potential associations may become visible under stressed conditions.
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24
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Forouzanfar M, Baker FC, de Zambotti M, McCall C, Giovangrandi L, Kovacs GTA. Toward a better noninvasive assessment of preejection period: A novel automatic algorithm for B-point detection and correction on thoracic impedance cardiogram. Psychophysiology 2018; 55:e13072. [PMID: 29512163 PMCID: PMC6105363 DOI: 10.1111/psyp.13072] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2017] [Revised: 01/11/2018] [Accepted: 02/08/2018] [Indexed: 11/28/2022]
Abstract
Impedance cardiography is the most common clinically validated, noninvasive method for determining the timing of the opening of the aortic valve, an important event used for measuring preejection period, which reflects sympathetic beta-adrenergic influences on the heart. Automatic detection of the exact time of the opening of the aortic valve (B point on the impedance cardiogram) has proven to be challenging as its appearance varies between and within individuals and may manifest as a reversal, inflection, or rapid slope change of the thoracic impedance derivative's (dZ/dt) rapid rise. Here, a novel automatic algorithm is proposed for the detection of the B point by finding the main rapid rise of the dZ/dt signal, which is due to blood ejection. Several conditions based on zero crossings, minima, and maxima of the dZ/dt signal and its derivatives are considered to reject any unwanted noise and artifacts and select the true B-point location. The detected B-point locations are then corrected by modeling the B-point time data using forward and reverse autoregressive models. The proposed algorithm is validated against expert-detected B points and is compared with different conventional methods; it significantly outperforms them by at least 54% in mean error, 30% in mean absolute error, and 27% in standard deviation of error. This algorithm can be adopted in ambulatory studies requiring beat-to-beat evaluation of cardiac hemodynamic parameters over extended time periods where expert scoring is not feasible.
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Affiliation(s)
- Mohamad Forouzanfar
- Center for Health Sciences, SRI International, Menlo Park, California, USA.,Transducers Lab, Department of Electrical Engineering, Stanford University, Stanford, California, USA
| | - Fiona C Baker
- Center for Health Sciences, SRI International, Menlo Park, California, USA
| | | | - Corey McCall
- Transducers Lab, Department of Electrical Engineering, Stanford University, Stanford, California, USA
| | - Laurent Giovangrandi
- Transducers Lab, Department of Electrical Engineering, Stanford University, Stanford, California, USA
| | - Gregory T A Kovacs
- Center for Health Sciences, SRI International, Menlo Park, California, USA.,Transducers Lab, Department of Electrical Engineering, Stanford University, Stanford, California, USA
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25
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Schäflein E, Sattel H, Schmidt U, Sack M. The enemy in the mirror: self-perception-induced stress results in dissociation of psychological and physiological responses in patients with dissociative disorder. Eur J Psychotraumatol 2018; 9:1472991. [PMID: 29938011 PMCID: PMC6008582 DOI: 10.1080/20008198.2018.1472991] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Accepted: 04/17/2018] [Indexed: 12/25/2022] Open
Abstract
Background: Patients suffering from dissociative disorders (DD) are characterized by an avoidance of aversive stimuli. Clinical experience has shown that DD patients typically avoid the confrontation with their own faces in a mirror (CFM). Objective: To investigate potential CFM-associated self-reported and psychophysiological stress reactions of DD patients, which most likely inform on the still unknown pathophysiology of dysfunctional self-perception in DD. Method: Eighteen DD patients and 18 healthy controls (HCs) underwent CFM. They were assessed for CFM-induced subjective self-reported stress, acute dissociative symptoms and sympathetic and parasympathetic drive using impedance cardiography. Results: DD patients experienced more subjective stress and acute dissociation than HCs upon CFM. Their psychological stress response did not activate the sympathetic and parasympathetic nervous system. Conclusions: In DD patients, CFM constitutes serious self-reported stress and is associated with a blunted autonomic reactivity. Therapeutic approaches promoting self-perception and self-compassion, in particular by using CFM, might serve as goal-oriented diagnostic and therapeutic tools in DD.
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Affiliation(s)
- Eva Schäflein
- Department of Psychosomatic Medicine and Psychotherapy, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Heribert Sattel
- Department of Psychosomatic Medicine and Psychotherapy, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Ulrike Schmidt
- Department of Psychiatry and Psychotherapy, University Medical Centre of Göttingen, RG Stressmodulation of Neurodegeneration, Göttingen, Germany
| | - Martin Sack
- Department of Psychosomatic Medicine and Psychotherapy, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
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26
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Danyluck C, Page-Gould E. Intergroup dissimilarity predicts physiological synchrony and affiliation in intergroup interaction. JOURNAL OF EXPERIMENTAL SOCIAL PSYCHOLOGY 2018. [DOI: 10.1016/j.jesp.2017.08.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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27
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Benouar S, Hafid A, Attari M, Kedir-Talha M, Seoane F. Systematic Variability in ICG Recordings Results in ICG Complex Subtypes - Steps Towards the Enhancement of ICG Characterization. JOURNAL OF ELECTRICAL BIOIMPEDANCE 2018; 9:72-82. [PMID: 33584923 PMCID: PMC7852018 DOI: 10.2478/joeb-2018-0012] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Indexed: 06/12/2023]
Abstract
The quality of an impedance cardiography (ICG) signal critically impacts the calculation of hemodynamic parameters. These calculations depend solely on the identification of ICG characteristic points on the ABEXYOZ complex. Unfortunately, contrary to the relatively constant morphology of the PQRST complex in electrocardiography, the waveform morphology of ICG data is far from stationary, which causes difficulties in the accuracy of the automated detection of characteristic ICG points. This study evaluated ICG recordings obtained from 10 volunteers. The results indicate that there are several different waveforms for the ABEXYOZ complex; there are up to five clearly distinct waveforms for the ABEXYOZ complex in addition to those that are typically reported. The differences between waveform types increased the difficulty of detecting ICG points. To accurately detect all ICG points, the ABEXYOZ complex should be analyzed according to the corresponding waveform type.
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Affiliation(s)
- Sara Benouar
- Laboratory of Instrumentation, University of Sciences and Technology Houari Boumediene, Algiers, Algeria
- Department of Textile Technology, University of Borås, 50190, Borås, Sweden
| | - Abdelakram Hafid
- Laboratory of Instrumentation, University of Sciences and Technology Houari Boumediene, Algiers, Algeria
- Department of Textile Technology, University of Borås, 50190, Borås, Sweden
| | - Mokhtar Attari
- Laboratory of Instrumentation, University of Sciences and Technology Houari Boumediene, Algiers, Algeria
| | - Malika Kedir-Talha
- Laboratory of Instrumentation, University of Sciences and Technology Houari Boumediene, Algiers, Algeria
| | - Fernando Seoane
- Department of Textile Technology, University of Borås, 50190, Borås, Sweden
- Dept. for Clinical Science, Intervention and Technology, Karolinska Institute, 14186Stockholm, Sweden
- Dept. Biomedical Engineering, Karolinska University Hospital, 14186Stockholm, Sweden
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Nederend I, Ten Harkel ADJ, Blom NA, Berntson GG, de Geus EJC. Impedance cardiography in healthy children and children with congenital heart disease: Improving stroke volume assessment. Int J Psychophysiol 2017; 120:136-147. [PMID: 28778397 DOI: 10.1016/j.ijpsycho.2017.07.015] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Revised: 07/20/2017] [Accepted: 07/29/2017] [Indexed: 10/19/2022]
Abstract
INTRODUCTION Stroke volume (SV) and cardiac output are important measures in the clinical evaluation of cardiac patients and are also frequently used in research applications. This study was aimed to improve SV scoring derived from spot-electrode based impedance cardiography (ICG) in a pediatric population of healthy volunteers and patients with a corrected congenital heart defect. METHODS 128 healthy volunteers and 66 patients participated. First, scoring methods for ambiguous ICG signals were optimized to improve agreement of B- and X-points with aortic valve opening/closure in simultaneously recorded transthoracic echocardiography (TTE). Building on the improved scoring of B- and X-points, the Kubicek equation for SV estimation was optimized by testing the agreement with the simultaneously recorded SV by TTE. Both steps were initially done in a subset of the sample of healthy children and then validated in the remaining subset of healthy children and in a sample of patients. RESULTS SV assessment by ICG in healthy children strongly improved (intra class correlation increased from 0.26 to 0.72) after replacing baseline thorax impedance (Z0) in the Kubicek equation by an equation (7.337-6.208∗dZ/dtmax), where dZ/dtmax is the amplitude of the ICG signal at the C-point. Reliable SV assessment remained more difficult in patients compared to healthy controls. CONCLUSIONS After proper adjustment of the Kubicek equation, SV assessed by the use of spot-electrode based ICG is comparable to that obtained from TTE. This approach is highly feasible in a pediatric population and can be used in an ambulatory setting.
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Affiliation(s)
- Ineke Nederend
- Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Department of Biological Psychology, Faculty of Behavioral and Movement Sciences, Van der Boechorststraat 1, 1081 BT Amsterdam, The Netherlands; Department of Pediatric Cardiology, LUMC University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands.
| | - Arend D J Ten Harkel
- Department of Pediatric Cardiology, LUMC University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands.
| | - Nico A Blom
- Department of Pediatric Cardiology, LUMC University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands.
| | - Gary G Berntson
- Ohio State University, Department of Psychology, 1835 Neil Avenue, Columbus OH 43210, United States.
| | - Eco J C de Geus
- Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Department of Biological Psychology, Faculty of Behavioral and Movement Sciences, Van der Boechorststraat 1, 1081 BT Amsterdam, The Netherlands.
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29
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Suurland J, van der Heijden KB, Huijbregts SCJ, van Goozen SHM, Swaab H. Interaction between prenatal risk and infant parasympathetic and sympathetic stress reactivity predicts early aggression. Biol Psychol 2017; 128:98-104. [PMID: 28720479 DOI: 10.1016/j.biopsycho.2017.07.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2016] [Revised: 07/11/2017] [Accepted: 07/11/2017] [Indexed: 10/19/2022]
Abstract
Nonreciprocal action of the parasympathetic (PNS) and sympathetic (SNS) nervous systems, increases susceptibility to emotional and behavioral problems in children exposed to adversity. Little is known about the PNS and SNS in interaction with early adversity during infancy. Yet this is when the physiological systems involved in emotion regulation are emerging and presumably most responsive to environmental influences. We examined whether parasympathetic respiratory sinus arrhythmia (RSA) and sympathetic pre-ejection period (PEP) response and recovery at six months, moderate the association between cumulative prenatal risk and physical aggression at 20 months (N=113). Prenatal risk predicted physical aggression, but only in infants exhibiting coactivation of PNS and SNS (i.e., increase in RSA and decrease in PEP) in response to stress. These findings indicate that coactivation of the PNS and SNS in combination with prenatal risk is a biological marker for the development of aggression.
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Affiliation(s)
- J Suurland
- Department of Clinical Child and Adolescent Studies, Leiden University, Leiden, The Netherlands; Leiden Institute for Brain and Cognition, Leiden University, Leiden, The Netherlands.
| | - K B van der Heijden
- Department of Clinical Child and Adolescent Studies, Leiden University, Leiden, The Netherlands; Leiden Institute for Brain and Cognition, Leiden University, Leiden, The Netherlands
| | - S C J Huijbregts
- Department of Clinical Child and Adolescent Studies, Leiden University, Leiden, The Netherlands; Leiden Institute for Brain and Cognition, Leiden University, Leiden, The Netherlands
| | - S H M van Goozen
- Department of Clinical Child and Adolescent Studies, Leiden University, Leiden, The Netherlands; School of Psychology, Cardiff University, Cardiff, United Kingdom
| | - H Swaab
- Department of Clinical Child and Adolescent Studies, Leiden University, Leiden, The Netherlands; Leiden Institute for Brain and Cognition, Leiden University, Leiden, The Netherlands
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30
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Árbol JR, Perakakis P, Garrido A, Mata JL, Fernández-Santaella MC, Vila J. Mathematical detection of aortic valve opening (B point) in impedance cardiography: A comparison of three popular algorithms. Psychophysiology 2016; 54:350-357. [PMID: 27914174 DOI: 10.1111/psyp.12799] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2016] [Accepted: 11/02/2016] [Indexed: 01/26/2023]
Abstract
The preejection period (PEP) is an index of left ventricle contractility widely used in psychophysiological research. Its computation requires detecting the moment when the aortic valve opens, which coincides with the B point in the first derivative of impedance cardiogram (ICG). Although this operation has been traditionally made via visual inspection, several algorithms based on derivative calculations have been developed to enable an automatic performance of the task. However, despite their popularity, data about their empirical validation are not always available. The present study analyzes the performance in the estimation of the aortic valve opening of three popular algorithms, by comparing their performance with the visual detection of the B point made by two independent scorers. Algorithm 1 is based on the first derivative of the ICG, Algorithm 2 on the second derivative, and Algorithm 3 on the third derivative. Algorithm 3 showed the highest accuracy rate (78.77%), followed by Algorithm 1 (24.57%) and Algorithm 2 (13.82%). In the automatic computation of PEP, Algorithm 2 resulted in significantly more missed cycles (48.57%) than Algorithm 1 (6.3%) and Algorithm 3 (3.5%). Algorithm 2 also estimated a significantly lower average PEP (70 ms), compared with the values obtained by Algorithm 1 (119 ms) and Algorithm 3 (113 ms). Our findings indicate that the algorithm based on the third derivative of the ICG performs significantly better. Nevertheless, a visual inspection of the signal proves indispensable, and this article provides a novel visual guide to facilitate the manual detection of the B point.
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Affiliation(s)
| | - Pandelis Perakakis
- Brain, Mind, and Behavior Research Center, University of Granada, Granada, Spain
| | - Alba Garrido
- Brain, Mind, and Behavior Research Center, University of Granada, Granada, Spain
| | - José Luis Mata
- Brain, Mind, and Behavior Research Center, University of Granada, Granada, Spain
| | | | - Jaime Vila
- Brain, Mind, and Behavior Research Center, University of Granada, Granada, Spain
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Heleniak C, McLaughlin KA, Ormel J, Riese H. Cardiovascular reactivity as a mechanism linking child trauma to adolescent psychopathology. Biol Psychol 2016; 120:108-119. [PMID: 27568327 DOI: 10.1016/j.biopsycho.2016.08.007] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Revised: 08/22/2016] [Accepted: 08/22/2016] [Indexed: 02/07/2023]
Abstract
Alterations in physiological reactivity to stress are argued to be central mechanisms linking adverse childhood environmental experiences to internalizing and externalizing psychopathology. Childhood trauma exposure may influence physiological reactivity to stress in distinct ways from other forms of childhood adversity. This study applied a novel theoretical model to investigate the impact of childhood trauma on cardiovascular stress reactivity - the biopsychosocial model of challenge and threat. This model suggests that inefficient cardiovascular responses to stress - a threat as opposed to challenge profile - are characterized by blunted cardiac output (CO) reactivity and increased vascular resistance. We examined whether childhood trauma exposure predicted an indicator of the threat profile of cardiovascular reactivity and whether such a pattern was associated with adolescent psychopathology in a population-representative sample of 488 adolescents (M=16.17years old, 49.2% boys) in the TRacking Adolescents' Individual Lives Survey (TRAILS). Exposure to trauma was associated with both internalizing and externalizing symptoms and a pattern of cardiovascular reactivity consistent with the threat profile, including blunted CO reactivity during a social stress task. Blunted CO reactivity, in turn, was positively associated with externalizing, but not internalizing symptoms and mediated the link between trauma and externalizing psychopathology. None of these associations varied by gender. The biopsychosocial model of challenge and threat provides a novel theoretical framework for understanding disruptions in physiological reactivity to stress following childhood trauma exposure, revealing a potential pathway linking such exposure with externalizing problems in adolescents.
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Affiliation(s)
| | | | - Johan Ormel
- Interdisciplinary Center Psychopathology and Emotion regulation, Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Harriette Riese
- Interdisciplinary Center Psychopathology and Emotion regulation, Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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Rahman MZU, Mirza SS. Process techniques for human thoracic electrical bio-impedance signal in remote healthcare systems. Healthc Technol Lett 2016; 3:124-8. [PMID: 27382481 DOI: 10.1049/htl.2015.0061] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Revised: 05/09/2016] [Accepted: 05/10/2016] [Indexed: 11/20/2022] Open
Abstract
Analysis of thoracic electrical bio-impedance (TEB) facilitates heart stroke volume in sudden cardiac arrest. This Letter proposes several efficient and computationally simplified adaptive algorithms to display high-resolution TEB component. In a clinical environment, TEB signal encounters with various physiological and non-physiological phenomenon, which masks the tiny features that are important in identifying the intensity of the stroke. Moreover, computational complexity is an important parameter in a modern wearable healthcare monitoring tool. Hence, in this Letter, the authors propose a new signal conditioning technique for TEB enhancement in remote healthcare systems. For this, the authors have chosen higher order adaptive filter as a basic element in the process of TEB. To improve filtering capability, convergence speed, to reduce computational complexity of the signal conditioning technique, the authors apply data normalisation and clipping the data regressor. The proposed implementations are tested on real TEB signals. Finally, simulation results confirm that proposed regressor clipped normalised higher order filter is suitable for a practical healthcare system.
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Affiliation(s)
- Muhammad Zia Ur Rahman
- Department of Electronics and Communication Engineering , K. L. University , Green Fields, Guntur-522502 , India
| | - Shafi Shahsavar Mirza
- Department of Electronics and Communication Engineering , K. L. University , Green Fields, Guntur-522502 , India
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Infant autonomic nervous system response and recovery: Associations with maternal risk status and infant emotion regulation. Dev Psychopathol 2016; 29:759-773. [PMID: 27581204 DOI: 10.1017/s0954579416000456] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
This study examined whether risk status and cumulative risk were associated with autonomic nervous system reactivity and recovery, and emotion regulation in infants. The sample included 121 6-month-old infants. Classification of risk status was based on World Health Organization criteria (e.g., presence of maternal psychopathology, substance use, and social adversity). Heart rate, parasympathetic respiratory sinus arrhythmia, and sympathetic preejection period were examined at baseline and across the still face paradigm. Infant emotion regulation was coded during the still face paradigm. Infants in the high-risk group showed increased heart rate, parasympathetic withdrawal, and sympathetic activation during recovery from the still face episode. Higher levels of cumulative risk were associated with increased sympathetic nervous system activation. Moreover, increased heart rate during recovery in the high-risk group was mediated by both parasympathetic and sympathetic activity, indicating mobilization of sympathetic resources when confronted with socioemotional challenge. Distinct indirect pathways were observed from maternal risk to infant emotion regulation during the still face paradigm through parasympathetic and sympathetic regulation. These findings underline the importance of specific measures of parasympathetic and sympathetic response and recovery, and indicate that maternal risk is associated with maladaptive regulation of stress early in life reflecting increased risk for later psychopathology.
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Mallam M, Rao KCB. Efficient reference-free adaptive artifact cancellers for impedance cardiography based remote health care monitoring systems. SPRINGERPLUS 2016; 5:770. [PMID: 27386256 PMCID: PMC4912518 DOI: 10.1186/s40064-016-2461-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/18/2016] [Accepted: 05/29/2016] [Indexed: 11/10/2022]
Abstract
In this paper, a new model for adaptive artifact cancelation in impedance cardiography (ICG) signals is presented. It is a hybrid model based on wavelet decomposition and an adaptive filter. A novel feature of this model is the implementation of reference-free adaptive artifact cancellers (AAC). For this implementation, the reference signal is constructed using a wavelet transformation. During critical conditions the filter weights may be negative and cause an imbalance in the convergence. To overcome this problem, we introduce non-negative adaptive algorithms in the proposed artifact canceller. To accelerate the performance of the AAC, we propose exponential non-negative and normalized non-negative algorithms to update the filter coefficients. The computational complexity of the filtering section in a remote health care system is important to avoid inter-symbol interference of the incoming samples. This can be achieved by combining sign-based algorithms with the adaptive filtering section. Finally, several AACs are developed using variants of the non-negative algorithms and performance measures are computed and compared. All of the proposed AACs are tested on actual ICG signals. Among the AACs evaluated, sign regressor normalized non-negative LMS (SRN(3)LMS) based adaptive artifact canceller achieves highest signal to noise ratio (SNR). The SNR achieved by this algorithm in baseline wander artifact elimination is 8.5312 dBs, in electrode muscle artifact elimination is 7.5908 dBs and in impedance measurement artifact elimination is 8.4231 dBs.
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Affiliation(s)
- Madhavi Mallam
- Department of Electronics and Communication Engineering, Jawaharlal Nehru Technological University, Kakinada, AP 533003 India
| | - K Chandra Bhutan Rao
- Department of Electronics and Communication Engineering, JNTUK, University College of Engineering, Vizianagaram, AP 535002 India
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35
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Janssens KAM, Riese H, Van Roon AM, Hunfeld JAM, Groot PFC, Oldehinkel AJ, Rosmalen JGM. Are Cardiac Autonomic Nervous System Activity and Perceived Stress Related to Functional Somatic Symptoms in Adolescents? The TRAILS Study. PLoS One 2016; 11:e0153318. [PMID: 27089394 PMCID: PMC4835073 DOI: 10.1371/journal.pone.0153318] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2015] [Accepted: 03/28/2016] [Indexed: 11/18/2022] Open
Abstract
Objective Stressors have been related to medically insufficiently explained or functional somatic symptoms (FSS). However, the underlying mechanism of this association is largely unclear. In the current study, we examined whether FSS are associated with different perceived stress and cardiac autonomic nervous system (ANS) levels during a standardized stressful situation, and whether these associations are symptom-specific. Methods We examined 715 adolescents (16.1 years, 51.3% girls) from the Dutch cohort study Tracking Adolescents’ Individual Lives Sample during the Groningen Social Stress Test (GSST). FSS were assessed by the Youth Self-Report, and clustered into a cluster of overtiredness, dizziness and musculoskeletal pain and a cluster of headache and gastrointestinal symptoms. Perceived stress levels (i.e. unpleasantness and arousal) were assessed by the Self-Assessment Manikin, and cardiac ANS activity by assessing heart rate variability (HRV-HF) and pre-ejection period (PEP). Perceived stress and cardiac ANS levels before, during, and after the GSST were studied as well as cardiac ANS reactivity. Linear regression analyses were used to examine the associations. Results Perceived arousal levels during (beta = 0.09, p = 0.04) and after (beta = 0.07, p = 0.047) the GSST, and perceived unpleasantness levels before (beta = 0.07, p = 0.048) and during (beta = 0.12, p = 0.001) the GSST were related to FSS during the past couple of months. The association between perceived stress and FSS was stronger for the FSS cluster of overtiredness, dizziness and musculoskeletal pain than for the cluster of headache and gastrointestinal symptoms. Neither ANS activity levels before, during, and after the GSST, nor maximal HF-HRV and PEP reactivity were related to FSS. Conclusions This study suggests that perceived stress levels during social stress are related to FSS, whereas cardiac ANS activity and reactivity are not related to FSS.
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Affiliation(s)
- Karin A. M. Janssens
- University of Groningen, University Medical Center Groningen, Interdisciplinary Center for Psychopathology and Emotion regulation, Groningen, The Netherlands
- * E-mail:
| | - Harriëtte Riese
- University of Groningen, University Medical Center Groningen, Interdisciplinary Center for Psychopathology and Emotion regulation, Groningen, The Netherlands
| | - Arie M. Van Roon
- University of Groningen, University Medical Center Groningen, Department of Internal Medicine, Groningen, The Netherlands
| | - Joke A. M. Hunfeld
- Erasmus Medical Center Rotterdam, Department of Medical Psychology & Psychotherapy, Rotterdam, The Netherlands
| | - Paul F. C. Groot
- Academic Medical Center, Department of Radiology, Amsterdam, The Netherlands
| | - Albertine J. Oldehinkel
- University of Groningen, University Medical Center Groningen, Interdisciplinary Center for Psychopathology and Emotion regulation, Groningen, The Netherlands
| | - Judith G. M. Rosmalen
- University of Groningen, University Medical Center Groningen, Interdisciplinary Center for Psychopathology and Emotion regulation, Groningen, The Netherlands
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van den Berg MMHE, Maas J, Muller R, Braun A, Kaandorp W, van Lien R, van Poppel MNM, van Mechelen W, van den Berg AE. Autonomic Nervous System Responses to Viewing Green and Built Settings: Differentiating Between Sympathetic and Parasympathetic Activity. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 12:15860-74. [PMID: 26694426 PMCID: PMC4690962 DOI: 10.3390/ijerph121215026] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Revised: 12/07/2015] [Accepted: 12/09/2015] [Indexed: 11/16/2022]
Abstract
This laboratory study explored buffering and recovery effects of viewing urban green and built spaces on autonomic nervous system activity. Forty-six students viewed photos of green and built spaces immediately following, and preceding acute stress induction. Simultaneously recorded electrocardiogram and impedance cardiogram signal was used to derive respiratory sinus arrhythmia (RSA) and pre-ejection period (PEP), indicators of respectively parasympathetic and sympathetic activity. The findings provide support for greater recovery after viewing green scenes, as marked by a stronger increase in RSA as a marker of parasympathetic activity. There were no indications for greater recovery after viewing green scenes in PEP as a marker of sympathetic activity, and there were also no indications of greater buffering effects of green space in neither RSA nor PEP. Overall, our findings are consistent with a predominant role of the parasympathetic nervous system in restorative effects of viewing green space.
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Affiliation(s)
- Magdalena M H E van den Berg
- Department of Public and Occupational Health, EMGO Institute for Health and Care Research, Vrije Universiteit (VU) University Medical Center, van der Boechorststraat 7, NL 1081 BT Amsterdam, The Netherlands.
| | - Jolanda Maas
- Department of Psychology and Pedagogy, Vrije Universiteit (VU), Transitorium Van der Boechorststraat 1, NL 1081 BT Amsterdam, The Netherlands.
| | - Rianne Muller
- Department of Public and Occupational Health, EMGO Institute for Health and Care Research, Vrije Universiteit (VU) University Medical Center, van der Boechorststraat 7, NL 1081 BT Amsterdam, The Netherlands.
| | - Anoek Braun
- Department of Public and Occupational Health, EMGO Institute for Health and Care Research, Vrije Universiteit (VU) University Medical Center, van der Boechorststraat 7, NL 1081 BT Amsterdam, The Netherlands.
| | - Wendy Kaandorp
- Department of Public and Occupational Health, EMGO Institute for Health and Care Research, Vrije Universiteit (VU) University Medical Center, van der Boechorststraat 7, NL 1081 BT Amsterdam, The Netherlands.
| | - René van Lien
- Department of Biological Psychology, Vrije Universiteit (VU), Transitorium Van der Boechorststraat 1, NL 1081 BT Amsterdam, The Netherlands.
| | - Mireille N M van Poppel
- Department of Public and Occupational Health, EMGO Institute for Health and Care Research, Vrije Universiteit (VU) University Medical Center, van der Boechorststraat 7, NL 1081 BT Amsterdam, The Netherlands.
| | - Willem van Mechelen
- Department of Public and Occupational Health, EMGO Institute for Health and Care Research, Vrije Universiteit (VU) University Medical Center, van der Boechorststraat 7, NL 1081 BT Amsterdam, The Netherlands.
| | - Agnes E van den Berg
- Department of Cultural Geography, Faculty of Spatial Sciences, University of Groningen, Landleven 1, 9747 AD Groningen, The Netherlands.
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Heritability and Temporal Stability of Ambulatory Autonomic Stress Reactivity in Unstructured 24-Hour Recordings. Psychosom Med 2015; 77:870-81. [PMID: 26371521 DOI: 10.1097/psy.0000000000000227] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Measurements of ambulatory autonomic reactivity can help with our understanding of the long-term health consequences of exposure to psychosocial stress in real-life settings. METHODS In this study, unstructured 24-hour ambulatory recordings of cardiac parasympathetic and sympathetic control were obtained in 1288 twins and siblings, spanning both work time and leisure time. These data were used to define two ambulatory baseline (sleep, leisure) and four stress conditions (wake, work, work_sitting, work_peak) from which six ambulatory stress reactivity measures were derived. The use of twin families allowed for estimation of heritability and testing for the amplification of existing or emergence of new genetic variance during stress compared with baseline conditions. RESULTS Temporal stability of ambulatory reactivity was assessed in 62 participants and was moderate to high over a 3-year period (0.36 < r < 0.91). Depending on the definition of ambulatory reactivity used, significant heritability was found, ranging from 29% to 40% for heart rate, 34% to 47% for cardiac parasympathetic control (indexed as respiratory sinus arrhythmia), and 10% to 19% for cardiac sympathetic control (indexed as the preejection period). Heritability of ambulatory reactivity was largely due to newly emerging genetic variance during stress compared with periods of rest. Interestingly, reactivity to short standardized stressors was poorly correlated with the ambulatory reactivity measures implying poor laboratory-real-life correspondence. CONCLUSIONS Ambulatory autonomic reactivity extracted from an unstructured real-life setting shows reliable, stable, and heritable individual differences. Real-life situations uncover a new and different genetic variation compared with that seen in resting baseline conditions, including sleep.
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Abstract
OBJECTIVES Exposure is regarded to be a crucial component of therapies for phobias. According to emotional processing theory, the success of exposure therapy is predicted by activation of subjective and physiological fear responses and their within-session habituation and between-session adaptation. This study tested this prediction for aviophobia. METHODS Seventy-nine participants following a highly standardized treatment program for aviophobia provided self-reported and physiological (heart rate, respiratory sinus arrhythmia and pre-ejection period) measurements of fear activation, within-session habituation, and between-session adaptation during exposure to flight-related stimuli, a flight simulator, and during two real flights. Multiple regression analyses were conducted to examine whether these measurements predicted therapy outcome up to 3 years after finishing therapy, including number of flights flown in this period. RESULTS Both subjective and physiological arousal measurements indicated strong fear activation and large within-session habituation and between-session adaptation during exposure. Flight anxiety measures showed large improvements up to 3 years after treatment (η between 0.72 and 0.91). Lower self-reported anxiety during flight exposure was associated with lower flight anxiety after exposure (R = 0.15) and more flights flown (R = 0.14). Within-flight habituation or between-session adaptation of self-reported anxiety had no relationship with treatment outcome. Within-flight habituation of HR reactivity (R = 0.10) and respiratory sinus arrhythmia reactivity (R = 0.11) was associated with lower flight anxiety directly after the flight, but not on flight anxiety 3 years after finishing therapy or on long-term flying behavior. CONCLUSIONS The results provide only weak support for emotional processing theory. Low self-reported anxiety during in vivo flight exposure was the best predictor of successful long-term therapy outcome.
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Early life adversities and adolescent antisocial behavior: The role of cardiac autonomic nervous system reactivity in the TRAILS study. Biol Psychol 2015; 110:24-33. [PMID: 26164813 DOI: 10.1016/j.biopsycho.2015.06.012] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2014] [Revised: 06/17/2015] [Accepted: 06/25/2015] [Indexed: 11/23/2022]
Abstract
In the current study, the role of pre-ejection period (PEP) and respiratory sinus arrhythmia (RSA) was studied in the association between prior adversities and antisocial behavior in adolescence. PEP and RSA task reactivity and recovery to a public speaking task were assessed in adolescents from a longitudinal population-based study (N=624, Mage=16.14 years, 49.2% boys). Perinatal adversities were unrelated to antisocial behavior, but experiencing more stressful adversities between age 0 and 15 was associated with antisocial behavior at age 16 in boys with blunted PEP reactivity and smaller PEP differences from rest to recovery. Number of adversities between age 0 and 15 was associated with antisocial behavior in boys with blunted and girls with heightened RSA reactivity and larger PEP differences from rest to recovery. The association between prior adversities and antisocial behavior were small in effect size and depended upon sex and PEP and RSA reactivity and recovery.
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van Lien R, Neijts M, Willemsen G, de Geus EJC. Ambulatory measurement of the ECG T-wave amplitude. Psychophysiology 2014; 52:225-37. [PMID: 25123155 DOI: 10.1111/psyp.12300] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2013] [Accepted: 07/03/2014] [Indexed: 11/29/2022]
Abstract
Ambulatory recording of the preejection period (PEP) can be used to measure changes in cardiac sympathetic nervous system (SNS) activity under naturalistic conditions. Here, we test the ECG T-wave amplitude (TWA) as an alternative measure, using 24-h ambulatory monitoring of PEP and TWA in a sample of 564 healthy adults. The TWA showed a decrease in response to mental stress and a monotonic decrease from nighttime sleep to daytime sitting and more physically active behaviors. Within-participant changes in TWA were correlated with changes in the PEP across the standardized stressors (r = .42) and the unstandardized naturalistic conditions (mean r = .35). Partialling out changes in heart rate and vagal effects attenuated these correlations, but they remained significant. Ambulatory TWA cannot replace PEP, but simultaneous recording of TWA and PEP provides a more comprehensive picture of changes in cardiac SNS activity in real-life settings.
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Affiliation(s)
- René van Lien
- Department of Biological Psychology, VU University Amsterdam, Amsterdam, The Netherlands, and EMGO+ Institute, VU University Medical Center, Amsterdam, The Netherlands
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Neijts M, Van Lien R, Kupper N, Boomsma D, Willemsen G, de Geus EJC. Heritability of cardiac vagal control in 24-h heart rate variability recordings: influence of ceiling effects at low heart rates. Psychophysiology 2014; 51:1023-36. [PMID: 24894483 DOI: 10.1111/psyp.12246] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2014] [Accepted: 05/08/2014] [Indexed: 12/01/2022]
Abstract
This study estimated the heritability of 24-h heart rate variability (HRV) measures, while considering ceiling effects on HRV at low heart rates during the night. HRV was indexed by the standard deviation of all valid interbeat intervals (SDNN), the root mean square of differences between valid, successive interbeat intervals (RMSSD), and peak-valley respiratory sinus arrhythmia (pvRSA). Sleep and waking levels of cardiac vagal control were assessed in 1,003 twins and 285 of their non-twin siblings. Comparable heritability estimates were found for SDNN (46%-53%), RMSSD (49%-54%), and pvRSA (48%-57%) during the day and night. A nighttime ceiling effect was revealed in 10.7% of participants by a quadratic relationship between mean pvRSA and the interbeat interval. Excluding these participants did not change the heritability estimates. The genetic factors influencing ambulatory pvRSA, RMSSD, and SDNN largely overlap. These results suggest that gene-finding studies may pool the different cardiac vagal indices and that exclusion of participants with low heart rates is not required.
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Affiliation(s)
- Melanie Neijts
- Department of Biological Psychology, Vrije University (VU) Amsterdam, Amsterdam, The Netherlands; EMGO+ Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
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Reijman S, Alink LRA, Block LHCGCD, Werner CD, Maras A, Rijnberk C, IJzendoorn MHV, Bakermans-Kranenburg MJ. Autonomic Reactivity to Infant Crying in Maltreating Mothers. CHILD MALTREATMENT 2014; 19:101-112. [PMID: 24879060 DOI: 10.1177/1077559514538115] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
We examined autonomic reactivity to infant crying in a sample of 42 maltreating and 38 non-maltreating mothers. Exploratively, we tested if differential reactivity was related to child neglect versus the combination of neglect and abuse, and we tested whether mothers' experiences with maltreatment in their own childhood moderated the association between their current maltreatment status and physiology. During a standardized cry paradigm, mothers listened to cry sounds of various pitches. Heart rate (HR), pre-ejection period (PEP), skin conductance levels (SCLs), and vagal tone (root mean square of successive differences [RMSSD]) were measured as indicators of underlying sympathetic and parasympathetic reactivity. The maltreating mothers showed lower SCL reactivity to the cry sounds than non-maltreating mothers. Furthermore, significant negative correlations between HR and PEP in the non-maltreating group differed from nonsignificant correlations in the maltreating group, which suggests a lack of sympathetic cardiac control in maltreating mothers. We found no differences between neglectful mothers and those who were additionally abusive. Together, our findings support the notion of sympathetic hypoarousal as a risk factor for child maltreatment, which may be indicative of disengagement in a caregiving context. Intervention programs might focus on improving maternal sensitivity to improve responsiveness to child signals.
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Affiliation(s)
- Sophie Reijman
- Centre for Child and Family Studies, Leiden University, Leiden, The Netherlands
| | - Lenneke R A Alink
- Centre for Child and Family Studies, Leiden University, Leiden, The Netherlands Leiden Institute for Brain and Cognition, Leiden, The Netherlands
| | - Laura H C G Compier-de Block
- Centre for Child and Family Studies, Leiden University, Leiden, The Netherlands Leiden Institute for Brain and Cognition, Leiden, The Netherlands
| | - Claudia D Werner
- Centre for Child and Family Studies, Leiden University, Leiden, The Netherlands
| | | | | | - Marinus H van IJzendoorn
- Centre for Child and Family Studies, Leiden University, Leiden, The Netherlands Leiden Institute for Brain and Cognition, Leiden, The Netherlands
| | - Marian J Bakermans-Kranenburg
- Centre for Child and Family Studies, Leiden University, Leiden, The Netherlands Leiden Institute for Brain and Cognition, Leiden, The Netherlands
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The impact of emotion-related autonomic nervous system responsiveness on pain sensitivity in female patients with fibromyalgia. Psychosom Med 2013; 75:765-73. [PMID: 23922401 DOI: 10.1097/psy.0b013e3182a03973] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Patients with fibromyalgia have shown hyporeactive autonomic nervous system (ANS) responses to physical stressors, augmented pain to ANS changes, and heightened negative emotions, which can increase pain. This study examined ANS reactivity to negative emotions and its association with pain in fibromyalgia and control participants. METHODS Sixty-two women with fibromyalgia and 59 women in a control group recalled neutral, and anger- and sadness-eliciting experiences while ANS activity was monitored. Clinical and experimental pain were assessed in response to each emotion. RESULTS Compared with neutral recall, heart rate (p = .050), mean arterial pressure (p < .001), and high-frequency heart rate variability (p = .012) increased in response to sadness, whereas heart rate decreased (p = .002) and mean arterial pressure increased (p < .001) in response to anger; however, ANS responses did not differ between patients and control participants (all p > .29). Among patients only, decreased preejection period (anger-pain threshold: r = 0.31, p = .018) and total peripheral resistance in response to negative emotions (anger-pain tolerance: r = 0.35, p = .025; sadness-pain threshold: r = 0.51, p < .001; sadness-pain tolerance: r = 0.61, p < .001) correlated with more pain. CONCLUSIONS These data suggest that the ANS is not hyporesponsive to elicited emotions in fibromyalgia; however, patients with a larger pain response showed an ANS response pattern reflecting heightened β-adrenergic and reduced α-adrenergic reactivity. Future research should test whether a specific ANS response pattern to emotions is a consequence of increased pain or whether it amplifies pain.
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Gademan MG, van Eijsden M, Roseboom TJ, van der Post JA, Stronks K, Vrijkotte TG. Maternal Prepregnancy Body Mass Index and Their Children’s Blood Pressure and Resting Cardiac Autonomic Balance at Age 5 to 6 Years. Hypertension 2013; 62:641-7. [DOI: 10.1161/hypertensionaha.113.01511] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Adverse intrauterine conditions can program hypertension. Because one of the underlying mechanisms is thought to be cardiac autonomic balance, we investigated the association between prepregnancy body mass index (BMI) and blood pressure and indicators of the autonomic balance in the child at age 5 to 6 years. Also investigated was whether these associations were mediated by standardized birth weight and child BMI. Pregnant women (n=3074) participating in the Amsterdam Born Children and their Development study completed a questionnaire at gestational week 14. At age 5 to 6 years, offspring’s sympathetic drive (pre-ejection period), parasympathetic drive (respiratory sinus arrhythmia), and heart rate were measured by electrocardiography and impedance cardiography at rest. Blood pressure was assessed simultaneously. After adjusting for possible maternal/offspring confounders, prepregnancy BMI was positively linearly associated with diastolic blood pressure (β=0.11 mm Hg; 95% confidence interval, 0.05–0.17), systolic blood pressure (β=0.14 mm Hg; 95% confidence interval, 0.07–0.21), but not with heart rate, sympathetic or parasympathetic drive. After adding birth weight and child BMI to the model, the independent effect size of prepregnancy body mass index on systolic blood pressure (β=0.07 mm Hg; 95% confidence interval, 0.00–0.14) and diastolic blood pressure (β=0.07 mm Hg; 95% confidence interval, 0.01–0.13) decreased by ≈50%. Birth weight did not mediate these relationships, but was independently and negatively associated with blood pressure. Child BMI was positively associated with blood pressure and partly mediated the association between prepregnancy BMI and blood pressure. In conclusion, higher prepregnancy BMI is associated with higher blood pressure in the child (aged 5–6 years) but does not seem to be attributable to early alterations in resting cardiac autonomic balance. Child BMI, but not birth weight, mediated the association between prepregnancy BMI and blood pressure.
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Affiliation(s)
- Maaike G.J. Gademan
- From the Department of Public Health (M.G.J.G., K.S., T.G.M.V.), Department of Obstetrics & Gynaecology (T.J.R., J.A.M.v.d.P.), and Department of Clinical Epidemiology, Biostatistics and Bioinformatics (T.J.R.), Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands; Department of Epidemiology, Documentation and Health Promotion, Public Health Service of Amsterdam (GGD), Amsterdam, The Netherlands (M.v.E.); and Department of Health Sciences, VU University, Amsterdam, The
| | - Manon van Eijsden
- From the Department of Public Health (M.G.J.G., K.S., T.G.M.V.), Department of Obstetrics & Gynaecology (T.J.R., J.A.M.v.d.P.), and Department of Clinical Epidemiology, Biostatistics and Bioinformatics (T.J.R.), Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands; Department of Epidemiology, Documentation and Health Promotion, Public Health Service of Amsterdam (GGD), Amsterdam, The Netherlands (M.v.E.); and Department of Health Sciences, VU University, Amsterdam, The
| | - Tessa J. Roseboom
- From the Department of Public Health (M.G.J.G., K.S., T.G.M.V.), Department of Obstetrics & Gynaecology (T.J.R., J.A.M.v.d.P.), and Department of Clinical Epidemiology, Biostatistics and Bioinformatics (T.J.R.), Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands; Department of Epidemiology, Documentation and Health Promotion, Public Health Service of Amsterdam (GGD), Amsterdam, The Netherlands (M.v.E.); and Department of Health Sciences, VU University, Amsterdam, The
| | - Joris A.M. van der Post
- From the Department of Public Health (M.G.J.G., K.S., T.G.M.V.), Department of Obstetrics & Gynaecology (T.J.R., J.A.M.v.d.P.), and Department of Clinical Epidemiology, Biostatistics and Bioinformatics (T.J.R.), Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands; Department of Epidemiology, Documentation and Health Promotion, Public Health Service of Amsterdam (GGD), Amsterdam, The Netherlands (M.v.E.); and Department of Health Sciences, VU University, Amsterdam, The
| | - Karien Stronks
- From the Department of Public Health (M.G.J.G., K.S., T.G.M.V.), Department of Obstetrics & Gynaecology (T.J.R., J.A.M.v.d.P.), and Department of Clinical Epidemiology, Biostatistics and Bioinformatics (T.J.R.), Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands; Department of Epidemiology, Documentation and Health Promotion, Public Health Service of Amsterdam (GGD), Amsterdam, The Netherlands (M.v.E.); and Department of Health Sciences, VU University, Amsterdam, The
| | - Tanja G.M. Vrijkotte
- From the Department of Public Health (M.G.J.G., K.S., T.G.M.V.), Department of Obstetrics & Gynaecology (T.J.R., J.A.M.v.d.P.), and Department of Clinical Epidemiology, Biostatistics and Bioinformatics (T.J.R.), Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands; Department of Epidemiology, Documentation and Health Promotion, Public Health Service of Amsterdam (GGD), Amsterdam, The Netherlands (M.v.E.); and Department of Health Sciences, VU University, Amsterdam, The
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van Dijk AE, van Lien R, van Eijsden M, Gemke RJBJ, Vrijkotte TGM, de Geus EJ. Measuring cardiac autonomic nervous system (ANS) activity in children. J Vis Exp 2013:e50073. [PMID: 23666435 PMCID: PMC3667644 DOI: 10.3791/50073] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
The autonomic nervous system (ANS) controls mainly automatic bodily functions that are engaged in homeostasis, like heart rate, digestion, respiratory rate, salivation, perspiration and renal function. The ANS has two main branches: the sympathetic nervous system, preparing the human body for action in times of danger and stress, and the parasympathetic nervous system, which regulates the resting state of the body. ANS activity can be measured invasively, for instance by radiotracer techniques or microelectrode recording from superficial nerves, or it can be measured non-invasively by using changes in an organ's response as a proxy for changes in ANS activity, for instance of the sweat glands or the heart. Invasive measurements have the highest validity but are very poorly feasible in large scale samples where non-invasive measures are the preferred approach. Autonomic effects on the heart can be reliably quantified by the recording of the electrocardiogram (ECG) in combination with the impedance cardiogram (ICG), which reflects the changes in thorax impedance in response to respiration and the ejection of blood from the ventricle into the aorta. From the respiration and ECG signals, respiratory sinus arrhythmia can be extracted as a measure of cardiac parasympathetic control. From the ECG and the left ventricular ejection signals, the preejection period can be extracted as a measure of cardiac sympathetic control. ECG and ICG recording is mostly done in laboratory settings. However, having the subjects report to a laboratory greatly reduces ecological validity, is not always doable in large scale epidemiological studies, and can be intimidating for young children. An ambulatory device for ECG and ICG simultaneously resolves these three problems. Here, we present a study design for a minimally invasive and rapid assessment of cardiac autonomic control in children, using a validated ambulatory device 1-5, the VU University Ambulatory Monitoring System (VU-AMS, Amsterdam, the Netherlands, www.vu-ams.nl).
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Affiliation(s)
- Aimée E van Dijk
- Department of Public Health, Academic Medical Center - University of Amsterdam, The Netherlands
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Abstract
Epidemiological and animal studies often find that higher social status is associated with better physical health outcomes, but these findings are by design correlational and lack mediational explanations. In two studies, we examine neurobiological reactivity to test the hypothesis that higher social status leads to salutary short-term psychological, physiological, and behavioral responses. In Study 1, we measured police officers’ subjective social status and had them engage in a stressful task during which we measured cardiovascular and neuroendocrine reactivity. In Study 2, we manipulated social status and examined physiological reactivity and performance outcomes to explore links among status, performance, and physiological reactivity. Results indicated that higher social status (whether measured or manipulated) was associated with approach-oriented physiology (Studies 1 and 2) and better performance (Study 2) relative to lower status. These findings point to acute reactivity as one possible causal mechanism to better physical health among those higher in social status.
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Busscher B, Spinhoven P, van Gerwen LJ, de Geus EJC. Anxiety sensitivity moderates the relationship of changes in physiological arousal with flight anxiety during in vivo exposure therapy. Behav Res Ther 2012; 51:98-105. [PMID: 23262117 DOI: 10.1016/j.brat.2012.10.009] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2012] [Revised: 10/22/2012] [Accepted: 10/30/2012] [Indexed: 11/16/2022]
Abstract
Physiological sensations and discomfort constitute the major symptoms reported by aviophobics. Anxiety sensitivity (AS) seems to moderate the relationship between self-reported somatic sensations and flight anxiety, and AS has been identified as a vulnerability factor for flight phobia. In this study we examined whether AS moderates the effects of somatic sensations and autonomic nervous system reactivity on flight anxiety induced by real flight. In fifty aviophobics participating in Cognitive Behaviour Group Therapy (CBGT), flight anxiety, somatic sensations and autonomic nervous system reactivity were assessed during a guided return flight. Results indicate that physiological reactivity interacted with AS. Changes in heart rate and parasympathetic activity were more strongly associated with changes in reported flight anxiety for high AS participants, and less for participants low on AS. Results did not indicate a moderating effect of AS on the relationship between self-reported somatic sensations and flight anxiety. Our results suggest that therapy for flight phobia might benefit from addressing the physical effect of anxiety, by means of cognitive restructuring and exposure to interoceptive stimuli, particularly in aviophobics high in AS.
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van Lien R, Schutte NM, Meijer JH, de Geus EJC. Estimated preejection period (PEP) based on the detection of the R-wave and dZ/dt-min peaks does not adequately reflect the actual PEP across a wide range of laboratory and ambulatory conditions. Int J Psychophysiol 2012; 87:60-9. [PMID: 23142412 DOI: 10.1016/j.ijpsycho.2012.11.001] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2012] [Revised: 10/31/2012] [Accepted: 11/01/2012] [Indexed: 11/16/2022]
Abstract
The current study evaluates the validity of the PEP computed from a fixed value for the Q-wave onset to R-wave peak (QR) interval and an R-wave peak to B-point (RB) interval that is estimated from the R-peak to dZ/dt-min peak (ISTI) interval. Ninety-one subjects participated in a 90min laboratory experiment in which a variety of often employed physical and mental stressors were presented and 31 further subjects participated in a structured 2hour ambulatory recording in which they partook in natural activities that induced large variation in posture and physical activity. PEP, QR interval, and ISTI were scored and rigorously checked by interactive inspection. Across the very diverse laboratory and ambulatory conditions the QR interval could be approximated by a fixed interval of 40ms but 95% confidence intervals were large (25.5 to 54.5ms). Multilevel analysis showed that 79% to 81% of the within and between-subject variation in the RB interval could be predicted by the ISTI with a simple linear regression equation. However, the optimal intercept and slope values in this equation varied significantly across subjects and study setting. Bland Altman plots revealed a large discrepancy between the estimated PEP using the R-wave peak and dZ/dt-min peak and the actual PEP based on the Q-wave onset and B-point. We conclude that the PEP estimated from a fixed QR interval and the ISTI could be a useful addition to the psychophysiologist's toolbox, but that it cannot replace the actual PEP to index cardiac sympathetic control.
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Affiliation(s)
- René van Lien
- Department of Biological Psychology, VU University, Amsterdam, The Netherlands.
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van Dijk AE, van Eijsden M, Stronks K, Gemke RJBJ, Vrijkotte TGM. Prenatal stress and balance of the child's cardiac autonomic nervous system at age 5-6 years. PLoS One 2012; 7:e30413. [PMID: 22272345 PMCID: PMC3260299 DOI: 10.1371/journal.pone.0030413] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2011] [Accepted: 12/15/2011] [Indexed: 01/04/2023] Open
Abstract
OBJECTIVE Autonomic nervous system (ANS) misbalance is a potential causal factor in the development of cardiovascular disease. The ANS may be programmed during pregnancy due to various maternal factors. Our aim is to study maternal prenatal psychosocial stress as a potential disruptor of cardiac ANS balance in the child. METHODS Mothers from a prospective birth cohort (ABCD study) filled out a questionnaire at gestational week 16 [IQR 12-20], that included validated instruments for state anxiety, depressive symptoms, pregnancy-related anxiety, parenting daily hassles and job strain. A cumulative stress score was also calculated (based on 80(th) percentiles). Indicators of cardiac ANS in the offspring at age 5-6 years are: pre-ejection period (PEP), heart rate (HR), respiratory sinus arrhythmia (RSA) and cardiac autonomic balance (CAB), measured with electrocardiography and impedance cardiography in resting supine and sitting positions. RESULTS 2,624 mother-child pairs, only single births, were available for analysis. The stress scales were not significantly associated with HR, PEP, RSA and CAB (p≥0.17). Accumulation of maternal stress was also not associated with HR, PEP, RSA and CAB (p≥0.07). CONCLUSION Results did not support the hypothesis that prenatal maternal psychosocial stress deregulates cardiac ANS balance in the offspring, at least in rest, and at the age of five-six years.
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Affiliation(s)
- Aimée E van Dijk
- Department of Public Health, Academic Medical Center-University of Amsterdam, Amsterdam, The Netherlands.
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Type D personality and cardiovascular function in daily life of people without documented cardiovascular disease. Int J Psychophysiol 2011; 80:139-42. [DOI: 10.1016/j.ijpsycho.2011.02.014] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2010] [Revised: 02/18/2011] [Accepted: 02/21/2011] [Indexed: 11/20/2022]
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