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Gruenewald T, Seeman TE, Choo TH, Scodes J, Snyder C, Pavlicova M, Weinstein M, Schwartz JE, Mukkamala R, Sloan RP. Cardiovascular variability, sociodemographics, and biomarkers of disease: the MIDUS study. Front Physiol 2023; 14:1234427. [PMID: 37693005 PMCID: PMC10484414 DOI: 10.3389/fphys.2023.1234427] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 08/09/2023] [Indexed: 09/12/2023] Open
Abstract
Introduction: Like heart rate, blood pressure (BP) is not steady but varies over intervals as long as months to as short as consecutive cardiac cycles. This blood pressure variability (BPV) consists of regularly occurring oscillations as well as less well-organized changes and typically is computed as the standard deviation of multiple clinic visit-to-visit (VVV-BP) measures or from 24-h ambulatory BP recordings (ABPV). BP also varies on a beat-to-beat basis, quantified by methods that parse variation into discrete bins, e.g., low frequency (0.04-0.15 Hz, LF). However, beat-to-beat BPV requires continuous recordings that are not easily acquired. As a result, we know little about the relationship between LF-BPV and basic sociodemographic characteristics such as age, sex, and race and clinical conditions. Methods: We computed LF-BPV during an 11-min resting period in 2,118 participants in the Midlife in the US (MIDUS) study. Results: LF-BPV was negatively associated with age, greater in men than women, and unrelated to race or socioeconomic status. It was greater in participants with hypertension but unrelated to hyperlipidemia, hypertriglyceridemia, diabetes, elevated CRP, or obesity. LF-diastolic BPV (DBPV), but not-systolic BPV (SBPV), was negatively correlated with IL-6 and s-ICAM and positively correlated with urinary epinephrine and cortisol. Finally, LF-DBPV was negatively associated with mortality, an effect was rendered nonsignificant by adjustment by age but not other sociodemographic characteristics. Discussion: These findings, the first from a large, national sample, suggest that LF-BPV differs significantly from VVV-BP and ABPV. Confirming its relationship to sociodemographic risk factors and clinical outcomes requires further study with large and representative samples.
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Affiliation(s)
- Tara Gruenewald
- Department of Psychology, Chapman University, Orange, CA, United States
| | - Teresa E. Seeman
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, United States
| | - Tse-Hwei Choo
- Mental Health Data Science Division, New York State Psychiatric Institute, New York, NY, United States
| | - Jennifer Scodes
- Mental Health Data Science Division, New York State Psychiatric Institute, New York, NY, United States
| | - Clayton Snyder
- Mental Health Data Science Division, New York State Psychiatric Institute, New York, NY, United States
| | - Martina Pavlicova
- Department of Biostatistics, Mailman School of Public Health, Columbia University Irving Medical Center, New York, NY, United States
| | | | - Joseph E. Schwartz
- Renaissance School of Medicine, Stony Brook University, New York, NY, United States
- Department of Medicine, Columbia University Irving Medical Center, New York, NY, United States
| | - Ramakrishna Mukkamala
- Swanson School of Engineering, University of Pittsburgh, Pittsburgh, PA, United States
| | - Richard P. Sloan
- Division of Behavioral Medicine, Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, United States
- New York State Psychiatric Institute, New York, NY, United States
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Yeung LK, Alschuler DM, Wall M, Luttmann-Gibson H, Copeland T, Hale C, Sloan RP, Sesso HD, Manson JE, Brickman AM. Multivitamin Supplementation Improves Memory in Older Adults: A Randomized Clinical Trial. Am J Clin Nutr 2023; 118:273-282. [PMID: 37244291 PMCID: PMC10375458 DOI: 10.1016/j.ajcnut.2023.05.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 04/18/2023] [Accepted: 05/02/2023] [Indexed: 05/29/2023] Open
Abstract
BACKGROUND Maintenance of cognitive abilities is of critical importance to older adults, yet few effective strategies to slow cognitive decline currently exist. Multivitamin supplementation is used to promote general health; it is unclear whether it favorably affects cognition in older age. OBJECTIVES To examine the effect of daily multivitamin/multimineral supplementation on memory in older adults. METHODS The COcoa Supplement and Multivitamin Outcomes Study Web (COSMOS-Web) ancillary study (NCT04582617) included 3562 older adults. Participants were randomly assigned to a daily multivitamin supplement (Centrum Silver) or placebo and evaluated annually with an Internet-based battery of neuropsychological tests for 3 y. The prespecified primary outcome measure was change in episodic memory, operationally defined as immediate recall performance on the ModRey test, after 1 y of intervention. Secondary outcome measures included changes in episodic memory over 3 y of follow-up and changes in performance on neuropsychological tasks of novel object recognition and executive function over 3 y. RESULTS Compared with placebo, participants randomly assigned to multivitamin supplementation had significantly better ModRey immediate recall at 1 y, the primary endpoint (t(5889) = 2.25, P = 0.025), as well as across the 3 y of follow-up on average (t(5889) = 2.54, P = 0.011). Multivitamin supplementation had no significant effects on secondary outcomes. Based on cross-sectional analysis of the association between age and performance on the ModRey, we estimated that the effect of the multivitamin intervention improved memory performance above placebo by the equivalent of 3.1 y of age-related memory change. CONCLUSIONS Daily multivitamin supplementation, compared with placebo, improves memory in older adults. Multivitamin supplementation holds promise as a safe and accessible approach to maintaining cognitive health in older age. This trial was registered at clinicaltrials.gov as NCT04582617.
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Affiliation(s)
- Lok-Kin Yeung
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, United States
| | - Daniel M Alschuler
- Area Mental Health Data Science, New York State Psychiatric Institute, New York, NY, United States
| | - Melanie Wall
- Area Mental Health Data Science, New York State Psychiatric Institute, New York, NY, United States; Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, United States
| | - Heike Luttmann-Gibson
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Trisha Copeland
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
| | - Christiane Hale
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, United States
| | - Richard P Sloan
- Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, United States; Division of Behavioral Medicine, New York State Psychiatric Institute, New York, NY, United States
| | - Howard D Sesso
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States; Division of Aging, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
| | - JoAnn E Manson
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Adam M Brickman
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, United States; Gertrude H. Sergievsky Center, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, United States; Department of Neurology, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, United States.
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3
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Brickman AM, Yeung LK, Alschuler DM, Ottaviani JI, Kuhnle GGC, Sloan RP, Luttmann-Gibson H, Copeland T, Schroeter H, Sesso HD, Manson JE, Wall M, Small SA. Dietary flavanols restore hippocampal-dependent memory in older adults with lower diet quality and lower habitual flavanol consumption. Proc Natl Acad Sci U S A 2023; 120:e2216932120. [PMID: 37252983 PMCID: PMC10265949 DOI: 10.1073/pnas.2216932120] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 03/29/2023] [Indexed: 06/01/2023] Open
Abstract
Dietary flavanols are food constituents found in certain fruits and vegetables that have been linked to cognitive aging. Previous studies suggested that consumption of dietary flavanols might specifically be associated with the hippocampal-dependent memory component of cognitive aging and that memory benefits of a flavanol intervention might depend on habitual diet quality. Here, we tested these hypotheses in the context of a large-scale study of 3,562 older adults, who were randomly assigned to a 3-y intervention of cocoa extract (500 mg of cocoa flavanols per day) or a placebo [(COcoa Supplement and Multivitamin Outcomes Study) COSMOS-Web, NCT04582617]. Using the alternative Healthy Eating Index in all participants and a urine-based biomarker of flavanol intake in a subset of participants [n = 1,361], we show that habitual flavanol consumption and diet quality at baseline are positively and selectively correlated with hippocampal-dependent memory. While the prespecified primary end point testing for an intervention-related improvement in memory in all participants after 1 y was not statistically significant, the flavanol intervention restored memory among participants in lower tertiles of habitual diet quality or habitual flavanol consumption. Increases in the flavanol biomarker over the course of the trial were associated with improving memory. Collectively, our results allow dietary flavanols to be considered in the context of a depletion-repletion paradigm and suggest that low flavanol consumption can act as a driver of the hippocampal-dependent component of cognitive aging.
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Affiliation(s)
- Adam M. Brickman
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY10032
- Gertrude H. Sergievsky Center, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY10032
- Department of Neurology, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY10032
| | - Lok-Kin Yeung
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY10032
- Gertrude H. Sergievsky Center, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY10032
- Department of Neurology, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY10032
| | - Daniel M. Alschuler
- Mental Health Data Science Area, New York State Psychiatric Institute, New York, NY10032
| | | | - Gunter G. C. Kuhnle
- Department of Food and Nutritional Sciences, Hugh Sinclair Unit of Human Nutrition, University of Reading, Reading RG6 6DZ, United Kingdom
| | - Richard P. Sloan
- Mental Health Data Science Area, New York State Psychiatric Institute, New York, NY10032
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY10032
| | - Heike Luttmann-Gibson
- Division of Preventive Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA02115
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA02115
| | - Trisha Copeland
- Division of Preventive Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA02115
| | | | - Howard D. Sesso
- Division of Preventive Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA02115
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA02115
| | - JoAnn E. Manson
- Division of Preventive Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA02115
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA02115
| | - Melanie Wall
- Mental Health Data Science Area, New York State Psychiatric Institute, New York, NY10032
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY10032
| | - Scott A. Small
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY10032
- Gertrude H. Sergievsky Center, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY10032
- Department of Neurology, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY10032
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY10032
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4
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Lauriola V, Brickman AM, Sloan RP, Small SA. Anatomical biology guides a search for nutrients for the aging brain. Mol Aspects Med 2023; 89:101154. [PMID: 36372583 PMCID: PMC10783103 DOI: 10.1016/j.mam.2022.101154] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Revised: 10/22/2022] [Accepted: 10/23/2022] [Indexed: 11/11/2022]
Abstract
Considerable evidence has established the importance of specific nutrients that have been found vital for the developing brain. We hypothesize that in a similar manner there should be nutrients vital to the aging brain and that based on aging's distinct pathophysiology they should be different than those essential to development. Specific brain networks that govern cognition are particularly vulnerable to the aging process, resulting in what is referred to as 'cognitive aging'. Common late-life disorders, however, such as Alzheimer's disease also target these same brain networks. Studies have disambiguated cognitive aging from late-life disease by isolating regions and biological pathways within each network differentially linked to one or the other. This anatomical biology anchors a framework to identify nutrients and/or dietary bioactives relevant to cognitive aging whose utility is illustrated via a decades-long research program into how dietary bioactive flavanols benefit the brain. As we are living longer in cognitively more demanding lives, the framework's ultimate goal is to generate specific dietary recommendations that will fortify our mind for its golden years.
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Affiliation(s)
- Vincenzo Lauriola
- Division of Behavioral Medicine, Department of Psychiatry, Columbia University Irving Medical Center, 622 West 168th St., New York, NY, 10032, USA; New York State Psychiatric Institute, 1050 Riverside Drive, New York, NY, 10032, USA
| | - Adam M Brickman
- Department of Neurology and the Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Vagelos College of Physicians and Surgeons, Columbia University, 622 West 168th St., New York, NY, 10032, USA
| | - Richard P Sloan
- Division of Behavioral Medicine, Department of Psychiatry, Columbia University Irving Medical Center, 622 West 168th St., New York, NY, 10032, USA; New York State Psychiatric Institute, 1050 Riverside Drive, New York, NY, 10032, USA
| | - Scott A Small
- Department of Neurology and the Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Vagelos College of Physicians and Surgeons, Columbia University, 622 West 168th St., New York, NY, 10032, USA.
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5
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Vaccarino V, Shah AJ, Moncayo V, Nye JA, Piccinelli M, Ko YA, Ma X, Murrah N, Shallenberger L, Driggers E, Jajeh N, Haffar A, Al-Abboud O, Raggi P, Hall MH, Sloan RP, Goldberg J, Smith NL, Garcia EV, Quyyumi AA, Bremner JD, Bliwise DL. Obstructive sleep apnea, myocardial perfusion and myocardial blood flow: A study of older male twins. PLoS One 2022; 17:e0278420. [PMID: 36449510 PMCID: PMC9710778 DOI: 10.1371/journal.pone.0278420] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 11/15/2022] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Obstructive sleep apnea (OSA) has been associated with incidence of cardiovascular disease and with nocturnal angina, but evidence of a link with coronary atherosclerosis and myocardial ischemia is limited and previous studies may have been affected by selection bias or unmeasured confounding factors. METHODS We performed overnight polysomnography in 178 older male twins. The Apnea/Hypopnea Index (AHI) was calculated to assess OSA from the overnight sleep evaluation. AHI ≥15 was used as indicator of moderate/severe OSA. The following day, twins underwent myocardial perfusion imaging with [82Rb]-chloride positron emission tomography. Quantitative and semiquantitative measures of myocardial perfusion and absolute myocardial blood flow were obtained. RESULTS The mean age was 68 years and 40% of the sample had an AHI≥15, which indicates moderate to severe OSA. Abnormal myocardial perfusion, both with stress and at rest, was more common in twins with elevated AHI. After adjusting for clinical, lifestyle and behavioral factors, and previous history of cardiovascular disease, twins with AHI ≥15 had 3.6 higher odds (95% CI, 1.5-8.9) of an abnormal total severity score, defined as a score ≥100, and for each 5-point increment in AHI, the odds of abnormality increased by 20% (95% CI, 7%-34%). Twin pairs where both twins had OSA exhibited the greatest risk. There were no differences in measures of ischemia and absolute myocardial blood flow and flow reserve by AHI status. CONCLUSIONS OSA is associated with myocardial perfusion abnormalities that suggest prior subclinical myocardial scarring or infarction. Early environmental factors that affect both twins equally may play a role and should be further explored.
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Affiliation(s)
- Viola Vaccarino
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America,Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, Georgia, United States of America,* E-mail:
| | - Amit J. Shah
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America,Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, Georgia, United States of America,Atlanta Veterans Affairs Health Care System, Decatur, Georgia, United States of America
| | - Valeria Moncayo
- Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia, United States of America
| | - Jonathon A. Nye
- Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia, United States of America
| | - Marina Piccinelli
- Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia, United States of America
| | - Yi-An Ko
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
| | - Xin Ma
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
| | - Nancy Murrah
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
| | - Lucy Shallenberger
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
| | - Emily Driggers
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
| | - Nour Jajeh
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
| | - Ammer Haffar
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
| | - Omar Al-Abboud
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
| | - Paolo Raggi
- Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Alberta, Canada
| | - Martica H. Hall
- Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Richard P. Sloan
- Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, New York, United States of America
| | - Jack Goldberg
- Seattle Epidemiologic Research and Information Center, Office of Research and Development, United States Department of Veterans Affairs, Seattle, Washington, United States of America
| | - Nicholas L. Smith
- Seattle Epidemiologic Research and Information Center, Office of Research and Development, United States Department of Veterans Affairs, Seattle, Washington, United States of America,Department of Epidemiology, University of Washington, Seattle, Washington, United States of America
| | - Ernest V. Garcia
- Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia, United States of America
| | - Arshed A. Quyyumi
- Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, Georgia, United States of America
| | - J. Douglas Bremner
- Atlanta Veterans Affairs Health Care System, Decatur, Georgia, United States of America,Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia, United States of America,Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia, United States of America
| | - Donald L. Bliwise
- Department of Neurology, Emory University School of Medicine, Atlanta, Georgia, United States of America
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Muldoon MF, Sloan RP. Editorial to Accompany AMGP-22-25R1. Visit-to-Visit Blood Pressure Variability and Subthreshold Depressive Symptoms in Older Adults, by Sible, et al. Blood Pressure Variability: Trash or Treasure? Am J Geriatr Psychiatry 2022; 30:1120-1122. [PMID: 35641402 DOI: 10.1016/j.jagp.2022.04.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 04/26/2022] [Indexed: 01/25/2023]
Affiliation(s)
- Matthew F Muldoon
- Division of Cardiology, Department of Medicine (MFM), University of Pittsburgh School of Medicine, Pittsburgh, PA.
| | - Richard P Sloan
- Division of Behavioral Medicine, Department of Psychiatry (RPS), Columbia University Irving Medical Center, New York, NY
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Lauriola V, McIntyre KM, Garber CE, Sloan RP. Home-based Exercise Training When You Can’t Leave The House: Promoting Physical Activity In Postpartum Women. Med Sci Sports Exerc 2022. [DOI: 10.1249/01.mss.0000877200.84150.4c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Mefford MT, Rana JS, Reynolds K, Ranasinghe O, Mittleman MA, Liu JY, Qian L, Zhou H, Harrison TN, Geller AC, Sloan RP, Mostofsky E, Williams DR, Sidney S. Association of the 2020 US Presidential Election With Hospitalizations for Acute Cardiovascular Conditions. JAMA Netw Open 2022; 5:e228031. [PMID: 35442454 PMCID: PMC9021908 DOI: 10.1001/jamanetworkopen.2022.8031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
IMPORTANCE Prior studies found a higher risk of acute cardiovascular disease (CVD) around population-wide psychosocial or environmental stressors. Less is known about acute CVD risk in relation to political events. OBJECTIVE To examine acute CVD hospitalizations following the 2020 presidential election. DESIGN, SETTING, AND PARTICIPANTS This retrospective cohort study examined acute CVD hospitalizations following the 2020 presidential election. Participants were adult members aged 18 years or older at Kaiser Permanente Southern California and Kaiser Permanente Northern California, 2 large, integrated health care delivery systems. Statistical analysis was performed from March to July 2021. EXPOSURE 2020 US presidential election. MAIN OUTCOMES AND MEASURES Hospitalizations for acute CVD around the 2020 presidential election were examined. CVD was defined as hospitalizations for acute myocardial infarction (AMI), heart failure (HF), or stroke. Rate ratios (RR) and 95% CIs were calculated comparing rates of CVD hospitalization in the 5 days following the 2020 election with the same 5-day period 2 weeks prior. RESULTS Among 6 396 830 adults (3 970 077 [62.1%] aged 18 to 54 years; 3 422 479 [53.5%] female; 1 083 128 [16.9%] Asian/Pacific Islander, 2 101 367 [32.9%] Hispanic, and 2 641 897 [41.3%] White), rates of hospitalization for CVD following the election (666 hospitalizations; rate = 760.5 per 100 000 person-years [PY]) were 1.17 times higher (95% CI, 1.05-1.31) compared with the same 5-day period 2 weeks prior (569 hospitalizations; rate = 648.0 per 100 000 PY). Rates of AMI were significantly higher following the election (RR, 1.42; 95% CI, 1.13-1.79). No significant difference was found for stroke (RR, 1.02; 95% CI, 0.86-1.21) or HF (RR, 1.18; 95% CI, 0.98-1.42). CONCLUSIONS AND RELEVANCE Higher rates of acute CVD hospitalization were observed following the 2020 presidential election. Awareness of the heightened risk of CVD and strategies to mitigate risk during notable political events are needed.
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Affiliation(s)
- Matthew T. Mefford
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena
| | - Jamal S. Rana
- Department of Cardiology, Kaiser Permanente Oakland Medical Center, Oakland, California
- Division of Research, Kaiser Permanente Northern California, Oakland
| | - Kristi Reynolds
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena
- Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, California
| | - Omesh Ranasinghe
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena
| | - Murray A. Mittleman
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Cardiovascular Division, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Jennifer Y. Liu
- Division of Research, Kaiser Permanente Northern California, Oakland
| | - Lei Qian
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena
| | - Hui Zhou
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena
| | - Teresa N. Harrison
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena
| | - Alan C. Geller
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Richard P. Sloan
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York
| | - Elizabeth Mostofsky
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - David R. Williams
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Department of African and African American Studies, Harvard University, Cambridge, Massachusetts
| | - Stephen Sidney
- Division of Research, Kaiser Permanente Northern California, Oakland
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9
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Clouston SAP, Hall CB, Kritikos M, Bennett DA, DeKosky S, Edwards J, Finch C, Kreisl WC, Mielke M, Peskind ER, Raskind M, Richards M, Sloan RP, Spiro A, Vasdev N, Brackbill R, Farfel M, Horton M, Lowe S, Lucchini RG, Prezant D, Reibman J, Rosen R, Seil K, Zeig-Owens R, Deri Y, Diminich ED, Fausto BA, Gandy S, Sano M, Bromet EJ, Luft BJ. Cognitive impairment and World Trade Centre-related exposures. Nat Rev Neurol 2022; 18:103-116. [PMID: 34795448 PMCID: PMC8938977 DOI: 10.1038/s41582-021-00576-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/29/2021] [Indexed: 02/03/2023]
Abstract
On 11 September 2001 the World Trade Center (WTC) in New York was attacked by terrorists, causing the collapse of multiple buildings including the iconic 110-story 'Twin Towers'. Thousands of people died that day from the collapse of the buildings, fires, falling from the buildings, falling debris, or other related accidents. Survivors of the attacks, those who worked in search and rescue during and after the buildings collapsed, and those working in recovery and clean-up operations were exposed to severe psychological stressors. Concurrently, these 'WTC-affected' individuals breathed and ingested a mixture of organic and particulate neurotoxins and pro-inflammogens generated as a result of the attack and building collapse. Twenty years later, researchers have documented neurocognitive and motor dysfunctions that resemble the typical features of neurodegenerative disease in some WTC responders at midlife. Cortical atrophy, which usually manifests later in life, has also been observed in this population. Evidence indicates that neurocognitive symptoms and corresponding brain atrophy are associated with both physical exposures at the WTC and chronic post-traumatic stress disorder, including regularly re-experiencing traumatic memories of the events while awake or during sleep. Despite these findings, little is understood about the long-term effects of these physical and mental exposures on the brain health of WTC-affected individuals, and the potential for neurocognitive disorders. Here, we review the existing evidence concerning neurological outcomes in WTC-affected individuals, with the aim of contextualizing this research for policymakers, researchers and clinicians and educating WTC-affected individuals and their friends and families. We conclude by providing a rationale and recommendations for monitoring the neurological health of WTC-affected individuals.
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Affiliation(s)
- Sean A P Clouston
- Program in Public Health, Department of Family, Population, and Preventive Medicine, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA.
| | - Charles B Hall
- Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Minos Kritikos
- Program in Public Health, Department of Family, Population, and Preventive Medicine, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA
| | - David A Bennett
- Rush Alzheimer's Disease Center, Department of Neurological Sciences, Rush Medical College, Rush University, Chicago, IL, USA
| | - Steven DeKosky
- Evelyn F. and William L. McKnight Brain Institute and Florida Alzheimer's Disease Research Center, Department of Neurology and Neuroscience, University of Florida, Gainesville, FL, USA
| | - Jerri Edwards
- Department of Psychiatry and Behavioral Neuroscience, Morsani College of Medicine, University of South Florida, Tampa, FL, USA
| | - Caleb Finch
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA
| | - William C Kreisl
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Department of Neurology, Columbia University, New York, NY, USA
| | - Michelle Mielke
- Specialized Center of Research Excellence on Sex Differences, Department of Neurology, Department of Epidemiology, Mayo Clinic, Rochester, MN, USA
| | - Elaine R Peskind
- Veteran's Association VISN 20 Northwest Mental Illness Research, Education, and Clinical Center, Veteran's Affairs Puget Sound Health Care System, Seattle, WA, USA
- Alzheimer's Disease Research Center, Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA, USA
| | - Murray Raskind
- Veteran's Association VISN 20 Northwest Mental Illness Research, Education, and Clinical Center, Veteran's Affairs Puget Sound Health Care System, Seattle, WA, USA
- Alzheimer's Disease Research Center, Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA, USA
| | - Marcus Richards
- Medical Research Council Unit for Lifelong Health and Ageing, Population Health Sciences, University College London, London, UK
| | - Richard P Sloan
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA
| | - Avron Spiro
- Department of Epidemiology, School of Public Health, Boston University, Boston, MA, USA
- Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC), Department of Veterans Affairs Boston Healthcare System, Boston, MA, USA
| | - Neil Vasdev
- Azrieli Centre for Neuro-Radiochemistry, Brain Health Imaging Center, Center for Addiction and Mental Health, Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Robert Brackbill
- World Trade Center Health Registry, New York Department of Health and Mental Hygiene, New York, NY, USA
| | - Mark Farfel
- World Trade Center Health Registry, New York Department of Health and Mental Hygiene, New York, NY, USA
| | - Megan Horton
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Sandra Lowe
- The World Trade Center Mental Health Program, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Roberto G Lucchini
- Department of Environmental Health Sciences, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA
| | - David Prezant
- World Trade Center Health Program, Fire Department of the City of New York, Brooklyn, NY, USA
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Joan Reibman
- Department of Environmental Medicine, New York University Langone Health, New York, NY, USA
| | - Rebecca Rosen
- World Trade Center Environmental Health Center, Department of Psychiatry, New York University, New York, NY, USA
| | - Kacie Seil
- World Trade Center Health Registry, New York Department of Health and Mental Hygiene, New York, NY, USA
| | - Rachel Zeig-Owens
- World Trade Center Health Program, Fire Department of the City of New York, Brooklyn, NY, USA
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Yael Deri
- Department of Medicine, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY, USA
- Department of Psychiatry, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY, USA
| | - Erica D Diminich
- Program in Public Health, Department of Family, Population, and Preventive Medicine, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA
| | - Bernadette A Fausto
- Center for Molecular & Behavioral Neuroscience, Rutgers, The State University of New Jersey, Newark, NJ, USA
| | - Sam Gandy
- Research and Development Service, James J. Peters Department of Veterans Affairs Medical Center, Bronx, NY, USA
- Mount Sinai Alzheimer's Disease Research Center and Ronald M. Loeb Center for Alzheimer's Disease, Department of Psychiatry, Icahn School of Medicine, Mount Sinai, New York, NY, USA
| | - Mary Sano
- Research and Development Service, James J. Peters Department of Veterans Affairs Medical Center, Bronx, NY, USA
- Mount Sinai Alzheimer's Disease Research Center and Ronald M. Loeb Center for Alzheimer's Disease, Department of Psychiatry, Icahn School of Medicine, Mount Sinai, New York, NY, USA
| | - Evelyn J Bromet
- Department of Psychiatry, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY, USA
| | - Benjamin J Luft
- Department of Medicine, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY, USA
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10
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Sloan RP, Cole SW. Parasympathetic neural activity and the reciprocal regulation of innate antiviral and inflammatory genes in the human immune system. Brain Behav Immun 2021; 98:251-256. [PMID: 34400237 PMCID: PMC8511100 DOI: 10.1016/j.bbi.2021.08.217] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 07/18/2021] [Accepted: 08/09/2021] [Indexed: 12/26/2022] Open
Abstract
The vagus nerve mediates parasympathetic nervous system control of peripheral physiological processes including cardiovascular activity and immune response. In mice, tonic vagal activation down-regulates inflammation via nicotinic acetylcholine receptor-mediated inhibition of the pro-inflammatory transcription factor NF-κB in monocyte/macrophages. Because Type I interferon and pro-inflammatory genes are regulated reciprocally at the level of transcription factor activation and cell differentiation, we hypothesized that vagal activity would up-regulate Type I interferon response genes concurrently with inflammatory downregulation in human immune cells. We mapped empirical individual differences in the circulating leukocyte transcriptome and vagal activity indexed by high frequency (0.15-0.40 Hz) heart rate variability (HF-HRV) in 380 participants in the Midlife in the US study. Here we show that promoter-based bioinformatics analyses linked greater HF-HRV to reduced NF-κB activity and increased activity of IRF transcription factors involved in Type I interferon response (independent of β-antagonists, BMI, smoking, heavy alcohol consumption, and demographic factors). Transcript origin analyses implicated myeloid lineage immune cells as targets, representing per-cell alterations in gene transcription as HF-HRV was not associated with differential prevalence of leukocyte subsets. These findings support the concept of parasympathetic inhibition of pro-inflammatory gene expression in humans and up-regulation of Type I interferons that could augment host defense against viral infections.
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Affiliation(s)
- Richard P Sloan
- Division of Behavioral Medicine, Department of Psychiatry, Columbia University Irving Medical Center, 622 West 168(th)St., PH1540, New York, NY 10032, USA; New York State Psychiatric Institute, 1051 Riverside Dr., New York, NY, USA.
| | - Steve W Cole
- Department of Psychiatry & Biobehavioral Sciences, Department of Medicine, Division of Hematology-Oncology, Norman Cousins Center, Jonsson Comprehensive Cancer Center, University of California Los Angeles, 11-934 Factor Building, Los Angeles, CA 90095-1678, USA.
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11
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Predovan D, Gazes Y, Lee S, Li P, Sloan RP, Stern Y. Effect of Aerobic Exercise on White Matter Tract Microstructure in Young and Middle-Aged Healthy Adults. Front Hum Neurosci 2021; 15:681634. [PMID: 34276329 PMCID: PMC8283503 DOI: 10.3389/fnhum.2021.681634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 05/10/2021] [Indexed: 11/13/2022] Open
Abstract
Recent evidence suggests that being physically active can mitigate age-related white matter (WM) changes. In a randomized clinical trial, the effect of 6-month aerobic exercise (AE) or stretching/toning interventions on measures of WM microstructure (WMM) was assessed in a sample of 74 adults aged 20-67 years. Major WM pathways were reconstructed. No significant group-level change in WM tract microstructure following an AE training was observed. Without adjustment for multiple comparisons, an increase in fractional anisotropy (FA) and a decrease in mean diffusivity (MD) of the uncinate fasciculus were observed post-intervention in the AE group in comparison with the stretching group. In the AE group, a significant increase in cardiorespiratory fitness was measured but did not correlate with FA and MD change. The present results of this study are in accordance with similar studies in healthy adults that did not show significant benefit on WMM after participating in an AE program. Clinical Trial Registration: Clinicaltrials.gov identifier, NCT01179958.
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Affiliation(s)
- David Predovan
- Cognitive Neuroscience Division, The Taub Institute for Research on Aging and Alzheimer's Disease, Columbia University, New York, NY, United States
| | - Yunglin Gazes
- Cognitive Neuroscience Division, The Taub Institute for Research on Aging and Alzheimer's Disease, Columbia University, New York, NY, United States
| | - Seonjoo Lee
- Department of Biostatistics, Columbia University, New York, NY, United States.,Mental Health Data Science, New York State Psychiatric Institute, New York, NY, United States
| | - Peipei Li
- Cognitive Neuroscience Division, The Taub Institute for Research on Aging and Alzheimer's Disease, Columbia University, New York, NY, United States
| | - Richard P Sloan
- Division of Behavioral Medicine, Department of Psychiatry, Columbia University, New York, NY, United States
| | - Yaakov Stern
- Cognitive Neuroscience Division, The Taub Institute for Research on Aging and Alzheimer's Disease, Columbia University, New York, NY, United States
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12
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Huang M, Bliwise DL, Hall MH, Johnson DA, Sloan RP, Shah A, Goldberg J, Ko YA, Murrah N, Levantsevych OM, Shallenberger L, Abdulbagki R, Bremner JD, Vaccarino V. Association of Depressive Symptoms with Sleep Disturbance: A Co-twin Control Study. Ann Behav Med 2021; 56:245-256. [PMID: 33991086 PMCID: PMC8887572 DOI: 10.1093/abm/kaab040] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Few studies have comprehensively evaluated the association of depression with sleep disturbance using a controlled twin study design. PURPOSE To cross-sectionally evaluate the association of depression with both objective and subjective sleep disturbance. METHODS We studied 246 members of the Vietnam Era Twin Registry. We measured depressive symptoms using the Beck Depression Inventory-II (BDI) and assessed major depression using structured clinical interviews. Twins underwent one-night polysomnography and 7-day actigraphy to derive measures of objective sleep and completed the Pittsburgh Sleep Quality Index for subjective sleep. Multivariable mixed-effects models were used to examine the association. RESULTS Twins were all male, mostly white (97%), with a mean (SD) age of 68 (2). The mean (SD) BDI was 5.9 (6.3), and 49 (20%) met the criteria for major depression. For polysomnography, each 5-unit higher BDI, within-pair, was significantly associated with 19.7 min longer rapid eye movement (REM) sleep latency, and 1.1% shorter REM sleep after multivariable adjustment. BDI was not associated with sleep architecture or sleep-disordered breathing. For actigraphy, a higher BDI, within-pair, was significantly associated with lower sleep efficiency, more fragmentation and higher variability in sleep duration. BDI was associated with almost all dimensions of self-reported sleep disturbance. Results did not differ by zygosity, and remained consistent using major depression instead of BDI and were independent of the presence of comorbid posttraumatic stress disorder and antidepressant use. CONCLUSIONS Depression is associated with REM sleep disruption in lab and sleep fragmentation and sleep variability at home, but not with sleep architecture or sleep-disordered breathing.
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Affiliation(s)
- Minxuan Huang
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Donald L Bliwise
- Department of Neurology, School of Medicine, Emory University, Atlanta, GA, USA
| | - Martica H Hall
- Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Dayna A Johnson
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Richard P Sloan
- Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Amit Shah
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA.,Department of Medicine (Cardiology), School of Medicine, Emory University, Atlanta, GA, USA.,Atlanta Veteran Affairs Medical Center, Decatur, GA, USA
| | - Jack Goldberg
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA.,Vietnam Era Twin Registry, Seattle Epidemiologic Research and Information Center, US Department of Veterans Affairs, Seattle, WA, USA
| | - Yi-An Ko
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Nancy Murrah
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Oleksiy M Levantsevych
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Lucy Shallenberger
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Rami Abdulbagki
- Department of Pathology, Georgia Washington University Hospital, Washington, DC, USA
| | - J Douglas Bremner
- Atlanta Veteran Affairs Medical Center, Decatur, GA, USA.,Department of Psychiatry and Behavioral Sciences, School of Medicine, Emory University, Atlanta, GA, USA
| | - Viola Vaccarino
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA.,Department of Medicine (Cardiology), School of Medicine, Emory University, Atlanta, GA, USA
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13
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Abstract
Theoretical perspectives and empirical evidence suggest that the parasympathetic nervous system engages in active monitoring and moderating of inflammatory processes. A clearer understanding of the bidirectional communication between the parasympathetic nervous system and the immune system could lead to novel clinical interventions for inflammatory illnesses. The current study used a large (N = 836) nationally representative sample of adults in the United States to investigate the associations between resting parasympathetic modulation of the heart, indexed through both high frequency heart rate variability (HF-HRV) and low frequency heart rate variability (LF-HRV), and six circulating markers of inflammation. Statistical analyses revealed robust inverse associations of HF-HRV with interleukin-6 (IL6), C-reactive protein (CRP), and fibrinogen, with or without covariate adjustment. Similar inverse associations were observed between LF-HRV and IL6 and CRP. No significant associations were observed between HRV and either inflammatory adhesion molecules (E-selectin, intracellular adhesion molecule-1) or soluble IL6 receptor. Results are consistent with the cholinergic anti-inflammatory pathway and suggest that parasympathetic modulation of inflammation through the vagus nerve may act on specific inflammatory molecules more than others.
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14
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Damme KSF, Sloan RP, Bartels MN, Ozsan A, Ospina LH, Kimhy D, Mittal VA. Psychosis risk individuals show poor fitness and discrepancies with objective and subjective measures. Sci Rep 2021; 11:9851. [PMID: 33972634 PMCID: PMC8110757 DOI: 10.1038/s41598-021-89301-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 04/20/2021] [Indexed: 11/25/2022] Open
Abstract
Exercise is a promising intervention for individuals at clinical high-risk for psychosis (CHR). However, these youth may not be reliable reporters on fitness. There have been no investigations that utilized objective fitness assessment in this population. The present study objectively characterizes the level of fitness in CHR youth, compares the accuracy of self-report measures to objective fitness indices, and explores clinical factors that may influence the accuracy of self-reported measures of fitness. Forty CHR individuals completed an exercise survey and objective indices of fitness (i.e., VO2max and BMI). Forty healthy volunteers completed objective indices of fitness and a structured clinical interview ruling out the presence of psychiatric illness. CHR youth showed greater BMI and lowered VO2max compared to healthy volunteers. In the CHR group, self-report items (perceived fitness) did not reflect objective indices of fitness, whereas specific exercise behaviors (intensity of exercise) showed stronger correlations with objective fitness measurements. Exploratory analyses suggested that symptoms (grandiosity and avolition) related to errors in self-perception. Results indicate that CHR individuals are less fit than controls as indexed by objective measures of fitness and that it is important to consider unique population clinical characteristics when employing self-report data.
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Affiliation(s)
- Katherine S F Damme
- Department of Psychology, Northwestern University, 2029 Sheridan Rd., Evanston, IL, 60208, USA.
- Institute for Innovations in Developmental Sciences (DevSci), Northwestern University, Evanston/Chicago, IL, USA.
| | - Richard P Sloan
- Department of Psychiatry, Columbia University, New York, NY, USA
| | - Matthew N Bartels
- Department of Rehabilitation Medicine, Albert Einstein College of Medicine, Bronx, NY, USA
- Department of Rehabilitation Medicine, Montefiore Medical Center, New York, NY, USA
| | - Alara Ozsan
- Department of Psychology, Northwestern University, 2029 Sheridan Rd., Evanston, IL, 60208, USA
- Department of Psychiatry, Northwestern University, Chicago, IL, USA
| | - Luz H Ospina
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - David Kimhy
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- MIRECC, The James J. Peters VA Medical Center, Bronx, NY, USA
| | - Vijay A Mittal
- Department of Psychology, Northwestern University, 2029 Sheridan Rd., Evanston, IL, 60208, USA
- Institute for Innovations in Developmental Sciences (DevSci), Northwestern University, Evanston/Chicago, IL, USA
- Department of Psychiatry, Northwestern University, Chicago, IL, USA
- Medical Social Sciences, Northwestern University, Chicago, IL, USA
- Institute for Policy Research (IPR), Northwestern University, Chicago, IL, USA
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15
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Sloan RP, Wall M, Yeung LK, Feng T, Feng X, Provenzano F, Schroeter H, Lauriola V, Brickman AM, Small SA. Insights into the role of diet and dietary flavanols in cognitive aging: results of a randomized controlled trial. Sci Rep 2021; 11:3837. [PMID: 33589674 PMCID: PMC7884710 DOI: 10.1038/s41598-021-83370-2] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Accepted: 01/22/2021] [Indexed: 11/09/2022] Open
Abstract
With the world's population aging, age-related memory decline is an impending cognitive epidemic. Assessing the impact of diet on cognitive aging, we conducted a controlled, randomized, parallel-arm dietary intervention with 211 healthy adults (50-75 years) investigating effects of either a placebo or 260, 510 and 770 mg/day of cocoa flavanols for 12-weeks followed by 8-weeks washout. The primary outcome was a newly-developed object-recognition task localized to the hippocampus' dentate gyrus. Secondary outcomes included a hippocampal-dependent list-learning task and a prefrontal cortex-dependent list-sorting task. The alternative Healthy Eating Index and a biomarker of flavanol intake (gVLM) were measured. In an MRI substudy, hippocampal cerebral blood volume was mapped. Object-recognition and list-sorting performance did not correlate with baseline diet quality and did not improve after flavanol intake. However, the hippocampal-dependent list-learning performance was directly associated with baseline diet quality and improved after flavanol intake, particularly in participants in the bottom tertile of baseline diet quality. In the imaging substudy, a region-of-interest analysis was negative but a voxel-based-analysis suggested that dietary flavanols target the dentate gyrus. While replication is needed, these findings suggest that diet in general, and dietary flavanols in particular, may be associated with memory function of the aging hippocampus and normal cognitive decline.
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Affiliation(s)
- Richard P Sloan
- Division of Behavioral Medicine, Department of Psychiatry, Columbia University Irving Medical Center, 622 West 168th St., New York, NY, 10032, USA. .,New York State Psychiatric Institute, 1050 Riverside Drive, New York, NY, 10032, USA.
| | - Melanie Wall
- New York State Psychiatric Institute, 1050 Riverside Drive, New York, NY, 10032, USA
| | - Lok-Kin Yeung
- Department of Neurology, Vagelos College of Physicians and Surgeons, Columbia University, 622 West 168th St., New York, NY, 10032, USA.,Taub Institute for Research On Alzheimer's Disease and the Aging Brain, Vagelos College of Physicians and Surgeons, Columbia University, 622 West 168th St., New York, NY, 10032, USA
| | - Tianshu Feng
- New York State Psychiatric Institute, 1050 Riverside Drive, New York, NY, 10032, USA
| | - Xinyang Feng
- Department of Neurology, Vagelos College of Physicians and Surgeons, Columbia University, 622 West 168th St., New York, NY, 10032, USA
| | - Frank Provenzano
- Department of Neurology, Vagelos College of Physicians and Surgeons, Columbia University, 622 West 168th St., New York, NY, 10032, USA.,Taub Institute for Research On Alzheimer's Disease and the Aging Brain, Vagelos College of Physicians and Surgeons, Columbia University, 622 West 168th St., New York, NY, 10032, USA
| | | | - Vincenzo Lauriola
- Division of Behavioral Medicine, Department of Psychiatry, Columbia University Irving Medical Center, 622 West 168th St., New York, NY, 10032, USA
| | - Adam M Brickman
- Department of Neurology, Vagelos College of Physicians and Surgeons, Columbia University, 622 West 168th St., New York, NY, 10032, USA.,Taub Institute for Research On Alzheimer's Disease and the Aging Brain, Vagelos College of Physicians and Surgeons, Columbia University, 622 West 168th St., New York, NY, 10032, USA
| | - Scott A Small
- Department of Neurology, Vagelos College of Physicians and Surgeons, Columbia University, 622 West 168th St., New York, NY, 10032, USA. .,Taub Institute for Research On Alzheimer's Disease and the Aging Brain, Vagelos College of Physicians and Surgeons, Columbia University, 622 West 168th St., New York, NY, 10032, USA.
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16
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Simon SG, Sloan RP, Thayer JF, Jamner LD. Taking context to heart: Momentary emotions, menstrual cycle phase, and cardiac autonomic regulation. Psychophysiology 2021; 58:e13765. [PMID: 33453074 DOI: 10.1111/psyp.13765] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 12/17/2020] [Accepted: 12/17/2020] [Indexed: 11/26/2022]
Abstract
Emotions have long been discussed in conjunction with the autonomic nervous system. Most research on emotion-autonomic linkages does not consider sex differences or an evident underlying mechanism for sex differences: menstrual cycle phase. Further, most research is limited to cross-sectional and laboratory studies. The degree to which emotion-autonomic associations manifest in everyday life may be different and may vary by sex and, for women, by menstrual cycle phase. This study employs the ambulatory monitoring of cardiovascular measures (e.g., heart rate and heart rate variability; HRV) and concurrent emotional states (e.g., sadness, stress, anxiety, anger, and happiness) in everyday life to better characterize emotion-autonomic associations as a function of sex and menstrual cycle phase. Participants (N = 174; 87 female) ages 18 to 46 (31.23 ± 6.49) were monitored over a 5-day observation period (one 2- and one 3-day session), using an ambulatory 24-hour electrocardiogram to monitor heart rate and ecological momentary assessment to record emotions every ~30 min. Women were monitored in both the early to mid-follicular and -luteal phases and men in two comparably distanced sessions. Multilevel models indicated that across sex, negative emotions and happiness were associated with elevated heart rate. Relative to men, women exhibited an elevated heart rate and reduced HRV during reports of anger. For women, during the luteal phase, but not follicular phase, momentary sadness, stress, and anxiety predicted increased heart rate and reduced HRV. These findings demonstrate the importance of considering sex and menstrual cycle phase in research investigating emotion-autonomic linkages.
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Affiliation(s)
- Shauna G Simon
- Department of Psychological Science, University of California Irvine, Irvine, CA, USA
| | - Richard P Sloan
- Division of Behavioral Medicine, Department of Psychiatry, New York State Psychiatric Institute, Columbia University, New York, NY, USA
| | - Julian F Thayer
- Department of Psychological Science, University of California Irvine, Irvine, CA, USA
| | - Larry D Jamner
- Department of Psychological Science, University of California Irvine, Irvine, CA, USA
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17
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Daniels RD, Clouston SAP, Hall CB, Anderson KR, Bennett DA, Bromet EJ, Calvert GM, Carreón T, DeKosky ST, Diminich ED, Finch CE, Gandy S, Kreisl WC, Kritikos M, Kubale TL, Mielke MM, Peskind ER, Raskind MA, Richards M, Sano M, Santiago-Colón A, Sloan RP, Spiro A, Vasdev N, Luft BJ, Reissman DB. A Workshop on Cognitive Aging and Impairment in the 9/11-Exposed Population. Int J Environ Res Public Health 2021; 18:E681. [PMID: 33466931 PMCID: PMC7830144 DOI: 10.3390/ijerph18020681] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 01/09/2021] [Accepted: 01/12/2021] [Indexed: 12/11/2022]
Abstract
The terrorist attacks on 11 September 2001 potentially exposed more than 400,000 responders, workers, and residents to psychological and physical stressors, and numerous hazardous pollutants. In 2011, the World Trade Center Health Program (WTCHP) was mandated to monitor and treat persons with 9/11-related adverse health conditions and conduct research on physical and mental health conditions related to the attacks. Emerging evidence suggests that persons exposed to 9/11 may be at increased risk of developing mild cognitive impairment. To investigate further, the WTCHP convened a scientific workshop that examined the natural history of cognitive aging and impairment, biomarkers in the pathway of neurodegenerative diseases, the neuropathological changes associated with hazardous exposures, and the evidence of cognitive decline and impairment in the 9/11-exposed population. Invited participants included scientists actively involved in health-effects research of 9/11-exposed persons and other at-risk populations. Attendees shared relevant research results from their respective programs and discussed several options for enhancements to research and surveillance activities, including the development of a multi-institutional collaborative research network. The goal of this report is to outline the meeting's agenda and provide an overview of the presentation materials and group discussion.
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Affiliation(s)
- Robert D. Daniels
- World Trade Center Health Program, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Washington, DC 20201, USA; (K.R.A.); (G.M.C.); (T.C.); (T.L.K.); (A.S.-C.); (D.B.R.)
| | - Sean A. P. Clouston
- Renaissance School of Medicine, Stony Brook University, Stony Brook, NY 11794, USA; (S.A.P.C.); (E.J.B.); (E.D.D.); (M.K.); (B.J.L.)
| | - Charles B. Hall
- Department of Epidemiology & Population Health (Biostatistics), Albert Einstein College of Medicine, Bronx, NY 10461, USA;
| | - Kristi R. Anderson
- World Trade Center Health Program, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Washington, DC 20201, USA; (K.R.A.); (G.M.C.); (T.C.); (T.L.K.); (A.S.-C.); (D.B.R.)
| | - David A. Bennett
- Department of Neurological Sciences, Rush Medical College, Rush University, Chicago, IL 60612, USA;
| | - Evelyn J. Bromet
- Renaissance School of Medicine, Stony Brook University, Stony Brook, NY 11794, USA; (S.A.P.C.); (E.J.B.); (E.D.D.); (M.K.); (B.J.L.)
| | - Geoffrey M. Calvert
- World Trade Center Health Program, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Washington, DC 20201, USA; (K.R.A.); (G.M.C.); (T.C.); (T.L.K.); (A.S.-C.); (D.B.R.)
| | - Tania Carreón
- World Trade Center Health Program, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Washington, DC 20201, USA; (K.R.A.); (G.M.C.); (T.C.); (T.L.K.); (A.S.-C.); (D.B.R.)
| | - Steven T. DeKosky
- McKnight Brain Institute, University of Florida, Gainesville, FL 32611, USA;
| | - Erica D. Diminich
- Renaissance School of Medicine, Stony Brook University, Stony Brook, NY 11794, USA; (S.A.P.C.); (E.J.B.); (E.D.D.); (M.K.); (B.J.L.)
| | - Caleb E. Finch
- USC Leonard Davis School of Gerontology, Los Angeles, CA 90089, USA;
| | - Sam Gandy
- Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; (S.G.); (M.S.)
| | - William C. Kreisl
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, New York, NY 10032, USA;
| | - Minos Kritikos
- Renaissance School of Medicine, Stony Brook University, Stony Brook, NY 11794, USA; (S.A.P.C.); (E.J.B.); (E.D.D.); (M.K.); (B.J.L.)
| | - Travis L. Kubale
- World Trade Center Health Program, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Washington, DC 20201, USA; (K.R.A.); (G.M.C.); (T.C.); (T.L.K.); (A.S.-C.); (D.B.R.)
| | - Michelle M. Mielke
- Division of Epidemiology and Department of Neurology, Department of Health Sciences Research, Mayo Clinic, Rochester, MN 55905, USA;
| | - Elaine R. Peskind
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA 98195, USA;
| | - Murray A. Raskind
- Northwest Mental Illness Research, Education and Clinical Center (MIRECC), VA Puget Sound Health Care System, Seattle, WA 98108, USA;
| | - Marcus Richards
- Faculty of Population Health Sciences, University College London, London WC1E 6BT, UK;
| | - Mary Sano
- Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; (S.G.); (M.S.)
| | - Albeliz Santiago-Colón
- World Trade Center Health Program, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Washington, DC 20201, USA; (K.R.A.); (G.M.C.); (T.C.); (T.L.K.); (A.S.-C.); (D.B.R.)
| | - Richard P. Sloan
- Division of Behavioral Medicine, Columbia University, New York, NY 10027, USA;
| | - Avron Spiro
- Boston University Schools of Public Health and Medicine and Veterans Affairs Boston Healthcare System, Boston, MA 02130, USA;
| | - Neil Vasdev
- Azrieli Centre for Neuro-Radiochemistry, Brain Health Imaging Centre, Centre for Addiction and Mental Health (CAMH) & Department of Psychiatry, University of Toronto, Toronto, ON M5S, Canada;
| | - Benjamin J. Luft
- Renaissance School of Medicine, Stony Brook University, Stony Brook, NY 11794, USA; (S.A.P.C.); (E.J.B.); (E.D.D.); (M.K.); (B.J.L.)
| | - Dori B. Reissman
- World Trade Center Health Program, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Washington, DC 20201, USA; (K.R.A.); (G.M.C.); (T.C.); (T.L.K.); (A.S.-C.); (D.B.R.)
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Beck-Felts K, Goodman M, Ospina LH, Wall M, McEvoy J, Jarskog LF, Ballon JS, Bartels MN, Buchsbaum R, Sloan RP, Stroup TS, Kimhy D. Suicide Reduction in Schizophrenia via Exercise (SUnRISE): study protocol for a multi-site, single-blind, randomized clinical trial of aerobic exercise for suicide risk reduction in individuals with schizophrenia. Trials 2020; 21:871. [PMID: 33087170 PMCID: PMC7579916 DOI: 10.1186/s13063-020-04788-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Accepted: 10/05/2020] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Suicide risk among individuals with schizophrenia (SZ) is intractably high, with over 40% of individuals attempting to take their own lives during their lifetime and an estimated 5-10% completing suicide. At present, available pharmacological and psychotherapeutic treatments offer limited risk reduction benefits, and thus, there remains an urgent need to explore novel interventions that will ameliorate this risk. Aerobic exercise (AE) has been shown to improve a number of predictors of suicide risk (e.g., depressed mood, sleeping difficulties). As individuals with SZ display a highly sedentary lifestyle, AE may reduce suicide risk. METHODS Employing a multi-site, single-blind, randomized clinical trial design, we will examine the impact of AE on risk for suicide and related variables in individuals with SZ. Participants will be randomized to one of two 12-week exercise interventions: AE or a stretching and toning (ST) control intervention. Primary outcome measures will include suicide risk (Columbia Suicide Severity Rating Scale, C-SSRS) and aerobic fitness (VO2max), along with additional measures of suicide risk, mood, emotion regulation, sleep, cognition, and physical activity, with assessments completed at baseline and after 6 and 12 weeks of interventions. DISCUSSION It is hypothesized that AE will reduce suicide risk among individuals with SZ. This study may offer support for a more efficacious treatment method for this population in addition to the pre-existing pharmacological and psychotherapeutic treatment regimens. TRIAL REGISTRATION Clinicaltrials.gov, NCT03270098 . Registered on September 1, 2017.
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Affiliation(s)
- Katie Beck-Felts
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1230, New York, NY, 10029, USA
| | | | - Luz H Ospina
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1230, New York, NY, 10029, USA
| | - Melanie Wall
- Department of Psychiatry, Columbia University, New York, NY, USA
| | - Joseph McEvoy
- Department of Psychiatry and Health Behavior, Georgia Regents University, Augusta, GA, USA
| | - Lars F Jarskog
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC, USA
| | - Jacob S Ballon
- Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, CA, USA
| | - Matthew N Bartels
- Department of Rehabilitation Medicine, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY, USA
| | | | - Richard P Sloan
- Department of Psychiatry, Columbia University, New York, NY, USA
| | - T Scott Stroup
- Department of Psychiatry, Columbia University, New York, NY, USA
| | - David Kimhy
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1230, New York, NY, 10029, USA.
- MIRECC, James J. Peters VA Medical Center, Bronx, NY, USA.
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Alen NV, Sloan RP, Seeman TE, Hostinar CE. Childhood Parental Warmth and Heart Rate Variability in Midlife: Implications for Health. Pers Relatsh 2020; 27:506-525. [PMID: 33244293 PMCID: PMC7685289 DOI: 10.1111/pere.12329] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The current study investigated high-frequency heart rate variability (HF-HRV) as a potential mediator between childhood parental warmth and later health and mortality outcomes. Participants were 1,255 adults (56.9% female). Childhood parental warmth was reported retrospectively at mean age 46; resting HF-HRV was measured at mean age 57; cardiovascular health and self-evaluated health were assessed at mean age 57 and 63, and mortality records extracted at mean age 63. Results revealed a positive association between childhood parental warmth and resting HF-HRV, as well as associations between higher HF-HRV and reduced risk of having a later cardiovascular health problem and of mortality by age 63. Mediation analyses revealed a small significant indirect effect of parental warmth, through HF-HRV, on cardiovascular health.
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20
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Lauriola V, Liu G, McIntyre KM, Garber CE, Sloan RP. Where Are My Keys? Can Lifestyle Factors Predict Cognitive Function In Older Adults? Med Sci Sports Exerc 2020. [DOI: 10.1249/01.mss.0000684688.46927.9e] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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21
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Karan KR, Trumpff C, McGill MA, Thomas JE, Sturm G, Lauriola V, Sloan RP, Rohleder N, Kaufman BA, Marsland AL, Picard M. Mitochondrial respiratory capacity modulates LPS-induced inflammatory signatures in human blood. Brain Behav Immun Health 2020; 5:100080. [PMID: 33073254 PMCID: PMC7561023 DOI: 10.1016/j.bbih.2020.100080] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Revised: 05/01/2020] [Accepted: 05/03/2020] [Indexed: 01/26/2023] Open
Abstract
Mitochondria modulate inflammatory processes in various model organisms, but it is unclear how much mitochondria regulate immune responses in human blood leukocytes. Here, we examine the effect of i) experimental perturbations of mitochondrial respiratory chain function, and ii) baseline inter-individual variation in leukocyte mitochondrial energy production capacity on stimulated cytokine release and glucocorticoid (GC) sensitivity. In a first cohort, whole blood from 20 healthy women and men was stimulated with increasing concentrations of the immune agonist lipopolysaccharide (LPS). Four inhibitors of mitochondrial respiratory chain Complexes I, III, IV, and V were used (LPS + Mito-Inhibitors) to acutely perturb mitochondrial function, GC sensitivity was quantified using the GC-mimetic dexamethasone (DEX) (LPS + DEX), and the resultant cytokine signatures mapped with a 20-cytokine array. Inhibiting mitochondrial respiration caused large inter-individual differences in LPS-stimulated IL-6 reactivity (Cohen's d = 0.72) and TNF-α (d = 1.55) but only minor alteration in EC50-based LPS sensitivity (d = 0.21). Specifically, inhibiting mitochondrial Complex IV potentiated LPS-induced IL-6 levels by 13%, but inhibited TNF-α induction by 72%, indicating mitochondrial regulation of the IL-6/TNF-α ratio. As expected, DEX treatment suppressed multiple LPS-induced pro-inflammatory cytokines (IFN-γ, IL-6, IL-8, IL-1β, .TNF-α) by >85% and increased the anti-inflammatory cytokine IL-10 by 80%. Inhibiting Complex I potentiated DEX suppression of IL-6 by a further 12% (d = 0.73), indicating partial mitochondrial modulation of glucocorticoid sensitivity. Finally, to examine if intrinsic mitochondrial respiratory capacity may explain a portion of immune reactivity differences across individuals, we measured biochemical respiratory chain enzyme activities and mitochondrial DNA copy number in isolated peripheral blood mononuclear cells (PBMCs) from a second cohort of 44 healthy individuals in parallel with LPS-stimulated IL-6 and TNF-α response. Respiratory chain .function, particularly Complex IV activity, was positively correlated with LPS-stimulated IL-6 levels (r = 0.45, p = 0.002). Overall, these data provide preliminary evidence that mitochondrial behavior modulates LPS-induced inflammatory cytokine signatures in human blood.
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Affiliation(s)
- Kalpita Rashmi Karan
- Department of Psychiatry, Division of Behavioral Medicine, Columbia University Irving Medical Center, New York, NY, United States
| | - Caroline Trumpff
- Department of Psychiatry, Division of Behavioral Medicine, Columbia University Irving Medical Center, New York, NY, United States
| | - Marlon A. McGill
- Department of Psychiatry, Division of Behavioral Medicine, Columbia University Irving Medical Center, New York, NY, United States
| | - Jacob E. Thomas
- Department of Psychiatry, Division of Behavioral Medicine, Columbia University Irving Medical Center, New York, NY, United States
| | - Gabriel Sturm
- Department of Psychiatry, Division of Behavioral Medicine, Columbia University Irving Medical Center, New York, NY, United States
| | - Vincenzo Lauriola
- Department of Psychiatry, Division of Behavioral Medicine, Columbia University Irving Medical Center, New York, NY, United States
| | - Richard P. Sloan
- Department of Psychiatry, Division of Behavioral Medicine, Columbia University Irving Medical Center, New York, NY, United States
| | - Nicolas Rohleder
- Institute of Psychology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Brett A. Kaufman
- Department of Medicine, Division of Cardiology, University of Pittsburgh, Pittsburgh, PA, United States
| | - Anna L. Marsland
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, United States
| | - Martin Picard
- Department of Psychiatry, Division of Behavioral Medicine, Columbia University Irving Medical Center, New York, NY, United States
- Department of Neurology, H. Houston Merritt Center, Columbia Translational Neuroscience Initiative, Columbia University Irving Medical Center, New York, NY, United States
- New York State Psychiatric Institute, New York, NY, United States
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22
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McIntyre KM, Puterman E, Scodes JM, Choo TH, Choi CJ, Pavlicova M, Sloan RP. The effects of aerobic training on subclinical negative affect: A randomized controlled trial. Health Psychol 2020; 39:255-264. [PMID: 31916828 DOI: 10.1037/hea0000836] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
OBJECTIVE The antidepressant and anxiolytic effects of aerobic exercise are well known, but less is known about its effects on subclinical levels of trait negative affect in healthy but sedentary adults. In the present study, we test the effects of a 3-month randomized controlled trial of aerobic exercise training in young to midlife adults on trait measures of depression, anxiety, hostility, and anger. METHOD One-hundred and 19 men (n = 56) and women (n = 63) aged 20-45 were randomized to 1 of 2 conditions: (a) 12 weeks of aerobic exercise after which they were asked to halt exercising and decondition for 4 weeks, or (b) a 16-week waitlist control group. Assessments of depression, anxiety, hostility and anger were completed at study entry, Week 12 and Week 16. RESULTS At study entry, participants scored low on measures of depression, anxiety, hostility and anger. Analyses among the intent-to-treat and per protocol samples found significant treatment effects of aerobic training for hostility and depression, but not for anxiety and anger. Within-group analyses demonstrated that depression and hostility scores decreased in the exercise group over the course of the intervention, while remaining stable in the control group. These effects persisted for the exercise group at nonsignificant levels after 4 weeks of deconditioning. CONCLUSIONS Aerobic exercise training has significant psychological effects even in sedentary yet euthymic adults, adding experimental data on the known benefits of exercise in this population. (PsycINFO Database Record (c) 2020 APA, all rights reserved).
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Affiliation(s)
- Kathleen M McIntyre
- Division of Behavioral Medicine, Department of Psychiatry, Columbia University Medical Center
| | - Eli Puterman
- School of Kinesiology, University of British Columbia
| | | | - Tse-Hwei Choo
- Mental Health Data Science, New York State Psychiatric Institute
| | - C Jean Choi
- Mental Health Data Science, New York State Psychiatric Institute
| | - Martina Pavlicova
- Department of Biostatistics, Mailman School of Public Health, Columbia University
| | - Richard P Sloan
- Department of Psychiatry, Columbia University Medical Center
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Trumpff C, Marsland AL, Sloan RP, Kaufman BA, Picard M. Predictors of ccf-mtDNA reactivity to acute psychological stress identified using machine learning classifiers: A proof-of-concept. Psychoneuroendocrinology 2019; 107:82-92. [PMID: 31112904 PMCID: PMC6637411 DOI: 10.1016/j.psyneuen.2019.05.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Revised: 03/21/2019] [Accepted: 05/01/2019] [Indexed: 12/15/2022]
Abstract
OBJECTIVE We have previously found that acute psychological stress may affect mitochondria and trigger an increase in serum mitochondrial DNA, known as circulating cell-free mtDNA (ccf-mtDNA). Similar to other stress reactivity measures, there are substantial unexplained inter-individual differences in the magnitude of ccf-mtDNA reactivity, as well as within-person differences across different occasions of testing. Here, we sought to identify psychological and physiological predictors of ccf-mtDNA reactivity using machine learning-based multivariate classifiers. METHOD We used data from serum ccf-mtDNA concentration measured pre- and post-stress in 46 healthy midlife adults tested on two separate occasions. To identify variables predicting the magnitude of ccf-mtDNA reactivity, two multivariate classification models, partial least-squares discriminant analysis (PLS-DA) and random forest (RF), were trained to discriminate between high and low ccf-mtDNA responders. Potential predictors used in the models included state variables such as physiological measures and affective states, and trait variables such as sex and personality measures. Variables identified across both models were considered to be predictors of ccf-mtDNA reactivity and selected for downstream analyses. RESULTS Identified predictors were significantly enriched for state over trait measures (X2 = 7.03; p = 0.008) and for physiological over psychological measures (X2 = 4.36; p = 0.04). High responders were more likely to be male (X2 = 26.95; p < 0.001) and differed from low-responders on baseline cardiovascular and autonomic measures, and on stress-induced reduction in fatigue (Cohen's d = 0.38-0.73). These group-level findings also accurately accounted for within-person differences in 90% of cases. CONCLUSION These results suggest that acute cardiovascular and psychological indices, rather than stable individual traits, predict stress-induced ccf-mtDNA reactivity. This work provides a proof-of-concept that machine learning approaches can be used to explore determinants of inter-individual and within-person differences in stress psychophysiology.
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Affiliation(s)
- Caroline Trumpff
- Department of Psychiatry, Division of Behavioral Medicine, Columbia University Irving Medical Center, New York, NY, 10032, USA
| | - Anna L Marsland
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, 15260, USA
| | - Richard P Sloan
- Department of Psychiatry, Division of Behavioral Medicine, Columbia University Irving Medical Center, New York, NY, 10032, USA
| | - Brett A Kaufman
- University of Pittsburgh School of Medicine, Division of Cardiology, Center for Metabolism and Mitochondrial Medicine and Vascular Medicine Institute, Pittsburgh, PA, 15261, USA
| | - Martin Picard
- Department of Psychiatry, Division of Behavioral Medicine, Columbia University Irving Medical Center, New York, NY, 10032, USA; Department of Neurology, H. Houston Merritt Center, Columbia Translational Neuroscience Initiative, Columbia University Irving Medical Center, New York, NY, 10032, USA; Columbia Aging Center, Columbia University Mailman School of Public Health, New York, NY, 10032, USA.
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Yeung LK, Hale C, Last BS, Andrews H, Sloan RP, Honig LS, Small SA, Brickman AM. Cerebrospinal fluid amyloid levels are associated with delayed memory retention in cognitively normal biomarker-negative older adults. Neurobiol Aging 2019; 84:90-97. [PMID: 31520793 DOI: 10.1016/j.neurobiolaging.2019.08.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Revised: 08/07/2019] [Accepted: 08/11/2019] [Indexed: 01/22/2023]
Abstract
Alzheimer's disease is defined by abnormal levels of amyloid and tau biomarkers. Even cognitively normal older adults with clinically relevant amyloid and tau levels perform worse on memory tests. However, it is unclear if the relationship between biomarker level and memory extends below clinical thresholds. We hypothesized that even subclinical biomarker levels are associated with memory when measured with neuropsychological tests designed to detect dysfunction in preclinical disease states. In a group of cognitively normal, "biomarker-negative" older men and women, we investigated the relationship between cerebrospinal fluid biomarker levels and memory measured with the ModRey, a list-learning task designed to assess memory in preclinical and cognitively normal adults. Cerebrospinal amyloid levels were associated with ModRey memory retention, the proportion of information retained after a delay period. When older adults with mild impairment were included, cerebrospinal fluid tau levels were also associated with ModRey retention. The association of amyloid and tau levels with memory was independent of each other. These results suggest cognitive changes associated with Alzheimer's disease pathology might occur earlier than currently thought.
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Affiliation(s)
- Lok-Kin Yeung
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Christiane Hale
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Briana S Last
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Howard Andrews
- Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY, USA; Gertrude H. Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, NY, USA; Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Richard P Sloan
- Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Lawrence S Honig
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, NY, USA; Gertrude H. Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, NY, USA; Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Scott A Small
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, NY, USA; Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY, USA; Gertrude H. Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, NY, USA; Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY, USA; Department of Radiology, College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Adam M Brickman
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, NY, USA; Gertrude H. Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, NY, USA; Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY, USA.
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Lauriola V, McIntyre KM, Stovezky Y, Choo THJ, Fyer A, Hen R, Simpson B, Sloan RP. High Intensity Interval Training Is Associated With Decreased Negative Affect In Individuals With Anxiety Disorders. Med Sci Sports Exerc 2019. [DOI: 10.1249/01.mss.0000560824.85860.40] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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26
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Stern Y, MacKay-Brandt A, Lee S, McKinley P, McIntyre K, Razlighi Q, Agarunov E, Bartels M, Sloan RP. Effect of aerobic exercise on cognition in younger adults: A randomized clinical trial. Neurology 2019; 92:e905-e916. [PMID: 30700591 PMCID: PMC6404470 DOI: 10.1212/wnl.0000000000007003] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Accepted: 10/08/2018] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To determine efficacy of aerobic exercise for cognitive function in younger healthy adults. METHODS In a randomized, parallel-group, observer-masked, community-based clinical trial, 132 cognitively normal individuals aged 20-67 with below median aerobic capacity were randomly assigned to one of two 6-month, 4-times-weekly conditions: aerobic exercise and stretching/toning. Efficacy measures included aerobic capacity; cognitive function in several domains (executive function, episodic memory, processing speed, language, and attention), everyday function, body mass index (BMI), and cortical thickness. RESULTS Aerobic capacity increased significantly (β = 2.718; p = 0.003), and BMI decreased significantly (β = -0.596; p = 0.013) in the aerobic exercise but not in the stretching/toning condition. Executive function improved significantly in the aerobic exercise condition; this effect was moderated by age (β = 0.018 SD/y; p = 0.028). At age 40, the executive function measure increased by 0.228 SD (95% confidence interval [CI] 0.007-0.448), and by 0.596 SD (95% CI 0.219-0.973) at age 60. Cortical thickness increased significantly in the aerobic exercise group in a left frontal region and did not interact with age. Controlling for age and baseline performance, individuals with at least one APOE ε4 allele showed less improvement in executive function with aerobic exercise (β = 0.5129, 95% CI 0.0381-0.988; p = 0.0346). CONCLUSIONS This randomized clinical trial demonstrates the efficacy of aerobic exercise for cognition in adults age 20-67. The effect of aerobic exercise on executive function was more pronounced as age increased, suggesting that it may mitigate age-related declines. Increased cortical thickness suggests that aerobic exercise contributes to brain health in individuals as young as age 20. CLINICALTRIALSGOV IDENTIFIER NCT01179958. CLASSIFICATION OF EVIDENCE This study provides Class II evidence that for adults age 20-67 with below median aerobic capacity, aerobic exercise significantly improves executive function but not other measures of cognitive function.
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Affiliation(s)
- Yaakov Stern
- From the Cognitive Neuroscience Division, Department of Neurology and Taub Institute (Y.S., A.M.-B., Q.R., E.A.), Department of Biostatistics (S.L.), and Department of Psychiatry, Division of Behavioral Medicine (P.M., K.M., R.P.S.), Columbia University, New York; Division of Clinical Research (A.M.-B.), Nathan Kline Institute for Psychiatric Research, Orangeburg; Division of Biostatistics (S.L.), New York State Psychiatric Institute; and Cardiopulmonary Rehabilitation and the Human Performance Laboratory (M.B.), Columbia Presbyterian Medical Center, New York, NY.
| | - Anna MacKay-Brandt
- From the Cognitive Neuroscience Division, Department of Neurology and Taub Institute (Y.S., A.M.-B., Q.R., E.A.), Department of Biostatistics (S.L.), and Department of Psychiatry, Division of Behavioral Medicine (P.M., K.M., R.P.S.), Columbia University, New York; Division of Clinical Research (A.M.-B.), Nathan Kline Institute for Psychiatric Research, Orangeburg; Division of Biostatistics (S.L.), New York State Psychiatric Institute; and Cardiopulmonary Rehabilitation and the Human Performance Laboratory (M.B.), Columbia Presbyterian Medical Center, New York, NY
| | - Seonjoo Lee
- From the Cognitive Neuroscience Division, Department of Neurology and Taub Institute (Y.S., A.M.-B., Q.R., E.A.), Department of Biostatistics (S.L.), and Department of Psychiatry, Division of Behavioral Medicine (P.M., K.M., R.P.S.), Columbia University, New York; Division of Clinical Research (A.M.-B.), Nathan Kline Institute for Psychiatric Research, Orangeburg; Division of Biostatistics (S.L.), New York State Psychiatric Institute; and Cardiopulmonary Rehabilitation and the Human Performance Laboratory (M.B.), Columbia Presbyterian Medical Center, New York, NY
| | - Paula McKinley
- From the Cognitive Neuroscience Division, Department of Neurology and Taub Institute (Y.S., A.M.-B., Q.R., E.A.), Department of Biostatistics (S.L.), and Department of Psychiatry, Division of Behavioral Medicine (P.M., K.M., R.P.S.), Columbia University, New York; Division of Clinical Research (A.M.-B.), Nathan Kline Institute for Psychiatric Research, Orangeburg; Division of Biostatistics (S.L.), New York State Psychiatric Institute; and Cardiopulmonary Rehabilitation and the Human Performance Laboratory (M.B.), Columbia Presbyterian Medical Center, New York, NY
| | - Kathleen McIntyre
- From the Cognitive Neuroscience Division, Department of Neurology and Taub Institute (Y.S., A.M.-B., Q.R., E.A.), Department of Biostatistics (S.L.), and Department of Psychiatry, Division of Behavioral Medicine (P.M., K.M., R.P.S.), Columbia University, New York; Division of Clinical Research (A.M.-B.), Nathan Kline Institute for Psychiatric Research, Orangeburg; Division of Biostatistics (S.L.), New York State Psychiatric Institute; and Cardiopulmonary Rehabilitation and the Human Performance Laboratory (M.B.), Columbia Presbyterian Medical Center, New York, NY
| | - Qolamreza Razlighi
- From the Cognitive Neuroscience Division, Department of Neurology and Taub Institute (Y.S., A.M.-B., Q.R., E.A.), Department of Biostatistics (S.L.), and Department of Psychiatry, Division of Behavioral Medicine (P.M., K.M., R.P.S.), Columbia University, New York; Division of Clinical Research (A.M.-B.), Nathan Kline Institute for Psychiatric Research, Orangeburg; Division of Biostatistics (S.L.), New York State Psychiatric Institute; and Cardiopulmonary Rehabilitation and the Human Performance Laboratory (M.B.), Columbia Presbyterian Medical Center, New York, NY
| | - Emil Agarunov
- From the Cognitive Neuroscience Division, Department of Neurology and Taub Institute (Y.S., A.M.-B., Q.R., E.A.), Department of Biostatistics (S.L.), and Department of Psychiatry, Division of Behavioral Medicine (P.M., K.M., R.P.S.), Columbia University, New York; Division of Clinical Research (A.M.-B.), Nathan Kline Institute for Psychiatric Research, Orangeburg; Division of Biostatistics (S.L.), New York State Psychiatric Institute; and Cardiopulmonary Rehabilitation and the Human Performance Laboratory (M.B.), Columbia Presbyterian Medical Center, New York, NY
| | - Matthew Bartels
- From the Cognitive Neuroscience Division, Department of Neurology and Taub Institute (Y.S., A.M.-B., Q.R., E.A.), Department of Biostatistics (S.L.), and Department of Psychiatry, Division of Behavioral Medicine (P.M., K.M., R.P.S.), Columbia University, New York; Division of Clinical Research (A.M.-B.), Nathan Kline Institute for Psychiatric Research, Orangeburg; Division of Biostatistics (S.L.), New York State Psychiatric Institute; and Cardiopulmonary Rehabilitation and the Human Performance Laboratory (M.B.), Columbia Presbyterian Medical Center, New York, NY
| | - Richard P Sloan
- From the Cognitive Neuroscience Division, Department of Neurology and Taub Institute (Y.S., A.M.-B., Q.R., E.A.), Department of Biostatistics (S.L.), and Department of Psychiatry, Division of Behavioral Medicine (P.M., K.M., R.P.S.), Columbia University, New York; Division of Clinical Research (A.M.-B.), Nathan Kline Institute for Psychiatric Research, Orangeburg; Division of Biostatistics (S.L.), New York State Psychiatric Institute; and Cardiopulmonary Rehabilitation and the Human Performance Laboratory (M.B.), Columbia Presbyterian Medical Center, New York, NY
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McIntyre KM, Mogle JA, Scodes JM, Pavlicova M, Shapiro PA, Gorenstein EE, Tager FA, Monk C, Almeida DM, Sloan RP. Anger-reduction treatment reduces negative affect reactivity to daily stressors. J Consult Clin Psychol 2019; 87:141-150. [DOI: 10.1037/ccp0000359] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Sloan RP, Shapiro PA, McKinley PS, Bartels M, Shimbo D, Lauriola V, Karmally W, Pavlicova M, Choi CJ, Choo T, Scodes JM, Flood P, Tracey KJ. Aerobic Exercise Training and Inducible Inflammation: Results of a Randomized Controlled Trial in Healthy, Young Adults. J Am Heart Assoc 2018; 7:e010201. [PMID: 30371169 PMCID: PMC6201415 DOI: 10.1161/jaha.118.010201] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Accepted: 07/17/2018] [Indexed: 12/31/2022]
Abstract
Background Consensus panels regularly recommend aerobic exercise for its health-promoting properties, due in part to presumed anti-inflammatory effects, but many studies show no such effect, possibly related to study differences in participants, interventions, inflammatory markers, and statistical approaches. This variability makes an unequivocal determination of the anti-inflammatory effects of aerobic training elusive. Methods and Results We conducted a randomized controlled trial of 12 weeks of aerobic exercise training or a wait list control condition followed by 4 weeks of sedentary deconditioning on lipopolysaccharide (0, 0.1, and 1.0 ng/mL)-inducible tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6), and on toll-like receptor 4 in 119 healthy, sedentary young adults. Aerobic capacity by cardiopulmonary exercise testing was measured at study entry (T1) and after training (T2) and deconditioning (T3). Despite a 15% increase in maximal oxygen consumption, there were no changes in inflammatory markers. Additional analyses revealed a differential longitudinal aerobic exercise training effect by lipopolysaccharide level in inducible TNF -α ( P=0.08) and IL-6 ( P=0.011), showing T1 to T2 increases rather than decreases in inducible (lipopolysaccharide 0.1, 1.0 versus 0.0 ng/mL) TNF- α (51% increase, P=0.041) and IL-6 (42% increase, P=0.11), and significant T2 to T3 decreases in inducible TNF- α (54% decrease, P=0.007) and IL-6 (55% decrease, P<0.001). There were no significant changes in either group at the 0.0 ng/mL lipopolysaccharide level for TNF- α or IL-6. Conclusions The failure to support the primary hypotheses and the unexpected post hoc findings of an exercise-training-induced proinflammatory response raise questions about whether and under what conditions exercise training has anti-inflammatory effects. Clinical Trial Registration URL : http://www.clinicaltrials.gov . Unique identifier: NCT 01335737.
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Affiliation(s)
- Richard P. Sloan
- Division of Behavioral MedicineDepartment of PsychiatryColumbia University Medical CenterNew YorkNY
- New York State Psychiatric InstituteNew YorkNY
| | - Peter A. Shapiro
- Division of Consultation/Liaison PsychiatryDepartment of PsychiatryColumbia University Medical CenterNew YorkNY
| | - Paula S. McKinley
- Division of Behavioral MedicineDepartment of PsychiatryColumbia University Medical CenterNew YorkNY
| | - Matthew Bartels
- Department of Rehabilitation MedicineColumbia University Medical CenterNew YorkNY
| | - Daichi Shimbo
- Department of MedicineColumbia University Medical CenterNew YorkNY
| | - Vincenzo Lauriola
- Division of Behavioral MedicineDepartment of PsychiatryColumbia University Medical CenterNew YorkNY
| | - Wahida Karmally
- Irving Institute for Clinical and Translational ResearchColumbia University Medical CenterNew YorkNY
| | - Martina Pavlicova
- Department of BiostatisticsMailman School of Public HealthColumbia University Medical CenterNew YorkNY
| | | | | | | | - Pamela Flood
- Department of AnesthesiologyColumbia University Medical CenterNew YorkNY
| | - Kevin J. Tracey
- The Feinstein Institute for Medical ResearchNorthwell HealthManhassettNY
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Abstract
OBJECTIVE Experimental studies have shown that 2 emotion regulation strategies-suppression and reappraisal-are associated with differential profiles of physiological activation in response to a stress test. The present study aims to add to those findings by investigating whether individual differences in trait emotion regulation strategies are associated with diurnal cortisol patterns in a naturalistic context. METHOD A sample of 46 men and women from the Midlife in the United States II (MIDUS II) study completed the Emotion Regulation Questionnaire (ERQ) and provided 4 salivary cortisol samples per day over 4 consecutive days. Trait reappraisal and suppression were tested as predictors of 3 cortisol parameters averaged across days: cortisol awakening response (CAR), diurnal cortisol slope (DCS), and area under the curve with respect to ground (AUCg). RESULTS Higher scores on the suppression scale were associated with more physiological activation, as indicated by steeper CAR and flatter DCS. Suppression was not associated with AUCg, and reappraisal was not predictive of any cortisol parameter. CONCLUSIONS Individual differences in suppression, but not reappraisal, were linked to greater cortisol activation in this naturalistic study. These preliminary results add to a growing body of findings that link suppression to adverse psychological and physiological profiles. (PsycINFO Database Record
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Hale C, Last BS, Meier IB, Yeung LK, Budge M, Sloan RP, Small SA, Brickman AM. The ModRey: An Episodic Memory Test for Nonclinical and Preclinical Populations. Assessment 2017; 26:1154-1161. [PMID: 28799411 DOI: 10.1177/1073191117723113] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
List learning tests are used in practice for diagnosis and in research to characterize episodic memory, but often suffer from ceiling effects in unimpaired individuals. We developed the Modified Rey Auditory Verbal Learning Test, or ModRey, an episodic memory test for use in normal and preclinical populations. We administered the ModRey to 230 healthy adults and to 86 of the same individuals 102 days later and examined psychometric properties and effects of demographic factors. Primary measures were normally distributed without evidence of ceiling effect. Differences between alternate forms were of very small magnitude and not significant. Test-retest reliability was good. Higher participant age and lower participant education was associated with poorer performance across most outcome measures. We conclude that the ModRey is appropriate for episodic memory characterization in normal populations and could be used as an outcome measure in studies involving preclinical populations.
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Kimhy D, Wall MM, Hansen MC, Vakhrusheva J, Choi CJ, Delespaul P, Tarrier N, Sloan RP, Malaspina D. Autonomic Regulation and Auditory Hallucinations in Individuals With Schizophrenia: An Experience Sampling Study. Schizophr Bull 2017; 43:754-763. [PMID: 28177507 PMCID: PMC5472124 DOI: 10.1093/schbul/sbw219] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Auditory Hallucinations (AH) cause substantial suffering and dysfunction, yet remain poorly understood and modeled. Previous reports have linked AH to increases in negative emotions, suggesting a role for the autonomic nervous system (ANS) in underlying this link. Employing an Experience Sampling Method (ESM) approach, 40 individuals with schizophrenia completed a 36-hour ambulatory assessment of AH and cardiac autonomic regulation. Participants carried mobile electronic devices that prompted them to report 10 times/d the severity of their momentary AH, along with a Holter monitor that continuously recorded their cardiac autonomic regulation. The clocks of the devices and monitors were synchronized, allowing for high time-resolution temporal linking of the AH and concurrent autonomic data. Power spectral analysis was used to determine the relative vagal (parasympathetic) contribution to autonomic regulation during 5 minutes prior to each experience sample. The participants also completed interview-based measures of AH (SAPS; PSYRATS). The ESM-measured severity of AH was significantly correlated with the overall SAPS-indexed AH severity, along with the PSYRATS-indexed AH frequency, duration, loudness, degree of negative content, and associated distress. A mixed-effect regression model indicated that momentary increases in autonomic arousal, characterized by decreases in vagal input, significantly predicted increases in ESM-measured AH severity. Vagal input averaged over the 36-hour assessment displayed a small but significant inverse correlation with the SAPS-indexed AH. The results provide preliminary support for a link between ANS regulation and AH. The findings also underscore the highly dynamic nature of AH and the need to utilize high time-resolution methodologies to investigate AH.
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Affiliation(s)
- David Kimhy
- Department of Psychiatry, Columbia University, New York, NY;,New York State Psychiatric Institute, New York, NY
| | - Melanie M. Wall
- Department of Psychiatry, Columbia University, New York, NY;,New York State Psychiatric Institute, New York, NY
| | | | | | - C. Jean Choi
- New York State Psychiatric Institute, New York, NY
| | - Philippe Delespaul
- Departments of Psychiatry & Neuropsychology, Maastricht University, Maastricht, The Netherlands
| | - Nicholas Tarrier
- Department of Psychology, University of Manchester, Manchester, UK
| | - Richard P. Sloan
- Department of Psychiatry, Columbia University, New York, NY;,New York State Psychiatric Institute, New York, NY
| | - Dolores Malaspina
- Department of Psychiatry & Child Psychiatry, New York University Medical Center, New York, NY
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Lauriola V, McIntyre K, Choo THJ, Pavlicova M, Sloan RP, Garber CE. Keep Up The Good Work. Med Sci Sports Exerc 2017. [DOI: 10.1249/01.mss.0000516912.09281.b2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Sloan RP, Schwarz E, McKinley PS, Weinstein M, Love G, Ryff C, Mroczek D, Choo TH, Lee S, Seeman T. Vagally-mediated heart rate variability and indices of well-being: Results of a nationally representative study. Health Psychol 2016; 36:73-81. [PMID: 27570892 DOI: 10.1037/hea0000397] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVE High frequency (HF) heart rate variability (HRV) has long been accepted as an index of cardiac vagal control. Recent studies report relationships between HF-HRV and indices of positive and negative affect, personality traits and well-being but these studies generally are based on small and selective samples. METHOD These relationships were examined using data from 967 participants in the second Midlife in the U.S. (MIDUS II) study. Participants completed survey questionnaires on well-being and affect. HF-HRV was measured at rest. A hierarchical series of regression analyses examined relationships between these various indices and HF-HRV before and after adjustment for relevant demographic and biomedical factors. RESULTS Significant inverse relationships were found only between indices of negative affect and HF-HRV. Relationships between indices of psychological and hedonic well-being and positive affect failed to reach significance. CONCLUSIONS These findings raise questions about relationships between cardiac parasympathetic modulation, emotion regulation, and indices of well-being. (PsycINFO Database Record
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Affiliation(s)
| | | | | | | | - Gayle Love
- Institute on Aging, University of Wisconsin-Madison
| | - Carol Ryff
- Department of Psychology, University of Wisconsin-Madison
| | | | | | | | - Teresa Seeman
- Division of Geriatrics, University of California at Los Angeles
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Armstrong HF, Bartels MN, Paslavski O, Cain D, Shoval HA, Ballon JS, Khan S, Sloan RP, Kimhy D. The impact of aerobic exercise training on cardiopulmonary functioning in individuals with schizophrenia. Schizophr Res 2016; 173:116-7. [PMID: 26976498 DOI: 10.1016/j.schres.2016.03.009] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2016] [Revised: 03/02/2016] [Accepted: 03/07/2016] [Indexed: 10/22/2022]
Affiliation(s)
- Hilary F Armstrong
- Department of Rehabilitation and Regenerative Medicine, College of Physicians and Surgeons, Columbia University, New York, NY, USA; Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA.
| | - Matthew N Bartels
- Department of Rehabilitation Medicine, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Orest Paslavski
- Department of Rehabilitation and Regenerative Medicine, College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Darnell Cain
- Department of Rehabilitation and Regenerative Medicine, College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Hannah A Shoval
- Department of Rehabilitation and Regenerative Medicine, College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Jacob S Ballon
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - Samira Khan
- New York State Psychiatric Institute, New York, NY, USA
| | - Richard P Sloan
- New York State Psychiatric Institute, New York, NY, USA; Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - David Kimhy
- New York State Psychiatric Institute, New York, NY, USA; Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY, USA
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Kimhy D, Lauriola V, Bartels MN, Armstrong HF, Vakhrusheva J, Ballon JS, Sloan RP. Aerobic exercise for cognitive deficits in schizophrenia - The impact of frequency, duration, and fidelity with target training intensity. Schizophr Res 2016; 172:213-5. [PMID: 26852401 DOI: 10.1016/j.schres.2016.01.055] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2015] [Revised: 01/25/2016] [Accepted: 01/29/2016] [Indexed: 12/21/2022]
Affiliation(s)
- David Kimhy
- Department of Psychiatry, Columbia University, New York, NY, United States; New York State Psychiatric Institute, New York, NY, United States.
| | - Vincenzo Lauriola
- Department of Psychiatry, Columbia University, New York, NY, United States
| | - Matthew N Bartels
- Department of Rehabilitation Medicine, Albert Einstein College of Medicine, Bronx, NY, United States
| | - Hilary F Armstrong
- Department of Rehabilitation & Regenerative Medicine, Columbia University, New York, NY, United States
| | - Julia Vakhrusheva
- Department of Psychiatry, Weill Cornell Medical College, New York, NY, United States
| | - Jacob S Ballon
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, United States
| | - Richard P Sloan
- Department of Psychiatry, Columbia University, New York, NY, United States; New York State Psychiatric Institute, New York, NY, United States
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Kimhy D, Khan S, Ayanrouh L, Chang RW, Hansen MC, Lister A, Ballon JS, Vakhrusheva J, Armstrong HF, Bartels MN, Sloan RP. Use of Active-Play Video Games to Enhance Aerobic Fitness in Schizophrenia: Feasibility, Safety, and Adherence. Psychiatr Serv 2016; 67:240-3. [PMID: 26423100 DOI: 10.1176/appi.ps.201400523] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Active-play video games have been used to enhance aerobic fitness in various clinical populations, but their use among individuals with schizophrenia has been limited. METHODS Feasibility, acceptability, safety, and adherence data were obtained for use of aerobic exercise (AE) equipment by 16 individuals with schizophrenia during a 12-week AE program consisting of three one-hour exercise sessions per week. Equipment included exercise video games for Xbox 360 with Kinect motion sensing devices and traditional exercise equipment. RESULTS Most participants (81%) completed the training, attending an average of 79% of sessions. The proportion of time spent playing Xbox (39%) exceeded time spent on any other type of equipment. When using Xbox, participants played 2.24±1.59 games per session and reported high acceptability and enjoyment ratings, with no adverse events. CONCLUSIONS Measures of feasibility, acceptability, adherence, and safety support the integration of active-play video games into AE training for people with schizophrenia.
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Affiliation(s)
- David Kimhy
- Dr. Kimhy, Dr. Ballon, Dr. Vakhrusheva, and Dr. Sloan are with the Department of Psychiatry and Ms. Armstrong is with the Department of Rehabilitation and Regenerative Medicine, Columbia University, New York (e-mail: ). Dr. Kimhy, Dr. Ballon, and Dr. Sloan are also with the New York State Psychiatric Institute, New York, where Ms. Khan, Ms. Ayanrouh, Ms. Chang, Ms. Hansen, and Ms. Lister are affiliated. Dr. Bartels is with the Department of Rehabilitation Medicine, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, New York
| | - Samira Khan
- Dr. Kimhy, Dr. Ballon, Dr. Vakhrusheva, and Dr. Sloan are with the Department of Psychiatry and Ms. Armstrong is with the Department of Rehabilitation and Regenerative Medicine, Columbia University, New York (e-mail: ). Dr. Kimhy, Dr. Ballon, and Dr. Sloan are also with the New York State Psychiatric Institute, New York, where Ms. Khan, Ms. Ayanrouh, Ms. Chang, Ms. Hansen, and Ms. Lister are affiliated. Dr. Bartels is with the Department of Rehabilitation Medicine, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, New York
| | - Lindsey Ayanrouh
- Dr. Kimhy, Dr. Ballon, Dr. Vakhrusheva, and Dr. Sloan are with the Department of Psychiatry and Ms. Armstrong is with the Department of Rehabilitation and Regenerative Medicine, Columbia University, New York (e-mail: ). Dr. Kimhy, Dr. Ballon, and Dr. Sloan are also with the New York State Psychiatric Institute, New York, where Ms. Khan, Ms. Ayanrouh, Ms. Chang, Ms. Hansen, and Ms. Lister are affiliated. Dr. Bartels is with the Department of Rehabilitation Medicine, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, New York
| | - Rachel W Chang
- Dr. Kimhy, Dr. Ballon, Dr. Vakhrusheva, and Dr. Sloan are with the Department of Psychiatry and Ms. Armstrong is with the Department of Rehabilitation and Regenerative Medicine, Columbia University, New York (e-mail: ). Dr. Kimhy, Dr. Ballon, and Dr. Sloan are also with the New York State Psychiatric Institute, New York, where Ms. Khan, Ms. Ayanrouh, Ms. Chang, Ms. Hansen, and Ms. Lister are affiliated. Dr. Bartels is with the Department of Rehabilitation Medicine, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, New York
| | - Marie C Hansen
- Dr. Kimhy, Dr. Ballon, Dr. Vakhrusheva, and Dr. Sloan are with the Department of Psychiatry and Ms. Armstrong is with the Department of Rehabilitation and Regenerative Medicine, Columbia University, New York (e-mail: ). Dr. Kimhy, Dr. Ballon, and Dr. Sloan are also with the New York State Psychiatric Institute, New York, where Ms. Khan, Ms. Ayanrouh, Ms. Chang, Ms. Hansen, and Ms. Lister are affiliated. Dr. Bartels is with the Department of Rehabilitation Medicine, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, New York
| | - Amanda Lister
- Dr. Kimhy, Dr. Ballon, Dr. Vakhrusheva, and Dr. Sloan are with the Department of Psychiatry and Ms. Armstrong is with the Department of Rehabilitation and Regenerative Medicine, Columbia University, New York (e-mail: ). Dr. Kimhy, Dr. Ballon, and Dr. Sloan are also with the New York State Psychiatric Institute, New York, where Ms. Khan, Ms. Ayanrouh, Ms. Chang, Ms. Hansen, and Ms. Lister are affiliated. Dr. Bartels is with the Department of Rehabilitation Medicine, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, New York
| | - Jacob S Ballon
- Dr. Kimhy, Dr. Ballon, Dr. Vakhrusheva, and Dr. Sloan are with the Department of Psychiatry and Ms. Armstrong is with the Department of Rehabilitation and Regenerative Medicine, Columbia University, New York (e-mail: ). Dr. Kimhy, Dr. Ballon, and Dr. Sloan are also with the New York State Psychiatric Institute, New York, where Ms. Khan, Ms. Ayanrouh, Ms. Chang, Ms. Hansen, and Ms. Lister are affiliated. Dr. Bartels is with the Department of Rehabilitation Medicine, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, New York
| | - Julia Vakhrusheva
- Dr. Kimhy, Dr. Ballon, Dr. Vakhrusheva, and Dr. Sloan are with the Department of Psychiatry and Ms. Armstrong is with the Department of Rehabilitation and Regenerative Medicine, Columbia University, New York (e-mail: ). Dr. Kimhy, Dr. Ballon, and Dr. Sloan are also with the New York State Psychiatric Institute, New York, where Ms. Khan, Ms. Ayanrouh, Ms. Chang, Ms. Hansen, and Ms. Lister are affiliated. Dr. Bartels is with the Department of Rehabilitation Medicine, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, New York
| | - Hilary F Armstrong
- Dr. Kimhy, Dr. Ballon, Dr. Vakhrusheva, and Dr. Sloan are with the Department of Psychiatry and Ms. Armstrong is with the Department of Rehabilitation and Regenerative Medicine, Columbia University, New York (e-mail: ). Dr. Kimhy, Dr. Ballon, and Dr. Sloan are also with the New York State Psychiatric Institute, New York, where Ms. Khan, Ms. Ayanrouh, Ms. Chang, Ms. Hansen, and Ms. Lister are affiliated. Dr. Bartels is with the Department of Rehabilitation Medicine, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, New York
| | - Matthew N Bartels
- Dr. Kimhy, Dr. Ballon, Dr. Vakhrusheva, and Dr. Sloan are with the Department of Psychiatry and Ms. Armstrong is with the Department of Rehabilitation and Regenerative Medicine, Columbia University, New York (e-mail: ). Dr. Kimhy, Dr. Ballon, and Dr. Sloan are also with the New York State Psychiatric Institute, New York, where Ms. Khan, Ms. Ayanrouh, Ms. Chang, Ms. Hansen, and Ms. Lister are affiliated. Dr. Bartels is with the Department of Rehabilitation Medicine, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, New York
| | - Richard P Sloan
- Dr. Kimhy, Dr. Ballon, Dr. Vakhrusheva, and Dr. Sloan are with the Department of Psychiatry and Ms. Armstrong is with the Department of Rehabilitation and Regenerative Medicine, Columbia University, New York (e-mail: ). Dr. Kimhy, Dr. Ballon, and Dr. Sloan are also with the New York State Psychiatric Institute, New York, where Ms. Khan, Ms. Ayanrouh, Ms. Chang, Ms. Hansen, and Ms. Lister are affiliated. Dr. Bartels is with the Department of Rehabilitation Medicine, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, New York
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Cooper TM, McKinley PS, Seeman TE, Choo TH, Lee S, Sloan RP. Heart rate variability predicts levels of inflammatory markers: Evidence for the vagal anti-inflammatory pathway. Brain Behav Immun 2015; 49:94-100. [PMID: 25541185 PMCID: PMC4476948 DOI: 10.1016/j.bbi.2014.12.017] [Citation(s) in RCA: 86] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2014] [Revised: 11/21/2014] [Accepted: 12/13/2014] [Indexed: 11/19/2022] Open
Abstract
Evidence from numerous animal models shows that vagal activity regulates inflammatory responses by decreasing cytokine release. Heart rate variability (HRV) is a reliable index of cardiac vagal regulation and should be inversely related to levels of inflammatory markers. Inflammation is also regulated by sympathetic inputs, but only one previous paper controlled for this. In a larger and more representative sample, we sought to replicate those results and examine potential sex differences in the relationship between HRV and inflammatory markers. Using data from the MIDUS II study, we analyzed the relationship between 6 inflammatory markers and both HF-HRV and LF-HRV. After controlling for sympathetic effects measured by urinary norepinephrine as well as a host of other factors, LF-HRV was found to be inversely associated with fibrinogen, CRP and IL-6, while HF-HRV was inversely associated with fibrinogen and CRP. We did not observe consistent sex differences. These results support the existence of the vagal anti-inflammatory pathway and suggest that it has similar effects in men and women.
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Affiliation(s)
- Timothy M Cooper
- Columbia University College of Physicians and Surgeons, Columbia University Medical Center, New York, NY, United States.
| | - Paula S McKinley
- Department of Psychiatry, Columbia University Medical Center, New York, NY, United States; New York State Psychiatric Institute, New York, NY, United States.
| | - Teresa E Seeman
- Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, United States.
| | - Tse-Hwei Choo
- New York State Psychiatric Institute, New York, NY, United States.
| | - Seonjoo Lee
- Department of Psychiatry, Columbia University Medical Center, New York, NY, United States; New York State Psychiatric Institute, New York, NY, United States.
| | - Richard P Sloan
- Department of Psychiatry, Columbia University Medical Center, New York, NY, United States; New York State Psychiatric Institute, New York, NY, United States.
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Flood P, McKinley P, Monk C, Muntner P, Colantonio LD, Goetzl L, Hatch M, Sloan RP. Beat-to-beat heart rate and blood pressure variability and hypertensive disease in pregnancy. Am J Perinatol 2015; 32:1050-8. [PMID: 25970272 DOI: 10.1055/s-0035-1548542] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE The aim of this study is to determine the relationship between heart rate and/or blood pressure variability, measured at 28 weeks' gestation, and the incidence of pregnancy-induced hypertension or preeclampsia. STUDY DESIGN Secondary analysis of data from a prospectively enrolled cohort of 385 active military women in whom spectral analysis of continuous heart rate and variability was measured at 28 weeks' gestation. The primary outcome was the predictive value of spectral analysis of heart rate and blood pressure for hypertensive diseases of pregnancy. RESULTS High-frequency heart rate variability was reduced and low-frequency variability of systolic and diastolic blood pressure increased in women who would develop pregnancy-induced hypertension but not preeclampsia. Low-frequency variability of diastolic blood pressure remained a significant predictor of pregnancy-induced hypertension but not preeclampsia after adjustment for age, weight, and blood pressure in a multivariate model. CONCLUSION Early identification of pregnancy-induced hypertension can facilitate treatment to avoid maternal morbidity. Understanding the physiological underpinnings of the two very different diseases may lead to improved treatment and prevention. If proven effective in a broader population, the ability to differentiate pregnancy-induced hypertension from preeclampsia may reduce unnecessary iatrogenic interventions or inappropriate preterm delivery.
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Affiliation(s)
- Pamela Flood
- Department of Anesthesia, Perioperative and Pain Medicine, Stanford University, San Francisco, California
| | - Paula McKinley
- Department of Behavioral Medicine, Columbia University, New York, New York
| | - Catherine Monk
- Department of Psychiatry, Behavioral Medicine and Developmental Neuroscience, Columbia University, New York, New York
| | - Paul Muntner
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, Alabama
| | - Lisandro D Colantonio
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, Alabama
| | - Laura Goetzl
- Department of Obstetrics and Gynecology, Temple University, Philadelphia, Pennsylvania
| | - Maureen Hatch
- National Institutes of Health/National Cancer Institute, Division of Cancer Epidemiology & Genetics, Radiation Epidemiology Branch Bethesda, Maryland
| | - Richard P Sloan
- Department of Behavioral Medicine, Columbia University, New York, New York
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Crowley OV, Kimhy D, McKinley PS, Burg MM, Schwartz JE, Lachman ME, Tun PA, Ryff CD, Seeman TE, Sloan RP. Vagal Recovery From Cognitive Challenge Moderates Age-Related Deficits in Executive Functioning. Res Aging 2015; 38:504-25. [PMID: 26303063 DOI: 10.1177/0164027515593345] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Decline in executive functioning (EF) is a hallmark of cognitive aging. We have previously reported that faster vagal recovery from cognitive challenge is associated with better EF. This study examined the association between vagal recovery from cognitive challenge and age-related differences in EF among 817 participants in the Midlife in the U.S. study (aged 35-86). Cardiac vagal control was measured as high-frequency heart rate variability. Vagal recovery moderated the association between age and EF (β = .811, p = .004). Secondary analyses revealed that older participants (aged 65-86) with faster vagal recovery had superior EF compared to their peers who had slower vagal recovery. In contrast, among younger (aged 35-54) and middle-aged (aged 55-64) participants, vagal recovery was not associated with EF. We conclude that faster vagal recovery from cognitive challenge is associated with reduced deficits in EF among older, but not younger individuals.
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Affiliation(s)
| | - David Kimhy
- Division of Cognitive Neuroscience, Department of Psychiatry, New York State Psychiatric Institute, Columbia University, New York, NY, USA
| | - Paula S McKinley
- Division of Behavioral Medicine, Department of Psychiatry, New York State Psychiatric Institute, Columbia University, New York, NY, USA
| | - Matthew M Burg
- Division of General Medicine, Columbia University School of Medicine, New York, NY, USA Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, USA
| | - Joseph E Schwartz
- Division of General Medicine, Columbia University School of Medicine, New York, NY, USA
| | | | - Patricia A Tun
- Department of Psychology, Brandeis University, Waltham, MA, USA
| | - Carol D Ryff
- Department of Psychology, University of Wisconsin, Madison, WI, USA
| | - Teresa E Seeman
- Division of Geriatrics, Los Angeles David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Richard P Sloan
- Division of Behavioral Medicine, Department of Psychiatry, New York State Psychiatric Institute, Columbia University, New York, NY, USA
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Kimhy D, Vakhrusheva J, Bartels MN, Armstrong HF, Ballon JS, Khan S, Chang RW, Hansen MC, Ayanruoh L, Lister A, Castrén E, Smith EE, Sloan RP. The Impact of Aerobic Exercise on Brain-Derived Neurotrophic Factor and Neurocognition in Individuals With Schizophrenia: A Single-Blind, Randomized Clinical Trial. Schizophr Bull 2015; 41:859-68. [PMID: 25805886 PMCID: PMC4466187 DOI: 10.1093/schbul/sbv022] [Citation(s) in RCA: 135] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Individuals with schizophrenia display substantial neurocognitive deficits for which available treatments offer only limited benefits. Yet, findings from studies of animals, clinical and nonclinical populations have linked neurocognitive improvements to increases in aerobic fitness (AF) via aerobic exercise training (AE). Such improvements have been attributed to up-regulation of brain-derived neurotrophic factor (BDNF). However, the impact of AE on neurocognition, and the putative role of BDNF, have not been investigated in schizophrenia. Employing a proof-of-concept, single-blind, randomized clinical trial design, 33 individuals with schizophrenia were randomized to receive standard psychiatric treatment (n = 17; "treatment as usual"; TAU) or attend a 12-week AE program (n = 16) utilizing active-play video games (Xbox 360 Kinect) and traditional AE equipment. Participants completed assessments of AF (indexed by VO2 peak ml/kg/min), neurocognition (MATRICS Consensus Cognitive Battery), and serum-BDNF before and after and 12-week period. Twenty-six participants (79%) completed the study. At follow-up, the AE participants improved their AF by 18.0% vs a -0.5% decline in the TAU group (P = .002) and improved their neurocognition by 15.1% vs -2.0% decline in the TAU group (P = .031). Hierarchical multiple regression analyses indicated that enhancement in AF and increases in BDNF predicted 25.4% and 14.6% of the neurocognitive improvement variance, respectively. The results indicate AE is effective in enhancing neurocognitive functioning in people with schizophrenia and provide preliminary support for the impact of AE-related BDNF up-regulation on neurocognition in this population. Poor AF represents a modifiable risk factor for neurocognitive dysfunction in schizophrenia for which AE training offer a safe, nonstigmatizing, and side-effect-free intervention.
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Affiliation(s)
- David Kimhy
- Department of Psychiatry, Columbia University, New York, NY; New York State Psychiatric Institute, New York, NY;
| | | | - Matthew N. Bartels
- Department of Rehabilitation Medicine, Albert Einstein College of Medicine, Bronx, NY
| | - Hilary F. Armstrong
- Department of Rehabilitation & Regenerative Medicine, Columbia University, New York, NY
| | - Jacob S. Ballon
- Department of Psychiatry, Columbia University, New York, NY;,New York State Psychiatric Institute, New York, NY
| | - Samira Khan
- New York State Psychiatric Institute, New York, NY
| | | | | | | | | | - Eero Castrén
- Neuroscience Center, University of Helsinki, Helsinki, Finland
| | - Edward E. Smith
- Department of Psychiatry, Columbia University, New York, NY;,New York State Psychiatric Institute, New York, NY
| | - Richard P. Sloan
- Department of Psychiatry, Columbia University, New York, NY;,New York State Psychiatric Institute, New York, NY
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Abstract
Previous research has shown marital status and marital quality are consistent predictors of health outcomes, including cardiovascular disease and mortality. To better understand the relationship among marital status, marital quality, and cardiovascular health, we examined how marital status and marital quality were associated with an early indicator of deteriorating cardiovascular health, high-frequency heart rate variability (HF-HRV). This study uses data from the National Survey of Midlife in the United States (MIDUS) Biomarker Substudy (N = 907) to examine differences in HF-HRV by traditional marital status categories (married, divorced, widowed, and never married) as well as further differentiating between the continuously married and remarried. In addition, links were also examined between HF-HRV and changes in marital quality (marital satisfaction, support, strain) among individuals in long-term marriages. No significant differences in HF-HRV were observed between married persons and those widowed, divorced, and never married. However, continuously married individuals had higher HF-HRV than remarried adults. Increases in marital satisfaction and support over 10 years were associated with higher HF-HRV, whereas increased marital strain over 10 years was associated with lower HF-HRV. Higher HF-HRV among the continuously married compared with the remarried suggests that previous marital disruptions may have lasting effects on cardiovascular health or that there may be other differences between the remarried versus those who remain married to the same person. Associations between marital quality and HF-HRV suggest that variations in the quality of one's marriage may affect cardiovascular health.
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Affiliation(s)
- Carrie J Donoho
- Davis School of Gerontology, University of Southern California
| | - Teresa E Seeman
- Department of Medicine, Division of Geriatrics, David Geffen School of Medicine
| | - Richard P Sloan
- Department of Psychiatry, Columbia University Medical Center
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Kimhy D, Vakhrusheva J, Bartels MN, Armstrong HF, Ballon JS, Khan S, Chang RW, Hansen MC, Ayanruoh L, Smith EE, Sloan RP. Aerobic fitness and body mass index in individuals with schizophrenia: Implications for neurocognition and daily functioning. Psychiatry Res 2014; 220:784-91. [PMID: 25219618 PMCID: PMC4258141 DOI: 10.1016/j.psychres.2014.08.052] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2014] [Revised: 08/13/2014] [Accepted: 08/25/2014] [Indexed: 11/15/2022]
Abstract
Previous reports indicate that among healthy individuals low aerobic fitness (AF) and high body-mass index (BMI) predict poor neurocognition and daily-functioning. It is unknown whether these associations extend to disorders characterized by poor neurocognition, such as schizophrenia. Therefore, we compared AF and BMI in individuals with schizophrenia and non-clinical controls, and then within the schizophrenia group we examined the links between AF, BMI, neurocognition and daily-functioning. Thirty-two individuals with schizophrenia and 64 gender- and age-matched controls completed assessments of AF (indexed by VO2max) and BMI. The former also completed measures of neurocognition, daily-functioning and physical activity. The schizophrenia group displayed significantly lower AF and higher BMI. In the schizophrenia group, AF was significantly correlated with overall neurocognition (r=0.57), along with executive functioning, working memory, social cognition, and processing speed. A hierarchical regression analysis indicated that AF accounted for 22% of the neurocognition variance. Furthermore, AF was significantly correlated with overall daily-functioning (r=0.46). In contrast, BMI displayed significant inverse correlations with neurocognition, but no associations to daily-functioning. AF was significantly correlated physical activity. The authors discuss the potential use of AF-enhancing interventions to improve neurocognitive and daily-functioning in schizophrenia, along with putative neurobiological mechanisms underlying these links, including Brain-Derived Neurotrophic Factor.
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Affiliation(s)
- David Kimhy
- Division of Cognitive Neuroscience, Department of Psychiatry, Columbia University, New York, NY 10032, USA; New York State Psychiatric Institute, New York, NY, USA.
| | - Julia Vakhrusheva
- Division of Cognitive Neuroscience, Department of Psychiatry, Columbia University, New York, NY, USA
| | - Matthew N. Bartels
- Department of Rehabilitation Medicine, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY, USA
| | - Hilary F. Armstrong
- Department of Rehabilitation & Regenerative Medicine, Columbia University, New York, NY, USA,Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Jacob S. Ballon
- Division of Cognitive Neuroscience, Department of Psychiatry, Columbia University, New York, NY, USA,New York State Psychiatric Institute, New York, NY, USA
| | - Samira Khan
- New York State Psychiatric Institute, New York, NY, USA
| | | | | | | | - Edward E. Smith
- Division of Cognitive Neuroscience, Department of Psychiatry, Columbia University, New York, NY, USA,New York State Psychiatric Institute, New York, NY, USA
| | - Richard P. Sloan
- New York State Psychiatric Institute, New York, NY, USA,Division of Behavioral Medicine, Department of Psychiatry, Columbia University, New York, NY, USA
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Shapiro PA, Sloan RP, Deochand C, Franceschi AM, Delorenzo C, Mann JJ, Parsey RV. Quantifying serotonin transporters by PET with [11C]-DASB before and after interferon-α treatment. Synapse 2014; 68:548-55. [PMID: 25043294 DOI: 10.1002/syn.21766] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2014] [Revised: 05/30/2014] [Accepted: 06/14/2014] [Indexed: 11/07/2022]
Abstract
BACKGROUND Interferon-α (IFN-α) therapy is frequently associated with disabling depression, fatigue, and related neuropsychiatric effects. Although depression in major depressive disorder is associated with low serotonin transporter binding, animal models suggest that IFN-associated mood effects are linked to increased presynaptic serotonin transporter binding. This study tested the hypotheses that IFN administration to human subjects increases presynaptic serotonin binding activity, and that this effect correlates with incident depression symptoms. METHODS Positron emission tomography (PET) scans using [11C]-DASB were obtained for nine hepatitis C patients before and after IFN-α treatment for 8 weeks. Serotonin transporter binding was estimated using the likelihood estimation in graphical analysis (LEGA) model and measured as the volume of distribution (VT) divided by the free fraction of ligand (fP). Depression was measured with the Structured Clinical Interview for DSM-IV Diagnosis (SCID) and the Hamilton Rating Scale for Depression (HAM-D). RESULTS Compared to pre-IFN treatment values, changes in serotonin transporter binding and depression symptoms were not significant. There was no correlation between changes in serotonin transporter binding and depression symptoms. LIMITATIONS The study is limited by small sample size, minimal effect on observed mood symptoms within the sample, and brief duration of follow-up. CONCLUSION These findings do not support the hypothesis of an IFN-induced change in serotonin transporter function as the cause of incident depressive symptoms in patients treated with IFN-α. Additional study of these possible relationships should be of longer duration and include more subjects with more pronounced changes in mood.
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Affiliation(s)
- Peter A Shapiro
- Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, New York
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Lindgren M, Alex C, Shapiro PA, McKinley PS, Brondolo EN, Myers MM, Choi CJ, Lopez-Pintado S, Sloan RP. Effects of aerobic conditioning on cardiovascular sympathetic response to and recovery from challenge. Psychophysiology 2013; 50:963-73. [PMID: 23889039 DOI: 10.1111/psyp.12078] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2012] [Accepted: 03/25/2013] [Indexed: 01/01/2023]
Abstract
Exercise has widely documented cardioprotective effects, but the mechanisms behind these effects are still poorly understood. Here, we test the hypothesis that aerobic training lowers cardiovascular sympathetic responses to and speeds recovery from challenge. We conducted a randomized, controlled trial contrasting aerobic versus strength training on indices of cardiac (pre-ejection period, PEP) and vascular (low-frequency blood pressure variability, LF-BPV) sympathetic responses to and recovery from psychological and orthostatic challenge in 149 young, healthy, sedentary adults. Aerobic and strength training did not alter PEP or LF-BPV reactivity to or recovery from challenge. These findings, from a large randomized, controlled trial using an intent-to-treat design, show that moderate aerobic exercise training has no effect on PEP and LF-BPV reactivity to or recovery from psychological or orthostatic challenge. In healthy young adults, the cardioprotective effects of exercise training are unlikely to be mediated by changes in sympathetic activity.
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Affiliation(s)
- M Lindgren
- Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - C Alex
- Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - P A Shapiro
- Department of Psychiatry, Columbia University Medical Center, New York, New York, USA
| | - P S McKinley
- Department of Psychiatry, Columbia University Medical Center, New York, New York, USA.,New York State Psychiatric Institute, New York, New York, USA
| | | | - M M Myers
- Department of Psychiatry, Columbia University Medical Center, New York, New York, USA.,New York State Psychiatric Institute, New York, New York, USA
| | - C J Choi
- New York State Psychiatric Institute, New York, New York, USA
| | - S Lopez-Pintado
- Mailman School of Public Health, Columbia University, New York, New York, USA
| | - R P Sloan
- Department of Psychiatry, Columbia University Medical Center, New York, New York, USA.,New York State Psychiatric Institute, New York, New York, USA
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Fuller-Rowell TE, Williams DR, Love GD, McKinley PS, Sloan RP, Ryff CD. Race differences in age-trends of autonomic nervous system functioning. J Aging Health 2013; 25:839-62. [PMID: 23781017 DOI: 10.1177/0898264313491427] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVE The objective of this study was to consider race differences in age-trends of autonomic nervous system functioning, using a national data set with a broad age range. METHODS Measures of baseline heart rate variability (HRV) and HRV reactivity were derived from electrocardiograph (ECG) recordings taken at rest and during cognitive stress tasks. Age-trends in HRV and HRV reactivity were compared among 204 African Americans and 833 Whites ages 34 to 83 years (M = 53.7, SD = 11.4), before and after controlling for socioeconomic status (SES). RESULTS For HRV-reactivity, age-trends were steeper among African Americans and lower SES participants than Whites and higher SES participants. For baseline HRV, age-trends varied by SES but not race. DISCUSSION Results relating to HRV-reactivity (but not baseline HRV) were consistent with hypotheses suggesting that African Americans are exposed to higher levels of stress and experience accelerated declines in health across the life span. The relevance of the findings to research on social stress and health disparities is discussed.
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Affiliation(s)
- Thomas E Fuller-Rowell
- Robert Wood Johnson Health & Society Scholar, School of Medicine and Public Health, University of Wisconsin, Madison, WI 53726, USA.
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Alex C, Lindgren M, Shapiro PA, McKinley PS, Brondolo EN, Myers MM, Zhao Y, Sloan RP. Aerobic exercise and strength training effects on cardiovascular sympathetic function in healthy adults: a randomized controlled trial. Psychosom Med 2013; 75:375-81. [PMID: 23630307 PMCID: PMC4518731 DOI: 10.1097/psy.0b013e3182906810] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
OBJECTIVE Exercise has widely documented cardioprotective effects, but the mechanisms underlying these effects are not entirely known. Previously, we demonstrated that aerobic but not strength training lowered resting heart rate and increased cardiac vagal regulation, changes that were reversed by sedentary deconditioning. Here, we focus on the sympathetic nervous system and test whether aerobic training lowers levels of cardiovascular sympathetic activity in rest and that deconditioning would reverse this effect. METHODS We conducted a randomized controlled trial contrasting the effects of aerobic (A) versus strength (S) training on indices of cardiac (preejection period, or PEP) and vascular (low-frequency blood pressure variability, or LF BPV) sympathetic regulation in 149 young, healthy, and sedentary adults. Participants were studied before and after conditioning, as well as after 4 weeks of sedentary deconditioning. RESULTS As previously reported, aerobic capacity increased in response to conditioning and decreased after deconditioning in the aerobic, but not the strength, training group. Contrary to prediction, there was no differential effect of training on either PEP (A: mean [SD] -0.83 [7.8] milliseconds versus S: 1.47 [6.69] milliseconds) or LF BPV (A: mean [SD] -0.09 [0.93] ln mm Hg(2) versus S: 0.06 [0.79] ln mm Hg(2)) (both p values > .05). CONCLUSIONS These findings, from a large randomized controlled trial using an intent-to-treat design, show that moderate aerobic exercise training has no effect on resting state cardiovascular indices of PEP and LF BPV. These results indicate that in healthy, young adults, the cardioprotective effects of exercise training are unlikely to be mediated by changes in resting sympathetic activity. TRIAL REGISTRATION Clinicaltrials.gov identifier: NCT00358137.
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Kimhy D, Crowley OV, McKinley PS, Burg MM, Lachman ME, Tun PA, Ryff CD, Seeman TE, Sloan RP. The association of cardiac vagal control and executive functioning--findings from the MIDUS study. J Psychiatr Res 2013; 47:628-35. [PMID: 23434176 PMCID: PMC3594003 DOI: 10.1016/j.jpsychires.2013.01.018] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2012] [Revised: 11/27/2012] [Accepted: 01/18/2013] [Indexed: 12/13/2022]
Abstract
Cardiac vagal control (CVC), an index of parasympathetic contribution to cardiac regulation, has been linked to enhanced executive functioning (EF). However, findings to date have been based on small or unique samples. Additionally, previous studies assessed the CVC-EF link only during rest or recovery period from a cognitive challenge, but not during both states. In the present study, data on 817 socioeconomically diverse participants were obtained from the Midlife Development in the United States (MIDUS) study. As part of this study, participants completed cognitive tests, including EF, along with laboratory-based measures of CVC during rest and following recovery from a cognitive challenge. Regression analyses adjusting for respiratory rate revealed no effect of CVC at rest or during recovery on a global index of EF. However, exploratory post-hoc analyses of the components of the global EF index revealed a significant association between faster vagal recovery and better attention-switching and response inhibition abilities, as indexed by faster reaction time to the mixed SGST. This association remained significant after controlling for demographic, clinical (BMI, diseases and medications altering cardiac autonomic functioning, etc.), and health behavior covariates (Beta = .148, p = .010). Our findings suggest that future studies may need to investigate the links of CVC to specific EF abilities, rather than global measures of EF. Additionally, our results highlight the importance of assessing CVC during both rest and recovery from a cognitive challenge. The authors discuss the putative neurobiological underpinning of this link, as well as suggestions for future basic and clinical research.
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Affiliation(s)
- D Kimhy
- Division of Cognitive Neuroscience, Department of Psychiatry, Columbia University, New York, NY 10032, USA.
| | - OV Crowley
- Division of Behavioral Medicine, Department of Psychiatry, Columbia University, New York, NY, New York State Psychiatric Institute, New York, NY
| | - PS McKinley
- Division of Behavioral Medicine, Department of Psychiatry, Columbia University, New York, NY, New York State Psychiatric Institute, New York, NY
| | - MM Burg
- Division of General Medicine, Columbia University School of Medicine, New York, NY, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT
| | - ME Lachman
- Department of Psychology, Brandeis University, Waltham, MA
| | - PA Tun
- Department of Psychology, Brandeis University, Waltham, MA
| | - CD Ryff
- Department of Psychology, University of Wisconsin, Madison, WI
| | - TE Seeman
- Division of Geriatrics, University of California, Los Angeles David Geffen School of Medicine, Los Angeles, CA
| | - RP Sloan
- Division of Behavioral Medicine, Department of Psychiatry, Columbia University, New York, NY, New York State Psychiatric Institute, New York, NY
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50
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Affiliation(s)
- Richard P Sloan
- Nathaniel Wharton Professor of Behavioral Medicine, Columbia University Medical Center, New York, NY 10032, USA.
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