Heart rate variability, the vagus and calm.
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276 to 300 of 1,007Vagus nerve stimulation: from epilepsy to the cholinergic anti-inflammatory pathway.
Background: The brain and the gut communicate bidirectionally through the autonomic nervous system (ANS). The vagus nerve (VN), a major component of the ANS, plays a key role in the neuro-endocrine-immune axis to maintain homeostasia through its afferents (through the activation of the hypothalamic pituitary adrenal axis and the central ANS) and through its efferents (i.e. the cholinergic anti-inflammatory pathway; CAP). The CAP has an anti-TNF effect both through the release of acetylcholine at the distal VN acting on macrophages and through the connection of the VN with the spleen through the splenic sympathetic nerve. Vagus nerve stimulation (VNS) of vagal afferents at high frequency (20-30 Hz) is used for the treatment of drug-resistant epilepsy and depression. Low-frequency (5 Hz) VNS of vagal efferents activates the CAP for an anti-inflammatory effect that is as an anti-TNF therapy…
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The chemical neuroanatomy of vagus nerve stimulation.
In this short overview a reappraisal of the anatomical connections of vagal afferents is reported. The manuscript moves from classic neuroanatomy to review details of vagus nerve anatomy which are now becoming more and more relevant for clinical outcomes (i.e. the therapeutic use of vagus nerve stimulation). In drawing such an updated odology of central vagal connections the anatomical basis subserving the neurochemical effects of vagal stimulation are addressed. In detail, apart from the thalamic projection of central vagal afferents, the monoaminergic systems appear to play a pivotal role. Stemming from the chemical neuroanatomy of monoamines such as serotonin and norepinephrine the widespread effects of vagal stimulation on cerebral cortical activity are better elucidated. This refers both to the antiepileptic effects and most recently to the beneficial effects of vagal stimulation in…
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Vagus nerve stimulation: from pre-clinical to clinical application: challenges and future directions.
Vagus nerve stimulation was performed experimentally for the first time more than 150 years ago. In the 1980s and 1990s, vagus nerve stimulation was shown, both in the anesthetized and in the conscious animal, to exert marked antiarrhythmic effects, particularly during acute myocardial ischemia. There is a strong rationale for a beneficial effect of augmented vagal activity in the setting of chronic heart failure. Studies in experimental models of heart failure showed that chronic vagus nerve stimulation exerts beneficial effects on left ventricular function and on survival. Vagus nerve stimulation is approved in man for refractory epilepsy and depression. The first-in-man study performed in 32 patients with chronic heart failure suggests that vagus nerve stimulation was safe and well tolerated. Six months of open-label treatment was associated with significant improvements (P < 0.001) i…
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Oxytocin, vasopressin and sociality.
The neurobiology of social behaviour is interwoven with autonomic, endocrine and other homoeostatic processes responsible for the adaptive functions of reproduction and survival. Young mammals are dependent on their mothers for nourishment, and the interaction between the mother and infant may be a physiological and neuroendocrine prototype for mammalian sociality. Although these adaptive functions of the mother-infant social behavioural dyad are obvious, adult social interactions, including social bonds, also are important to health and survival. Two neuropeptides, oxytocin (OXT) and arginine vasopressin (AVP), have been repeatedly implicated in mammalian social behaviours and emotional states that support sociality. Although best known for their roles in reproduction and homoeostasis, these peptides play a central role in the activation and expression of social behaviours and emotional…
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Polyvagal Theory and developmental psychopathology: emotion dysregulation and conduct problems from preschool to adolescence.
In science, theories lend coherence to vast amounts of descriptive information. However, current diagnostic approaches in psychopathology are primarily atheoretical, emphasizing description over etiological mechanisms. We describe the importance of Polyvagal Theory toward understanding the etiology of emotion dysregulation, a hallmark of psychopathology. When combined with theories of social reinforcement and motivation, Polyvagal Theory specifies etiological mechanisms through which distinct patterns of psychopathology emerge. In this paper, we summarize three studies evaluating autonomic nervous system functioning in children with conduct problems, ages 4-18. At all age ranges, these children exhibit attenuated sympathetic nervous system responses to reward, suggesting deficiencies in approach motivation. By middle school, this reward insensitivity is met with inadequate vagal modulati…
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What do measures of self-report interoception measure? Insights from a systematic review, latent factor analysis, and network approach.
Recent conceptualizations of interoception suggest several facets to this construct, including "interoceptive sensibility" and "self-report interoceptive scales", both of which are assessed with questionnaires. Although these conceptual efforts have helped move the field forward, uncertainty remains regarding whether current measures converge on their measurement of a common construct. To address this question, we first identified -via a systematic review- the most cited questionnaires of interoceptive sensibility. Then, we examined their correlations, their overall factorial structure, and their network structure in a large community sample (n = 1003). The results indicate that these questionnaires tap onto distinct constructs, with low overall convergence and interrelationships between questionnaire items. This observation mitigates the interpretation and replicability of findings in s…
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Impact of Fasting on Cardiovascular Outcomes in Patients With Hypertension.
Fasting has been frequently practiced for religious or medical purposes worldwide. However, limited literature assesses the impact of different fasting patterns on the physiologic and cardiac-related parameters in patients with hypertension. This review aims to examine the effect of fasting on cardiovascular outcomes in hypertensive patients. Medline, Embase, and Cochrane library were systematically screened until March 2021 for observational prospective cohorts investigating the effect of fasting on cardiovascular outcomes. Articles were assessed by searching for hypertension and fasting, both as Medical Subject Headings (MeSH) terms and text words. The review included studies assessing Ramadan, intermittent, and water-only fasting. Water-only fasting reduces body weight, blood pressure, and lipolytic activity of fasting hypertensive patients without affecting average heart rate. Ramada…
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Heart rate variability as a biomarker in health and affective disorders: A perspective on neuroimaging studies.
The dynamic embodiment of psychological processes is evident in the association of health outcomes, behavioural traits and psychological functioning with Heart Rate Variability (HRV). The dominant high-frequency component of HRV is an index of the central neural control of heart rhythm, mediated via the parasympathetic vagus nerve. HRV provides a potential objective measure of action policies for the adaptive and predictive allostatic regulation of homeostasis within the cardiovascular system. In its support, a network of brain regions (referred to as the 'central autonomic network') maps internal state, and controls autonomic responses. This network includes regions of prefrontal cortex, anterior cingulate cortex, insula, amygdala, periaqueductal grey, pons and medulla. Human neuroimaging studies of neural activation and functional connectivity broadly endorse this architecture, and its…
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Heart rate variability monitoring for emotion and disorders of emotion.
Background: Emotion is composed of cognitive processing, physiological response and behavioral reaction. Heart rate variability (HRV) refers to the fluctuations between consecutive heartbeat cycles, and is considered as a non-invasive method for evaluating cardiac autonomic function. HRV analysis plays an important role in emotional study and detection.
Objective: In this paper, the physiological foundation of HRV is briefly described, and then the relevant literature relating to HRV-based emotion studies for the performance of HRV in different emotions, emotion recognition, the evaluation of emotional disorders, HRV biofeedback, as well as HRV-based emotion analysis and management enhanced by wearable devices, are reviewed.
Significance: It is suggested that HRV is an effective tool for the measurement and regulation of emotional response, with a broad application prospect.
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Influence of Regular Physical Activity and Fitness on Stress Reactivity as Measured with the Trier Social Stress Test Protocol: A Systematic Review.
Background: Psychosocial stress is associated with multiple health complaints. Research to date suggests that regular physical activity (PA) and higher cardiorespiratory fitness may reduce stress reactivity and therefore contribute to a reduction of stress-related risk factors. While previous reviews have not differentiated between stressors, we focus on psychosocial stress elicited with the Trier Social Stress Test (TSST).
Objective: Our objective was to examine the effect of regular PA and cardiorespiratory fitness on stress reactivity, with a particular focus on the TSST. The TSST is the laboratory task most widely used to induce socio-evaluative stress and elicits stronger stress reactions than most other cognitive stressor tasks.
Methods: A systematic search within various databases was performed in January 2018. The following outcomes were considered: cortisol, heart rate, psycholo…
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Pain in the body. Altered interoception in chronic pain conditions: A systematic review.
Interoception is the sense of the physiological condition of the body. Modern definitions differentiated three separated sub-constructs: accuracy (IAc), i.e., the ability to detect physiological states, sensibility (IAs), i.e., a self-evaluated measure of interoception, and awareness (IAw) i.e., a metacognitive awareness of the accuracy. Preliminary researches correlated pain with alterations in the interoceptive matrix albeit, to the best of our knowledge, interoceptive alterations in chronic pain conditions have never been studied systematically. We searched for studies that assessed interoception in subjects with chronic pain and compared it to healthy population. Eleven studies were included among different chronic pain conditions. Results suggested that chronic pain subjects might present low IAc and, allegedly, that IAc negatively correlates with symptoms severity in specific disor…
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Lehrer P, Eddie D (2013)reviewMEDLINE-indexed journal, not yet read by usApplied psychophysiology and biofeedback58 citations Dynamic processes in regulation and some implications for biofeedback and biobehavioral interventions.
Systems theory has long been used in psychology, biology, and sociology. This paper applies newer methods of control systems modeling for assessing system stability in health and disease. Control systems can be characterized as open or closed systems with feedback loops. Feedback produces oscillatory activity, and the complexity of naturally occurring oscillatory patterns reflects the multiplicity of feedback mechanisms, such that many mechanisms operate simultaneously to control the system. Unstable systems, often associated with poor health, are characterized by absence of oscillation, random noise, or a very simple pattern of oscillation. This modeling approach can be applied to a diverse range of phenomena, including cardiovascular and brain activity, mood and thermal regulation, and social system stability. External system stressors such as disease, psychological stress, injury, or …
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Heart rate variability.
Heart rate variability (HRV) provides indirect insight into autonomic nervous system tone, and has a well-established role as a marker of cardiovascular risk. Recent decades brought an increasing interest in HRV assessment as a diagnostic tool in detection of autonomic impairment, and prediction of prognosis in several neurological disorders. Both bedside analysis of simple markers of HRV, as well as more sophisticated HRV analyses including time, frequency domain and nonlinear analysis have been proven to detect early autonomic involvement in several neurological disorders. Furthermore, altered HRV parameters were shown to be related with cardiovascular risk, including sudden cardiac risk, in patients with neurological diseases. This chapter aims to review clinical and prognostic application of HRV analysis in diabetes, stroke, multiple sclerosis, muscular dystrophies, Parkinson's disea…
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Heart rate variability today.
Heart rate variability (HRV) non-invasively assesses the activity of the autonomic nervous system. During the past 30 years, an increasing number of studies have related the imbalance of the autonomic nervous system (as assessed by HRV) to several pathophysiogical conditions, particularly in the setting of cardiovascular disease. Sudden death, coronary artery disease, heart failure, or merely cardiovascular risk factors (smoking, diabetes, hyperlipidemia, and hypertension) are the best-known clinical circumstances that can affect and/or be affected by the autonomic nervous system. Analyses of HRV variables have been proposed as a component of the clinical evaluation for patient risk stratification due to its independent prognostic information. Yet the potential for HRV to be used widely in clinical practice remains to be established.
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Biomarkers in burnout: a systematic review.
Background: Burnout is a stress state characterized by symptoms of mental exhaustion and physical fatigue, detachment from work, and feelings of diminished competence. Several biomarkers have been tested for association with burnout, but the results are conflicting.
Aim: The objective of this review was to identify potential biomarkers for burnout.
Methods: We carried out a systematic review of studies comparing biomarkers in individuals with burnout and healthy controls, or individuals with low scores and those with high scores on burnout questionnaires. Literature searches in MEDLINE and EMBASE were performed. We describe biomarkers on which at least three studies were available. Where appropriate, a meta-analysis was carried out.
Results: We identified 31 studies on 38 biomarkers involved in the hypothalamus-pituitary-adrenal axis, autonomic nervous system, immune system, metabolic pr…
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The relationship of autonomic imbalance, heart rate variability and cardiovascular disease risk factors.
Cardiovascular disease (CVD) is the leading cause of death and disability worldwide. The understanding of the risk factors for CVD may yield important insights into the prevention, etiology, course, and treatment of this major public health concern. Autonomic imbalance, characterized by a hyperactive sympathetic system and a hypoactive parasympathetic system, is associated with various pathological conditions. Over time, excessive energy demands on the system can lead to premature aging and diseases. Therefore, autonomic imbalance may be a final common pathway to increased morbidity and mortality from a host of conditions and diseases, including cardiovascular disease. Heart rate variability (HRV) may be used to assess autonomic imbalances, diseases and mortality. Parasympathetic activity and HRV have been associated with a wide range of conditions including CVD. Here we review the evide…
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Basic notions of heart rate variability and its clinical applicability.
Autonomic nervous system (ANS) plays an important role in the regulation of the physiological processes of the human organism during normal and pathological conditions. Among the techniques used in its evaluation, the heart rate variability (HRV) has arising as a simple and non-invasive measure of the autonomic impulses, representing one of the most promising quantitative markers of the autonomic balance. The HRV describes the oscillations in the interval between consecutive heart beats (RR interval), as well as the oscillations between consecutive instantaneous heart rates. It is a measure that can be used to assess the ANS modulation under physiological conditions, such as wakefulness and sleep conditions, different body positions, physical training and also pathological conditions. Changes in the HRV patterns provide a sensible and advanced indicator of health involvements. Higher HRV…
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The role of cardiac autonomic function in hypertension and cardiovascular disease.
Autonomic nervous system abnormality, clinically manifested as a hyperkinetic circulation characterized by elevations in heart rate, blood pressure, plasma norepinephrine levels, and cardiac output, has been repeatedly demonstrated in hypertension. Increased release of norepinephrine from the brain has also been described in hypertension, and increased sympathetic activity has been demonstrated using spectral analysis of heart rate variability, particularly in the early stage of hypertension and in white-coat hypertension. Studies performed with microneurographic assessment also have found a marked increase in muscle sympathetic nervous activity in subjects with both borderline and established hypertension. A transition from the early hyperkinetic state to a high-resistance, established hypertension has been documented in longitudinal studies. The high blood pressure induces vascular hyp…
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Autonomic control of heart rate during and after exercise : measurements and implications for monitoring training status.
Endurance training decreases resting and submaximal heart rate, while maximum heart rate may decrease slightly or remain unchanged after training. The effect of endurance training on various indices of heart rate variability remains inconclusive. This may be due to the use of inconsistent analysis methodologies and different training programmes that make it difficult to compare the results of various studies and thus reach a consensus on the specific training effects on heart rate variability. Heart rate recovery after exercise involves a coordinated interaction of parasympathetic re-activation and sympathetic withdrawal. It has been shown that a delayed heart rate recovery is a strong predictor of mortality. Conversely, endurance-trained athletes have an accelerated heart rate recovery after exercise. Since the autonomic nervous system is interlinked with many other physiological system…
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Moravec CS (2008)reviewMEDLINE-indexed journal, not yet read by usCleveland Clinic journal of medicine16 citations Biofeedback therapy in cardiovascular disease: rationale and research overview.
Biofeedback has much therapeutic potential in cardiovascular diseases, since many of these diseases involve dysregulation of the autonomic nervous system. Studies have clearly demonstrated that patients can use biofeedback techniques to regulate the input of the autonomic nervous system to the heart, but the clinical utility of these techniques has not been well explored in systematic trials. Much biofeedback research to date has focused on patients with hypertension, but outcomes have been inconclusive. Preliminary studies suggest that heart rate variability biofeedback may be useful in improving symptoms and quality of life in patients with cardiac disease, and early studies suggest a possible effect of biofeedback on remodeling of the failing heart. Both of these areas require further research, however. Biofeedback is increasingly used as an adjunct to stress management in cardiac reh…
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von Borell E, Langbein J, Després G, Hansen S, Leterrier C, Marchant J, Marchant-Forde R, Minero M, Mohr E, Prunier A, Valance D, Veissier I (2007)reviewMEDLINE-indexed journal, not yet read by usPhysiology & behavior471 citations Heart rate variability as a measure of autonomic regulation of cardiac activity for assessing stress and welfare in farm animals -- a review.
Measurement of heart rate variability (HRV) is a non-invasive technique that can be used to investigate the functioning of the autonomic nervous system, especially the balance between sympathetic and vagal activity. It has been proven to be very useful in humans for both research and clinical studies concerned with cardiovascular diseases, diabetic autonomic dysfunction, hypertension and psychiatric and psychological disorders. Over the past decade, HRV has been used increasingly in animal research to analyse changes in sympathovagal balance related to diseases, psychological and environmental stressors or individual characteristics such as temperament and coping strategies. This paper discusses current and past HRV research in farm animals. First, it describes how cardiac activity is regulated and the relationships between HRV, sympathovagal balance and stress and animal welfare. Then i…
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Heart rate variability: a review.
Heart rate variability (HRV) is a reliable reflection of the many physiological factors modulating the normal rhythm of the heart. In fact, they provide a powerful means of observing the interplay between the sympathetic and parasympathetic nervous systems. It shows that the structure generating the signal is not only simply linear, but also involves nonlinear contributions. Heart rate (HR) is a nonstationary signal; its variation may contain indicators of current disease, or warnings about impending cardiac diseases. The indicators may be present at all times or may occur at random-during certain intervals of the day. It is strenuous and time consuming to study and pinpoint abnormalities in voluminous data collected over several hours. Hence, HR variation analysis (instantaneous HR against time axis) has become a popular noninvasive tool for assessing the activities of the autonomic ner…
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Respiratory sinus arrhythmia reactivity in current and remitted major depressive disorder.
Objective: Low resting respiratory sinus arrhythmia (RSA) levels and blunted RSA reactivity are thought to index impaired emotion regulation capacity. Major depressive disorder (MDD) has been associated with aberrant RSA reactivity and recovery to a speech stressor task relative to healthy controls. Whether impaired RSA functioning reflects aspects of the depressed mood state or a stable vulnerability marker for depression is unknown.
Methods: We compared resting RSA and RSA reactivity between adults with MDD (n = 49), remitted depression (RMD, n = 24), and healthy controls (n = 45). Electrocardiogram data were collected during a resting baseline, a paced-breathing baseline, and two reactivity tasks (speech stressor, cold exposure).
Results: A group by time quadratic effect emerged (F(2,109) = 4.36, p = .015) for RSA across phases of the speech stressor (baseline, instruction, preparatio…
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Sessa F, Anna V, Messina G, Cibelli G, Monda V, Marsala G, Ruberto M, Biondi A, Cascio O, Bertozzi G, Pisanelli D, Maglietta F, Messina A, Mollica MP, Salerno M (2018)reviewMEDLINE-indexed journal, not yet read by usAging186 citations Heart rate variability as predictive factor for sudden cardiac death.
Sudden cardiac death (SCD) represents about 25% of deaths in clinical cardiology. The identification of risk factors for SCD is the philosopher's stone of cardiology and the identification of non-invasive markers of risk of SCD remains one of the most important goals for the scientific community. The aim of this review is to analyze the state of the art around the heart rate variability (HRV) as a predictor factor for SCD.HRV is probably the most analyzed index in cardiovascular risk stratification technical literature, therefore an important number of models and methods have been developed. Nowadays, low HRV has been shown to be independently predictive of increased mortality in post- myocardial infarction patients, heart failure patients, in contrast with the data of the general population. Contrariwise, the relationship between HRV and SCD has received scarce attention in low-risk coh…
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Monfredi O, Lyashkov AE, Johnsen AB, Inada S, Schneider H, Wang R, Nirmalan M, Wisloff U, Maltsev VA, Lakatta EG, Zhang H, Boyett MR (2014)MEDLINE-indexed journal, not yet read by usHypertension (Dallas, Tex. : 1979)238 citations Biophysical characterization of the underappreciated and important relationship between heart rate variability and heart rate.
Heart rate (HR) variability (HRV; beat-to-beat changes in the R-wave to R-wave interval) has attracted considerable attention during the past 30+ years (PubMed currently lists >17 000 publications). Clinically, a decrease in HRV is correlated to higher morbidity and mortality in diverse conditions, from heart disease to fetal distress. It is usually attributed to fluctuation in cardiac autonomic nerve activity. We calculated HRV parameters from a variety of cardiac preparations (including humans, living animals, Langendorff-perfused heart, and single sinoatrial nodal cell) in diverse species, combining this with data from previously published articles. We show that regardless of conditions, there is a universal exponential decay-like relationship between HRV and HR. Using 2 biophysical models, we develop a theory for this and confirm that HRV is primarily dependent on HR and cannot be us…
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