Acute Mental Stress Research Articles

Psychological Factors and Blood Pressure Responses to Acute Stress in Women with Takotsubo Syndrome: An Exploratory Study.

This secondary analysis aimed to: 1) describe psychological resources and distress in women with Takotsubo Syndrome (TS), and 2) explore whether such factors affect blood pressure (BP) responses to acute mental stress. Participants were 47 women consecutively enrolled in an ongoing study examining the prognostic significance of stress reactivity in TS. Psychological resources (resilience, adaptive coping) and distress (depression, anxiety, PTSD, perceived stress) were self-reported using validated questionnaires <12 weeks after TS. Using a standardized protocol, systolic BP (SBP) and diastolic BP (DBP) (mmHg) were measured every 5 minutes during baseline (10 min), mental stress (10 min), and recovery (20 min). Associations of psychological resources and distress (high vs. low composite scores), respectively, with BP during mental stress and recovery (change from baseline) were examined using one-way ANCOVAs (covariates: age, anti-hypertensive medications). Given the study's exploratory nature, results are shown as effect sizes.On average, women (Mage= 64.3 years) had high perceived stress, anxiety, and PTSD symptoms and low resilience. Women with high (vs. low) psychological distress displayed less complete SBP (d=.57) and DBP (d=.33) recovery to baseline. Women with low (vs. high) psychological resources demonstrated lower SBP responses during mental stress (d=-.26) alongside a more complete SBP recovery (d=.30). Female survivors of TS with high psychological distress exhibited impaired BP recovery following acute mental stress. While the prognostic significance of impaired BP recovery from mental stress remains to be determined in longitudinal studies, this finding could help identify TS survivors at risk for recurrence.

Autonomic Reactivity to Mental Stress is Associated with Cardiovascular Mortality

Abstract Background and Aims The mechanisms linking acute psychological stress to cardiovascular disease (CVD) mortality are incompletely understood. We studied the relationship of electrocardiographic measures of autonomic dysfunction during acute mental stress provocation and CVD death. Methods In a pooled cohort of 765 participants with stable CVD from two related studies, we collected Holter data during standardized laboratory-based mental stress testing with a speech task and followed them for events. We assessed autonomic function using low frequency (LF) heart rate variability (HRV) in five-minute intervals before, during, and after stress induction, and specifically examined changes from rest to stress. We employed cause-specific survival models to examine its association with CVD and all-cause mortality, controlling for demographic and CVD risk factors. Results The mean (SD) age was 58 (10) years, 35% were women, and 44% self-identified as Black. After a median follow-up of 5.6 years, 37 (5%) died from CVD causes. A stress-induced low frequency (LF) HRV decrease (67% of sample), versus increase, was associated with a hazard ratio (HR) of 3.48 (95% confidence interval, 3.25, 3.73) for CVD mortality. Low rest LF HRV (bottom quartile) was also independently associated with CVD mortality, HR = 1.75 (1.58, 1.94), versus normal rest LF HRV (upper three quartiles). The combination of stress-induced LF HRV decrease and low rest LF HRV was associated with HR = 5.73 (5.33, 6.15) versus the normal stress/rest LF HRV reference. We found similar results with HF HRV. Conclusions Stress-induced LF HRV decrease and low rest LF HRV are both independently and additively associated with a higher CVD mortality risk. Additional research is needed to assess whether targeting autonomic dysfunction may improve CVD outcomes.

Beneficial Effects of Cocoa Flavanols on Microvascular Responses in Young Men May Be Dependent on Ethnicity and Lifestyle.

Cocoa flavan-3-ols affect endothelium-dependent responses in resistance vessels and microcirculation has received little attention. We tested the effects of dark chocolate consumption (396 mg total flavanols/day for 3 days) in two Groups of 10 men (18-25 years; non-smokers) each comprising equal numbers of White European (WE) and South Asian (SA) ethnicity. In Group 1, dark chocolate did not affect reactive hyperaemia in forearm muscle, but augmented muscle dilatation evoked by acute mental stress, and reactive hyperaemia and acetylcholine (ACh)-evoked dilatation in cutaneous microcirculation. Conversely, in Group 2, chocolate did not affect cutaneous reactive hyperaemia or ACh-evoked dilatation, but these responses were blunted in Group 1 relative to Group 2. Further, when Groups 1 and 2 were combined, responses were blunted in SAs relative to WEs, augmented by chocolate in SAs only. In Group 2 individuals whose ACh-evoked dilatation was attenuated by nitric oxide synthase (NOS) inhibition, ACh-evoked dilatation was not altered after chocolate, but the attenuating effect of NOS inhibition was lost. Conversely, in Group 2 individuals whose ACh-evoked dilatation was enhanced by NOS inhibition, ACh-evoked dilatation was also augmented by chocolate. We propose that in resistance and microvessels of young men, cocoa flavan-3-ols preferentially augment endothelium-dependent dilator responses whose responses are depressed by familial and lifestyle factors more prevalent in SAs than Wes. Flavan-3-ols may facilitate the NOS pathway but also influence other endothelium-dependent dilators.

Effects of Acute Mental Stress on Choroidal Thickness.

Purpose: Previous studies have indicated an association between education and myopia, suggesting that numerous stress events during the educational process may influence eye health. This study aimed to investigate the impact of mental stress induced by mental arithmetic (MA) on choroidal thickness (CT). Methods: This study included 33 participants aged between 19 and 29 years. Swept-source optical coherence tomography (SS-OCT) was used to capture images of the posterior segment of the left eye during baseline and MA to assess changes in the CT. After denoising and compensation, the baseline images and MA images that had been rigidly registered and resampled to the baseline images were segmented using a deep learning-based method. Based on the segmentation results, the CT within the regions of 1 mm and 3 mm diameter centered at the lowest point of the fovea was calculated. Results: Significant increases were observed in both CT1mm and CT3mm during MA, with mean changes of 2.742 ± 7.098 μm (p = 0.034) and 3.326 ± 6.143 μm (p < 0.001), respectively. Conclusions: Thickening of the choroid has been observed during acute mental stress. We speculate that long-term or chronic mental stress could have a potential adverse impact on myopia progression.

Neuroimmune crosstalk : How mental stress fuels vascular inflammation.

Cardiovascular diseases are the leading cause of death worldwide. Pathophysiologically, metabolic and inflammatory processes contribute substantially to the development and progression of cardiovascular diseases. Over the past decade, the role of disease-propagating inflammatory processes has been strengthened and reframed, leading to trials testing anti-inflammatory drugs for the treatment of atherosclerosis and its complications. Despite these achievements, further research in both pre-clinical and clinical studies is warranted to explore new targets, to better identify responders, and to refine therapy strategies to combat inflammation in human disease. Environmental disturbances, so-called lifestyle-associated cardiovascular risk factors, greatly alter the immune system in general and leukocytes in particular, thus affecting the progression of atherosclerosis. Epidemiological studies have shown that exposure to mental stress can be closely linked to the occurrence of cardiovascular disease. Here, we describe how acute and chronic mental stress alter the immune system via neuroimmune interactions, thereby modifying vascular inflammation. In addition, we identify gaps that still need to be addressed in the future.

Blunted brachial blood flow velocity response to acute mental stress in PTSD females.

Post-traumatic stress disorder (PTSD) is associated with increased cardiovascular disease (CVD) risk. Compared with males, females are twice as likely to develop PTSD after trauma exposure, and cardiovascular reactivity to stress is a known risk factor for CVD. We aimed to examine hemodynamic responses to acute mental stress in trauma-exposed females with and without a clinical diagnosis of PTSD. We hypothesized that females with PTSD would have higher heart rate (HR), blood pressure (BP), and lower blood flow velocity (BFV) responsiveness compared with controls. We enrolled 21 females with PTSD and 21 trauma-exposed controls. We continuously measured HR using a three-lead electrocardiogram, BP using finger plethysmography, and brachial BFV using Doppler ultrasound. All variables were recorded during 10 min of supine rest, 5 min of mental arithmetic, and 5 min of recovery. Females with PTSD were older, and had higher BMI and higher resting diastolic BP. Accordingly, age, BMI, and diastolic BP were covariates for all repeated measures analyses. Females with PTSD had a blunted brachial BFV response to mental stress (time × group, p = 0.005) compared with controls, suggesting greater vasoconstriction. HR and BP responses were comparable. In conclusion, our results suggest early impairment of vascular function in premenopausal females with PTSD.

Blunted Brachial Blood Flow Velocity Recovery to Acute Mental Stress in Young Women with PTSD Compared to Controls

Introduction: Post-traumatic stress disorder (PTSD) is a debilitating mental illness associated with increased cardiovascular disease (CVD) risk, a major cause of death among women in the United States. Women are twice as likely as men to develop PTSD after trauma exposure, and cardiovascular reactivity to stress is a known risk factor for CVD. Therefore, our aim was to investigate if young women diagnosed with PTSD will present with impaired hemodynamic responses to acute stress compared to controls. We hypothesized that women with PTSD will have high blood pressure (BP), heart rate (HR) and blood flow velocity (BFV) response to a mental stress protocol, and a blunted recovery. Methods: We recruited for this study ten young women with PTSD and nine trauma-exposed women without PTSD (controls) between the ages of 18 to 40 years. We collected data in a single laboratory visit after informed consent and PTSD symptoms severity questionnaire. After demographics and resting hemodynamics, we continuously measured HR using a three-lead EKG, beat-to-beat BP using finger plethysmography and continuous brachial BFV using Doppler ultrasound. A Doppler audio translator was used to transfer the doppler signal in our data analysis software for simultaneous recording of all hemodynamics variables. All variables were recorded during 5 min of supine rest, 5 min of mental stress (via mental arithmetic) and 5 min of recovery. The response and recovery to stress was analyzed using an analysis of covariance with timepoint as within factor and PTSD diagnosis as between-factor. Results: Women with a clinical diagnosis of PTSD had a mean age of 27±10 years and body mass index (BMI) of 30.1±2.9 kg/m2. Controls (trauma-exposed women without PTSD) had a mean age of 26±7 years and body mass index (BMI) of 24± 2.1 kg/m2. Resting seated BP and HR were not different between the groups. The slopes of the overall changes in BFV from baseline to mental stress to recovery were different between young women with PTSD and controls (timepoint*group, P= 0.057) when controlling for PTSD symptoms severity. Specifically, although mental stress elicited similar increases in BFV in women with PTSD (Δ0.80±1.8 cm/sec) and in controls [Δ0.45±1.2 cm/sec, P= 0.44 (timepoint*group)], BFV recovery from stress was impaired in PTSD (Δ0.64±1.3 cm/sec), but not in controls [Δ-2.20±0.84 cm/sec, P= 0.047 (timepoint*group)]. BP and HR reactivity to mental stress and recovery were not different between the groups (P&gt;0.05). Conclusion: The current pilot study revealed that PTSD is associated with blunted recovery from acute mental stress, suggesting early impairment of vascular function in these women at a young age. Young pre-menopausal women are overlooked in prevention strategies and health policies targeting populations at-risk for CVD; with the rising prevalence of trauma exposure in young women, evidence is pointing to a parallel increase in CVD risk. K01HL161027 and UMN CTSI UL1TR002494 No Disclosure. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Comparing Habituation of Cardiovascular Reactivity to Acute Mental Stress and the Cold Pressor Test

Exaggerated cardiovascular reactivity (CVR) to acute laboratory stress has been linked to the development of cardiovascular disease. However, recent evidence within the field of psychophysiology reveals that exaggerated CVR may actually be adaptive for long-term health if the response is relatively brief and decreases across subsequent stress exposures (i.e., habituation). Extensive research has validated the occurrence of CVR habituation, specifically to repeated mental stress. However, to our knowledge, no research to date has attempted to directly compare CVR habituation to mental stress with other types of stress tasks (i.e., the cold pressor test; CPT) within the same individuals. The present study aimed to compare CVR habituation to mental stress and CPT across repeated exposures. Based upon prior CVR profiles for repeated mental stress and CPT, we hypothesized that CVR habituation would be observable in response to repeated mental stress, but not repeated CPT. Sixteen healthy young adults (9M/7F, 21±1 yrs, 23±1kg/m2) participated in three experimental sessions. The initial two sessions were administered during a single laboratory visit and separated by a 45 min rest period. The third session occurred one month later at a follow-up visit. Each session included a mental stress trial (5 min baseline, 5 min mental arithmetic task) and a CPT trial (3 min baseline, 2 min CPT), with continuous recordings of heart rate (HR; electrocardiogram) and beat-by-beat arterial blood pressure (finger plethysmography). Reactivity (i.e., stress — baseline) was calculated separately for HR and mean arterial pressure (MAP). Repeated measures ANOVAs revealed a significant main effect of time for HR, F(2, 30) = 6.57, p = 0.004, η2 = 0.30, and MAP, F(2, 30) = 4.37, p = 0.02, η2 = 0.23 in response to the repeated mental stress, but not in response to the repeated CPT (all p-values ≥ 0.05). Post hoc analyses demonstrated HR reactivity to be significantly lower during session 3 of the mental stress (Δ20±9 beats/min, ps ≤ 0.015) compared to session 1 (Δ25±10 beats/min) and session 2 (Δ23±10 beats/min). No significant differences were observed between HR reactivity at sessions 1 and 2 of mental stress ( p = 0.151). MAP reactivity was significantly lower during session 2 (Δ13±5 mmHg) and session 3 (Δ12±6 mmHg) of the mental stress compared to session 1 (Δ15±5 mmHg, ps ≤ 0.030). No significant differences were observed between MAP reactivity at sessions 2 and 3 of mental stress ( p = 0.374). In summary, HR and MAP reactivity significantly habituated in response to repeated mental stress, but not in response to the repeated CPT. Findings suggest that the cardiovascular system adapts to repeated laboratory mental stress, but remains consistently engaged during repeated exposures to the CPT. National Heart, Lung, and Blood Institute (HL-122919). This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Hemodynamic Reactivity to Mental Stress and Cognitive Function in Coronary Artery Disease.

People with coronary artery disease (CAD) are at higher risk of cognitive impairment than those without CAD. Psychological stress is a risk factor for both conditions, and assessing the hemodynamic reactivity to mental stress could explain the link between stress and cognitive function. A total of 779 individuals with stable CAD from two prospective cohort studies were included. All individuals underwent acute mental stress testing, as well as conventional stress testing. Cognitive function was assessed both at baseline and at a 2-year follow-up. The rate-pressure product (RPP) was calculated as the mean systolic blood pressure times the mean heart rate at rest. RPP reactivity was defined as the maximum RPP during standardized mental stress test minus the RPP at rest. After multivariable adjustment, every standard deviation decrease in RPP reactivity with mental stress was associated with slower completion of Trail-A and Trail-B in both cohorts (13% and 11% in cohort 1, and 15% and 16% in cohort 2, respectively; p for all <.01). After a 2-year follow-up period, every standard deviation decrease in RPP reactivity with mental stress was associated with a 8% and 9% slower completion of Trail-A and Trail-B, respectively ( p for all <.01). There was no significant association between RPP reactivity with conventional stress testing and any of the cognitive tests. In the CAD population, a blunted hemodynamic response to mental stress is associated with slower visuomotor processing and worse executive function at baseline and with greater decline in these abilities over time.

Heart Rate Reactivity to Acute Mental Stress is Associated With Parasympathetic Withdrawal and Adiposity in Firefighters

Heart Rate Reactivity to Acute Mental Stress is Associated With Parasympathetic Withdrawal and Adiposity in Firefighters

A Synthetic Multi-Modal Variable to Capture Cardiovascular Responses to Acute Mental Stress and Transcutaneous Median Nerve Stimulation.

To develop a novel synthetic multi-modal variable capable of capturing cardiovascular responses to acute mental stress and the stress-mitigating effect of transcutaneous median nerve stimulation (TMNS), as an initial step toward the overarching goal of enabling closed-loop controlled mitigation of the physiological response to acute mental stress. Using data collected from 40 experiments in 20 participants involving acute mental stress and TMNS, we examined the ability of six plausibly explainable physio-markers to capture cardiovascular responses to acute mental stress and TMNS. Then, we developed a novel synthetic multi-modal variable by fusing the six physio-markers based on numerical optimization and compared its ability to capture cardiovascular responses to acute mental stress and TMNS against the six physio-markers in isolation. The synthetic multi-modal variable showed explainable responses to acute mental stress and TMNS in more experiments (24 vs ≤19). It also exhibited superior consistency, balanced sensitivity, and robustness compared to individual physio-markers. The results showed the promise of the synthetic multi-modal variable as a means to measure cardiovascular responses to acute mental stress and TMNS. However, the results also suggested the potential necessity to develop a personalized synthetic multi-modal variable. The findings of this work may inform the realization of TMNS-enabled closed-loop control systems for the mitigation of sympathetic arousal to acute mental stress by leveraging physiological measurements that can readily be implemented in wearable form factors.

Gender differences in resting cardiovascular parameters and their reactivity to acute mental stress

Background: Several cardiovascular disorders (CVDs) have been linked to abnormal cardiovascular reactivity to mental stress. Females are relatively protected from the onslaught of CVDs during their reproductive age. Mental stress tests (MST) have been known to unravel the susceptibility to CVDs. Aims and Objectives: This study envisaged to observe cardiovascular parameters, that is, systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate (HR) under resting conditions as well as their reactivity to mental stress in both genders. Materials and Methods: The study group consisted of sixty-one males and sixty-one females satisfying the prescribed inclusion and exclusion criteria. Blood pressures and HR were measured/calculated in both groups under resting conditions and subsequently after subjecting to MST. The results were subjected to statistical analysis using an unpaired t-test, with significance at P &lt; 0.05. Results: Resting SBP was significantly higher in males (M = 116.16, F =105.00 mm of Hg), whereas resting HR (M = 77.33, F = 80.28 bpm) and DBP (M = 67.16, F = 67.36 mm of Hg) were identical. MST produced identical increases in SBP, DBP, and HR in both genders. Conclusion: Males have a significantly higher resting SBP compared to females, but the reactivity of blood pressures (SBP and DBP) and HR to acute mental stress was identical in both genders (males and females).

Assessment of the human response to acute mental stress-An overview and a multimodal study.

Numerous vital signs are reported in association with stress response assessment, but their application varies widely. This work provides an overview over methods for stress induction and strain assessment, and presents a multimodal experimental study to identify the most important vital signs for effective assessment of the response to acute mental stress. We induced acute mental stress in 65 healthy participants with the Mannheim Multicomponent Stress Test and acquired self-assessment measures (Likert scale, Self-Assessment Manikin), salivary α-amylase and cortisol concentrations as well as 60 vital signs from biosignals, such as heart rate variability parameters, QT variability parameters, skin conductance level, and breath rate. By means of statistical testing and a self-optimizing logistic regression, we identified the most important biosignal vital signs. Fifteen biosignal vital signs related to ventricular repolarization variability, blood pressure, skin conductance, and respiration showed significant results. The logistic regression converged with QT variability index, left ventricular work index, earlobe pulse arrival time, skin conductance level, rise time and number of skin conductance responses, breath rate, and breath rate variability (F1 = 0.82). Self-assessment measures indicated successful stress induction. α-amylase and cortisol showed effect sizes of -0.78 and 0.55, respectively. In summary, the hypothalamic-pituitary-adrenocortical axis and sympathetic nervous system were successfully activated. Our findings facilitate a coherent and integrative understanding of the assessment of the stress response and help to align applications and future research concerning acute mental stress.

Transcutaneous vagal nerve stimulation modulates stress-induced plasma ghrelin levels: A double-blind, randomized, sham-controlled trial

BackgroundTranscutaneous cervical vagus nerve stimulation (tcVNS) has emerged as a potential treatment strategy for patients with stress-related psychiatric disorders. Ghrelin is a hormone that has been postulated to be a biomarker of stress. While the mechanisms of action of tcVNS are unclear, we hypothesized that tcVNS reduces the levels of ghrelin in response to stress. MethodsUsing a randomized double-blind approach, we studied the effects of tcVNS on ghrelin levels in individuals with a history of exposure to traumatic stress. Participants received either sham (n = 29) or active tcVNS (n = 26) after exposure to acute personalized traumatic script stress and mental stress challenges (public speech, mental arithmetic) over a three day period. ResultsThere were no significant differences in the levels of ghrelin between the tcVNS and sham stimulation groups at either baseline or in the absence of trauma scripts. However, tcVNS in conjunction with personalized traumatic scripts resulted in lower ghrelin levels compared to the sham stimulation group (265.2 ± 143.6 pg/ml vs 478.7 ± 349.2 pg/ml, P = 0.01). Additionally, after completing the public speaking and mental arithmetic tests, ghrelin levels were found to be lower in the group receiving tcVNS compared to the sham group (293.3 ± 102.4 pg/ml vs 540.3 ± 203.9 pg/ml, P = 0.009). LimitationsTiming of ghrelin measurements, and stimulation of only left vagus nerve. ConclusiontcVNS decreases ghrelin levels in response to various stressful stimuli. These findings are consistent with a growing literature that tcVNS modulates hormonal and autonomic responses to stress.

Mental stress recognition on the fly using neuroplasticity spiking neural networks

Mental stress is found to be strongly connected with human cognition and wellbeing. As the complexities of human life increase, the effects of mental stress have impacted human health and cognitive performance across the globe. This highlights the need for effective non-invasive stress detection methods. In this work, we introduce a novel, artificial spiking neural network model called Online Neuroplasticity Spiking Neural Network (O-NSNN) that utilizes a repertoire of learning concepts inspired by the brain to classify mental stress using Electroencephalogram (EEG) data. These models are personalized and tested on EEG data recorded during sessions in which participants listen to different types of audio comments designed to induce acute stress. Our O-NSNN models learn on the fly producing an average accuracy of 90.76% (σ = 2.09) when classifying EEG signals of brain states associated with these audio comments. The brain-inspired nature of the individual models makes them robust and efficient and has the potential to be integrated into wearable technology. Furthermore, this article presents an exploratory analysis of trained O-NSNNs to discover links between perceived and acute mental stress. The O-NSNN algorithm proved to be better for personalized stress recognition in terms of accuracy, efficiency, and model interpretability.

Physiological reactivity to acute mental stress in essential hypertension-a systematic review.

Exaggerated physiological reactions to acute mental stress (AMS) are associated with hypertension (development) and have been proposed to play an important role in mediating the cardiovascular disease risk with hypertension. A variety of studies compared physiological reactivity to AMS between essential hypertensive (HT) and normotensive (NT) individuals. However, a systematic review of studies across stress-reactive physiological systems including intermediate biological risk factors for cardiovascular diseases is lacking. We conducted a systematic literature search (PubMed) for original articles and short reports, published in English language in peer-reviewed journals in November and December 2022. We targeted studies comparing the reactivity between essential HT and NT to AMS in terms of cognitive tasks, public speaking tasks, or the combination of both, in at least one of the predefined stress-reactive physiological systems. We included a total of 58 publications. The majority of studies investigated physiological reactivity to mental stressors of mild or moderate intensity. Whereas HT seem to exhibit increased reactivity in response to mild or moderate AMS only under certain conditions (i.e., in response to mild mental stressors with specific characteristics, in an early hyperkinetic stage of HT, or with respect to certain stress systems), increased physiological reactivity in HT as compared to NT to AMS of strong intensity was observed across all investigated stress-reactive physiological systems. Overall, this systematic review supports the proposed and expected generalized physiological hyperreactivity to AMS with essential hypertension, in particular to strong mental stress. Moreover, we discuss potential underlying mechanisms and highlight open questions for future research of importance for the comprehensive understanding of the observed hyperreactivity to AMS in essential hypertension.

Detrimental impacts of acute mental stress on arterial function and exercise as a countermeasure

Detrimental impacts of acute mental stress on arterial function and exercise as a countermeasure

Contributors to beat-to-beat stroke volume variability during acute mental stress in healthy volunteers.

Acute mental stress elicits sympathetic activation, increasing heart rate and shortening the QT interval, but it is unknown whether this activation translates to stroke volume (SV) changes. Multivariate power spectral decomposition was used to assess the influence of heart rate and QT variabilities on SV variability at rest and during acute mental stress. Acute mental stress elicits mild but statistically significant increase in SV variability. Heart rate variability contributes almost one third of SV variability, while the contribution of QT variability is below 3%. In conclusion, although heart rate variability appears to contribute directly to increase in SV variability during acute mental stress, most of SV variability is attributed to sources independent of heart rate and QT variabilities.Clinical Relevance-Acute mental stress elicits small fluctuations in stroke volume in healthy volunteers. Its significance for clinical populations remains to be established.

A proof-of-concept investigation of multi-modal physiological signal responses to acute mental stress

In this paper, we investigated how cardiorespiratory parameters derived from multiple modalities of physiological signals respond to acute mental stress. The novelty of our study is that it derived physiology-inspired signatures of acute mental stress by exploiting (i) cross-integration of multi-modal physiological signals, (ii) cardio-mechanical signals (i.e., the seismocardiogram (SCG) and the ballistocardiogram (BCG)), and (iii) physiological signals compatible with wearable-based sensing platforms. Experimental results from 24 healthy volunteers showed that cross-integration of multi-modal wearable-compatible physiological signals may provide effective signatures that can elucidate the collective physiological changes in response to acute mental stress. In particular, (i) the R-R interval in the electrocardiogram (ECG) and the pulse rate in the photoplethysmogram (PPG), (ii) PPG amplitude, (iii) pre-ejection period (PEP) and the ratio of PEP to left ventricular ejection time (LVET) (both of which are derived from ECG and SCG), (iv) the product of R-R interval and PEP as well as the ratio of pulse transit time (PTT) derived from SCG-PPG (or BCG-PPG) pairs to PPG amplitude, (v) pulse arrival time (PAT) derived from ECG-PPG pair and PTT, and (vi) respiratory rate may be interpreted as stress-induced acute changes in (i) heart rate, (ii) total peripheral resistance, (iii) cardiac contractility (i.e., stroke volume), (iv) cardiac output, (v) arterial blood pressure, and (vi) respiratory activity, respectively. In sum, this work illustrated the proof-of-concept of tracking acute mental stress via physiology-inspired signatures derived from multi-modal physiological signals, thereby paving the way for future efforts aimed at better quantifying acute stress responses in real-world settings.

Physiological and Psychological Response to Acute Mental Stress in Female Patients Affected by Chronic Pulmonary Arterial Hypertension: An Explorative Controlled Pilot Trial.

Little is known about physiological and psychological responses to mental stress in stable patients affected by pulmonary arterial hypertension (PAH). The current explorative controlled pilot study was conducted to investigate whether heart rate (HR) and perceived stress would differ during standardized mental stress testing in PAH patients compared to healthy subjects. Correlation analysis between HR, perceived stress, participants' psychological status and performance on the mental stress task was also performed. The study included 13 female PAH patients (average age: 44.38 ± 10.88 years; average education: 14 ± 3.07 years; mean duration of illness: 9.15 ± 5.37 years) and 13 female controls similar in age (mean age: 47.85 ± 6.36 years) and education (15.92 ± 1.55 years). Participants performed a standardized 9 min mental stress test (computer based, adaptive math task). HR and perceived stress during the task were compared to resting baseline and correlated with psychological state and task performance. Both HR and perceived stress significantly increased during mental stress in a similar way in both groups. A significant correlation was found between HR and perceived stress. Our data show that moderate mental stress has a comparable effect on HR and perceived stress increase in stable PAH patients and control subjects.