Autonomic Nervous System Dynamics Research Articles

Electrodermal activity in bipolar patients during affective elicitation.

Bipolar patients are characterized by a pathological unpredictable behavior, resulting in fluctuations between states of depression and episodes of mania or hypomania. In the current clinical practice, the psychiatric diagnosis is made through clinician-administered rating scales and questionnaires, disregarding the potential contribution provided by physiological signs. The aim of this paper is to investigate how changes in the autonomic nervous system activity can be correlated with clinical mood swings. More specifically, a group of ten bipolar patients underwent an emotional elicitation protocol to investigate the autonomic nervous system dynamics, through the electrodermal activity (EDA), among different mood states. In addition, a control group of ten healthy subjects were recruited and underwent the same protocol. Physiological signals were analyzed by applying the deconvolutive method to reconstruct EDA tonic and phasic components, from which several significant features were extracted to quantify the sympathetic activation. Experimental results performed on both the healthy subjects and the bipolar patients supported the hypothesis of a relationship between autonomic dysfunctions and pathological mood states.

Cardiac coherence, self-regulation, autonomic stability, and psychosocial well-being.

The ability to alter one’s emotional responses is central to overall well-being and to effectively meeting the demands of life. One of the chief symptoms of events such as trauma, that overwhelm our capacities to successfully handle and adapt to them, is a shift in our internal baseline reference such that there ensues a repetitive activation of the traumatic event. This can result in high vigilance and over-sensitivity to environmental signals which are reflected in inappropriate emotional responses and autonomic nervous system dynamics. In this article we discuss the perspective that one’s ability to self-regulate the quality of feeling and emotion of one’s moment-to-moment experience is intimately tied to our physiology, and the reciprocal interactions among physiological, cognitive, and emotional systems. These interactions form the basis of information processing networks in which communication between systems occurs through the generation and transmission of rhythms and patterns of activity. Our discussion emphasizes the communication pathways between the heart and brain, as well as how these are related to cognitive and emotional function and self-regulatory capacity. We discuss the hypothesis that self-induced positive emotions increase the coherence in bodily processes, which is reflected in the pattern of the heart’s rhythm. This shift in the heart rhythm in turn plays an important role in facilitating higher cognitive functions, creating emotional stability and facilitating states of calm. Over time, this establishes a new inner-baseline reference, a type of implicit memory that organizes perception, feelings, and behavior. Without establishing a new baseline reference, people are at risk of getting “stuck” in familiar, yet unhealthy emotional and behavioral patterns and living their lives through the automatic filters of past familiar or traumatic experience.

The autonomic effects of cardiopulmonary decompression sickness in swine using principal dynamic mode analysis

Methods to predict onset of cardiopulmonary (CP) decompression sickness (DCS) would be of great benefit to clinicians caring for stricken divers. Principal dynamic mode (PDM) analysis of the electrocardiogram has been shown to provide accurate separation of the sympathetic and parasympathetic tone dynamics. Nine swine (Sus scrofa) underwent a 15-h saturation dive at 184 kPa (60 ft. of saltwater) in a hyperbaric chamber followed by dropout decompression, whereas six swine, used as a control, underwent a 15-h saturation dive at 15 kPa (5 ft. of saltwater). Noninvasive electrocardiograms were recorded throughout the experiment and autonomic nervous system dynamics were evaluated by heart rate series analysis using power spectral density (PSD) and PDM methods. We observed a significant increase in the sympathetic and parasympathetic tones using the PDM method on average 20 min before DCS onset following a sudden induction of decompression. Parasympathetic activities remained elevated, but the sympathetic modulation was significantly reduced at onset of cutis and CP DCS signs, as reported by a trained observer. Similar nonsignificant observations occurred during PSD analysis. PDM observations contrast with previous work showing that neurological DCS resulted in a >50% reduction in both sympathetic and parasympathetic tone. Therefore, tracking dynamics of the parasympathetic tones via the PDM method may allow discrimination between CP DCS and neurological DCS, and this significant increase in parasympathetic tone has potential use as a marker for early diagnosis of CP DCS.

Effect of Mild, Asymptomatic Obstructive Sleep Apnea on Daytime Heart Rate Variability and Impedance Cardiography Measurements

Dysregulation of autonomic nervous system dynamics is important in the pathophysiology of cardiovascular risk in obstructive sleep apnea (OSA). Heart rate variability (HRV) and impedance cardiography measures can estimate autonomic activity but have not gained traction clinically. The hypothesis of this study was that even in a cohort of patients with mild, asymptomatic OSA without overt cardiovascular disease, daytime HRV metrics and impedance cardiography measurements of preejection period would demonstrate increased sympathetic and decreased parasympathetic modulation compared to matched controls. Obese subjects (body mass index ≥30 kg/m(2)) without any known cardiovascular or inflammatory co-morbidities were recruited from the community. Subjects underwent standard in-laboratory polysomnography followed by simultaneous electrocardiographic and impedance cardiographic recordings while supine, supine with paced breathing, and after standing. Seventy-four subjects were studied, and 59% had OSA (apnea-hypopnea index ≥10 events/hour), with a median apnea-hypopnea index of 25.8 events/hour. Subjects with OSA had significantly decreased daytime time- and frequency-domain HRV indexes, but not significantly different preejection periods, compared to controls. Apnea-hypopnea index was a significant independent predictor of time-domain HRV measures in all awake conditions, after controlling for age, gender, blood pressure, fasting cholesterol levels and glycosylated hemoglobin. In conclusion, these results demonstrate reductions in cardiac vagal modulation, as measured by multiple daytime time-domain markers of HRV, in patients with asymptomatic OSA compared to controls. Further prospective outcomes-based studies are needed to evaluate the applicability of these metrics for noninvasive screening of obese patients with asymptomatic OSA, before the onset of overt cardiovascular disease.

Mining Physiological Conditions from Heart Rate Variability Analysis

This article presents a successfully developed methodology for mining physiological conditions from heart rate variability (HRV) analysis. The application of HRV analysis in both research and clinical settings has seen rapid development in the past decades. Unlike previous research, this study employed features derived from longterm monitoring of HRV indices, as these trends can best reflect the autonomic nervous system dynamics influenced by various physiological conditions. We proposed two methods for mining physiological conditions from HRV trends: a decision-tree learning method and a hybrid learning method that combines feature selection, feature extraction, and classifier construction processes. The proposed methods have been validated through a clinical case study: severity classification for Parkinson's disease. Our approach yielded classification accuracy greater than 90.0%, and high sensitivity, specificity, positive predictive values (PPV), and negative predictive values (NPV).

Melatonin levels decrease in type 2 diabetic patients with cardiac autonomic neuropathy

The present study has been designed to determine melatonin levels in type 2 diabetic patients and test the relationship between the autonomic nervous system and melatonin dynamics. Thirty-six type 2 diabetic patients and 13 age-matched healthy subjects were recruited for the study. Circadian rhythm of melatonin secretion was assessed by measuring serum melatonin concentrations between 02:00-04:00 and 16:00-18:00 hr. Melatonin dynamics were re-evaluated with respect to autonomic nervous system in diabetic patients with autonomic neuropathy who were diagnosed by the cardiovascular reflex tests, heart rate variability (HRV), and 24-hr blood pressure monitoring. Nocturnal melatonin levels and the nocturnal melatonin surge were low in the diabetic group (P = 0.027 and 0.008 respectively). Patients with autonomic neuropathy revealed decreased melatonin levels both at night and during day when compared with healthy controls (P < 0.001 and 0.004 respectively) while the melatonin dynamics were similar to controls in patients without autonomic neuropathy. Nocturnal melatonin level was positively correlated with nocturnal high and low frequency components of HRV (P = 0.005 and 0.011 respectively) and systolic and diastolic blood pressures at night (P = 0.002 and 0.004 respectively) in patients with autonomic neuropathy. We found a negative correlation between nocturnal melatonin levels and the degree of systolic blood pressure decrease at night (r = -0.478, P = 0.045). As a conclusion this study has shown that circadian rhythm of melatonin secretion is blunted in type 2 diabetic patients and there is a complex relationship between various components of autonomic nervous system and melatonin secretion at night. Among the patients with autonomic neuropathy those with more preserved HRV and the systolic nondippers (<10% reduction in blood pressure during the night relative to daytime values) have more pronounced melatonin surge at night.

Existing and Training Induced Differences in Aerobic Fitness: Their Relationship to Physiological Response Patterns During Different Types of Stress

Aerobic fitness has been associated with various desirable psychological and physiological characteristics. Recently, attenuation of physiological reactivity during stressful situations was added to this list, although comparison of the stress responses of sportsmen and sedentary subjects has yielded equivocal results. The present study examined cardiovascular patterns rather than single variables, and tried to clarify these matters. Tasks were used that were known to increase blood pressure through different combinations of changes in cardiac output and vascular resistance. Autonomic nervous system dynamics underlying these response patterns were studied using preejection period as an index of beta-adrenergic activity, and respiratory sinus arrhythmia as an index of vagal activity. Pre-existing differences in aerobic fitness in a sample of sedentary subjects were related to their responses during the stressful tasks and the recovery periods afterwards. This approach prevented confounding of the relationship between fitness and stress-reactivity with the psychological effects of regular exercise. Furthermore, it excluded the bias in psychological makeup that is introduced when subjects spontaneously engaged in sports are compared to non-exercising persons. To rule out a third (hereditary?) factor underlying both stress-reactivity and fitness, physiological responses before and after a seven-week training program were compared to those of subjects in a waiting list control group. Substantial individual differences in aerobic fitness were found in spite of the fact that all subjects reported low levels of habitual activity. During two active coping tasks, diastolic blood pressure reactivity and vagal withdrawal were negatively related to these pre-existing differences in fitness. No such relation was seen during a cold pressor test or during recovery from the tasks. Neither beta-adrenergic cardiac reactivity nor heart rate responses were related to fitness, but the absolute heart rate during the tasks was lower in the more fit subjects. Seven weeks of training were not effective in changing either reactivity or recovery of any of the variables. The discrepancy between cross-sectional and longitudinal results in the present study suggests that training of longer duration is necessary to induce the psychological or physiological changes underlying reduced reactivity. The latter may include changes in cardiac vagal/sympathetic balance or in adrenoceptor sensitivity. Alternatively, both psychological and physiological determinants of stress-reactivity may be related to aerobic fitness at a dispositional level.