Autonomic Nervous System Regulation Research Articles

Research progress on the improvement of cardiovascular diseases through the autonomic nervous system regulation of the NLRP3 inflammasome pathway.

Cardiovascular disease stands as a leading global cause of mortality. Nucleotide-binding Oligomerization Domain-like Receptor Protein 3 (NLRP3) inflammasome is widely acknowledged as pivotal factor in specific cardiovascular disease progression, such as myocardial infarction, heart failure. Recent investigations underscore a close interconnection between autonomic nervous system (ANS) dysfunction and cardiac inflammation. It has been substantiated that sympathetic nervous system activation and vagus nerve stimulation (VNS) assumes critical roles withinNLRP3 inflammasome pathway regulation, thereby contributing to the amelioration of cardiac injury and enhancement of prognosis in heart diseases. This article reviews the nexus between NLRP3 inflammasome and cardiovascular disorders, elucidating the modulatory functions of the sympathetic and vagus nerves within the ANS with regard to NLRP3 inflammasome. Furthermore, it delves into the potential therapeutic utility of NLRP3 inflammasome to be targeted by VNS. This review serves as a valuable reference for further exploration into the potential mechanisms underlying VNS in the modulation of NLRP3 inflammasome.

Unearthing Subtle Cognitive Variations: A Digital Screening Tool for Detecting and Monitoring Mild Cognitive Impairment

Early diagnosis of mild cognitive impairment (MCI) is pivotal in mitigating the risk of cognitive impairment and the onset of dementia. However, prevailing clinical cognitive screening tests and biomarker assessment approaches often suffer from drawbacks such as high cost, invasiveness, time consumption, or subjectivity. In China, existing digital cognitive assessment tools face multiple challenges due to their distinctive cultural, language, and healthcare landscape. Therefore, we embarked on a study to develop a digital cognitive assessment tool, evaluate its efficacy in distinguishing between healthy individuals and MCI patients, and examine its acceptability among Chinese older adults. Through a series of symposiums, programming, and interviews with stakeholders, we iteratively designed the "BrainNursing" mobile application. The system consists of eleven single tasks and three dual tasks, each taking only 1–3 minutes. Subsequently, we conducted statistical comparisons of movement kinetics and physiological signals recorded during cognitive testing in 181 older adults to investigate which parameters could serve as effective digital biomarkers for MCI screening. Leveraging machine learning classifiers and a majority voting principle, we evaluated the classification performance of the BrainNursing system in detecting MCI, yielding an accuracy rate of 90.3%. Furthermore, our analysis of movement kinetics revealed that time, score, and sequence features are crucial in cognitive assessment. Contrasting with their healthy counterparts, MCI patients exhibited decreased heart rate variability, increased sympathetic nervous system activity, and weakened autonomic nervous system regulation in response to stimuli during cognitive testing. Finally, user experience feedback indicated that participants universally perceived BrainNursing as a convenient and user-friendly cognitive screening tool and provided valuable insights for further improvement.

Taniec na manifestacjach ulicznych jako forma regulacji autonomicznego układu nerwowego oraz sposób wyrażania emocji

The subject of this article is dancing at protests as a form of autonomic nervous system regulation and a way of expressing emotions. Selected results of a survey and interview conducted among people (n=42) dancing at the Women’s Strike demonstration in Warsaw on March 8, 2021 are presented. The protest described was one of many against the October 22, 2020 Constitutional Court ruling declaring abortion for severe fetal defect unconstitutional. In addition to discussing the results of the survey, the article also evaluates the content of respondents’ answers using research tools in the form of S.W. Porges’ polyvagal theory and the regulation zones developed from it by a group of researchers, including D.J. Siegel, as well as the concept of regulating emotions through movement. Dancing at a protest constitutes a zone of regulation, thanks to the activation of the social engagement system in the dancers. It provides protest participants with the opportunity for both self-regulation and co-regulation, producing a sense of safety. It leads to building social resilience, and by establishing a relationship with the body, it is also a way of expressing emotions. Furthermore, it has a community-building function, integrating those who dance and creating a social bond. Key-words: autonomic nervous system, vagus nerve, emotion regulation through movement, regulation zones, dancing at street protests, polyvagal theory, social engagement

Exposure to prenatal stressors and infant autonomic nervous system regulation of stress.

The purpose of this study was to determine the relationship between fetal exposure to maternal prenatal stressors and infant parasympathetic (PNS) and sympathetic (SNS) nervous function at 3 timepoints across the first year of life. Autonomic nervous system impairments may mediate associations between gestational exposure to stressors and later infant health problems. Heart rate variability (HRV) provides a sensitive index of PNS and SNS function. However, no studies have assessed longitudinal associations between prenatal stressors and infant HRV measures of both PNS and SNS over the first year of life. During the third trimester of pregnancy, 233 women completed measures of life stressors and depression. At 1, 6 and 12 months of age, a stressor protocol was administered while infant electrocardiographic (ECG) data were collected from a baseline through a post-stressor period. HRV measures of PNS and SNS activity (HF, LF, LF/HF ratio) were generated from ECG data. We used multilevel regression to examine the aims, adjusting for maternal depression and neonatal morbidity. There were no associations between prenatal stressors and any baseline or reactivity HRV metric over the infant's first year of life. However, exposure to more stressors was associated with lower post-stressor LF HRV at both 6 (β = -.44, p = .001) and 12 (β = -.37, p = .005) months of age. Findings suggest potential alterations in development of the vagally mediated baroreflex function as a result of exposure to prenatal stressors, with implications for the infants' ability to generate a resilient recovery in response to stressors.

The short-term effect of Blood Pressure Reduction after Biofeedback in Malignant Hypertension: A case report

Objectives: The purpose of this study was to report the short-term blood pressure-lowering effects observed in a patient with malignant hypertension through slow breathing maneuver with heart rate variability(HRV) biofeedback.Methods: Biofeedback sessions, totaling 13, each lasting 10 minutes, were administered. Blood pressure was measured pre and post-treatment, as well as thrice daily at 10 am, 4 pm, and 8 pm. Systolic blood pressure(SBP), diastolic blood pressure(DBP), and pulse rate were recorded for comparative analysis.Results: Before biofeedback, the average SBP, DBP, and pulse rate were 227.2±18.3, 135.2±11.0, and 104.4±5.3, respectively. Immediately post-biofeedback, these values changed to 213.7±15.2, 126.9±8.5, and 99.2±3.6. However, sustained long-term blood pressure reduction was not observed.Conclusions: The findings suggest that biofeedback therapy induces a short-term reduction in blood pressure in cases of malignant hypertension, potentially associated with autonomic nervous system regulation. Integrating biofeedback with other Korean medicine treatments, such as acupuncture or moxibustion, may offer a comprehensive approach for managing malignant hypertension.

Особливості прояву психоемоційного стану висококваліфікованих борців із урахуванням статевого диморфізму

Purpose: the manifestation of psycho-emotional state in elite wrestlers with taking into account of sexually dimorphism. Material and methods. 24 elite females athletes and 33 elite males athletes specializing in freestyle wrestling were examined. All athletes were members of the Ukrainian National Team. Mental states were studied using the Luscher test. Stress resistance was studied using the «Stress test» method. All tests used, including the hardware-software complex «Multipsychometr-05». Results: based on the analysis of scientific and methodological literature, it was determined that modern sports wrestling is characterized by a high level of physical and psycho-emotional stress of the athlete in the conditions of competitive activity, and the study of the psycho-emotional state is an important issue for building a training system. The presence of sexual dimorphism with the manifestation of a psycho-emotional state in elite wrestlers has been established. It has been found that due to mental anxiety, male wrestlers have higher values of mental fatigue and internal discomfort compared to female wrestlers. This fact indicates a connection between anxiety as a pre-stress condition that causes fatigue and mental discomfort. At the same time, a higher level of stress resistance was found in men compared to women. The results indicate that a higher level of stress resistance in men is due to a slower impulsivity. In women, a decrease in stress resistance is compensated by an increase in impulsivity. The presence of lower absolute values of the vegetative coefficient in women compared to men was revealed, which indicates a reduced level of tension of vegetative regulation, and, above all, activation of the sympathetic link of the autonomic nervous system. Conclusions. The presence of sexual dimorphism in the manifestation of the psychoemotional state among highly skilled wrestlers has been established. It was found that the presence of mental fatigue and anxiety in male wrestlers leads to emotional discomfort. A higher level of stress resistance was found in male wrestlers compared to female wrestlers. Stress resistance is formed in women by adaptive behavior, tension of the autonomic nervous system regulation and the balance of emotions. In men, stress resistance is ensured by mental focus. Keywords: wrestling, highly skilled, sexual dimorphism, psycho-emotional state, stress resistance.

The Role of Central Oxytocin in Autonomic Regulation.

Oxytocin (OXT), a neuropeptide originating from the hypothalamus and traditionally associated with peripheral functions in parturition and lactation, has emerged as a pivotal player in the central regulation of the autonomic nervous system (ANS). This comprehensive ANS, comprising sympathetic, parasympathetic, and enteric components, intricately combines sympathetic and parasympathetic influences to provide unified control. The central oversight of sympathetic and parasympathetic outputs involves a network of interconnected regions spanning the neuroaxis, playing a pivotal role in the real-time regulation of visceral function, homeostasis, and adaptation to challenges. This review unveils the significant involvement of the central OXT system in modulating autonomic functions, shedding light on diverse subpopulations of OXT neurons within the paraventricular nucleus of the hypothalamus and their intricate projections. The narrative progresses from the basics of central ANS regulation to a detailed discussion of the central controls of sympathetic and parasympathetic outflows. The subsequent segment focuses specifically on the central OXT system, providing a foundation for exploring the central role of OXT in ANS regulation. This review synthesizes current knowledge, paving the way for future research endeavors to unravel the full scope of autonomic control and understand multifaceted impact of OXT on physiological outcomes.

Development of wearable pulsed electromagnetic field device and its application to autonomous nervous system regulation

Development of wearable pulsed electromagnetic field device and its application to autonomous nervous system regulation

Profiling Novel Quinuclidine-Based Derivatives as Potential Anticholinesterase Drugs: Enzyme Inhibition and Effects on Cell Viability.

The cholinergic system, relying on the neurotransmitter acetylcholine (ACh), plays a significant role in muscle contraction, cognition, and autonomic nervous system regulation. The enzymes acetylcholinesterase, AChE, and butyrylcholinesterase, BChE, responsible for hydrolyzing ACh, can fine-tune the cholinergic system's activity and are, therefore, excellent pharmacological targets to address a range of medical conditions. We designed, synthesized, and profiled 14 N-alkyl quaternary quinuclidines as inhibitors of human AChE and BChE and analyzed their impact on cell viability to assess their safety in the context of application as potential therapeutics. Our results showed that all of the 14 tested quinuclidines inhibited both AChE and BChE in the micromolar range (Ki = 0.26 - 156.2 μM). The highest inhibition potency was observed for two bisquaternary derivatives, 7 (1,1'-(decano)bis(3-hydroxyquinuclidinium bromide)) and 14 (1,1'-(decano)bis(3-hydroxyiminoquinuclidinium bromide)). The cytotoxic effect within 7-200 μM was observed only for monoquaternary quinuclidine derivatives, especially those with the C12-C16 alkyl chain. Further analysis revealed a time-independent mechanism of action, significant LDH release, and a decrease in the cells' mitochondrial membrane potential. Taking all results into consideration, we can confirm that a quinuclidine core presents a good scaffold for cholinesterase binding and that two bisquaternary quinuclidine derivatives could be considered as candidates worth further investigations as drugs acting in the cholinergic system. On the other hand, specific cell-related effects probably triggered by the free long alkyl chain in monoquaternary quinuclidine derivatives should not be neglected in future N-alkyl quaternary quinuclidine derivative structure refinements. Such an effect and their potential to interact with other specific targets, as indicated by a pharmacophore model, open up a new perspective for future investigations of these compounds' scaffold in the treatment of specific conditions and diseases other than cholinergic system-linked disorders.

COMPARATIVE CHARACTERISTICS OF AUTONOMIC IMBALANCE DIAGNOSTIC METHODS IN SCHOOL-AGE CHILDREN

Introduction. An imbalance in the autonomic nervous system regulation, known as dysautonomia, is one of the most common clinical syndromes that accompany several diseases. The balance between sympathetic and parasympathetic influences on the body can rapidly change during dynamic processes, especially in cases of infectious and acute diseases, where autonomic regulation plays an active role in shaping the immune response. In children with respiratory diseases, the influence of the vagus nerve (n.vagus) on the frequency and depth of breathing is also important but remains relatively understudied. Assessment of vegetative balance in pediatrics is carried out using various methods depending on the child's age and condition, with commonly used approaches including questionnaires, calculation of the Kerdo autonomic index, and orthostatic testing.
 The aim. To compare the diagnostic capabilities of different methods for assessment of the autonomic nervous system state in school-age children on the model of acute bronchitis.
 Materials and methods. The paper presents data from a study that assessed the state of the autonomic nervous system in 52 school-age children (12-16 years old) divided into two groups: 30 children with acute bronchitis in the convalescent period and 22 clinically healthy individuals. Three different methods were used: the A.M. Wayne scale, the Kerdo index, and the orthostatic test.
 Results. The survey based on Wayne's questionnaire did not reveal a significant difference between the groups of healthy children and those affected by bronchitis. Dynamic tests proved to be more suitable for assessing acute pathology, such as Kerdo's autonomic index and the orthostatic test. The autonomic Kerdo index in children with bronchitis was significantly higher (14.2±2.38 points) than in healthy children (6.4±3.18 points, p<0.05). In children with acute bronchitis, dysautonomia with a predominance of sympathicotonia was recorded, which may be attributed to insufficient vagal innervation and a decrease in parasympathetic influence on the formation of an adequate immune response to the inflammatory process in the respiratory tract.
 Conclusions. Determining the autonomic Kerdo index and conducting the orthostatic test is suitable for diagnosing dysautonomia in children with acute respiratory pathology. These tests are dynamic, functionally based, and easy to perform and evaluate.

Anthracycline's Effects on Heart Rate Variability in Children with Acute Lymphoblastic Leukemia: Early Toxicity Signs-Pilot Study.

Anthracycline treatments are known to cause cardiotoxic long-term side effects in cancer survivors. Recently, a decrease in heart rate variability (HRV) has been identified in these patients, signaling autonomic dysfunction and altered cardiac fitness. This study aimed at evaluating changes in HRV in children treated with anthracyclines. A total of 35 pediatric patients with acute lymphoblastic leukemia were evaluated by means of a 24 h Holter ECG, at baseline and after reaching half the total cumulative dose of doxorubicin equivalent (120 mg/m2). Parameters of HRV were assessed, as well as any arrhythmic episodes, bradycardia and tachycardia percentages. The results showed a significant decrease in both time-domain and frequency-domain HRV parameters, following anthracycline treatment. The low-frequency (LF) to high-frequency (HF) parameters' ratio also displayed a significant difference (p = 0.035), suggestive of early cardiac autonomic dysfunction. Of note, none of the patients presented symptoms of heart disease or elevated troponins, and only two patients presented echocardiographic signs of diastolic dysfunction. The present study showed that cardiac autonomic nervous system regulation is compromised in children treated with anthracyclines even before reaching the total cumulative dose. Therefore, HRV parameters could be the first indicators of subclinical cardiac toxicity, making Holter ECG monitoring of the oncological patient a necessity.

Sex Differences in Autonomic Blood Pressure Regulation: Sex Chromosome Complement and Hormonal Involvement

Although several lines of evidence from different studies highlight sex differences in cardiovascular diseases, to date, most studies have been focused on males, with the idea that males and females are similar, differing only in the magnitude of the response. However, the principles learned in male models cannot and should not be extrapolated to women and, therefore, it is important to study in greater detail not only the differences between the sexes but also the physiological intertwining of the underlying genetic and hormonal mechanisms of sexual dimorphism. This review explores the sex disparities in the autonomic nervous system regulation of blood pressure (particularly baroreceptor function), with special emphasis on sex hormones and sex chromosome complement factors involved in sexually dimorphic autonomic blood pressure regulation. A more detailed understanding of the sources of physiological disparities between the sexes may also help in understanding the differences between the sexes in rates of cardiovascular disease and may also aid in designing future improvements for sex-tailored therapeutic treatments.

Autonomic nervous system and postural control regulation during orthostatic test as putative markers of physical resilience among community-dwelling older adults

IntroductionWe examined whether autonomic nervous system (ANS) and postural control regulation during orthostatic test reflect physical resilience by studying their associations with maximal walking speed and mortality. MethodsThe participants were community-dwelling Finnish men (n = 303) and women (n = 386) aged 75, 80, and 85 years at baseline. Systolic and diastolic blood pressure (BP), heart rate, heart rate variability (HRV), respiratory rate, and postural sway were obtained using a digital sphygmomanometer, a single-channel ECG, and thigh- and chest-worn accelerometers. Linear and Cox regression models were used to estimate the associations of the physiological indices with maximal 10-m walking speed and 5-year mortality separately for sexes. ResultsBetter maintenance of BP under orthostatic stress was associated with faster walking speed in women and lower mortality hazard in men. Greater HRV in terms of low frequency power and lower respiration rate in supine position and smaller orthostatic changes in these were associated with faster walking speed especially in women. Less postural sway after standing up was associated with faster walking speed in women (−0.057, SE 0.022, p = 0.011) and more postural sway with increased mortality hazard in men (HR 1.71, 95 % CI 1.20–2.43) even after controlling for BP responses. ConclusionsIn addition to ANS regulation at rest and under stress, adaptation of postural control system to orthostasis may be used in quantifying older adults' physical resilience. Wearable sensors capturing stimulus-response patterns and natural fluctuations of body functions may provide opportunities to monitor and incorporate different subsystems' resilience also in free-living conditions.

Lifetide biofeedback intervention in type 2 diabetic patients: a pilot observation

To evaluate the therapeutic efficacy of lifetide biofeedback intervention in patients with type 2 diabetes mellitus (T2DM). We analyzed the changes in average blood glucose, estimated glycosylated hemoglobin (HbA1c), fasting blood glucose and HbA1c levels in 5 patients with T2DM undergoing lifetide biofeedback intervention without the use of hypoglycemic drugs. A transient blood glucose monitoring system was used for drug withdrawal management during the intervention. Compared with those before the intervention, the average blood glucose and fasting blood glucose and HbA1c levels showed no significant changes after the intervention without using hypoglycemic drugs (P>0.05), but the estimated HbA1c was significantly decreased after the intervention (P<0.05). Two patients achieved complete remission, two showed partial remission, and one had substantially improved blood glucose levels. One patient showed a marked increase in extremity temperature after the intervention (P<0.05). Another patient had a significantly increased heart rate variability index (P<0.05) without obvious changes in heart rate after the intervention (P>0.05). By reestablishing the balance in autonomic nervous system regulation and enhancing peripheral microcirculation, lifetide biofeedback intervention helps to maintain stable blood glucose levels, achieve disease remission, and reduce the occurrence of complications in T2DM patients after discontinuation of hypoglycemic drugs without changing their lifestyles.

Impact of low-level prenatal alcohol exposure and maternal stress on autonomic regulation.

Prenatal alcohol exposure (PAE) impacts the neurodevelopment of the fetus, including the infant's ability to self-regulate. Heart rate variability (HRV), that is, the beat-to-beat variability in heart rate, is a non-invasive measurement that can indicate autonomic nervous system (ANS) function/dysfunction. The study consisted of a subset of our ENRICH-2 cohort: 80 participants (32 PAE and 48 Controls) who had completed three visits during pregnancy. The participants completed a comprehensive assessment of PAE and other substances throughout pregnancy and assessments for stress, anxiety, and depression in the third trimester. At 24 h of age, infant HRV was assessed in the hospital during the clinically indicated heel lance; 3- to 5-min HRV epochs were obtained during baseline, heel lancing, and recovery episodes. Parameters of HRV differed in infants with PAE compared to Controls during the recovery phase of the heel lance (respiratory sinus arrhythmia (RSA) and high-frequency (HF), p < 0.05). Increased maternal stress was also strongly associated with abnormalities in RSA, HF, and low-frequency / high-frequency (LF/HF, p's < 0.05). Alterations in ANS regulation associated with PAE and maternal stress may reflect abnormal development of the hypothalamic-pituitary-adrenal axis and have long term implications for infant responsiveness and self-regulation. Previous studies have focused on effects of moderate to heavy prenatal alcohol exposure (PAE) on autonomic dysregulation, but little is known about the effects of lower levels of PAE on infant self-regulation and heart rate variability (HRV). Prenatal stress is another risk factor for autonomic dysregulation. Mild PAE impacts infant self-regulation, which can be assessed using HRV. However, the effect of prenatal stress is stronger than that of mild PAE or other mental health variables on autonomic dysregulation.

Mindfulness-Based Intervention Effect on the Psychophysiological Marker of Self-Regulation in Women With Endometriosis-Related Chronic Pain

Endometriosis is a gynecological disease that involves a broad biopsychosocial compromise with the potential to create a negative vicious cycle. Despite the complexity of factors influencing women's improvement, most interventions investigated target just the peripheral nociceptive sources of endometriosis-related pain. An alternative is intervening in self-regulation, which can potentially influence multiple domains of the illness experience. The present study examines the effect of a brief Mindfulness-Based Intervention (bMBI) on attention and autonomic nervous system regulation in women with endometriosis-related pain. Also, explore the interaction between these self-regulation domains and the affective pain dimension. An exploratory analysis of the secondary outcomes of a pilot randomized controlled trial was performed. The vagally-mediated Heart Rate Variability (vmHRV) at rest, cognitive stress, and recovery was employed to measure autonomic regulation. The Flanker and Stroop tasks were used to estimate the attention domains. Results showed that bMBI (n = 26) significantly improved Flanker accuracy and Flanker and Stroop reaction time compared to the control group (n = 28). bMBI significantly increased vmHRV at rest and recovery after cognitive stress. Attention mediated the bMBI effect on affective pain improvement. Results suggest that bMBI improves self-regulation domains with the potential to develop a broad biopsychosocial benefit in the endometriosis context. PerspectiveThis article demonstrates the positive impact of a brief Mindfulness-Based Intervention on attention and parasympathetic regulation in women suffering from endometriosis-related pain. This mindfulness-induced self-regulation improvement can benefit affective pain and potentially multiple psychophysiological processes relevant to endometriosis.

Unraveling the mystery of Takutsubo cardiomyopathy: a descendant of COVID-19 heart syndrome

Takutsubo, or stress cardiomyopathy (TCM) is one of the important cardiovascular disorders encountered during the COVID-19 pandemic. We performed a PubMed search of relevant articles and presented this review which included epidemiology, etiopathogenesis, diagnosis and treatment of this clinical disorder. Takutsubo is usually more common in women than men. COVID-19 infection or vaccination can incite severe emotional disorders such as anxiety and depression, which flames up impaired neural networks in the limbic system. This stirs up disorganized regulation of autonomic nervous system with predominance and excessive firing of sympathetic nervous system to the ventricular myocardium. Moreover, direct invasion and systemic effects of COVID-19 infection including hormonal influences, autoimmunity, cytokine storm and neighboring infections might also play a significant role in the manifestation of this disorder. It commonly presents signs and symptoms of left ventricular dysfunction. Although most cases are undergoing remission within a few weeks, complications such as LV outflow tract obstruction, thromboembolism and arrhythmias were also reported. Since clinical symptoms are non-specific, a high degree of clinical suspicion is warranted particularly with the co-existing COVID-19 infections. Clinicians often leaned upon battery of tests including ECG, echocardiography and CMR to rule out myocarditis and coronary artery disease. Supportive management including treatment of heart failure and any associated arrhythmias and thromboembolism. Recurrences are common, but the treatment of underlying psychiatric disorders, including relaxation techniques, is the key strategy to avoid future occurrences.

628-P: Symptoms of Autonomic Nervous System Dysregulation and Diabetes Distress in T2D Adults

Purpose: To test the association of autonomic nervous system (ANS) dysregulation symptoms and diabetes distress (DD) in adults with type 2 diabetes (T2D). US adults (n=299) with self-identified type 2 diabetes completed a web-based survey in October 2022, including demographics, ANS reactivity symptoms (Body Perception Questionnaire; BPQ), diabetes-related distress (Diabetes Distress Scale-17; DDS-17), depressive symptoms (PHQ-8) and anxiety (GAD-7). Mean age was 60.2 years (S.D. = 13.6), 58.7% female, 82.9% White, with a median annual household income of $40,000-$60,000. Mean self-reported A1c was 7.0% (S.D. 1.2%). Self-reported medications: oral hypoglycemic agents (51.8%), oral medications and injectable insulin or other medications (26.7%), and diet and exercise alone (8.4%). Mean glucose checks was 1.5 times/day (S.D. = 4.9). The sample reported high levels of comorbid hypertension (65.4%), dyslipidemia (55.8%), sleep apnea (33.9%) and depression (36.2%). Mean DDS-17 score was 2.3 (S.D. 1.0; moderate severity). The highest scores were observed in the emotional burden (mean = 2.6; S.D. 1.3) and regimen-related distress (mean = 2.7; S.D. 1.2) subscales. Mean PHQ-8 score was 6.7 (S.D. = 6.0; mild) and the mean GAD-7 score was 4.74 (S.D. 5.6, mild). BPQ mean T scores were 49.9 (S.D. 9.4) for Supradiaphragmatic and 52.0 (S.D. 8.8) for Subdiaphragmatic Reactivity subscales. Positive correlations between the DDS-17 and BPQ subscales (range: r=0.53-0.58, all p’s&amp;lt;.05) were observed. Controlling for covariates, significant differences in BPQ subscale T scores were observed across clinical severity levels of the DDS on all subscales, with the highest BPQ scores observed in the ‘high’ distress DDS category compared to ‘no/mild distress’ (p’s &amp;lt; 0.05). Findings confirm a relationship between ANS reactivity symptoms and diabetes-related distress, consistent with the Polyvagal Theory. Development of interventions that target ANS regulation to treat DD for T2D adults are needed. Disclosure M.De groot: Consultant; Barbara Kenner Family Foundation, Medscape, Mediflix, Inc. B.A.Myers: None. T.Stump: None. D.Dana: None. J.Kolacz: None. S.W.Porges: None.

Cardiac Rhythms and Variation in Hibernating Arctic Ground Squirrels.

AbstractThe dramatic decrease in heart rate (HR) during entrance into hibernation is not a mere response to the lowering of core body temperature (Tb) but a highly regulated fall, as the decrease in HR precedes the drop in Tb. This regulated fall in HR is thought to be mediated by increased cardiac parasympathetic activity. Conversely, the sympathetic nervous system is thought to drive the increase of HR during arousal. Despite this general understanding, we lack temporal information on cardiac parasympathetic regulation throughout a complete hibernation bout. The goal of this study was to fill this gap in knowledge by using Arctic ground squirrels implanted with electrocardiogram/temperature telemetry transmitters. Short-term HR variability (root mean square of successive differences [RMSSD]), an indirect measure of cardiac parasympathetic regulation, was calculated in 11 Arctic ground squirrels. RMSSD, normalized as RMSSD/RR interval (RRI), increased fourfold during early entrance (from to , ). RMSSD/RRI peaked after HR dropped by over 90% and Tb fell by 70%. Late entrance was delineated by a decline in RMSSD/RRI while Tb continued to decrease. During arousal, HR started to increase 2 h before Tb, with a concurrent decrease in RMSSD/RRI to a new minimum. As Tb increased to a maximum during interbout arousal, HR declined, and RMSSD/RRI increased. These data suggest that activation of the parasympathetic nervous system initiates and regulates the HR decrease during entrance into hibernation and that withdrawal of parasympathetic activation initiates arousal. We conclude that cardiac parasympathetic regulation persists throughout all phases of a hibernation bout-a feature of the autonomic nervous system's regulation of hibernation that was not appreciated previously.

Embodying Consciousness through Interoception and a Balanced Time Perspective

This review presents current research and scientific knowledge in body mind sciences through the lens of interoception, as a representative of the body; and time perspective, as the representative of the mind. This intertwining dichotomy has been a subject of discourse in many fields, all having the common denominator of consciousness. Our aim is to expand on the congruities of these seemingly deconstructed worlds-of science and philosophy, of the body and the mind, to show that the place of consciousness lies in the zone between these two. Being aware of the body in the present moment. We introduce interoception and time perspective, focusing on how interoceptive signals are depicted in autonomic nervous system (ANS) regulation, and how this relates to the concept of a balanced time perspective (BTP), a highly adaptive psychological characteristic. Time perspective and interoception are also reviewed in the case of clinical conditions. We assess findings on interoceptive pathways in the body, finding convergence with balanced time perspective through the neuroanatomical lens. We conclude with findings that both dysregulated interoceptive states and a time perspective disbalance are recognized as defining features of mental disorders, proposing prospective practical therapeutic approaches, as well as implications for further research in the field.