Autonomic Responses Research Articles

The effect of social anxiety on social attention in naturalistic situations

ABSTRACT Background and Objectives This multimodal two-phase study investigated the impact of trait social anxiety on exploration, social attention, and autonomic responses in a naturalistic setting. We expected higher avoidance of potentially crowded spaces, reduced visual attention on other people, and heightened physiological arousal in social situations for participants with higher social anxiety levels. Design and Methods Eighty-seven participants, pre-screened for high variance in trait social anxiety, first completed a half-hour walk on a freely chosen route and subsequently had a staged social interaction with a confederate consisting of a non-interactive waiting phase and a short conversation. Results While social anxiety did not modulate the choice of route during the walk phase, socially anxious participants avoided gazing at other individuals in non-interactive situations, i.e., during the walk and the waiting phase. In contrast, during actual interaction, they showed increased visual attention towards the confederate’s face. Across all experimental phases, highly socially anxious individuals showed elevated heart rates, but this effect was independent of the social context. Conclusions This study showed that social anxiety affects social exploration behavior not in a way of general avoidance, but rather in nuanced adaptations depending on the concrete situation, likelihood of interaction and associated socio-evaluative threat.

From the Laboratory to the Real-World: The Role of Mismatch Negativity in Psychosis.

Mismatch negativity (MMN) has gained attention as a biomarker for psychosis and a translational intermediate phenotype in animal models of psychosis, including rodents and non-human primates. MMN has been linked to global functioning (Global Assessment of Functioning [GAF] score) and prognosis (psychosis onset or remission), suggesting that MMN reflects activities beyond auditory processing alone. This review examines the 45-year history of MMN from the perspective of psychiatric researchers and discusses current advances in computational and translational research on MMN, summarizing the current understanding of the MMN generation mechanism. We then address the essential question, "What do we observe through MMN?" Currently, we regard the relationship between global functioning in the real world and MMN as the key to answering this question. As a preliminary investigation, we analyzed the relationship between GAF as an objective variable and MMN, diagnosis, and basic epidemiological factors (age, sex, premorbid intelligence quotient) as explanatory variables (total n = 201, healthy controls: n = 41, patients with psychiatric disorders: n = 160) without assuming diagnostic categories. The relationship between functional outcomes and MMN was confirmed without a case-control design. Finally, we propose that new neurophysiological studies should acknowledge psychophysiological responses such as emotion, intention, and autonomic responses, as well as behavioral differences among participants beyond the dichotomy between healthy controls and patients. Measurements could be conducted in various settings from the participant's perspective. We discuss the potential for research investigating psychosis based on the interaction between individuals and the environment, using MMN as an illustrative model.

A Comprehensive Investigation of Social Anxiety and Social Evaluative Stress in Autistic Children and Adolescents and Specific Learning Disorders.

The aim was to investigate trait social anxiety and social evaluative stress in autistic children and adolescents and Specific Learning Disorders (SLD). This was done by evaluating behavioral, subjective, and autonomic responses to the Trier Social Stress Test (TSST). Study 1 included 280 children and adolescents: 60 autistic without intellectual disability (ID), 70 SLD, and 150 non-diagnosed (ND) peers. Study 2 involved 55 participants: 15 autistic without ID, 15 SLD, and 20 ND. The sample was predominantly male. In Study 1, behavioral (quality of public speech) and subjective (valence, arousal, perceived competence, and worries) aspects of social stress were examined. Study 2 expands upon the first study, as physiological responses to social stress were also measured. Trait social anxiety was investigated using both parents' and children's reports in the two studies. Parents of autistic participants and with SLD reported higher trait social anxiety in their children than the parents of ND. No differences emerged from the participants' self-reports, though those autistic and with SLD were assigned lower scores in the public speech quality than ND. Autistic children and adolescents reported lower arousal and higher perceived competence than ND, while those with SLD reported a lower perception of competence. Autistic participants had a decreased cardiac reactivity across the TSST when compared to SLD and ND. Our findings show unique patterns of responses within each group, confirming that the combined investigation of trait anxiety and social stress responses could be a valuable insight in research and clinical practice.

Abnormal Autonomic Nervous Regulation in Patients with Globus Pharyngeus.

Globus pharyngeus could be described as a benign sensation of lump or foreign object in the throat. The etiology of the globus as a solitary syndrome is still unknown, but it is proposed that stress could have an important role in symptom emergence. To evaluate the autonomic nervous regulation in patients with globus compared to healthy controls in reaction to stress. Patients included in the study were diagnosed based on ROME IV criteria for Disorders of Gut Brain Interaction. Besides globus, the patients did not suffer any other substantial medical condition. As a control group, measurement of healthy volunteers was performed. Both groups underwent the same stress protocol assessment in the same laboratory settings. The protocol consist of two types of stressors: cold pressor test and mental arithmetic test to test different types of autonomic reactivity. Baroreflex sensitivity was significantly decreased in patients compared to controls in all phases of the protocol. Low-frequency band of systolic blood pressure variability was significantly increasedduring both stress phases in patients compared to controls. High-frequency band of heart rate variability was significantly decreased in patients compared to controls during the both of the stress phases. The results of this study shows discrete abnormalities in complex autonomic reflex control which are predominantly manifested in response to stressful stimuli indicating altered neurocardiac regulation as a reaction to stress associated with globus pharynegus. This fact could have an important role in the personalized management of globus patients such as biofeedback.

Autonomic response and attachment style in disruptive mood dysregulation disorder.

Disruptive mood dysregulation disorder (DMDD) is characterised by severe emotion regulation difficulties, particularly anger and irritability, in children. Despite the impact of attachment on emotional and behavioural regulation, the link between attachment style and DMDD is under-researched. This study investigated whether attachment style and parasympathetic regulation differentiate the response profiles to frustrating conditions between children diagnosed with DMDD and controls. Participants were assessed at schools in Johannesburg, Gauteng, South Africa. Thirty participants were divided into two matched groups (n DMDD = 15; n Control = 15) and assessed. Respiratory sinus arrhythmia (RSA) and heart period were measured during an Affective Posner Task, inducing frustration. Attachment style was assessed using the Attachment Style Classification Questionnaire for children. Parents of children with DMDD completed a social interaction problems questionnaire. The DMDD group showed a higher prevalence of avoidant attachment style (p = 0.013) compared to controls. Both groups displayed adaptive vagal withdrawal and recovery during the task (p = 0.005; p = 0.021). Controls had significantly higher heart period throughout the assessment (game 1: p = 0.006; game 2: p = 0.013; game 3: p = 0.007). In the DMDD group, lower vagal tone during frustration correlated with more social interaction problems (p = 0.049). The study demonstrates a potential link between attachment style and altered physiological state in children with DMDD. The findings provide insight into possible atypical vagal regulation of the heart and avoidant attachment styles in DMDD, highlighting potential therapeutic and intervention targets.

Atrial rates during treated ventricular tachycardia in patients with implantable cardioverter defibrillators: clinical implications of a vagal sinus node response

Abstract Introduction Autonomic tone plays an important role in the genesis and sustenance of ventricular tachycardia (VT). Whilst sympathetic hyperactivity is an established driver of ventricular arrhythmias, sinus node response during VT varies broadly between patients, and can be paradoxical. Purpose We hypothesized that device-detected changes in sinus node rate could be an important surrogate of the autonomic response to VT, and may exert significant – and potentially modifiable – haemodynamic consequences independent of ventricular activity. Methods Device electrograms were analysed from consecutive patients with dual chamber implantable cardioverter defibrillators (ICDs) requiring anti-tachycardia pacing (ATP) or defibrillation for sustained monomorphic VT. Atrial rates were measured before VT onset (‘baseline’) and again at the point of detection by the device. Sinus node response was characterized as ‘stable’ (atrial rate remained within 10% of baseline), ‘sympathetic’ (atrial rate increased >10%) or ‘vagal’ (atrial rate decreased >10%). Patients who did not maintain ventriculoatrial dissociation or who presented in atrial tachyarrhythmia were excluded. Symptoms and electrical response to ICD therapies were recorded. Results 172 treated episodes of VT were included from 97 patients (median age: 69 years, 65% male, 31% ischaemic cardiomyopathy, median ventricular rate: 205bpm, median ejection fraction: 30%). Sinus node response was stable in 55%, sympathetic in 24% and vagal in 21%. A vagal response was associated with ATP-refractory VT (OR: 2.2 (1.1-4.8) p=0.03) and, when adjusting for ventricular rate, was independently associated with symptoms of presyncope or syncope (adjusted OR: 6 (2.7-13.7), p<0.0001). Conclusions This preliminary analysis suggests that a vagal sinus node response during VT is associated with adverse outcomes in ICD patients. Vagolytic therapy has recently been demonstrated to improve haemodynamic tolerance during VT ablation; whether supportive atrial pacing during VT could mitigate symptoms and potentiate arrhythmia termination in ICD patients warrants further exploration. Figure 1: Change in sinus node rate during sustained monomorphic ventricular tachycardia in patients with dual chamber ICDs, stratified by the occurrence of presyncopal symptoms or syncopeFigure 1

Heart rate variability-based prediction of early cardiotoxicity in breast-cancer patients treated with anthracyclines and trastuzumab

Abstract Background Cardiotoxicity is a recognized complication in breast cancer (BC) patients undergoing chemotherapy with anthracyclines with or without trastuzumab. However, the prognostic value of heart rate variability (HRV) indexes for early cardiotoxicity development remains unknown. Purpose This study aimed to investigate cardiac autonomic responses to physiological stimuli in BC patients treated with anthracyclines with or without trastuzumab, and to evaluate the predictive value of transthoracic echocardiography (TTE) findings and HRV indexes for early cardiotoxicity. Methods A prospective cohort study involving 50 BC patients was conducted at a tertiary hospital with TTE assessments performed before and three months after chemotherapy. HRV indexes were obtained from continuous electrocardiograms in supine position with spontaneous breathing, active standing, and supine position with controlled breathing. The magnitude of change (Δ) between supine-standing and supine-controlled breathing was calculated. Variables were compared using t-test or ANOVA. Cardiotoxicity predictive value was assessed by ROC curve analysis. A p value of < 0.05 was considered significant. Results In our cohort, the mean age was 50 ± 8 years, and reported comorbidities included diabetes (n= 9), hypertension (n= 17), and dyslipidemia (n= 11). Twenty-three patients fulfilled echocardiographic and troponin cardiotoxicity criteria or both. TTE revealed reduced left atrial conduit strain in the cardiotoxicity group. Mean heart rate increased during all maneuvers at follow-up, with no differences in HRV indexes between patients with or without cardiotoxicity. However, a lower Δ in supine-controlled breathing of several HRV indexes predicted early cardiotoxicity identified by echocardiography (e.g. SDNN ≤ -8.44 ms: Sensitivity = 75%, Specificity = 69%). Conclusion BC patients treated with chemotherapy maintain cardiac autonomic responses to physiological stimuli after 3 months of chemotherapy. However, a lower Δ during active standing and controlled breathing before chemotherapy may predict early cardiotoxicity.Table 1.ROC curve analysisFigure 1.HRV-indexes

Autonomic nervous system responses to hypo- and hyperglycemia in type 2 diabetes and prediabetes.

Previous research points to a role of the brain in the regulation of glucose and pathogenesis of type 2 diabetes (T2D) via modulation of counter-regulatory hormone secretion and activity in the autonomic nervous system (ANS). The aim of this study was to investigate glucose-dependent responses of catecholamines and ANS activity in individuals with T2D, prediabetes (PD) and normoglycemia (NG). Cross-sectional. Individuals with T2D (n=19, 7 men, HbA1c 49 mmol/mol), prediabetes (PD, n=18, 8 men) and normoglycemia (NG, n=17, 3 men) underwent one stepwise hyperinsulinemic-euglycemic-hypoglycemic and one hyperglycemic clamp with repeated measurements of catecholamines, symptoms, heart rate variability (HRV) and hemodynamics. The hypoglycemic response of adrenaline was augmented in T2D and PD vs NG (both p<0.05) and there was a strong association with insulin resistance (p<0.05 for M-value). In relation to achieved glucose levels in both clamps, noradrenaline exhibited a steeper rise during hypoglycemia in T2D vs NG and PD (both p<0.05). There were trends toward more marked autonomic hypoglycemic symptoms in T2D vs PD and NG. By contrast, insulin resistance was associated with attenuated responses of heart rate and HRV-indices PLF and PHF at the target glucose plateau of 2.7 mmol/l (p<0.05), independent of BMI and HbA1c. Alterations in glucose-dependent responses of counter-regulatory hormones and the autonomic nervous system appear before, and probably contribute to, the onset of T2D. Together with other reported alterations in neuroendocrine pathways, the findings suggest that a maladaptation of the brain's responses to glucose fluctuations is important in T2D progression.

General anesthesia activates a central anxiolytic center in the BNST

Low doses of general anesthetics like ketamine and dexmedetomidine have anxiolytic properties independent of their sedative effects, but the underlying mechanisms remain unclear. We discovered a population of GABAergic neurons in the oval division of the bed nucleus of the stria terminalis that are activated by multiple anesthetics and the anxiolytic drug diazepam (ovBNSTGA). The majority of ovBNSTGA neurons express neurotensin receptor 1 (Ntsr1) and form circuits with brain regions known to regulate anxiety and stress responses. Optogenetic activation of ovBNSTGA or ovBNSTNtsr1 neurons significantly attenuated anxiety-like behaviors in both naive animals and mice with inflammatory pain, while inhibition of these cells elevated anxiety. Activation of these neurons decreased heart rate and increased heart rate variability, suggesting that they reduce anxiety by modulating autonomic responses. Our study identifies ovBNSTGA/ovBNSTNtsr1 neurons as a common neural substrate mediating the anxiolytic effect of low-dose anesthetics and a potential therapeutic target for treating anxiety-related disorders.

The role of gender in emotional reactions elicited by music: Autonomic reactivity, facial expression, and self-reports

Studies in the field of emotions have yielded mixed findings regarding differences between women’s and men’s emotional reactivity. In the majority, emotional scenes, facial expressions, and movies were used as stimuli. However, music has been less frequently used, despite its capacity to evoke strong emotional responses in the listeners. In this study, we aimed to explore the role of gender in emotional reactivity to music. A sample of 110 healthy participants (60 women) listened to 42 excerpts (14 pleasant, 14 neutral, 14 unpleasant) from the Film Music Stimulus Set (FMSS) for 8 s, while their autonomic reactivity and facial expression were continuously recorded. Participants then rated each excerpt on affective dimensions (hedonic valence, tension arousal, and energy arousal), discrete emotions (happiness, anger, fear, tenderness, and sadness), musical preference, and familiarity. Some differences were found between women’s and men’s reactivity to the stimuli, such that women showed a greater deceleration of heart rate while listening to both emotional (pleasant and unpleasant) and neutral music, and rated unpleasant excerpts as less preferred. Women also scored higher on trait anxiety compared to men. These results suggest that women may have heightened sensitivity to emotional stimuli, particularly unpleasant music, which could have implications for better understanding clinical pathologies that vary in prevalence based on gender.

Hypnotherapy Technique to Reduce Anxiety Levels in Elderly with Hypertension

Background: One of the non-pharmacological intervention that can be used is hypnotherapy. This intervention uses suggestions that will relax the client's condition so that the brain produces the hormones serotonin, endorpine, and activation of autonomic nerve responses. At the same time the neuroendocrine system will also lower levels of cortisol, glucocorticoids, gonadocorticoids, epinephrine, norepinephrine and will act directly on the alpha androgenic receptors of vascular smooth muscle, thus causing vasodilation of blood vessels, lowering total peripheral pressure and decreasing blood pressure, pulse, and breathing. Objectives: This study is to determine the effect of hypnotherapy techniques on reducing anxiety levels in elderly families with hypertension at RT 10/RW 05 Lenteng Agung, South Jakarta. Methods: This study employed a quantitative pre-experimental design with a one-group pre-test post-test approach to examine the effect of an intervention on anxiety levels in elderly individuals with hypertension. The study population consisted of 39 elderly individuals, with 15 participants meeting the inclusion criteria. Data were collected in 2023, and the sample was selected using total sampling, consisting of 9 women and 6 men. Participants were observed before and after the intervention to assess changes in anxiety levels. Results: This study showed that after being given hypnotherapy technique treatment, the majority experienced a decrease in anxiety levels, namely mild anxiety as many as 11 elderly (73.3%) and respondents who experienced moderate anxiety as many as 4 elderly (46.7%) Conclusion: The majority of elderly individuals with hypertension experienced severe anxiety before receiving hypnosis techniques. After the application of hypnosis, most experienced a reduction in anxiety to mild levels. This demonstrates that hypnosis techniques have a significant effect in reducing anxiety levels in elderly individuals with hypertension

INDICATORS OF OCULOMOTOR ACTIVITY AND CEREBRAL HEMODYNAMICS IN STUDENTS WITH DIFFERENT TYPES OF AUTONOMIC NERVOUS SYSTEM REACTIVITY IN COGNITIVE TASK PERFORMANCE

Background. The current stage of human development is characterized by high dynamics of knowledge accumulation, acceleration of social and technical development. The need to study psychophysiological characteristics of cognitive activity with time limitation increases under these conditions. Time limit can make activity more efficient or less effective. Purpose. To study indicators of oculomotor activity and cerebral hemodynamics of students with different types of autonomic nervous system reactivity during cognitive activity. Materials and methods. The study involved 110 students of the Northern (Arctic) Federal University named after M.V. Lomonosov took part in the study (average age of students 19.0±0.5 years). To identify specific features of ensuring cognitive activity in different time conditions, the type of reactivity of the autonomic nervous system (ANS) was determined in the subjects using the VNS-Spectrum computer complex (Neurosoft). Students performed cognitive tasks without and with time limits. At the same time, eye movements were recorded using the stationary binocular eye tracking system iView X™ RED, 500 Hz, and cerebral hemodynamic parameters were recorded using the Reo-Spectrum 2 hardware and software complex (Neurosoft). The efficiency of cognitive activity of the participants was also assessed. Statistical analysis was performed using the application package IBM SPSS Statistics 22.0. Results. Students with different types of reactivity of the autonomic nervous system had different effectiveness of cognitive activity without time limitation and with time limitation. Students with a sympathotonic type of autonomic reactivity had a higher result in processing visual information under time pressure. These students had more stable statistical relationships between the parameters of oculomotor activity and cerebral hemodynamics. Representatives with a vagotonic type of reactivity of the autonomic nervous system had the lowest rates of success in cognitive activity. These students showed less stable structure of statistical relationships between oculomotor activity and cerebral hemodynamics Conclusion. General and specific changes in cerebral hemodynamics and oculomotor activity, features of the effectiveness of cognitive activity under time constraints in young people with different types of autonomic nervous system reactivity were identified.

Negative auditory hallucinations are associated with increased activation of the defensive motivational system in schizophrenia

Auditory hallucinations (AH) are the most common symptom of psychosis. The voices people hear make comments that are benign or even encouraging, but most often voices are threatening and derogatory. Negative AH are often highly distressing and contribute to suicide risk and violent behavior. Biological mechanisms underlying the valence of voices (i.e., positive, negative, neutral) are not well delineated. In the current study, we examined whether AH voice valence was associated with increased activation of the Defensive Motivational System, as indexed by central and autonomic system response to unpleasant stimuli. Data were evaluated from two studies that used a common symptom rating instrument, the Psychotic Symptom Rating Scale (PSY-RATS), to measure AH valence. Participants included outpatients diagnosed with SZ. Tasks included: Study 1: Trier Social Stress Task while heart rate was recorded via electrocardiography (N = 27); Study 2: Passive Viewing Task while participants were exposed to pleasant, unpleasant, and neutral images from the International Affective Picture System (IAPS) library while eye movements, pupil dilation, and electroencephalography were recorded (N = 25). Results indicated that negative voice content was significantly associated with: 1) increased heart rate during an acute social stressor, 2) increased pupil dilation to unpleasant images, 3) higher neural reactivity to unpleasant images, and 4) a greater likelihood of having bottom-up attention drawn to unpleasant stimuli. Findings suggest that negative AH are associated with greater Defensive Motivational System activation in terms of central and autonomic nervous system response.

Physiological monitoring of movement and manoeuvrability during a military skiing exercise

IntroductionMilitary forces receive training in various high-altitude warfare techniques to safeguard border regions and lives. Skiing is one of such practices where research evidences are limited. Therefore, a study was...

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.

Visual Attention and Cardiac Response to Faces in Relation to Emotion Recognition

Abstract: Rapid and accurate emotion recognition is a crucial skill for social interactions, and visual attention to informative social cues in the environment can facilitate emotion recognition. Studies have found that emotion recognition is also associated with underlying cardiac autonomic responses. The current study examined (1) visual attention and cardiac response (change in heart rate) to emotionally-expressive faces and houses (as a nonsocial control image), and (2) associations between these responses and emotion recognition on the Reading the Mind in the Eyes Test (RMET) in college students. Results showed increased overall attention, but shorter first fixation durations, to faces as compared to houses. Across faces, attention was greater to eyes than mouth, but the magnitude of this difference was dependent on emotion. Analysis of cardiac responses revealed greater heart rate deceleration to happy and fearful faces as compared to neutral faces and houses. Better emotion recognition accuracy on the RMET was related to greater attention to faces, and eyes specifically, as well as greater heart rate deceleration to faces relative to houses. No relations between visual attention and cardiac response were found. The current work points to variations in visual attention and cardiac responses while viewing emotional faces that can be markers of emotion processing ability.

Acute cardiovascular responses of postmenopausal women to resistance training sessions differing in set configuration: A study protocol for a crossover trial.

Resistance training is hardly recommended for postmenopausal women to counteract negative effects of hormonal changes. However, some concern exists about the marked hemodynamic responses caused by high-load resistance exercises. In this regard, studies on young, healthy, physically active individuals suggest that set configuration can modulate acute cardiovascular, metabolic, and cardiac autonomic responses caused by resistance training sessions, but this has not yet been explored in postmenopausal women. A sample of 60 physically active postmenopausal women (30 normotensive, 30 hypertensive) will participate in this crossover study. After a medical exam, ergometry, familiarization session, and two testing sessions, participants will complete three experimental sessions and one control session in a randomized order. Each experimental session includes 36 repetitions of four exercises (horizontal leg press, bench press, prone leg curl, and lat pull-down) differing in set configuration: 9 sets of 4 repetitions (i.e., 33% intensity of effort) with 45 s of inter-set recovery, 6 sets of 6 repetitions (50% intensity of effort) with 72 s, and 4 sets of 9 repetitions (75% intensity of effort) with 120 s; with 4 min rest between exercises. Before and immediately after each session, arterial stiffness, hemodynamic variables, cardiac autonomic modulation, baroreflex sensitivity, sympathetic vasomotor tone, and resting oxygen uptake will be evaluated. Furthermore, perceived effort, mechanical performance (e.g., power, velocity), heart rate, and lactatemia will be collected throughout sessions. The impact of set configuration on these variables will be analyzed, along with comparisons between normotensive and hypertensive women. Cardiovascular responses to resistance exercise have been scarcely studied in females, particularly postmenopausal women. The results of this study will provide information about the modulating role of set structure on metabolic and cardiovascular responses of normotensive and hypertensive postmenopausal women to resistance training. NCT05544357 on 7 December 2022.

Photobiomodulation therapy on puncture-associated pain: A controlled randomized double-blind clinical trial.

Dental fear and phobia are prevalent worldwide, with local anesthesia being the most feared procedure. This study aimed to determine whether photobiomodulation therapy (PBMT), used as a pre-anesthetic, could modulate puncture pain and enhance the effectiveness of local anesthesia. In this controlled, randomized, double-blind study, 49 participants were divided into an experimental group (n = 24), which received infrared laser therapy (100 mW, at 808 nm, 8 J, 80 s at a single point) immediately before standard anesthesia; and control group (n = 25), which received the standard anesthetic technique and sham laser. Pain levels were measured using the visual analog scale, and anesthetic efficacy was assessed through electrical tests (latency), percentage of failures, and cartridge usage. Anxiety levels were evaluated using the Beck Anxiety Inventory. Cardiovascular parameters were evaluated through blood pressure, oxygen levels, and heart rate. This randomized, double-blind study found no difference between groups in these experimental conditions. The bias toward a positive PBMT result was sufficiently removed. Autonomic responses of the PBMT group were maintained stable during the procedure.

Heart rate recovery after the 6-min walk test in people with bronchiectasis

BackgroundThe cardiac autonomic response to exercise and during recovery has been poorly explored in bronchiectasis.MethodsA longitudinal study was conducted in adults with bronchiectasis. Sociodemograhic and clinical data were collected at baseline and after 12 months of follow-up. The heart rate recovery after the first (HRR1) and second minute (HRR2) of recovery in the six-minute walk test (6MWT) was estimated in both assessments. Adjusted regression models were used to identify predictors of a delayed HRR1(HRR1≤ 14).Results104 participants with a mean (sd) age of 64 (13) years and mostly woman (67%) were included. A delayed HRR1after the baseline 6MWT was identified in 36% of participants. These participants presented a higher proportion of males, increased body mass index, higher disease severity, more likely to required hospitalisation, more impact on quality of life, lower exercise capacity, lower HR at the end of the 6MWT and lower HRR2. Disease severity (ß, 95%CI) (moderate and severeversusmild, −0.47 (−0.94 to −0.01)) and distance walked (0.34 (0.11 to 0.56)) were the independent variables associated with HRR1. Of the 45 participants who completed the entire follow-up period, 24% exhibited delayed HRR1. The presence of at least two exacerbations during the follow-up period (OR, 95%CI) (16.89 (1.44 to 197.48)) was the only predictor of a delayed HRR1in the assessment completed at the end of the study.ConclusionHRR1is related to disease severity and mainly affected by having severe exacerbations in people with bronchiectasis.

Overgeneralization of autonomic defensive reactions in obesity

Generalizing defensive responses to new stimuli resembling learned threats is an adaptive process within an ever-changing environment. However, evaluation mechanisms excessively biased toward generalization (i.e., overgeneralization) may underlie anxiety-related symptoms. In the context of obesity, fear memory and fear generalization processes have never been investigated. In this study, participants with obesity and healthy participants as controls underwent a single-cue auditory fear conditioning paradigm and recognition memory tasks. We analyzed the autonomic reactions evoked by threat-predictive and new stimuli, as well as the recognition performance towards the same cues. We found that participants with obesity displayed similar autonomic defensive responses to a learned fearful stimulus, but enhanced reactions to new stimuli, when compared with the controls. We detected no significant differences between groups in recognition abilities. Our results provided the first evidence that obesity may widen fear generalization patterns. This alteration may encourage future research in investigating the link between emotional dysregulation and clinical anxiety-related symptoms in obesity.