Evaluation of autonomic nervous system by salivary alpha-amylase level and heart rate variability in patients with schizophrenia

Ieda, Masa; Miyaoka, Tsuyoshi; Wake, Rei; Liaury, Kristian; Tsuchie, Keiko; Fukushima, Michiyo; Araki, Toshimitsu; Ezoe, Satoko; Inagaki, Takuji; Horiguchi, Jun

doi:10.1007/s00406-013-0411-6

Cited by 39 publications

(43 citation statements)

References 40 publications

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“…Present findings limited to the assessment of salivary α-amylase to the time immediately after awakening and showing no drop of the enzyme after awakening in schizophrenic patients suggest enhanced activity of the sympathetic branch of the ANS in chronic schizophrenia. Consistent with our data, a Japanese research group recently reported increased levels of salivary α-amylase at one single time point in the morning in a sample of clinically stabilized chronic schizophrenic patients treated with both first- and second-generation antipsychotic drugs [36,37]. …”

Section: Discussionsupporting

confidence: 79%

“…Finally, it has been questioned whether chewing on the Salivette swabs would result in reliable salivary α-amylase levels [42]; hence, measuring the salivary flow rate in our participants would have helped to overcome these issues. Although we cannot exclude that our results were affected by psychotropic drug treatment, our study is comparable to other published studies that included antipsychotic-treated patients compared to nontreated healthy controls [26,27,28,29,36,37]. …”

Section: Discussionsupporting

confidence: 76%

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Investigation of the Endogenous Stress Response System in Patients with Chronic Schizophrenia

Monteleone¹,

Monteleone²,

Filippo³

et al. 2015

Neuropsychobiology

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Objective: Cardiophysiological and neuroendocrine studies suggest that the two components of the endogenous stress response system, the sympathetic nervous system (SNS) and the hypothalamic-pituitary-adrenal (HPA) axis, are dysregulated in patients with schizophrenia. However, cardiophysiological measures are influenced by several confounding factors and the secretion of α-amylase in saliva is believed to represent a more reliable index of SNS activity. Therefore, to characterize the functional status of the SNS and HPA axis in schizophrenia we explored the concomitant salivary secretion of cortisol and α-amylase. Methods: Saliva cortisol and α-amylase levels were measured after awakening in 30 patients with chronic schizophrenia and 22 healthy subjects. Results: After awakening, saliva cortisol increased in a similar way in both patients and healthy controls, while saliva α-amylase concentrations showed a clear-cut decrease in healthy subjects but not in patients with schizophrenia. No significant correlation emerged between biochemical measures and patients' demographic or psychopathological characteristics. Conclusions: These findings demonstrate normal activity of the HPA axis with an enhanced SNS tone, which suggests a functional dissociation of the two components of the endogenous stress response system in patients with chronic schizophrenia. The pathophysiological significance of such dysregulation needs further studies to be clarified.

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Section: Discussionsupporting

confidence: 79%

Section: Discussionsupporting

confidence: 76%

Investigation of the Endogenous Stress Response System in Patients with Chronic Schizophrenia

Monteleone¹,

Monteleone²,

Filippo³

et al. 2015

Neuropsychobiology

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“…The physiological mechanism by which anxiety affects autonomic nervous function, and especially sAA levels, remains unclear. Ieda et al [19] detected a significant increase in sAA levels in schizophrenia patients and speculated that the PNS was suppressed, whereas the SNS exhibited relatively high activity (according to HRV measurement). sAA has been suggested to be a surrogate for cardiovascular autonomic system balance correlating well with HRV parameters [27].…”

Section: Discussionmentioning

confidence: 99%

“…Thus, a total of one minute was required for measuring sAA activity. We previously used this methodology to analyze sAA in other studies [14] [18] [19]. To control for circadian variations in sAA, one-time saliva was conducted in the morning (10:00 -12:00 AM).…”

Section: Measurement Of Salivary Alpha-amylasementioning

confidence: 99%

Increase in Salivary Alpha-Amylase Levels among Non-Attending Junior High School Students Diagnosed with Social Anxiety Disorder

Inagaki¹,

Nagahama²,

Kawano³

et al. 2017

JBBS

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Purpose: Several studies have demonstrated that the measurement of salivary alpha-amylase (sAA) levels is a useful tool for evaluating the autonomic nervous system. Psychosocial stress increases the release of sAA as a useful marker for autonomic nervous system (ANS). To our knowledge, although some studies have evaluated sAA levels under psychosocial stress, no studies have investigated the changes in sAA activity that occur in junior high school students who are not attending school due to social anxiety disorder (SAD). We aimed to investigate the relationship between the sAA levels and psychiatric states of such patients. Methods: The study subjects consisted of SAD patients (n = 39) and healthy controls (n = 57). We used a portable hand-held monitor to measure the level of sAA and State-Trait Anxiety Index (STAI) to evaluate the psychiatric state. Results: The patients' sAA activity was significantly higher than that of the controls (n = 57) (p < 0.001). Significant differences in heart rate (HR) (76.10 ± 11.96 vs. 68.69 ± 10.61, respectively, p < 0.01) and STAI scores (both the STAI-State and STAI-Trait scores) (49.35 ± 10.57 vs. 41.24 ± 8.59, respectively, p < 0.01; 55.69 ± 10.44 vs. 45.61 ± 9.36, respectively, p < 0.001) were detected between the patients and healthy controls. Conclusions: These results indicated that junior high school students with SAD exhibit a higher state of anxiety and high autonomic activity, probably due to changes in the sympathetic nervous system. As a result, junior high school students with SAD are expected to exhibit high levels of sAA accompanied by anxiety symptoms.How to cite this paper:

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“…Albeit the authors found evidence that the CLOCK gene's association with clinical ADHD samples may be generalizable to traits measured in the general population, a mediating role of evening preference, however, could not be verified. Based on findings of a dysfunction of the autonomic nervous system (ANS) in schizophrenia patients, Ieda et al [7] used the marker salivary alpha-amylase (sAA) for ANS function to investigate this dysfunction by measuring sAA and heart rate variability of 25 schizophrenic patients compared with controls. The authors found a significant increase in sAA plus considerably lower parasympathetic nervous system activity in the heart rate variability in the patient sample but no significant group differences in sympathetic nervous system activity.…”

mentioning

confidence: 99%

Comorbidity, stigma and emotional perception in psychiatric disorders

Schmitt

Falkai

2013

Eur Arch Psychiatry Clin Neurosci

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Evaluation of autonomic nervous system by salivary alpha-amylase level and heart rate variability in patients with schizophrenia

Cited by 39 publications

References 40 publications

Investigation of the Endogenous Stress Response System in Patients with Chronic Schizophrenia

Investigation of the Endogenous Stress Response System in Patients with Chronic Schizophrenia

Increase in Salivary Alpha-Amylase Levels among Non-Attending Junior High School Students Diagnosed with Social Anxiety Disorder

Comorbidity, stigma and emotional perception in psychiatric disorders

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