Features of autonomic cardiovascular control during cognition in major depressive disorder

Bair, Angela; Marksteiner, Josef; Falch, Reingard; Paso, Gustavo A. Reyes del; Duschek, Stefan

doi:10.1111/psyp.13628

Cited by 16 publications

(14 citation statements)

References 100 publications

(173 reference statements)

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“…The findings are also consistent with the proposed connection between activity of the cardiac baroreflex and general cerebral inhibition (Duschek, Werner, et al, 2013). In addition to observations in pain studies, this is supported by negative correlations between cardiac BRS and cognitive performance (Bair et al, 2020;Reyes del Paso et al, 2009;Yasumasu et al, 2006), amplitudes of event-related EEG potentials (Duschek, Wörsching, et al, 2013), and spontaneous EEG oscillations (Duschek et al, 2015). Regarding the vasomotor and myocardial branches of the reflex, it is also noteworthy that low vBRS and mBRS (PEP), as observed in FMS patients, are associated with low sympathetic vascular and myocardial outflow (Reyes del Paso et al, 2017).…”

Section: Discussionsupporting

confidence: 88%

“…Regarding the vasomotor and myocardial branches of the reflex, it is also noteworthy that low vBRS and mBRS (PEP), as observed in FMS patients, are associated with low sympathetic vascular and myocardial outflow (Reyes del Paso et al., 2017). In turn, cardiovascular sympathetic hypoactivity is related to an adversely affected emotional state and symptoms of depression (Bair et al., 2020; Duschek et al., 2017; Yu et al., 2008).…”

Section: Discussionmentioning

confidence: 99%

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The cardiac, vasomotor, and myocardial branches of the baroreflex in fibromyalgia: Associations with pain, affective impairments, sleep problems, and fatigue

et al. 2021

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This study investigated the cardiac, vasomotor, and myocardial branches of the baroreflex in fibromyalgia using the spontaneous sequence method. Systolic blood pressure (SBP), interbeat interval (IBI), stroke volume (SV), pre‐ejection period (PEP), and total peripheral resistance (TPR) were continuously recorded in 40 fibromyalgia patients and 30 healthy individuals during a cold pressor test and a mental arithmetic task. Sequences of covariation between SBP and IBI (cardiac branch), SV and PEP (myocardial branch), and TPR (vasomotor branch) were identified. Baroreflex sensitivity (BRS) was represented by the slope of the regression line between values in the sequences; baroreflex effectiveness (BEI) was indexed by the proportion of progressive SBP changes that elicited reflex responses. Patients exhibited lower BRS in the three branches, lower BEI in the cardiac and vasomotor branches, and reduced reactivity in cardiac BRS and BEI, SBP, IBI, SV, and PEP. Moreover, BRS and BEI were inversely related to clinical pain, cold pressor pain, depression, trait anxiety, sleep problems, and fatigue. Reduced function of the three baroreflex branches implies diminished resources for autonomic inotropic, chronotropic, and vascular regulation in fibromyalgia. Blunted stress reactivity indicates a limited capacity for autonomic cardiovascular adjustment to situational requirements. The associations of BRS and BEI with pain perception may reflect the antinociceptive effects arising from baroreceptor afferents, where reduced baroreflex function may contribute to the hyperalgesia characterizing fibromyalgia. The associations with affective impairments, sleep problems, and fatigue suggest that baroreflex dysfunctions are also involved in the secondary symptoms of the disorder.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 99%

The cardiac, vasomotor, and myocardial branches of the baroreflex in fibromyalgia: Associations with pain, affective impairments, sleep problems, and fatigue

et al. 2021

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“…EEG data were segmented into 1,000–2,500 ms periods relative to the ERP stimulus’ markers to reduce the overlap from vision-evoked potential. Although in a recent study, authors were asked to segment heartbeat period with −100 to 700 ms based on the R-peak marker in the healthy population, the heartbeats of the most MDDs in our study were above average 86/per min during the task, which was in line with the authenticated phenomenon that MDDs had faster heartbeats than healthy human ( 45 – 47 ). It would fail to show disease attributes with segmentation standard by −100 to 700 ms.…”

Section: Methodssupporting

confidence: 77%

Interoception Dysfunction Contributes to the Negative Emotional Bias in Major Depressive Disorder

et al. 2022

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BackgroundPrevious research studies have demonstrated that impaired interoception is involved in emotional information processing in major depressive disorder (MDD). Heartbeat-evoked potential (HEP) amplitudes, an index for interoception, could be manipulated by emotional faces in healthy people. Considering negative emotional bias is the core characteristic in MDD, we hypothesized that interoception dysfunction was associated with the negative emotional bias in MDD.MethodsAn electroencephalogram (EEG) study under an emotional faces task was applied to explore the relationship between interoception and emotional bias. HEPs before emotional faces stimuli were used to predict the late positive potential (LPP) amplitudes and it worked as an index of emotional bias. Twenty-seven patients with MDD and 27 healthy controls (HCs) participated in this study. Source analysis gave an auxiliary description for results in sensory level.ResultsMajor depressive disorders (MDDs) had poor performance in the heartbeat count task (HCT) and attenuate HEP average amplitudes (455–550 ms). Compared with HCs, cluster-based permutation t-tests revealed that MDDs had attenuated LPP amplitudes (300–1,000 ms) over centroparietal regions and enhanced LPP amplitudes over frontocentral regions. Furthermore, abnormal attenuated HEPs could predict aberrant LPPs under sad face stimuli in MDDs, which could be associated with the dysfunction of the anterior cingulate cortex (ACC) and right insula.ConclusionMediated by ACC and insula, interoception dysfunction contributes to the negative emotional bias of MDD, highlighting the importance of interoception in the disorder.

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“…The time dynamics of the IBI and blood pressure responses suggest that hemodynamic adjustment to cognitive stress in MDD merely involves sympathetic hypo-reactivity rather than parasympathetic mechanisms. This hypothesis is supported by a recent finding pertaining to changes in the pre-ejection period (PEP) during executive function tasks (Bair et al, 2020). PEP is an established index of beta-adrenergic influences on myocardial contractility (Berntson et al, 2016;Garrido et al, 2020).…”

Section: Discussionmentioning

confidence: 82%

“…This study was part of a larger project investigating autonomic cardiovascular control in MDD in the context of cognition and stress (Bair et al, 2020; Hoffmann et al, 2017). In total, 76 patients (48 women and 28 men) with a current MDD (recurrent or single episode) diagnosed according to DSM-IV criteria (American Psychiatric Association, 2000) and 71 healthy individuals (45 women and 26 men) participated.…”

Section: Methodsmentioning

confidence: 99%

Cardiovascular Variability and Reactivity in Major Depressive Disorder

Duschek

Bair

Hoffmann

et al. 2021

Journal of Psychophysiology

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Abstract. This study investigated cardiovascular variability and stress reactivity in major depressive disorder (MDD). While previous research has documented reduced heart rate variability, knowledge about blood pressure variability in MDD remains scarce. Regarding reactivity, a particular focus was placed on the time courses of the cardiovascular responses, which may provide insight into the autonomic mechanisms underlying the hypo-reactivity expected in MDD. In 76 MDD patients and 71 healthy controls, blood pressure was continuously recorded at rest and during mental stress induced by a 3-min serial subtraction task. Compared to controls, patients exhibited lower systolic and diastolic blood pressure, heart rate variability, and systolic and diastolic blood pressure variability. Moreover, smaller stress-related changes in heart rate, systolic and diastolic blood pressure, and sensitivity of the cardiac baroreflex arose in patients. Cardiovascular parameters did not differ between patients using antidepressants and unmedicated patients. According to time-course analysis, reduced hemodynamic modulations in MDD mainly occurred after 50 s of the stress period. Low heart rate variability in MDD reflects deficient top-down integration of the brain mechanisms allowing flexible autonomic and behavioral control; diminished blood pressure variability is indicative of poor homeostatic capacity with respect to the regulation of blood pressure and organ perfusion. Moreover, blunted cardiovascular reactivity implies poor adjustment of energetic resources to internal and environmental demands and may be a correlate of deficient motivational dynamics characterizing MDD. While cardiovascular hypo-reactivity in MDD may be mediated by baroreflex and adrenergic mechanisms, the fast-acting parasympathetic system may play a subordinate role.

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Features of autonomic cardiovascular control during cognition in major depressive disorder

Cited by 16 publications

References 100 publications

The cardiac, vasomotor, and myocardial branches of the baroreflex in fibromyalgia: Associations with pain, affective impairments, sleep problems, and fatigue

The cardiac, vasomotor, and myocardial branches of the baroreflex in fibromyalgia: Associations with pain, affective impairments, sleep problems, and fatigue

Interoception Dysfunction Contributes to the Negative Emotional Bias in Major Depressive Disorder

Cardiovascular Variability and Reactivity in Major Depressive Disorder

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