Heart rate variability: Can it serve as a marker of mental health resilience?

Perna, Giampaolo; Riva, Alice; Defillo, Archie; Sangiorgio, Erika; Nobile, Maria; Caldirola, Daniela

doi:10.1016/j.jad.2019.10.017

Cited by 83 publications

(50 citation statements)

References 29 publications

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“…Together, these results support the idea that under baseline conditions, there is an inhibitory role of the vagal nerve in the regulation of the HPA system. Specifically, tonic vagal inhibition of the amygdala by the prefrontal cortex (PFC) results in the attenuated HPA axis activity and decreased cortisol secretion (3,6,15). On the other hand, it is proposed that higher cortisol levels act indirectly via increased serotonin reuptake and results in a breakdown of the functional connectivity between PFC and amygdala (4,16).…”

Section: Discussionmentioning

confidence: 99%

Association of salivary steroid hormones and their ratios with time-domain heart rate variability indices in healthy individuals

et al. 2021

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Backgound: Stress system consists of the hypothalamic-pituitary-adrenal (HPA) axis and the locus caeruleus/norepinephrine-autonomic nervous system (ANS). Traditionally, HPA axis activity is evaluated by measuring its end-product cortisol while the activity of ANS is assessed using heart rate variability (HRV) indices. Alterations in cortisol levels and HRV measures during laboratory-based stress tasks were extensively studied in previous research. However, scarce data exist on the associations of HRV measures with the levels of other adrenal steroid hormones under baseline conditions. Thus, we aimed to evaluate the activity of HPA axis by measuring salivary cortisol, cortisone, dehydroepiandrosterone (DHEA) levels and their ratios and to examine its association with HRV measures in a sample of healthy young and middle-aged adults. Methods: For each participant (n=40), three data collection sessions taking place at the same time of the day were scheduled within five working days. Participants completed a self-reported questionnaire on sociodemographic and lifestyle characteristics, filled out Perceived Stress Scale and State-Trait Anxiety Inventory. Also, saliva samples were collected and physiological measures including resting HR and HRV were recorded during three data collection sessions. Results: Statistically significant associations between diminished parasympathetic vagal tone evaluated by time-domain HRV measures and higher salivary cortisol, lower DHEA levels, as well as increased DHEA to cortisol ratio were found. Also, physiological stress indicators (i.e. HRV) showed greater intrindividual stability compared with biochemical biomarkers (i. e. salivary steroid hormones) within the period of five days. Conclusions: Our findings suggest that both cortisol and DHEA mediate the link between two stress-sensitive homeostatic systems.

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Section: Discussionmentioning

confidence: 99%

Association of salivary steroid hormones and their ratios with time-domain heart rate variability indices in healthy individuals

et al. 2021

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“…Thus, perceived stress has been linked to greater CAR in both chronically stressed individuals [28,29] and healthy young adults [30]. In addition, CAR has been shown to predict major depressive disorder [31,32] and heart rate variability [33], the latter a marker of mental health resilience [34]. Importantly, an interaction between AUCg and experiences of negative life events has been found to predict the onset of depression [35].…”

Section: Introductionmentioning

confidence: 99%

Differential Susceptibility to the Impact of the COVID-19 Pandemic on Working Memory, Empathy, and Perceived Stress: The Role of Cortisol and Resilience

et al. 2021

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There are important individual differences in adaptation and reactivity to stressful challenges. Being subjected to strict social confinement is a distressful psychological experience leading to reduced emotional well-being, but it is not known how it can affect the cognitive and empathic tendencies of different individuals. Cortisol, a key glucocorticoid in humans, is a strong modulator of brain function, behavior, and cognition, and the diurnal cortisol rhythm has been postulated to interact with environmental stressors to predict stress adaptation. The present study investigates in 45 young adults (21.09 years old, SD = 6.42) whether pre-pandemic diurnal cortisol indices, overall diurnal cortisol secretion (AUCg) and cortisol awakening response (CAR) can predict individuals’ differential susceptibility to the impact of strict social confinement during the Coronavirus Disease 2019 (COVID-19) pandemic on working memory, empathy, and perceived stress. We observed that, following long-term home confinement, there was an increase in subjects’ perceived stress and cognitive empathy scores, as well as an improvement in visuospatial working memory. Moreover, during confinement, resilient coping moderated the relationship between perceived stress scores and pre-pandemic AUCg and CAR. In addition, in mediation models, we observed a direct effect of AUCg and an indirect effect of both CAR and AUCg, on change in perceived self-efficacy. These effects were parallelly mediated by the increase in working memory span and cognitive empathy. In summary, our findings reveal the role of the diurnal pattern of cortisol in predicting the emotional impact of the COVID-19 pandemic, highlighting a potential biomarker for the identification of at-risk groups following public health crises.

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“…Most biomarkers of stress vulnerability that research currently considers rely on biological measurements that frequently involve invasive approaches, such as blood extraction, or low-throughput neuroimaging technologies 37,[80][81][82] that deter from their systematic use. Although HRV measures are easier to collect and are emerging as particularly relevant [36][37][38] , establishing when and how phasic HRV predicts physiological vulnerability to stress requires standardized and validated conditions. Resting HRV has been associated with health, but ensuring its reliability requires long recordings 49,58 .…”

Section: Discussionmentioning

confidence: 99%

“…To define stress vulnerability, we focused on heart rate variability (HRV) [36][37][38] , a surrogate index of cardiac vagal break that yields information about flexibility of the ANS 39 . HRV is a measure of fluctuations over time in cardiac interbeat intervals due to the interaction of the two ANS branches: sympathetic (SNS) and parasympathetic (PNS).…”

mentioning

confidence: 99%

Locomotion in virtual environments predicts cardiovascular responsiveness to subsequent stressful challenges

et al. 2020

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Individuals differ in their physiological responsiveness to stressful challenges, and stress potentiates the development of many diseases. Heart rate variability (HRV), a measure of cardiac vagal break, is emerging as a strong index of physiological stress vulnerability. Thus, it is important to develop tools that identify predictive markers of individual differences in HRV responsiveness without exposing subjects to high stress. Here, using machine learning approaches, we show the strong predictive power of high-dimensional locomotor responses during novelty exploration to predict HRV responsiveness during stress exposure. Locomotor responses are collected in two ecologically valid virtual reality scenarios inspired by the animal literature and stress is elicited and measured in a third threatening virtual scenario. Our model’s predictions generalize to other stressful challenges and outperforms other stress prediction instruments, such as anxiety questionnaires. Our study paves the way for the development of behavioral digital phenotyping tools for early detection of stress-vulnerable individuals.

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Heart rate variability: Can it serve as a marker of mental health resilience?

Cited by 83 publications

References 29 publications

Association of salivary steroid hormones and their ratios with time-domain heart rate variability indices in healthy individuals

Association of salivary steroid hormones and their ratios with time-domain heart rate variability indices in healthy individuals

Differential Susceptibility to the Impact of the COVID-19 Pandemic on Working Memory, Empathy, and Perceived Stress: The Role of Cortisol and Resilience

Locomotion in virtual environments predicts cardiovascular responsiveness to subsequent stressful challenges

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