Loss of Efferent Vagal Activity in Acute Schizophrenia

Bär, Karl Jürgen; Letzsch, A.; Jochum, Thomas; Wagner, Gerd; Greiner, W.; Sauer, Heinrich

doi:10.1055/s-2004-831920

Cited by 124 publications

(24 citation statements)

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“…The cardiovascular impact of neuroleptics is of large clinical importance given reported associations with ventricular arrhythmias and sudden cardiac death (Agelink et al, 2001;Ray et al, 2009). While some studies have shown that tricyclic antidepressants (TCA) (for example, amitriptyline, doxepine, imipramine) and neuroleptics such as clozapine strongly reduce HRV (Agelink et al, 2001;Bär et al, 2008b;Rechlin et al, 1994a;Zahn and Pickar, 1993) due to their anticholinergic properties (Jakobsen et al, 1984;Rechlin et al, 1994b), other studies report no significant negative effects of neuroleptics on HRV (Bär et al, 2005;Chang et al, 2010;Malaspina et al, 2002). There appears to be more agreement however regarding the lack of a parasympathetic effect associated with selective serotonin reuptake inhibitors (SSRIs) (Kemp et al, 2010;Rechlin et al, 1994b).…”

Section: Introductionmentioning

confidence: 99%

Reduced heart rate variability in a treatment-seeking early psychosis sample

Cacciotti-Saija

Quintana

Alvares

et al. 2018

Psychiatry Research

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Reduced cardiac autonomic function is associated with increased risk of cardiovascular disease (CVD), with heart rate variability (HRV) providing an accessible index of cardiac autonomic function. HRV may provide a candidate physiological mechanism linking reduced cardiac autonomic function to increased risk for CVD in schizophrenia illness. This study examines whether HRV is also reduced in a community sample of treatment-seeking participants experiencing early psychosis (n = 48) compared to healthy volunteers (n = 48) and social anxiety control groups (n = 48) matched by gender and age. HRV was assessed during a five-minute interbeat interval recording at rest. Participants also completed self-report psychiatric symptom measures. Early psychosis participants showed significant reductions in HRV compared to social anxiety and healthy control groups. Reductions in HRV were also observed in early psychosis participants taking anticholinergic medications compared to both control groups taking cardio-benign medications or who were non-medicated. Lastly, whether or not early psychosis participants were taking anticholinergic medications was not associated with reductions in HRV. Findings provide preliminary evidence that early psychosis is associated with reduced HRV. This study supports further research with larger sample sizes to precisely determine the influence of anticholinergic drugs on HRV in early psychosis populations.

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Section: Introductionmentioning

confidence: 99%

Reduced heart rate variability in a treatment-seeking early psychosis sample

Cacciotti-Saija

Quintana

Alvares

et al. 2018

Psychiatry Research

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“…The DMNV has not been the topic of studies in schizophrenia research, although autonomic dysfunction was reported for various branches of the peripheral vagal nerve (2,28). The difference in neuronal numbers in the right DMNV seems to be a specific finding since no changes were observed in the hypoglossal nucleus.…”

Section: Discussionmentioning

confidence: 98%

“…Various physiological studies have revealed autonomic dysfunction in schizophrenia, assuming that this might play a role in the cascade of events. In particular, efferent parasympathetic modulation has been shown to be decreased in the acute (2) and the chronic stage (3). Furthermore, decreased baroreflex sensitivity (BRS) and increased QT variability have been described in the acute state of the disease (4).…”

Section: Introductionmentioning

confidence: 99%

Increased neuronal cell number in the dorsal motor nucleus of the vagus in schizophrenia

Axer

Bernstein

Keiner

et al. 2010

Acta Neuropsychiatr.

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“…These measures have been reported to be associated with vagal tone in both healthy control and atrial fibrillation groups. 40,46 While schizophrenia patients have been characterized by decreased vagal tone, 14,47,48 the discontinuation patients are likely to have experienced some anticholinergic symptoms. And it has been reported that HR was associated with subsequent treatment discontinuation and of symptomatic outcome of schizophrenia spectrum disorders.…”

Section: Discussionmentioning

confidence: 99%

Evaluating subjective domains of antipsychotic‐induced adverse effects using heart rate variability

Chang

Hwang

et al. 2014

Psychiatry Clin Neurosci

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Aims Antipsychotic‐induced autonomic dysregulation may lead to a wide range of subjective side‐effects in schizophrenia patients. Using heart rate variability (HRV) measures, we prospectively examined the relationship between subjective side‐effects and cardiac autonomic regulation in unmedicated schizophrenia patients. Methods Forty‐five unmedicated schizophrenia patients were assessed for antipsychotic‐associated side‐effects and HRV parameters at baseline and after 6 weeks of treatment. Psychiatric symptoms and subjective side‐effects were assessed using the Positive and Negative Syndrome Scale (PANSS) and the Liverpool University Neuroleptic Side‐effect Rating Scale (LUNSERS). Results Correlations between subjective adverse effects and HRV measures at baseline and at week 6 varied. Nonetheless, the changes in the psychic side‐effects domain were significantly correlated with the changes in time‐domain HRV measures and sample entropy (SampEn). In addition, the change in SampEn was significantly associated with that in the scores of extrapyramidal, anticholinergic, miscellaneous, and red herring domains as well as the mean total LUNSERS score. Conclusion Baseline HRV measures may predict clinical response and adverse events associated with treatment adherence. Also, subjective side‐effects may correspond well with the changes in neurocardiac dynamics, and the changes in SampEn may effectively reflect subjective discomfort in patients receiving antipsychotic treatment.

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Loss of Efferent Vagal Activity in Acute Schizophrenia

Cited by 124 publications

References 0 publications

Reduced heart rate variability in a treatment-seeking early psychosis sample

Reduced heart rate variability in a treatment-seeking early psychosis sample

Increased neuronal cell number in the dorsal motor nucleus of the vagus in schizophrenia

Evaluating subjective domains of antipsychotic‐induced adverse effects using heart rate variability

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