Reduced cognitive performance and
prolonged reaction time accompany moderate
hypotension

Duschek, Stefan; Weisz, Nathan; Schandry, Rainer

doi:10.1007/s10286-003-0124-4

Cited by 52 publications

(27 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In this respect, the blood pressure-pain relationship clearly differs from the relationships between blood pressure and other behavioral and psychophysiological factors which were found to be non-linear (for overview see Duschek and Schandry, 2007). The association between blood pressure and cognitive functioning, for instance, has an inverted u-shape with a decline in performance at both ends of the spectrum (Duschek et al, 2003;Duschek et al, 2005;Qiu et al, 2005;Waldstein et al, 2005). Also, cortical activation, as well as cerebral blood flow have repeatedly been shown to be reduced both in individuals with elevated and low blood pressure (Baumbach and Heistad, 1988;Duschek and Schandry, 2004;Duschek et al, 2006;Hajdu and Baumbach, 1994;Stegagno et al, 2007;Weisz et al, 2002).…”

Section: Discussionmentioning

confidence: 98%

Increased sensitivity to heat pain in chronic low blood pressure

Duschek

Dietel

Schandry

et al. 2009

European Journal of Pain

Self Cite

View full text Add to dashboard Cite

While in elevated blood pressure reduced sensitivity to acute pain has been well established, little is known about possible alterations in pain perception within the lower range of blood pressure. In this study, sensitivity to heat pain was assessed in 40 subjects with chronic hypotension (mean blood pressure 96.5/57.7 mmHg) and 40 normotensive control persons (mean blood pressure 121.8/77.2 mmHg). Employing a contact thermode, heat stimuli were applied to the forearm. Pain threshold and tolerance were determined. Participants furthermore rated subjective intensities and unpleasantness of tonic heat stimuli (45.5-47.5 degrees C) on visual analogue scales and in a questionnaire. Possible confounding of sensitivity to heat pain with skin temperature, temperature sensitivity and mood was controlled for. In addition to blood pressure, functional features of the arterial baroreceptor system were related to pain experience. Therefore, estimates for the input on the baroreceptors, as well as baroreflex sensitivity were obtained. Hypotensive individuals exhibited markedly reduced pain threshold and pain tolerance, as well as increased sensory and affective pain experience. The measures related to the baroreceptor system were not associated with pain experience, suggesting that no significant modulation of heat pain occurs through this system. The results of this study complete the findings on hypertension-related hypoalgesia and suggest an inverse relationship between blood pressure and pain sensitivity across the whole blood pressure spectrum. Furthermore, increased proneness of hypotensive individuals to clinical pain may be discussed.

show abstract

Section: Discussionmentioning

confidence: 98%

Increased sensitivity to heat pain in chronic low blood pressure

Duschek

Dietel

Schandry

et al. 2009

European Journal of Pain

Self Cite

View full text Add to dashboard Cite

show abstract

“…Although little clinical import is given to the treatment of low blood pressure, several studies in the non-SCI population have documented an association between hypotension and impaired cognitive function [11, 21, 25, 39, 58], particularly among older individuals [2, 39, 48]. It is of additional interest to us that the hypotensive group tended to be younger than the normotensive cohort, albeit not statistically significant, because much of the work on hypotension and cognitive impairment suggests that advancing age may be a co-contributor [45, 52].…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, individuals with high cord lesions are prone to systemic hypotension, which is worsened with postural stress [9, 10, 29, 32, 56, 57]. In the non-SCI population, an association between essential hypotension and cognitive impairment has been reported [11, 21, 25, 58]. Specifically, prolonged reaction times and decreased accuracy in sustained attention and working memory are reported in hypotensive compared to normotensive subjects [21, 23, 25].…”

Section: Introductionmentioning

confidence: 99%

Cognitive performance in hypotensive persons with spinal cord injury

et al. 2009

View full text Add to dashboard Cite

Background Due to sympathetic de-centralization, individuals with spinal cord injury (SCI), especially those with tetraplegia, often present with hypotension, worsened with upright posture. Several investigations in the non-SCI population have noted a relationship between chronic hypotension and deficits in memory, attention and processing speed and delayed reaction times. Objective To determine cognitive function in persons with SCI who were normotensive or hypotensive over a 24-h observation period while maintaining their routine activities. Methods Subjects included 20 individuals with chronic SCI (2–39 years), 13 with tetraplegia (C4–8) and 7 with paraplegia (T2–11). Individuals with hypotension were defined as having a mean 24-h systolic blood pressure (SBP) below 110 mmHg for males and 100 mmHg for females, and having spent ≥50% of the total time below these gender-specific thresholds. The cognitive battery used included assessment of memory (CVLT), attention and processing speed (Digit Span, Stroop word and color and Oral Trails A), language (COWAT) and executive function (Oral Trails B and Stroop color–word). Results Demographic parameters did not differ among the hypotensive and normotensive groups; the proportion of individuals with tetraplegia (82%) was higher in the hypotensive group. Memory was significantly impaired (P<0.05) and there was a trend toward slowed attention and processing speed (P<0.06) in the hypotensive compared to the normotensive group. Interpretation These preliminary data suggest that chronic hypotension in persons with SCI is associated with deficits in memory and possibly attention and processing speed, as previously reported in the non-SCI population.

show abstract

“…In a number of recent studies, a reduced cognitive performance in hypotension was established. The findings point toward considerable deficits in attention (Costa, Stegagno, Schandry, & Bitti, 1998;Duschek, Schandry, & Matthias, 2004;Duschek, Weisz, & Schandry, 2003;Richter-Heinrich, Borys, Sprung, & La¨uter, 1971;Stegagno, Angrilli, Costa, & Palomba, 1996;Weisz, Schandry, Jacobs, Mialet, & Duschek, 2002). Moreover, poorer performance in memory and arithmetic tasks was demonstrated (Costa et al, 1998;Morris et al, 2002;Stegagno et al, 1996).…”

mentioning

confidence: 97%

Cognitive performance and cerebral blood flow in essential hypotension

Duschek¹,

Schandry²

2004

Psychophysiology

Self Cite

View full text Add to dashboard Cite

In the present study cerebral blood flow was assessed in 40 subjects with chronically low blood pressure and 40 normotensive controls at resting conditions and during the execution of a cued reaction time task. Blood flow velocities were recorded by means of transcranial Doppler sonography in both middle cerebral arteries. In hypotensives flow velocity at rest was reduced bilaterally. During the anticipation of the stimuli, which the subjects had to respond to, a predominantly right hemispheric increase of flow velocity was observed in both groups. This increase was significantly less pronounced in the hypotensive group. Hypotensives showed longer reaction times, and there was a negative correlation between the extent of the flow velocity increase and the reaction times. This study is the first to demonstrate a reduced cerebral perfusion and maladaption of blood flow to cognitive demands due to essential hypotension.

show abstract

Reduced cognitive performance and prolonged reaction time accompany moderate hypotension

Cited by 52 publications

References 25 publications

Increased sensitivity to heat pain in chronic low blood pressure

Increased sensitivity to heat pain in chronic low blood pressure

Cognitive performance in hypotensive persons with spinal cord injury

Cognitive performance and cerebral blood flow in essential hypotension

Contact Info

Product

Resources

About