An autonomic flexibility-neurovisceral integration model of anxiety and cardiac vagal tone

Research on heart rate variability (HRV), cardiac vagal tone, and their relationship to anxiety is reviewed in the context of the autonomic flexibility and neurovisceral integration models of adaptive functioning. These perspectives address the qualities of response flexibility and inhibition across multiple levels, incorporating central and autonomic nervous system mechanisms of environmental engagement, as well as principles derived from non-linear dynamics. These models predict reduced HRV and vagal tone in anxiety, and the literature has generally supported this prediction, with exceptions as are noted. State, trait, and clinical expressions of anxiety are considered, along with the clinical, methodological, and theoretical implications of this research. A portrayal of anxiety as a restricted response range across biological and behavioral realms of functioning is drawn from the literature on anxiety and HRV.     

Changes of respiratory sinus arrhythmia during the menstrual cycle depend on average heart rate

To evaluate the complex time course of changes in respiratory sinus arrhythmia (RSA) during the menstrual cycle, daily beat-to-beat morning recordings of heart rate (HR) were carried out in 26 healthy female subjects (age 20–29 years) during two menstrual cycles. For determination of fast, vagally mediated variations of HR we used a robust time-domain measure of RSA (logRSA). We found pronounced changes in HR during the menstrual cycle with a minimum in the early follicular phase and a maximum in the late luteal phase. There were large differences between individuals in the fluctuations of logRSA during the menstrual cycle that were related to average HR: subjects with a low HR exhibited higher values of logRSA in the luteal compared to the follicular phase, whereas the trend was reversed in subjects with a high HR. The difference of extreme points of logRSA fluctuations (early follicular and mid luteal phase) was correlated to average HR (r=–0.64, P<0.001). We conclude that different patterns of RSA fluctuations occur depending on the level of average HR. Electronic Publication     

A phylogenetic journey through the vague and ambiguous Xth cranial nerve: a commentary on contemporary heart rate variability research

Contemporary heart rate variability research is discussed within a historical context. Implicit in this history is the discovery that the central nervous system regulates the heart and how information regarding neural regulation of the heart is imbedded in the beat-to-beat heart rate pattern. As methodologies have become more sensitive to neural regulation and as theories have expanded to integrate behavior and psychological processes with neurobiological principles, researchers are becoming better positioned to successfully understand how neurovisceral processes mediate the expression of health and disease. The contributions to this special issue describe research representing different levels of scientific inquiry and focus on different features of the complex neural feedback system that are manifested in the robust relationships between heart rate variability and several behavioral, psychological, physiological, and health processes. This article provides a commentary to these contributions.     

Respiratory sinus arrhythmia: Autonomic origins, physiological mechanisms, and psychophysiological implications

Respiratory sinus arrhythmia (RSA) is being used increasingly in psychophysiological studies as an index of vagal control of the heart and may be among the most selective noninvasive indices of parasympathetic control of cardiac functions. A comprehensive understanding of RSA, however, requires an appreciation of its multiple autonomic and physiological origins. We review the physiological bases of RSA and show that RSA arises from multiple tonic and phasic processes of both central and peripheral origin. These underlying mechanisms are at least partially differentiated, have distinct dynamics and consequences, and may be differentially sensitive to behavioral and cognitive events. These multiple mechanisms are relevant for psychophysiological studies of RSA, and a thorough understanding of RSA can only be achieved through an appreciation of the dynamics of its underlying origins. There is a distinction between the psychophysiological and neurophysiological domains, and conceptual and empirical bridges between these domains are needed.     

The many metrics of cardiac chronotropy: a pragmatic primer and a brief comparison of metrics

This paper focuses on pragmatic issues in obtaining measures of cardiac vagal control, and overviews a set of freely available software tools for obtaining several widely used metrics that putatively reflect sympathetic and/or parasympathetic contributions to cardiac chronotropy. After an overview of those metrics, and a discussion of potential confounds and extraneous influences, an empirical examination of the relationships amongst these metrics is provided. This study examined 10 metrics in 96 unselected college students under conditions of resting baseline and serial paced arithmetic. Intercorrelations between metrics were very high. Factor analyses were conducted on the metrics reflecting variability in cardiac rate, once at baseline and again during mental arithmetic. Factor structure was highly stable across tasks, and included a factor that had high loadings of all variables except Toichi's "cardiac sympathetic index" (CSI), and a second factor that was defined predominantly by the CSI. Although generally highly correlated, the various metrics responded differently under challenge.     

Autonomic cardiac control. II. Noninvasive indices and basal response as revealed by autonomic blockades

Heart period, systolic time intervals, low and high frequency heart period variability, blood pressure, and respiration were measured in female subjects under three drug conditions (saline, atropine sulfate, metoprolol) while sitting and standing on three consecutive days. Following preinfusion baseline recordings, saline, metoprolol (14 mg), or atropine sulfate (2 mg) was infused for 15 min (by using a double-blind procedure). Recordings were taken during a postinfusion baseline and in response to an orthostatic stressor (standing versus sitting postures). At the end of the metoprolol session, atropine sulfate was infused and responses were monitored during the post-infusion (i.e., double blockade) baseline and during orthostatic stressor. Analyses of the blockade data revealed that the preejection period (PEP) reflected sympathetic but not vagal influences on the heart, and high frequency (HF, 0.12–0.40 Hz) heart rate variability (respiratory sinus arrhythmia) reflected vagal but not sympathetic influences on the heart. No other measure provided a specific index of the tonic sympathetic or vagal activation of the heart. Postinfusion PEP under saline predicted individual differences in postinfusion cardiac sympathetic activation, whereas postinfusion heart period (but not HF variability) under saline predicted individual differences in postinfusion cardiac vagal activation.     

Efficacy of paced breathing for insomnia: Enhances vagal activity and improves sleep quality

Fourteen self‐reported insomniacs (SRI) and 14 good sleepers (GS) had their cardiac neuronal activity assessed by heart rate variability (HRV) under controlled respiration at a slow frequency rate of 0.1 Hz, and a forced rate of 0.2 Hz during daytime rest. Nighttime sleep was measured by polysomnography. The SRI showed depressed high frequency power of HRV compared to the GS. An increased total power of HRV was observed among the SRI during slow, paced breathing compared with spontaneous breathing and 0.2 Hz. Sleep onset latency, number of awakenings, and awakening time during sleep were decreased and sleep efficiency was increased if SRI practiced slow, paced breathing exercises for 20 min before going to sleep. Our results indicate that there is autonomic dysfunction among insomniacs, especially in relation to vagal activity; however, this decreased vagal activity can be facilitated by practicing slow, paced breathing, thereby improving sleep quality.     

Changes in R–R variability before and after endurance training measured by power spectral analysis and by the effect of isometric muscle contraction

The long-term conditioning effects of physical training on cardiorespiratory interaction in 11 young healthy males were studied. Significant increases in maximum oxygen uptake ( )(P < 0.05) and decreases in heart rate (P < 0.05) were achieved in all subjects following a 6-week training programme consisting of cycling for 25 min each day at a work level that increased heart rate to 85% of maximum. Heart rate variability, measured as the differences between the maximum and minimum R-R interval in a respiratory cycle, increased in nine of the subjects and decreased in two. The respiratory-cycle-related high-frequency peak in the power spectral plot of R-R variability also showed significant increases in the same nine subjects and decreases in two. The latter result was similar after normalisation of the data for changes in heart rate by calculating the common coefficient of variance ( ), where HF is the high-frequency component of the power spectral plots, using a further measure of vagal tone it was shown that, for all subjects, the R-R interval change in response to isometric contractions of the arm flexors in one respiratory cycle were significantly greater after training. These data suggest that cardiac vagal tone is increased by aerobic training for all subjects and that this is accompanied by a respiratory sinus arrhythmia (RSA) in most, but may be associated with a decrease in RSA in subjects with a very low ( < 50 beats-min⁻¹ heart rate.     

Statistical strategies to quantify respiratory sinus arrhythmia: are commonly used metrics equivalent?

Three frequently used RSA metrics are investigated to document violations of assumptions for parametric analyses, moderation by respiration, influences of nonstationarity, and sensitivity to vagal blockade. Although all metrics are highly correlated, new findings illustrate that the metrics are noticeably different on the above dimensions. Only one method conforms to the assumptions for parametric analyses, is not moderated by respiration, is not influenced by nonstationarity, and reliably generates stronger effect sizes. Moreover, this method is also the most sensitive to vagal blockade. Specific features of this method may provide insights into improving the statistical characteristics of other commonly used RSA metrics. These data provide the evidence to question, based on statistical grounds, published reports using particular metrics of RSA.     

Atypical autonomic regulation,auditory processing,and affect recognition in women with HIV

This study examined the effect of HIV on visceromotor (i.e., heart rate and heart rate variability) and somatomotor (i.e., auditory processing and affect recognition) components of a Social Engagement System defined by the Polyvagal Theory (Porges, 1995) that links vagal regulation of the heart with brainstem regulation of the striated muscles of the face and head. Relative to at risk HIV-seronegative women, HIV-seropositive women had less heart rate variability (i.e., respiratory sinus arrhythmia) and had poorer performance on auditory processing and affect recognition tasks. CD4 was negatively correlated with the accuracy to detect specific emotions. The observed indices of atypical autonomic and behavioral regulation may contribute to greater difficulties in social behavior and social communication between HIV-infected women and other individuals in their social network.     

Physiological blunting during pregnancy extends to induced relaxation

There is accumulating evidence that pregnancy is accompanied by hyporesponsivity to physical, cognitive, and psychological challenges. This study evaluates whether observed autonomic blunting extends to conditions designed to decrease arousal. Physiological and psychological responsivity to an 18-min guided imagery relaxation protocol in healthy pregnant women during the 32nd week of gestation (n = 54) and non-pregnant women (n = 28) was measured. Data collection included heart period (HP), respiratory sinus arrhythmia (RSA), tonic and phasic measures of skin conductance (SCL and NS-SCR), respiratory period (RP), and self-reported psychological relaxation. As expected, responses to the manipulation included increased HP, RSA, and RP and decreased SCL and NS-SCR, followed by post-manipulation recovery. However, responsivity was attenuated for all physiological measures except RP in pregnant women, despite no difference in self-reported psychological relaxation. Findings support non-specific blunting of physiological responsivity during pregnancy.     

呼吸性窦性心律不齐定量分析研究进展

呼吸性窦性心律不齐(RSA)是一种心率随呼吸周期性波动的生理现象。近年来在临床上常被用作心迷走神经张力的非侵入式检测指征。但它的定量分析受呼吸参数、体位、体动等因素影响,使得至今还没有建立起一个通用的定量分析标准和校准方法。本文主要介绍了五种常见的定量分析方法:相邻R-R间期差值均方根(RMSSD)法、峰谷(pvRSA)法、逐次呼吸余弦拟合(cosinor fitting)法、谱分析(spectral analysis)法以及时频联合分析(JTFA)法;同时本文介绍了定量分析中常见的呼吸参数校准方法:引导呼吸法、协方差分析统计学控制法、相对呼吸参数残余量法以及潮气量修正法。最后,对如何解决现阶段RSA定量估计中存在的问题做了展望。     

Cardiopulmonary Adjustments During Operant Heart Rate Control

Twenty-three healthy men and women participated in a 5-session experiment in which they attempted to increase and decrease their heart rate with the assistance of visual analogue biofeedback. As a group subjects did successfully raise and lower heart rate from resting baseline. These changes in heart rate were closely paralleled by changes in V, a measure of cardiac vagal tone. Heart rate slowing was associated with increases in V, and heart rate speeding was associated with decreases in V. Respiration rate and amplitude did not differ significantly between heart rate slowing and speeding trials, and covariance analysis indicated that respiratory changes did not account for the heart rate or V effects. The weighted coherence between respiration and heart rate showed that cardiopulmonary coupling increased during heart rate slowing and decreased during heart rate speeding. Individual differences in cardiac vagal tone and cardiopulmonary coupling were unrelated to heart rate speeding and slowing performance.     

Respiratory sinus arrhythmia and diseases of aging: obesity, diabetes mellitus, and hypertension

Associations between respiratory sinus arrhythmia (RSA) and several chronic diseases, including obesity, diabetes mellitus, and hypertension, have been documented in recent years. Although most evidence suggests reduced RSA is the result of chronic disease rather than the cause, some studies have documented reduced RSA among at-risk individuals prior to disease onset. These results raise the possibility that decreased vagal tone may play a role in the pathogenesis of certain chronic diseases. Presented here is a brief overview of studies which examine the relationship between vagal tone, as measured by RSA and baroreflex gain, and diseases of aging, including obesity, diabetes mellitus, and hypertension. Mechanisms by which vagal tone may be related to disease processes are discussed. In addition, we present results from a population-based study of RSA and hypertension in older adults. Consistent with previous studies, we found an inverse relationship between RSA and age, cigarette use, and diabetes. In logistic regression models which control for age, cigarette use, and diabetes, we found RSA was a significant negative predictor of hypertension. We conclude that the relationship between RSA and hypertension is somewhat independent of the age-related decline in parasympathetic activity.     

Cardiac autonomic balance versus cardiac regulatory capacity

The concept of autonomic balance views autonomic states along a bipolar continuum from sympathetic (S) to parasympathetic (P) dominance, whereas regulatory capacity models emphasize overall autonomic flexibility as a marker of the capacity for regulation. These two concepts were evaluated for their utility in characterizing patterns of autonomic control. Measures of P (high frequency heart rate variability, HF) and S (preejection period, PEP) cardiac control were obtained. A measure of cardiac autonomic balance (CAB) was derived as the difference in the normalized P index minus the S index, and a measure of cardiac autonomic regulation (CAR) was derived as the normalized P index plus the S index. Results reveal that CAR, but not CAB, was a significant predictor of the prior occurrence of a myocardial infarction, net of demographic and other variables, whereas CAB, but not CAR, was a significant predictor of concurrent diabetes.     

Paced Respiratory Sinus Arrhythmia as an Index of Cardiac Parasympathetic Tone During Varying Behavioral Tasks

This study addresses a number of unresolved issues regarding the employment of respiratory sinus arrhythmia as an index of tonic parasympathetic cardiac control in psychophysiological investigations. These questions include the following: (1) Does respiratory sinus arrhythmia reflect cardiac vagal tone under conditions in which alterations in parasympathetic control are expected to be mild to moderate? (2) Are variations in human respiratory sinus arrhythmia that occur in response to varying behavioral demands independent of beta-adrenergic effects on the heart? (3) To what extent do typical experimental tasks apparently affect tonic cardiac vagal control? Twelve healthy male subjects were administered a joint alpha- and β-adrenoreceptor pharmacological blocker on one day and a placebo on another (balanced across subjects). On both days, respiratory sinus arrhythmia and heart period were monitored during a number of different experimental tasks while subjects continuously paced their respiration. Results indicated that respiratory sinus arrhythmia, under controlled respiratory conditions, is uninfluenced by variations in sympathetic activity, and provides a reasonably sensitive index of cardiac vagal tone, even when alterations in parasympathetic tone are not large. Furthermore, our findings suggest that cardiac vagal tone is responsive to varying behavioral demands and may interact in different ways with β-adrenergic mechanisms.     

Relations between psychometric profiles and cardiovascular autonomic regulation in physical education students

This study was designed to investigate physical education (PE) students the link between mood disturbances, caused by psychological or physical stressors associated with studying, and the autonomic nervous system modifications. PE students completed the profile of mood state (POMS) questionnaire at the end of the university year. Heart rate variability (HRV) was then measured during a head-up tilt test (HUT) in those with the highest and lowest total mood disturbance (TMD) scores on three successive POMS. Among the 218 students who completed the POMS (85 female and 137 male), 65 had high TMD scores, suggesting mood disturbances and fatigue. The final sample included 12 subjects in the potentially overtrained (POT) group and 16 subjects in the control (CTL) group. A greater decrease of two indices of the autonomic system (SD1 and RMSSD) was observed during the HUT in the POT than in the CTL group (P < 0.05). The depression (Dep) and vigor (Vig) subscales of POMS were correlated with several HRV indices. More specifically, in the POT group, the Vig score was correlated with autonomous activity in the supine position, and the Dep score with percentages of change of sympatho-vagal activity during the HUT. This suggests that (1) POT students could present a weaker autonomic response to HUT, (2) Dep and Vig subscales of the POMS questionnaire may indicate autonomic dysregulations.     

Vagal function indexed by respiratory sinus arrhythmia and cholinergic anti-inflammatory pathway

The autonomic nervous system, in particular vagal function, plays an important role in a wide range of somatic and mental disorders. Cardiac vagal function can be indexed by the respiratory sinus arrhythmia (RSA) – oscillations in heart rate linked to respiration mediated predominantly by fluctuations of vagus nerve efferent traffic originating in the nucleus ambiguus. Moreover, the neurocardiac vagal modulation has been shown to be related to physiological adaptability/flexibity and emotional regulation. Thus, greater vagal withdrawal during stressors and subsequent recovery should be indicative of a more flexible physiological response system.