Respiratory sinus arrhythmia as a measure of cognitive workload

The current standard for measuring cognitive workload is the NASA Task-load Index (TLX) questionnaire. Although this measure has a high degree of reliability, diagnosticity, and sensitivity, a reliable physiological measure of cognitive workload could provide a non-invasive, objective measure of workload that could be tracked in real or near real-time without interrupting the task. This study investigated changes in respiratory sinus arrhythmia (RSA) during seven different sub-sections of a proposed selection test for Navy aviation and compared them to changes reported on the NASA-TLX. 201 healthy participants performed the seven tasks of the Navy's Performance Based Measure. RSA was measured during each task and the NASA-TLX was administered after each task. Multi-level modeling revealed that RSA significantly predicted NASA-TLX scores. A moderate within-subject correlation was also found between RSA and NASA TLX scores. The findings support the potential development of RSA as a real-time measure of cognitive workload.     

Spectral evaluation of aging effects on blood pressure and heart rate variations in healthy subjects

The background to heart rate variability (HRV) and blood pressure variability (BPV), and their determinants and physiological correlates, remain obscure. The impact of age must be taken into account if HRV and BPV are used for predictive purposes in clinical settings. Healthy subjects show wide inter-individual variation in their heart rate behaviour and the factors affecting heart rate dynamics are not well known. This paper has undertaken to evaluate heart rate variability (HRV) and baroreflex sensitivity (BRS) in a random sample of subjects without evidence of heart disease, and to estimate the relation of HRV and BPV behaviour to age. The aim of this study was to analyse the effects of ageing on HRV and BPV for simultaneous recordings of electrocardiograph (ECG) and blood pressure (BP) signals at rest in healthy subjects. We studied eight young (21 – 34 years old) and eight elderly (68 – 85 years old) rigorously screened subjects from the Fantasia Database to make the reproducibility and comparability of the results more extensive. Time- and frequency-domain analysis of HRV and BPV was performed on 5-minute ectopic-free recordings. BRS on the heart was estimated by frequency-domain analysis of spontaneous variability of systolic blood pressure (SBP) and RR interval. It has been observed that compared to young the elderly subjects have (i) diminished HRV; (ii) a shift in the power spectral density and median frequency to low frequency side for HRV and to higher frequency side for BPV; and (iii) increased low-frequency alpha index and decreased high-frequency alpha index of BRS with overall alpha index augmented. The results convey that normal ageing in the absence of disease is associated with lesser parasympathetic regulation of heart rate. Thus it is concluded that the age is an important factor to be considered for prognosis and diagnosis by HRV and BPV. For reliable clinical applications, more research needs to be done on a broad spectrum of subjects. In addition, these observations will prove to be useful for dynamic modelling of cardiovascular regulation for testing the authentication of new techniques for analysis purposes.     

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.     

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.     

Effects of long-term exercise training on cardiac autonomic nervous activities and baroreflex sensitivity

Reductions in tonic vagal controls of the heart and depressed baroreflex sensitivity (BRS) have been associated with a postural fall in blood pressure (BP) and the incidence of cardiac events among older people. We examined the hypothesis that BP regulation during orthostatic challenge as well as heart rate variability (HRV) at rest can be better maintained in long-term exercise-trained, healthy, older men (aged 60–70 years). Subjects were classified into two groups; long-term exercise-trained (LTET, n=14) and sedentary (SED, n=10) according to their history of physical activity. Prior to the dynamic BRS assessment, supine resting autonomic cardiac modulation was assessed by means of time domain HRV [standard deviation of ECG R–R interval (RRISD) and the coefficient of variation (CV)]. The BRS was assessed during 60° head-up tilting by simultaneously measuring beat-by-beat systolic blood pressure (SBP) and ECG R–R interval changes. The BRS gain was determined by the regression slope coefficient based on the extent of the SBP fall and the corresponding ECG R–R shortening during the orthostatic challenge. The results indicated that the LTET group manifested greater ECG R–R interval fluctuations with significantly higher resting RRISD and CV, compared with the SED group [59.5 (10.4) versus 27.7 (7.8) ms, p<0.05; 5.5 (0.8) versus 2.8 (0.7)%, p<0.05], respectively. Using dynamic BRS testing during the acute orthostatic challenge, the LTET group showed a significantly higher BRS gain than the SED [6.4 (0.8) versus 3.8 (0.6) ms·mmHg⁻¹, p<0.017] group. These results indicate that CV and BRS are well maintained in healthy, LTET older individuals when compared with their sedentary peers. Our data suggest that this augmented autonomic cardiac modulation reflects better parasympathetic responsiveness in LTET individuals. Data provide further support for long-term exercise training as another possible cardioprotective factor that might decrease susceptibility to ventricular fibrillation as well as assist arterial BP at the onset of an orthostatic challenge in older men. Electronic Publication     

A Nonlinear Model of Cardiac Autonomic Control in Obstructive Sleep Apnea Syndrome

Using the Volterra–Wiener approach, we employed a minimal model to quantitatively characterize the linear and nonlinear effects of respiration (RCC) and arterial blood pressure (ABR) on heart rate variability (HRV) in normal controls and subjects with moderate-to-severe obstructive sleep apnea syndrome (OSAS). Respiration, R–R interval (RRI), blood pressure (BP) and other polysomnographic variables were recorded in eight normal controls and nine OSAS subjects in wakefulness, Stage 2 and rapid eye-movement sleep. To increase respiratory and cardiovascular variability, a preprogrammed ventilator delivered randomly timed inspiratory pressures that were superimposed on a baseline continuous positive airway pressure. Except for lower resting RRI in OSAS subjects, summary statistical measures of RRI and BP and their variabilities were similar in controls and OSAS. In contrast, RCC and ABR gains were significantly lower in OSAS. Nonlinear ABR gain and the interaction between respiration and blood pressure in modulating RRI were substantially reduced in OSAS. ABR gain increased during sleep in controls but remained unchanged in OSAS. These findings suggest that normotensive OSAS subjects have impaired daytime parasympathetic and sympathetic function. Nonlinear minimal modeling of HRV provides a useful, insightful, and comprehensive approach for the detection and assessment of abnormal autonomic function in OSAS. Supported by NIH Grants HL-58725, EB-001978, and M01 RR-43     

Effects of paced respiration on heart period and heart period variability

The present study investigated psychophysiological responses to paced respiration of different frequencies. Twenty men and 20 women (mean age: 24.3 years) underwent five breathing conditions (paced with 0.15 Hz, 0.20 Hz, 0.25 Hz, 0.30 Hz, and unpaced), each lasting 5 min. As dependent physiological measures heart period, and different heart period variability (HPV) parameters were assessed. Psychological variables consisted of mood estimates as well as rated accuracy and effort to follow the pacing rhythm. HPV decreased with higher breathing frequencies, under paced and unpaced conditions, whereas mood ratings did not change. Subjects indicated more effort and less accuracy in following the pacing signal, the more its frequency differed from their spontaneous breathing frequency. The comparison of a spontaneous breathing condition with a frequency-matched paced condition revealed that pacing per se provoked a reduction in heart period. Because this decrease was not accompanied by changes in any of the HPV frequency components, their validity as measures of autonomic control needs to be questioned.     

ECG artifacts and heart period variability: Don't miss a beat!

The impact of artifacts on estimates of heart period variability were evaluated by modeling the effects of missed R-waves and spurious R-wave detections in actual and simulated heart period series. Results revealed that even a single artifact, occurring within a 128-s interbeat interval series, can impart substantial spurious variance into all commonly analyzed frequency bands, including that associated with respiratory sinus arrhythmia. In fact, the spurious variance introduced by a single artifact may be greater than that associated with true basal heart period variability and can far exceed typical effect sizes in psychophysiological studies. The effects of artifacts are not related to a specific analytical method and are apparent in both frequency and time domain analyses. Results emphasize the importance of artifact detection and resolution for studies of heart period variability.     

Time and frequency domain methods for heart rate variability analysis: A methodological comparison

The purpose of this paper is to analytically evaluate and compare two of the most common methods for measuring respiration-related heart rate fluctuations: linear detrended heart rate power spectral analysis and the Porges technique of filtered variance. Low-frequency power was removed from instantaneous 4-Hz R-R interval signals using either a first-order linear (linear/spectral technique) or a third-order polynomial (MPF-var technique). The signals were band-pass filtered and analyzed in both the time and frequency domains. Although in most cases the two techniques yielded substantially similar results, the MPF-var technique resulted in signal amplification at a few specific frequencies. The frequency range and effect of amplification of the MPF-var technique were dependent upon the polynomial size, sampling frequency, and frequency content of the signal.     

Respiration and heart rate complexity: Effects of age and gender assessed by band-limited transfer entropy

Aging and disease are accompanied with a reduction of complex variability in the temporal patterns of heart rate. This reduction has been attributed to a break down of the underlying regulatory feedback mechanisms that maintain a homeodynamic state. Previous work has established the utility of entropy as an index of disorder, for quantification of changes in heart rate complexity. However, questions remain regarding the origin of heart rate complexity and the mechanisms involved in its reduction with aging and disease. In this work we use a newly developed technique based on the concept of band-limited transfer entropy to assess the aging-related changes in contribution of respiration and blood pressure to entropy of heart rate at different frequency bands. Noninvasive measurements of heart beat interval, respiration, and systolic blood pressure were recorded from 20 young (21–34 years) and 20 older (68–85 years) healthy adults. Band-limited transfer entropy analysis revealed a reduction in high-frequency contribution of respiration to heart rate complexity (p < 0.001) with normal aging, particularly in men. These results have the potential for dissecting the relative contributions of respiration and blood pressure-related reflexes to heart rate complexity and their degeneration with normal aging.     

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.     

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.     

Reproducibility of heart rate variability and baroreflex sensitivity measurements in children

Despite their extensive use, the reproducibility of cardiac autonomic measurements in children is not well-known. We investigated the reproducibility of short-term continuous measurements of heart rate (HR), heart rate variability (HRV, time and frequency domain), and spontaneous baroreflex sensitivity (BRS, frequency domain) in the supine and standing position in 57 children (11.2 ± 0.7 years, 52.6% boys). Reproducibility between two sessions within a two-week interval was evaluated by intraclass correlation coefficients (ICCs), standard error of measurement, coefficients of variation (CVs), limits of agreement, and Bland-Altman plots. HR and HRV were moderately-to-highly (ICC = .63-.79; CV = 5.7%-9.7%) and BRS moderately (ICC = .49-.63; CV = 11.4%-14.0%) reproducible. While the BRS measurements were slightly less reproducible than the HR and HRV measurements, all can be reliably applied in research, thus implicating sufficient capacity to detect real differences between children. Still, clinical studies focusing on individual changes in cardiac autonomic functioning need to address the considerable random variations that may occur between test-retest measurements.     

Sleep state and vagal regulation of heart period patterns in the human newborn: an extension of the polyvagal theory

The influence of sleep state (i.e., active and quiet) on heart period, heart period variability, respiratory sinus arrhythmia (RSA), and the coupling between RSA and heart period was evaluated in 24 healthy full-term newborns. Electrocardiogram (ECG) data were collected, and sleep state was coded 1 hr after feeding until at least 10 min of data were collected in states of active and quiet sleep. ECG data were analyzed for the first five continuous minutes of each sleep state. Relative to active sleep, quiet sleep was associated with significantly higher amplitude RSA, lower heart period variability, and longer heart periods. Because RSA amplitude reflects the functional output of vagal pathways originating in the nucleus ambiguus, it was hypothesized that sleep state would influence how these vagal pathways regulate instantaneous changes in heart period. A new method, evaluating the instantaneous coupling of RSA and heart period, demonstrated that coupling was significantly greater during active sleep. The neurophysiological explanation extends the polyvagal theory to include potential cortical-brain stem connections.     

Effects of mental and physical demands on heart rate variability during computer work

The aim of the study was to evaluate the effect of physical and mental demands on heart rate variability- (HRV-) derived indices of autonomic activity. Ten healthy, female subjects performed two computer tasks: one with combined mental and physical demands and a reference task primarily consisting of physical demands. The combined task, which was performed once with a keyboard and once with a computer mouse, was a computerized version of the colour word conflict task (CWT). The CWT is highly mentally demanding due to the inherent perceptual conflict between a word stimulus and a colour stimulus. In the reference task (REF) the physical demands were comparable to CWT, while the mental demands were low. Finally, the subjects rested at the workplace (REST). Data on performance, heart rate (HR), mean arterial blood pressure (MAP), HRV, and urinary concentrations of catecholamines were obtained. The following frequency bands were applied for HRV: very low frequency (VLF, 0.00–0.04 Hz), low frequency (LF, 0.05–0.15 Hz), high frequency (HF, 0.16–0.40 Hz) and total power (TP, 0.00–0.40 Hz). Indices of sympathetic nervous activity (I_SNS) and parasympathetic nervous activity (I_PNS) were estimated as normalized powers in LF and HF bands: I_SNS=LF/(TP–VLF) and I_PNS=HF/(TP–VLF). Values are expressed as normalised units (nu). There was an increase in I_SNS during CWT [mouse: 0.490 (0.052) nu [ave (SEM)] and keyboard: 0.476 (0.039) nu] and REF [mouse: 0.453 (0.059) nu and keyboard: 0.489 (0.047) nu] compared to REST [0.397 (0.047) nu], but no difference between CWT and REF. Corresponding decreases were observed for I_PNS. HR and MAP were higher during CWT compared to REST. No effects were observed for excreted amounts of catecholamines. There were no differences between the computer mouse and the keyboard condition for I_SNS and I_PNS. In conclusion, an increase in I_SNS and a decrease in I_PNS were found in response to a physically demanding reference computer task. Addition of mental demands did not elicit any further effect on I_SNS and I_PNS, suggesting a significant influence of the physical rather than the mental demands during computer work. Electronic Publication     

Comparison of Respiratory Rates Derived from Heart Rate Variability, ECG Amplitude, and Nasal/Oral Airflow

It would often be desirable to obtain the respiratory rate during everyday conditions without obtaining an additional respiratory trace. This study investigates the agreement between respiratory rate assessed from the electrocardiogram (ECG) and the reference respiratory rate derived from a nasal/oral airflow (AF). Nasal/oral airflow and a Holter ECG were recorded in 52 healthy subjects (26 males, age range: 25.4–85.4 years) during everyday conditions for at least 10 h, including night-time sleep. The respiratory rate was assessed for each 5-min epoch (1) using respiratory sinus arrhythmia (RSA), (2) utilizing the respiration induced variations of the R-wave amplitude (ECG derived respiration (EDR)). The agreement with respect to AF was quantified using the average/std and the concordance correlation coefficient ρ_c. For RSA and EDR the difference with respect to AF was 0.2 cpm (std: 0.6 cpm) during sleep and −0.2 cpm (std: 1.0 cpm) during wake time. During sleep the RSA-approach performed best for subjects ≤50 years (ρ_c = 0.79) and worst for subjects >50 years (ρ_c = 0.41). The correlation of the EDR-approach was ρ_c = 0.73 for both groups. In conclusion, the respiratory rate may be assessed with reasonable agreement by both methods in younger subjects, but EDR should be preferred in the elderly.

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.     

Cardiac vagal tone, exercise performance and the effect of respiratory training

Heart rate variability (HRV) at rest and heart rate recovery after exercise reflect cardiac vagal activity. The aim of this study was to determine whether increasing HRV during involuntary respiratory training induced by rebreathing air using a Hepburn heart and lung exerciser (HHALE) could, like exercise, improve vagal tone. Eighteen subjects (36–88 years) underwent a 6-week control period, then a 6-week training period with the HHALE following which half continued training for 6 weeks and half ceased training. Measurements were made of HRV, work at 60% predicted heart rate max for 15 min, heart rate recovery after exercise, resting blood pressure, heart rate, vital capacity and forced expiratory volume. After the first 6-week HHALE training, there was a significant increase of 13.2±5.7 in the high frequency peak of the power spectrum of HRV at rest, whereas, the low frequency peak decreased. Similarly, exercise performance showed a significant improvement of 0.031±0.012 J per heartbeat from a pre-training 0.128±0.022. Also, heart rate recovery after exercise significantly faster (drop in the first 20 s improving by 3.3±1.5 beats from a pre-training 12.9±1.6). The subgroup that continued training maintained or slightly improved these values. In those that ceased training the speed of heart rate recovery at the end of the exercise test returned to pre-trained levels, whereas, other responses were either maintained or decreased slightly. We conclude that training with the HHALE can, without additional exercise, increase cardiac vagal tone and exercise performance.     

Influence of respiratory activity on the cardiac response pattern to mental effort

A group of 32 healthy adult volunteers completed three blocks of a reaction time task that varied in the degree of controlled processing load. A rest period preceded each of the task blocks. The task blocks were presented in the order of either increasing or decreasing cognitive load. For each of the six periods, mean values and spectral measures of heart rate and respiration variability were calculated. The spectral measures were obtained for three different frequency bands. Differences between the cardiac measures of the task and preceding rest periods were compared with respect to differences in task load and the order of task presentation. All comparisons were carried out while adjusting for respiratory variability in the corresponding frequency band. The frequency band in which task load-related changes in heart rate variability became manifest appeared to be dependent on the individual's breathing pattern.     

Temperamental activation and inhibition associated with autonomic function in preadolescents. The TRAILS study

We investigated the temperamental traits high-intensity pleasure (temperamental activation) and shyness (temperamental inhibition) in relation to autonomic function as measured by heart rate (HR), respiratory sinus arrhythmia (RSA), and baroreflex sensitivity (BRS) in 938 10-13-year-old preadolescents from a population cohort. Temperament was evaluated by parent reports on the Revised Early Adolescent Temperament Questionnaire. Autonomic measurements were obtained in supine and standing position. High-intensity pleasure was negatively associated with supine HR and positively with supine RSA and BRS in both genders. Shyness was positively related to supine BRS in girls only. Orthostatic-based autonomic reactivity (difference) scores adjusted for supine values were unrelated to temperamental measures. It appeared that higher scores on temperamental activation and inhibition are associated with higher cardiac vagal activity (RSA) and/or flexible regulation of autonomic balance (BRS), implicating healthy physiological functioning. Moreover, results suggest a physiological basis promoting the tendency towards engagement in high-intensity activities.