Effects of dynamic resistance training on heart rate variability in healthy older women

Twenty healthy women aged between 65 and 74 years, trained three times a week, for 16 weeks, on a cycle ergometer, to determine the effects of dynamic resistance training on heart rate variability (HRV). Subjects were allocated to two training groups, high (HI, n=10) and low (LO, n=10) intensity. The HI group performed eight sets of 8 revolutions at 80% of the maximum resistance to complete 2 pedal revolutions (2RM); the LO group performed eight sets of 16 pedal revolutions at 40% of 2RM. Subjects were tested twice before, as control period (−4 weeks and 0 weeks) and once after training (16 weeks) for HRV, maximum voluntary contraction (MVC) of knee extensors and peak power (P _p) of lower limbs by jumping on a force platform. HRV was measured using time and frequency domain parameters. Two-way ANOVA for repeated measures was performed on all variables (P<0.05). Results showed no differences between training groups. Following training HRV was not modified, while MVC and P _p significantly increased. The two proposed forms of dynamic resistance training were appropriate to improve muscle power and strength in elderly females without affecting HRV. More research should verify the effects of an isometric and more prolonged training stimulus on HRV in older subjects. Electronic Publication     

Time‐varying correlations between delta EEG power and heart rate variability in midlife women: The SWAN Sleep Study

No studies have evaluated the dynamic, time‐varying relationship between delta electroencephalographic (EEG) sleep and high frequency heart rate variability (HF‐HRV) in women. Delta EEG and HF‐HRV were measured during sleep in 197 midlife women (M_age = 52.1, SD = 2.2). Delta EEG–HF‐HRV correlations in nonrapid eye movement (NREM) sleep were modeled as whole‐night averages and as continuous functions of time. The whole‐night delta EEG–HF‐HRV correlation was positive. The strongest correlations were observed during the first NREM sleep period preceding and following peak delta power. Time‐varying correlations between delta EEG–HF‐HRV were stronger in participants with sleep‐disordered breathing and self‐reported insomnia compared to healthy controls. The dynamic interplay between sleep and autonomic activity can be modeled across the night to examine within‐ and between‐participant differences including individuals with and without sleep disorders.     

Emotional functioning among children with neurofibromatosis type 1 or Noonan syndrome

While neurofibromatosis type 1 (NF1) and Noonan syndrome (NS) are clinically distinct genetic syndromes, they have overlapping features because they are caused by pathogenic variants in genes encoding molecules within the Ras‐mitogen‐activated protein kinase signaling pathway. Increased risk for emotional and behavioral challenges has been reported in both children and adults with these syndromes. The current study examined parent‐report and self‐report measures of emotional functioning among children with NF1 and NS as compared to their unaffected siblings. Parents and children with NS (n = 39), NF1 (n = 39), and their siblings without a genetic condition (n = 32) completed well‐validated clinical symptom rating scales. Results from parent questionnaires indicated greater symptomatology on scales measuring internalizing behaviors and symptoms of attention deficit hyperactivity disorder (ADHD) in both syndrome groups as compared with unaffected children. Frequency and severity of emotional and behavioral symptoms were remarkably similar across the two clinical groups. Symptoms of depression and anxiety were higher in children who were also rated as meeting symptom criteria for ADHD. While self‐report ratings by children generally correlated with parent ratings, symptom severity was less pronounced. Among unaffected siblings, parent ratings indicated higher than expected levels of anxiety. Study findings may assist with guiding family‐based interventions to address emotional challenges.     

End-tidal carbon dioxide monitoring indicates recovery from cardiogenic shock in patients receiving percutaneous cardiopulmonary support

The aim of this study was to examine the prognostic value of monitoring end-tidal carbon dioxide (ETCO₂) levels for patients in cardiogenic shock undergoing percutaneous cardiopulmonary support (PCPS). Fifteen patients in whom PCPS was used to treat cardiogenic shock were enrolled in this study. For hemodynamic measurements, a thermodilution catheter was inserted into the pulmonary artery and an infrared absorption sensor was placed in the main stream of exhaled air between the respiration tube and the respirator to measure ETCO₂ levels. Nine patients (group II, 60%) died of multiple organ failure. In the six survivors (group I), there was a significant increase in average ETCO₂ level from 8.8 ± 3.9 mmHg before treatment to 20.5 ± 2.1 mmHg 24 h after the start of PCPS compared with values in group II patients (8.8 ± 3.9 mmHg, P = 0.0411). Also, serum lactate concentrations fell significantly in group I patients (group I 2.8 ± 0.47 mmol/l, group II 9.0 ± 2.31 mmol/l, P = 0.0435). The mean ETCO₂ level in group I patients gradually returned to 23 mmHg, which was within the normal healthy range; these patients were successfully weaned from PCPS. These results suggest that, in cardiogenic shock patients, ETCO₂ level is a possible index of cardiac recovery during PCPS support.     

Epidemiologic,clinical, and virologic characteristics of human rhinovirus infection among otherwise healthy children and adults: Rhinovirus among adults and children

Backgroundhuman rhinovirus (HRV) is a major cause of influenza-like illness (ILI) in adults and children. Differences in disease severity by HRV species have been described among hospitalized patients with underlying illness. Less is known about the clinical and virologic characteristics of HRV infection among otherwise healthy populations, particularly adults.Objectivesto characterize molecular epidemiology of HRV and association between HRV species and clinical presentation and viral shedding.Study designobservational, prospective, facility-based study of ILI was conducted from February 2010 to April 2012. Collection of nasopharyngeal specimens, patient symptoms, and clinical information occurred on days 0, 3, 7, and 28. Patients recorded symptom severity daily for the first 7 days of illness in a symptom diary. HRV was identified by RT-PCR and genotyped for species determination. Cases who were co-infected with other viral respiratory pathogens were excluded from the analysis. We evaluated the associations between HRV species, clinical severity, and patterns of viral shedding.Resultseighty-four HRV cases were identified and their isolates genotyped. Of these, 62 (74%) were >18 years. Fifty-four were HRV-A, 11HRV-B, and 19HRV-C. HRV-C infection was more common among children than adults (59% vs. 10%, P < 0.001). Among adults, HRV-A was associated with higher severity of upper respiratory symptoms compared to HRV-B (P = 0.02), but no such association was found in children. In addition, adults shed HRV-A significantly longer than HRV-C (P trend = 0.01).Conclusionsamong otherwise healthy adults with HRV infection, we observed species-specific differences in respiratory symptom severity and duration of viral shedding.     

Dimensions of anxiety and depression and neurophysiological indicators of error-monitoring: Relationship with delta and theta oscillatory power and error-related negativity amplitude

Error-monitoring processes may be affected by transdiagnostic dimensions of psychopathology symptoms including trait anxiety, worry, and severity of depressive symptoms. We tested the relationship between continuous measures of anxiety and depressive symptomology and neural correlates of error-monitoring as measured by time-frequency domain delta and theta oscillatory power and time-domain error-related negativity (ERN) amplitude extracted from the electroencephalogram (EEG). Secondary analyses tested for diagnostic group differences in error-related neural responses in individuals with generalized anxiety disorder (GAD), major depressive disorder (MDD), and comorbid psychiatric disorders. About 178 participants (104 female, M[SD]_age = 21.7[4.6]) with a wide range of psychopathology symptoms completed a modified version of the Eriksen flanker task and symptom questionnaires. Residualized difference values between correct and error trials for delta/theta power and error/correct ERN amplitude were used as dependent variables. Linear regression analyses adjusted for age, sex, and task accuracy showed nonsignificant associations of symptom dimension measures with error-related residualized delta/theta power or residualized ERN amplitude. Subset analyses on those with confirmed psychopathology diagnoses also did not predict residualized error-related delta/theta power nor residualized ERN amplitude (n_GAD = 14, n_MDD = 28, n_Comorbid = 19, n_Control = 85). Taken in the context of the previous literature, results suggest a heterogeneous relationship between depressive and anxiety symptom dimensions and neurophysiological indices of error-monitoring.     

Sampling frequency of the RR interval time series for spectral analysis of heart rate variability

Spectral analysis of heart rate variability (HRV) is an accepted method for assessment of cardiac autonomic function and its relationship to numerous disorders and diseases. Various non-parametric methods for HRV estimation have been developed and extensive literature on their respective properties is available. The RR interval time series can be seen as a series of non-uniformly spaced samples. To analyse the power spectra of this series using the discrete Fourier transform (DFT), we need to interpolate the series for obtaining uniformly spaced intervals. The selection of sampling period plays a critical role in obtaining the power spectra in terms of computational efficiency and accuracy. In this paper, we shall analyse the RR interval time series from selected subjects for different sampling frequencies to compare the error introduced in selected frequency-domain measures of HRV at a constant frequency resolution for a specific duration of electrocardiogram (ECG) data. It should be pointed out that, although many other error causes are possible in the frequency-domain measures, our attention will be confined only to the performance comparison due to the different sampling frequencies. While the choice of RR interval sampling frequency (f_s) is arbitrary, the sampling rate of RR interval series must be selected with due consideration to mean and minimum RR interval; f_s?=?4 Hz was proposed for a majority of cases. This is an appropriate sampling rate for the study of autonomic regulation, since it enables us to compute reliable spectral estimates between dc and 1 Hz, which represents the frequency band within which the autonomic nervous system has significant response. Furthermore, resampled RR intervals are evenly spaced in time and are synchronized with the samples of the other physiologic signals, enabling cross-spectral estimates with these signals.     

Subjective Sleep Related to Post Traumatic Stress Disorder Symptoms among Trauma-Exposed Men and Women

Objective/Background: Sleep difficulty is both a common symptom of posttraumatic stress disorder (PTSD) and a risk factor for the development and maintenance of PTSD symptomatology. Gender differences in sleep following trauma exposure have been posited to contribute to the increased risk for the development of PTSD among women, but the persistence and long-term contributions of these potential differences to the maintenance and severity of PTSD symptoms is unclear. Participants: Men and women reporting a history of trauma exposure (n = 112, 63% female) participated in this study. Methods: Subjective sleep complaints and PTSD symptom severity were assessed using well-validated measures (Pittsburgh Sleep Quality Index, PTSD Symptom Checklist). Multivariable regression models (full sample and gender-stratified) were used to predict PTSD symptom severity from global, subscale, and individual item sleep parameters, adjusted for gender, age, race/ethnicity, education, and body mass index. Results: In the full sample, traditional measures of sleep quality and sleep disturbance were associated with PTSD symptom severity. Difficulty falling asleep, poor sleep quality, and sleep disturbance from a variety of sources were related to higher PTSD symptom severity in men, while self-reported sleep disturbance related to nightmares and emotional regulation were associated with PTSD symptom severity among women. Conclusions: These findings add to the limited literature on gender-specific risk factors related to sleep and PTSD, and may inform intervention development and implementation related to PTSD severity among vulnerable adults.     

Risk factors for homelessness: A structural equation approach

This study aims to assess the pathway relationships between adolescent adversities, adult addictive behaviours, divorce, conviction, long-standing unemployment, disability, and homelessness. A structural equation model was estimated using data on n₁ = 677 homeless men and n₂ = 651 housed men of the same age and educational distribution, living in Warsaw, Poland. Retrospective adolescent adversities were found to be significantly related to the occurrence of adult homelessness (p ≤ .01). This relationship was mainly indirect and largely mediated by addictive behaviours, divorce, conviction, and unemployment. Addiction, divorce, and conviction were the three most frequent events preceding homelessness and were likely to coincide. The first job experience did not differentiate the two groups from each other. However, homeless individuals were more likely to currently prefer self-employment over wage employment. Low perceived importance of family life and preference for self-employment over wage employment were hypothesised to be related to the severity of homelessness.     

Heart rate variability predicts outcome of short-term psychotherapy at the workplace

The bio-psycho-social model highlights intra-individual and inter-individual interactions, including psychotherapy. The processing of these interactions within a person takes place, among others, in the central autonomic network (CAN). The CAN's autonomic output to the periphery can be indexed by heart rate variability (HRV), representing individual adaptive capacity. Further, the CAN influences the hypothalamus-pituitary–adrenal axis with its product cortisol. The aim consisted in investigating HRV and cortisol as well as their relation to symptom course in response to short-term psychotherapy. A single-arm, uncontrolled, explorative study was conducted at an outpatient psychotherapeutic consultation in the workplace offered to employees with mental or psychosomatic complaints. Questionnaires included symptoms of depression, irritation and functional impairment. Circadian profile of HRV and salivary cortisol concentrations collected pre and post short-term psychotherapeutic intervention (4–12 sessions) were assessed. Multilevel-linear mixed regressions were calculated. Out of 29 participants (mean age 42; 72% female), 24% were on sick leave from work. Cortisol concentrations were neither affected by intervention nor by symptom course. The proportion of individuals showing a vagally mediated HRV in the range of the lowest quartile assessed for age- and sex-matched healthy controls was reduced at follow-up (pre 34%, post 22%; p = .017). Higher vagally mediated HRV at baseline predicted lower symptom burden at follow-up. Thus, the results support the assumption that HRV reflects the capability of an organism to adapt and recover. Patients with reduced HRV might need additional psychotherapeutic sessions to achieve the same symptom improvements than patients with retained HRV.     

Fit-Fat Index is better associated with heart rate variability compared to fitness and fatness alone as indicators of cardiometabolic human health

Objectives

Cardiorespiratory fitness and fatness indicators have been related to heart rate variability (HRV) parameters. The Fit-Fat Index (FFI) is a single index combining cardiorespiratory fitness and fatness indicators. To the best of our knowledge, no studies have previously analyzed whether FFI are related to cardiac autonomic nervous system activity assessed through HRV parameters. This study aimed (i) to examine the association of cardiorespiratory fitness, fatness indicators, and FFI with HRV parameters; and (ii) to report what of the different fatness indicators included in FFI is better associated with HRV parameters in sedentary adults.

Methods

One hundred and fifty healthy adults (74 women; 76 men), aged between 18 and 65 years old, participated in this cross-sectional study. We measured cardiorespiratory fitness (maximal oxygen consumption) and fatness indicators (waist-to-height ratio [WHR], fat mass percentage [FM%] and visceral adipose tissue [VAT]). Three FFIs were calculated as the quotient between cardiorespiratory fitness and one out of three possible fatness indicators: Fit-Fat Index calculated waist-to-height ratio (FFI_WHR), Fit-Fat Index calculated with FM% (FFI_FM%), and Fit-Fat Index calculated with VAT (FFI_VAT). HRV parameters were measured in resting conditions using a Polar RS800CX.

Results

FFI_WTHR, FFI_FM% and FFI_VAT were related to different HRV parameters (β ranges between −0.507 and 0.529; R² ranges between 0.096 and 0.275; all p < .001) and the association was stronger with HRV parameters than the isolated fitness or fatness indicators (β ranges between −0.483 and 0.518; R² ranges between 0.071 and 0.263; all p < .001). FFI_VAT was the index more consistently associated with HRV parameters (β ranges between −0.507 and 0.529; R² ranges between 0.235 and 0.275; all p < .001).

Conclusion

Our study suggests that compound FFIs are better predictors of HRV parameters than either cardiorespiratory fitness or fatness indicators alone. The FFI_VAT was the best index in terms of its association to HRV.     

Adaptation of the respiratory controller contributes to the attenuation of exercise hyperpnea in endurance-trained athletes

We have reported that minute ventilation [ [(V)\dot]_\textE \dot{V}_{\text{E}} ] and end-tidal CO₂ tension [ P_{\textETCO 2} P_{{{\text{ETCO}}_{ 2} }} ] are determined by the interaction between central controller and peripheral plant properties. During exercise, the controller curve shifts upward with unchanged central chemoreflex threshold to compensate for the plant curve shift accompanying increased metabolism. This effectively stabilizes P_{\textETCO 2} P_{{{\text{ETCO}}_{ 2} }} within the normal range at the expense of exercise hyperpnea. In the present study, we investigated how endurance-trained athletes reduce this exercise hyperpnea. Nine exercise-trained and seven untrained healthy males were studied. To characterize the controller, we induced hypercapnia by changing the inspiratory CO₂ fraction with a background of hyperoxia and measured the linear P_{\textETCO 2} - [(V)\dot]_\textE P_{{{\text{ETCO}}_{ 2} }} - \dot{V}_{\text{E}} relation [ [(V)\dot]_\textE = S (P_\textETCO2 - B) \dot{V}_{\text{E}} = S\, (P_{{{\text{ETCO}}_{2} }} - {\rm B}) ]. To characterize the plant, we instructed the subjects to alter [(V)\dot]_\textE \dot{V}_{\text{E}} voluntarily and measured the hyperbolic [(V)\dot]_\textE - P_{\textETCO 2} \dot{V}_{\text{E}} - P_{{{\text{ETCO}}_{ 2} }} relation ( P_{\textETCO 2} = A/[(V)\dot]_\textE + C P_{{{\text{ETCO}}_{ 2} }} = A/\dot{V}_{\text{E}} + C ). We characterized these relations both at rest and during light exercise. Regular exercise training did not affect the characteristics of either controller or plant at rest. Exercise stimulus increased the controller gain (S) both in untrained and trained subjects. On the other hand, the P_{\textETCO 2} P_{{{\text{ETCO}}_{ 2} }} -intercept (B) during exercise was greater in trained than in untrained subjects, indicating that exercise-induced upward shift of the controller property was less in trained than in untrained subjects. The results suggest that the additive exercise drive to breathe was less in trained subjects, without necessarily a change in central chemoreflex threshold. The hyperbolic plant property shifted rightward and upward during exercise as predicted by increased metabolism, with little difference between two groups. The [(V)\dot]_\textE \dot{V}_{\text{E}} during exercise in trained subjects was 21% lower than that in untrained subjects (P < 0.01). These results indicate that an adaptation of the controller, but not that of plant, contributes to the attenuation of exercise hyperpnea at an iso-metabolic rate in trained subjects. However, whether training induces changes in neural drive originating from the central nervous system, afferents from the working limbs, or afferents from the heart, which is additive to the chemoreflex drive to breathe, cannot be determined from these results.     

Anger: The Unrecognized Emotion in Emotional Disorders

Anger plays a prominent definitional role in some psychological disorders currently widely scattered across DSM‐5 categories (e.g., intermittent explosive disorder, borderline personality disorder). But the presence and consequences of anger in the emotional disorders (e.g., anxiety disorders, depressive disorders) remain sparsely examined. In this review, we examine the presence of anger in the emotional disorders and find that anger is elevated across these disorders and, when it is present, is associated with negative consequences, including greater symptom severity and worse treatment response. Based on this evidence, anger appears to be an important and understudied emotion in the development, maintenance, and treatment of emotional disorders.     

A neurophysiological deficit in early visual processing in schizophrenia patients with auditory hallucinations

Existing 67‐channel event‐related potentials, obtained during recognition and working memory paradigms with words or faces, were used to examine early visual processing in schizophrenia patients prone to auditory hallucinations (AH, n = 26) or not (NH, n = 49) and healthy controls (HC, n = 46). Current source density (CSD) transforms revealed distinct, strongly left‐ (words) or right‐lateralized (faces; N170) inferior‐temporal N1 sinks (150 ms) in each group. N1 was quantified by temporal PCA of peak‐adjusted CSDs. For words and faces in both paradigms, N1 was substantially reduced in AH compared with NH and HC, who did not differ from each other. The difference in N1 between AH and NH was not due to overall symptom severity or performance accuracy, with both groups showing comparable memory deficits. Our findings extend prior reports of reduced auditory N1 in AH, suggesting a broader early perceptual integration deficit that is not limited to the auditory modality.     

Association between heart rate variability and training response in sedentary middle-aged men

The effect of exercise training on heart rate variability (HRV) and improvements in peak oxygen consumption ( _peak) was examined in sedentary middle-aged men. The HRV and absolute and relative _peak of training (n = 19) and control (n = 15) subjects were assessed before and after a 24-session moderate intensity exercise training programme. Results indicated that with exercise training there was a significantly increased absolute and relative _peak (P < 0.005) for the training group (12% and 11% respectively) with no increase for the control group. The training group also displayed a significant reduction in resting heart rate; however, HRV remained unchanged. The trained subjects were further categorized into high (n = 5) and low (n = 5) HRV groups and changes in _peak were compared. Improvements in both absolute and relative _peak were significantly greater (P > 0.005) in the high HRV group (17% and 20% respectively) compared to the low HRV group (6% and 1% respectively). The groups did not differ in mean age, pretraining oxygen consumption, or resting heart rate. These results would seem to suggest that a short aerobic training programme does not alter HRV in middle-aged men. Individual differences in HRV, however, may be associated with _peak response to aerobic training.     

A cross-sectional examination of growth indicators from Thai adolescent girls: Evidence of obesity among Thai youth?

Background: Few studies have examined growth data from adolescent girls in Southeast Asia and almost none have been carried out in Thailand. Thus this study examines growth data from Thai adolescent girls.

Aim: Cross-sectional growth data from a sample of Thai girls were compared to reference data from healthy well-nourished girls. It is hypothesized that the reference girls will be taller and heavier than the Thai girls; however, the growth indicators will also indicate that obesity is present among Thai girls.

Subjects and methods: Anthropometric and age at menarche data were collected from a sample of 319 adolescent girls ages 11–17 years living in suburban Thailand.

Results: Thai girls are heavier than the reference girls at ages 11–13 years yet are shorter and lighter than the reference girls at ages 14–17 years. The data also reveal that 18.4% of the girls are overweight or obese as classified by the CDC BMI-for-age percentile growth curves.

Conclusion: The findings suggest the presence of overweight and obesity among this adolescent Thai population. These data may reflect the impact of the improved economic situation of Thailand as well as the impact of body image concerns among these young girls.     

A Tryptophan Hydroxylase 2 Gene Polymorphism is Associated with Panic Disorder

Panic disorder (PD) is a complex and heterogeneous psychiatric condition. Dysfunction within the serotonergic system has been hypothesized to play an important role in PD. The novel brain-specific serotonin synthesizing enzyme, tryptophan hydroxylase 2 (TPH2), which represents the rate-limiting enzyme of serotonin production in the brain, may therefore be of particular importance in PD. We investigated the TPH2 703G/T SNP for association with PD. Patients with PD (n = 108), and control subjects (n = 247), were genotyped for rs4570625 (TPH2 703G/T). Male and female subjects were analyzed separately. The severity of their symptoms was measured using the Spielberger state-trait anxiety inventory (STAI), panic disorder severity scale (PDSS), anxiety sensitivity index (ASI), acute panic inventory (API), and Hamilton’s rating scale for depression (HAMD). The genotype and allele frequencies of the PD patients and controls were analyzed using χ ² statistics. There was a significant difference in the allele frequency in rs4570625 between the PD patients and normal controls. The T allele was significantly less frequent in the PD patients. We also found a significant association with rs4570625 in the female subgroup. There was no difference in symptom severity among the genotypes of this polymorphism. This result suggests that rs4570625 polymorphism may play a significant role in the pathogenesis of PD. Moreover, rs4570625 may have a gender-dependent effect on susceptibility to PD. Further studies are needed to replicate the association that we observed. Edited by Tatiana Foroud.     

The Association of Heart Rate Variability with Parkinsonian Motor Symptom Duration

Purpose

Impaired cardiovascular autonomic regulation is a non-motor symptom of Parkinson''s disease (PD) and may increase long-term morbidity. This study applied frequency-domain analysis of heart rate variability (HRV) to understand the progression of sympathetic and parasympathetic cardiac regulation in patients with PD.

Materials and Methods

In this cross-sectional study, 21 male and 11 female Taiwanese patients with advanced PD and 32 healthy gender- and age-matched subjects were enrolled. To minimize artifacts due to subject motion, daytime electrocardiograms for 5 minutes were recorded in awake patients during levodopa-on periods and controls. Using fast Fourier transformation, heart rate variables were quantified into a high-frequency power component [0.15-0.45 Hz, considered to reflect vagal (parasympathetic) regulation], low-frequency power component (0.04-0.15 Hz, reflecting mixed sympathetic and parasympathetic regulation), and low-frequency power in normalized units (reflecting sympathetic regulation). The significance of between-group differences was analyzed using the paired t-test. Pearson correlation analysis and stepwise regression analysis were applied to assess the correlation of patient age, PD duration, and disease severity (represented by the Unified Parkinson''s Disease Rating Scale) with each heart rate variables.

Results

Impaired HRV is significantly correlated with the duration of PD, but not with disease severity and patient age. Meanwhile, parasympathetic heart rate variable is more likely than sympathetic heart rate variable to be affected by PD.

Conclusion

PD is more likely to affect cardiac parasympathetic regulation than sympathetic regulation by time and the heart rate variables have the association with Parkinsonian motor symptom duration.