Altered salivary alpha-amylase awakening response in Bosnian War refugees with posttraumatic stress disorder

In posttraumatic stress disorder (PTSD), chronic activation of the sympathetic nervous system (SNS) has been suggested. No study so far has investigated diurnal secretion patterns of salivary alpha-amylase (sAA) in PTSD, a promising candidate for non-invasive assessment of SNS activity. We compared sAA diurnal profiles between a group of Bosnian War refugees with PTSD and a healthy control group, and further analyzed for associations with psychiatric symptoms and glucocorticoid (GC) sensitivity of inflammatory regulation. PTSD patients showed a sAA awakening response profile that was opposite to those seen in healthy controls, i.e. an increase instead of a sharp decrease. Patterns of sAA secretion were further positively associated with psychiatric symptoms of PTSD. Finally, higher sAA awakening responses were associated with higher GC sensitivity of inflammatory cytokine production. These findings are in line with altered SNS function in PTSD, and lend further support for employing assessment of diurnal sAA profiles as non-invasive biomarkers in stress-related disease.     

Stress selectively and lastingly promotes learning of context-related high arousing information

The secretion of adrenal stress hormones in response to acute stress is known to affect learning and memory, particularly for emotionally arousing memory material. Here, we investigated whether stress-induced modulation of learning and memory performance depends on (i) the conceptual relatedness between the material to be learned/remembered and the stressor and (ii) the timing of stress exposure versus learning phase. Participants learned stressor-related and stressor-unrelated words of varying arousal 1 h prior to, immediately following, or 2 h after exposure to the Trier Social Stress Test (all groups n = 16). Twenty-four hours later, delayed free recall was assessed. Cortisol and alpha-amylase were sampled to evaluate if concurrent stress-induced raised glucocorticoid levels and high adrenergic activity are implicated in modulating learning performance. Our results demonstrate that immediate and delayed post-stress learning selectively enhanced the learning and delayed recall of stressor-related high arousing words. This enhancing effect was strongly associated with concurrent stress-induced cortisol and sympathetic activity. Our data suggest that when to-be-learned information is conceptually related to a stressor and considered important (i.e., arousing) by the individual, learning under stressful circumstances results in improved memorability afterwards.     

Salivary alpha-amylase and cortisol responsiveness following electrical stimulation stress in obsessive–compulsive disorder patients

Salivary α-amylase (sAA) serves as a marker of sympathoadrenal medullary system (SAM) activity. Salivary AA has not been extensively studied in obsessive–compulsive disorder (OCD) patients. In the current study, 45 OCD patients and 75 healthy volunteers were assessed with the Yale–Brown Obsessive–Compulsive Scale (Y–BOCS), the Profile of Mood State (POMS), and the State-Trait Anxiety Inventory (STAI). Measures of heart rate variability (HRV), sAA, and salivary cortisol were also obtained following the application of electrical stimulation stress. The Y–BOCS and POMS Tension–Anxiety, Depression–Dejection, Anger–Hostility, Fatigue, and Confusion scores were significantly increased in patients with OCD compared with healthy controls. In contrast, Vigor scores were significantly decreased in patients with OCD relative to scores in healthy controls. There was no difference in HRV between the patients and the controls. Salivary AA levels in female and male OCD patients were significantly elevated relative to controls both before and after electrical stimulation. In contrast, there were no differences in salivary cortisol levels between OCD patients and controls. The elevated secretion of sAA before and after stimulation may suggest an increased responsiveness to novel and uncontrollable situations in patients with OCD. An increase in sAA might be a characteristic change of OCD.     

Evidence for a modulating effect of transcutaneous auricular vagus nerve stimulation (taVNS) on salivary alpha-amylase as indirect noradrenergic marker: A pooled mega-analysis

BackgroundNon-invasive transcutaneous auricular vagus nerve stimulation (taVNS) has received tremendous attention as a potential neuromodulator of cognitive and affective functions, which likely exerts its effects via activation of the locus coeruleus-noradrenaline (LC-NA) system. Reliable effects of taVNS on markers of LC-NA system activity, however, have not been demonstrated yet.MethodsThe aim of the present study was to overcome previous limitations by pooling raw data from a large sample of ten taVNS studies (371 healthy participants) that collected salivary alpha-amylase (sAA) as a potential marker of central NA release.ResultsWhile a meta-analytic approach using summary statistics did not yield any significant effects, linear mixed model analyses showed that afferent stimulation of the vagus nerve via taVNS increased sAA levels compared to sham stimulation (b = 0.16, SE = 0.05, p = 0.001). When considering potential confounders of sAA, we further replicated previous findings on the diurnal trajectory of sAA activity.Conclusion(s)Vagal activation via taVNS increases sAA release compared to sham stimulation, which likely substantiates the assumption that taVNS triggers NA release. Moreover, our results highlight the benefits of data pooling and data sharing in order to allow stronger conclusions in research.     

Salivary alpha-amylase and cortisol responsiveness following electrical stimulation stress in major depressive disorder patients

Major depressive disorder (MDD) is often associated with dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis by chronic stress. In comparison, psychosocial stress-induced activation of salivary α-amylase (sAA) functions as a marker of sympathoadrenal medullary system (SAM) activity. However, in contrast to salivary cortisol, sAA has been less extensively studied in MDD patients. The present study measured sAA and salivary cortisol levels in patients with MDD. The authors determined Profile of Mood State (POMS) and State-Trait anxiety Inventory (STAI) scores, Heart Rate Variability (HRV), and sAA and salivary cortisol levels in 88 patients with MDD and 41 healthy volunteers following the application of electrical stimulation stress. Patients with major depressive disorder were 8 points or more on Hamilton Depression Scale (HAM-D) scores. Tension-Anxiety, Depression-Dejection, Anger-Hostility, Fatigue, and Confusion scores in patients with major depressive disorder were significantly increased compared to healthy controls. In contrast, Vigor scores in patients with MDD were significantly decreased compared with healthy controls. There was no difference in heart rate variability measures between MDD patients and healthy controls. The threshold of electrical stimulation applied in MDD patients was lower than that in healthy controls. SAA levels in female MDD patients were significantly elevated relative to controls both before and after electrical stimulation. Finally, there were no differences in salivary cortisol levels between major depressive patients and controls. In the present study only three time points were explored. Furthermore, the increased secretion of sAA before and after stimulation could allude to an increased responsiveness of novel and uncontrollable situations in patients with MDD. These preliminary results suggest that sAA might be a useful biological marker of MDD.     

Autonomic and hypothalamic-pituitary-adrenal stress resilience: Impact of cardiac vagal tone

Resilience refers to the ability to cope with stressful events. Variation in the activity of the stress-responsive sympatho-adrenal-medullary and hypothalamic-pituitary-adrenal axes is particularly important for adaptive stress responses and thus may give rise to individual differences in resilience. Here, we investigated whether cardiac vagal tone and adult attachment style are related to psychophysiological stress resilience by exposing a sample of healthy young men and women (n = 68) to a laboratory stress test while monitoring autonomic (heart rate, salivary alpha-amylase), hypothalamic-pituitary-adrenal (salivary cortisol), and psychological stress levels. Our results demonstrate that adult attachment style did not influence autonomic, hypothalamic-pituitary-adrenal, or psychological stress responses. In contrast, higher resting cardiac vagal tone was associated with stress-induced increases in cortisol. This suggests a role for sympathetic influences on heart rate regulation in hypothalamic-pituitary-adrenal stress responses, and extends previous observations of a link between vagal tone and stress resilience.     

Association of blood pressure and antihypertensive drugs with diurnal alpha-amylase activity

Salivary α-amylase (sAA) has been proposed as a marker of autonomic activity, but its association with blood pressure and antihypertensive drugs (AD) is unknown. Basal sAA rhythm was assessed immediately after awakening, 30 min after awakening, 11 am, 3 pm, and 8 pm in 78 older adults. Profiles differed significantly between men and women, with men lacking the typical decrease of sAA in the morning and showing more pronounced alterations throughout the day. A higher total output of sAA was found in individuals not using AD or being hypertensive, and especially pronounced in hypertensive individuals not using AD. These data indicates a difference between normotensives and hypertensives and an association of AD with characteristics of diurnal amylase. Findings highlight the usefulness of sAA as an index of autonomic imbalance in disease, and indicate sAA as a promising candidate to non-invasively study therapeutic treatment effects.     

True or false? Memory is differentially affected by stress-induced cortisol elevations and sympathetic activity at consolidation and retrieval

Adrenal stress hormones released in response to acute stress may yield memory-enhancing effects when released post-learning and impairing effects at memory retrieval, especially for emotional memory material. However, so far these differential effects of stress hormones on the various memory phases for neutral and emotional memory material have not been demonstrated within one experiment. This study investigated whether, in line with their effects on true memory, stress and stress-induced adrenal stress hormones affect the encoding, consolidation, and retrieval of emotional and neutral false memories. Participants (N = 90) were exposed to a stressor before encoding, during consolidation, before retrieval, or were not stressed and then were subjected to neutral and emotional versions of the Deese–Roediger–McDermott word list learning paradigm. Twenty-four hours later, recall of presented words (true recall) and non-presented critical lure words (false recall) was assessed. Results show that stress exposure resulted in superior true memory performance in the consolidation stress group and reduced true memory performance in the retrieval stress group compared to the other groups, predominantly for emotional words. These memory-enhancing and memory-impairing effects were strongly related to stress-induced cortisol and sympathetic activity measured via salivary alpha-amylase levels. Neutral and emotional false recall, on the other hand, was neither affected by stress exposure, nor related to cortisol and sympathetic activity following stress. These results demonstrate the importance of stress-induced hormone-related activity in enhancing memory consolidation and in impairing memory retrieval, in particular for emotional memory material.