677 research outputs found
The interaction between depression and autonomic dysregulation in patients undergoing cardiac surgery
No full textIn this thesis four studies have been described that were primarily meant to investigate the psychophysiological mechanisms underlying the relationship between depression and increased cardiac risk in patients after first time cardiac surgery, and, secondarily, to test the effectiveness of a cardiorespiratory biofeedback training in reducing cardiac risk in these patients.
Findings from the first study confirm and extend previous data on depressed patients with cardiovascular diseases by showing that also depressed patients after first time cardiac surgery had lowered vagal control on the heart, compared to patients without depression. In the second study, this relationship has been shown to be partially mediated by altered emotion regulation as a trait, and, specifically, by excessive use of suppression of emotions. Findings from the third study displayed that patients with postoperative depression had significantly greater stress response, characterized by disproportionate vagal withdrawal, specifically during unpleasant stressors, compared to nondepressed patients after surgery. More importantly, findings from the fourth study provide new evidence supporting the usefulness of a biofeedback of respiratory sinus arrhythmia training, in increasing vagal control on the heart and improving depressive symptoms.
In conclusion, the present thesis provides further information on the psychophysiological mechanisms underlying the relationship between depression and increased cardiac risk, and more importantly, yields evidence in support of the effectiveness of biofeedback training in patients after cardiac surgery
Are patient- or procedure-related factors relevant to middle-term cognitive decline after cardiac surgery? This is the question
No full textPreoperative biomedical risk and depressive symptoms are differently associated with reduced health-related quality of life in patients 1year after cardiac surgery
No full textObjective: To examine whether preoperative biomedical risk and depressive symptoms were associated with
physical and mental components of health-related quality of life (HRQoL) in patients 1 year after cardiac surgery.
Method: Seventy-five patients completed a psychological evaluation, including the Center for Epidemiological
Study of Depression scale, the 12-item Short-Form Physical Component Scale (SF-12-PCS) and Mental Component Scale (SF-12-MCS), the Instrumental Activities of Daily Living questionnaire for depressive symptoms and HRQoL, respectively, before surgery and at 1-year follow-up.
Results: Preoperative depressive symptoms predicted the SF-12-PCS (beta=−.22, P<.05) and SF-12-MCS
(beta=−.30, P<.04) scores in patients 1 year after cardiac surgery, whereas the European System for Cardiac
Operative Risk Evaluation was associated with SF-12-PCS (beta=−.28, P<.02), but not SF-12-MCS (beta=.01,
P=.97) scores postoperatively.
Conclusions: The current findings showed that preoperative depressive symptoms are associated with poor
physical and mental components of HRQoL, whereas high biomedical risk predicts reduced physical, but not
mental, functioning in patients postoperatively. This study suggests that a preoperative assessment of depressive symptoms in addition to the evaluation of common biomedical risk factors is essential to anticipate which patients are likely to show poor HRQoL after cardiac surgery
Preoperative and perioperative predictors of reactive and persistent depression after cardiac surgery: A three-month follow-up study
No full textObjective: Depression is commonly reported in patients after cardiac surgery and increases the risk of postoperative cardiac morbidity and/or mortality. Although preoperative depression has been implicated as the strongest predictor of depression after surgery, the characteristics thought to influence reactive or persistent depression have been poorly investigated in cardiac surgery patients. Therefore, the main aim of this study was to examine whether preexisting depression rather than perioperative variables may predict postoperative reactive or persistent depression.
Methods: Ninety-six patients completed a psychological evaluation, including the Center for Epidemiologic Studies of Depression (CES-D) scale and the State and Trait Anxiety Inventory (STAI Y1/Y2) for depression and anxiety, respectively, before surgery and at three-month follow-up.
Results: Twenty-seven (28%) and 24 (25%) patients had depression preoperatively and at three-month follow-up, respectively. Postoperative depression was predicted by preoperative scores in CES-D (beta= 0.29, P .75). Specifically, patients with reactive depression showed greater EuroSCORE than those without depression (P < .05), whereas patients with persistent depression had greater preoperative CES-D scores than those whose depression improved after surgery (P < .01).
Conclusions: The severity of preexisting depression and biomedical risk factors can be markers of depression-related risk three months after cardiac surgery in patients with persistent and reactive depression, respectively. An integrated psychological and biomedical evaluation is essential to anticipate which patients are likely to show depression after cardiac surgery
Improving Managers’ Psychophysical Well-Being: Effectiveness of Respiratory Sinus Arrhythmia Biofeedback
No full textHigh work stress has been consistently associated with disturbed autonomic balance, specifically, lowered vagal cardiac control and increased sympathetic activity, which may lead to increased cardiovascular risk. Stress management procedures have been proposed to reduce autonomic dysfunctions related to work stress in different categories of workers exposed to heightened work demands, while a limited number of studies addressed this issue in managers. The present study was aimed at evaluating the effectiveness of a respiratory sinus arrhythmia (RSA) biofeedback (BF) intervention on psychological and physiological outcomes, in managers with high-level work responsibilities. Thirty-one managers leading outstanding private or public companies were randomly assigned to either a RSA-BF training (RSA-BF; N = 16) or a control group (N = 15). The RSA-BF training consisted of five weekly 45 min sessions, designed to increase RSA, whereas controls had to provide a daily stress diary once a week. After the training, managers in both groups reported reduced heart rate at rest, lower anxiety levels and improvement in health-related quality of life. More importantly, managers in the RSA-BF group showed increased vagal control (as indexed by increased RSA), decreased sympathetic arousal (as indexed by reduced skin conductance and systolic blood pressure) and lower emotional interferences, compared to managers in the control group. Results from this study showed that RSA-BF training was effective in improving cardiac autonomic balance at rest. Moreover, findings from this study underline the effectiveness of biofeedback in reducing psychophysiological negative outcomes associated with stress in managers
Complexity Modulation in functional Brain-Heart Interplay series driven by Emotional Stimuli: an early study using Fuzzy Entropy
No full textIncreasing attention has recently been devoted to the multidisciplinary investigation of functional brain-heart interplay (BHI), which has provided meaningful insights in neuroscience and clinical domains including cardiology, neurology, clinical psychology, and psychiatry. While neural (brain) and heartbeat series show high nonlinear and complex dynamics, a complexity analysis on BHI series has not been performed yet. To this end, in this preliminary study, we investigate BHI complexity modulation in 17 healthy subjects undergoing a 3-minute resting state and emotional elicitation through standardized image slideshow. Electroencephalographic and heart rate variability series were the inputs of an adhoc BHI model, which provides directional (from-heart-to-brain and from-brain-to-heart) estimates at different frequency bands. A Fuzzy entropy analysis was performed channel-wise on the model output for the two experimental conditions. Results suggest that BHI complexity increases in the emotional elicitation phase with respect to a resting state, especially in the functional direction from the heart to the brain. We conclude that BHI complexity may be a viable computational tool to characterize neurophysiological and pathological states under different experimental conditions
Single-Session Attention Bias Modification Training in Victims of Work-Related Accidents
No full textIndividuals who experienced traumatic work-related accidents frequently show cognitive deficits and biased processing of trauma-relevant information, which, in turn, could increase the risk of further accidents. The attention bias modification training (ABMT) is designed to reduce hypervigilance toward and enhance attentional disengagement from threat stimuli. The aim of the present study was to assess whether it is possible to implicitly reduce the attentional bias toward trauma-related stimuli through a single session of ABMT in individuals who experienced a traumatic occupational accident. Nineteen individuals who had experienced a traumatic work-related accident and 11 workers who never experienced a work accident (control group) underwent a preliminary assessment of cognitive performance (executive functions and sustained attention) and an evaluation of the attentional bias toward accident-related pictures by means of a dot-probe task. The results showed that injured workers performed more poorly than controls in tasks of executive functions and concentration abilities. Also, injured workers showed an attentional bias toward trauma reminders (i.e., faster reaction times to probes replacing trauma-related pictures). Injured workers were then randomly allocated to a single-session of ABMT (N = 10) or to an Attention Control Condition (ACC; N = 9). After the training, the dot-probe task was administered again to assess changes in the attentional bias toward trauma-relevant pictures. Injured workers who underwent the ABMT, but not those who underwent the ACC, showed a significant reduction of the attentional bias from pre- to post-training. Overall, these results support previous findings reporting an association between traumatic occupational accidents and cognitive dysfunctions. More importantly, these preliminary findings add to a growing body of evidence suggesting the effectiveness of a short ABMT in reducing the attentional bias after a traumatic workplace accident
The role of cardiac vagal tone and inhibitory control in pre-schoolers' listening comprehension
No full textDirect Gaze Holds Attention, but Not in Individuals with Obsessive-Compulsive Disorder
No full text: The attentional response to eye-gaze stimuli is still largely unexplored in individuals with obsessive-compulsive disorder (OCD). Here, we focused on an attentional phenomenon according to which a direct-gaze face can hold attention in a perceiver. Individuals with OCD and a group of matched healthy controls were asked to discriminate, through a speeded manual response, a peripheral target. Meanwhile, a task-irrelevant face displaying either direct gaze (in the eye-contact condition) or averted gaze (in the no-eye-contact condition) was also presented at the centre of the screen. Overall, the latencies were slower for faces with direct gaze than for faces with averted gaze; however, this difference was reliable in the healthy control group but not in the OCD group. This suggests the presence of an unusual attentional response to direct gaze in this clinical population
Impaired functional brain-heart interplay sustains depressive symptomatology
No full text: Depressive symptoms are a leading worldwide cause of mental disorders and disability, strongly affecting emotional processing and regulation. Leveraging recent evidence on the cardiogenic generation of emotion, we hypothesize that dysfunctional behavior in depressive symptomatology is sustained by impaired nervous-system-wise dynamics. Accordingly, this study aims to experimentally characterize functional Brain-Heart Interplay (BHI) patterns specific to emotional dysregulation and processing in subjects exhibiting depressive symptoms compared to healthy controls. Functional BHI has been estimated through a synthetic data generation model, separately modeling and quantifying ascending peripheral-to-central, and descending central-to-peripheral interaction in a time-resolved way. Results gathered from a cohort of 72 individuals indicate that depressive symptoms are associated with continuous efferent central-to-peripheral hyperactivity, particularly in neutral and negative valence conditioning, and afferent vagal-to-central hypoactivity. This hypoactivity seems to be specific to negative emotional processing. Moreover, the expected modulation of ascending interplay during emotional elicitation was detected in healthy controls only, whereas a descending central-to-peripheral modulation in response to emotional conditioning has been found associated to depressive symptomatology, for the first time. This study offers novel insights into the systemic investigation of the neurophysiological bases of depression, serving as an exemplary pathological manifestation of the dysfunctional brain-heart axis
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