The Assessment of the Autonomic Response to Acute Stress Using Electrodermal Activity

The response of autonomic nervous system to mental stress is currently studied as a key role factor in the pathophysiology of stress related diseases. Altered autonomic regulation can result in increased morbidity, potentially affecting (directly or indirectly) any of the organs. Cardiovascular system (CVS) is one of the most sensitive systems to the effect of autonomic outputs. The predictive value of the laboratory stress tests was proved in several studies with CVS pathology. In this study we aimed to assess the autonomic reactivity to different mental stressors (cognitive and emotional) in healthy subjects using electrodermal activity (EDA) as a sensitive psychophysiological marker of sympathetic activity. We found significantly increased EDA in response to all the mental tasks with decrease of the values during recovery periods. However, EDA did not return to the baseline values during recovery periods, potentially indicating the sympathetic arousal during complete stress profile protocol. We suggest EDA presents a well applicable marker of the sympathetic activation, offering a different information about central regulation processes regarding the sympathetic activity compared to cardiac autonomic indices

Pupillary Light Reflex in Children with ADHD

Attention deficit/hyperactivity disorder (ADHD) is one of the most frequently seen mental disorders in children with an increasing risk for other mental disorders. ADHD represents a primary biological dysfunction of the central nervous system, such as dysregulation of frontal-subcortical-cerebellar catecholaminergic circuits and imbalances in the dopaminergic system. However, autonomic nervous system, comprised of two primary branches - sympathetic and parasympathetic nervous systems that are normally in dynamic balance, plays an essential role in the regulation of body functions. Although it is generally assumed that the autonomic regulation is impaired during ADHD the information related to this dysregulation is limited. One of the options to observe changes of autonomic balance in ADHD is pupillary light reflex (PLR). Pupillometric evaluation can be used for the assessment of functioning of both autonomic nervous system branches and certain parameters of pupil responsivity can be helpful as a tool for medical diagnostic and treatment. In conclusion, these findings suggest the pupillometry as a non-invasive method that can indicate abnormalities in the complex central autonomic network regulating PLR

Potential Effect of Pharmacotherapy on Sympathetic Arousal in Autism

Background: Autism spectrum disorder (ASD) is a serious neurodevelopmental disorder associated with autonomic nervous system (ANS) abnormalities. Moreover, at least 50% of children with ASD suffer from other comorbid diseases such as anxiety, depression, and attention deficit hyperactivity disorder (ADHD) associated with receiving psychotropic medication. From this context we aimed to evaluate changes in sympathetic arousal using analysis of electrodermal activity (EDA) as an index of sympathetic cholinergic activity in treated and non-treated autistic children under resting conditions

The effect of orthostasis on recurrence quantification analysis of heart rate and blood pressure dynamics

The purpose of this paper is to investigate the effect of orthostatic challenge on recurrence plot based complexity measures of heart rate and blood pressure variability (HRV and BPV). HRV and BPV complexities were assessed in 28 healthy subjects over 15 min in the supine and standing positions. The complexity of HRV and BPV was assessed based on recurrence quantification analysis. HRV complexity was reduced along with the HRV magnitude after changing from the supine to the standing position. In contrast, the BPV magnitude increased and BPV complexity decreased upon standing. Recurrence quantification analysis (RQA) of HRV and BPV is sensitive to orthostatic challenge and might therefore be suited to assess changes in autonomic neural outflow to the cardiovascular system.M Javorka, Z Turianikova, I Tonhajzerova, K Javorka and M Baumer

Therapeutic Drug Monitoring of Venlafaxine and Impact of Age, Gender, BMI, and Diagnosis

Depression is a common mental disorder affecting more than 264 million people in the world and 5.1% of the Slovak population. Although various antidepressant approaches have been used; still, about 40% of patients do not respond to a first-choice drug administration and one third of patients do not achieve total remission. Therapeutic drug monitoring (TDM) is a method used for quantification and interpreting the drug concentrations in plasma in order to optimize the pharmacotherapy. The aim of this study was to measure the plasma concentrations of venlafaxine, the fourth most prescribed antidepressant in Slovakia, as well as its active metabolite and interpret them with the relevant patients’ characteristics

Short-term heart rate complexity is reduced in patients 14 with type 1 diabetes mellitus

Copyright © 2008 International Federation of Clinical Neurophysiology Published by Elsevier Ireland Ltd.Objective The aim of this study was to test whether new heart rate variability (HRV) complexity measures provide diagnostic information regarding early subclinical autonomic dysfunction in diabetes mellitus (DM). Methods HRV in DM type 1 patients (n = 17, 10f, 7m) aged 12.9–31.5 years (duration of DM 12.4 ± 1.2 years) was compared to a control group of 17 healthy matched probands. The length of R–R intervals was measured over 1 h using a telemetric ECG system. In addition to linear measures, we assessed HRV complexity measures, including multiscale entropy (MSE), compression entropy and various symbolic dynamic measures (Shannon and Renyi entropies, normalized complexity index (NCI), and pattern classification). Results HRV magnitude was significantly reduced in patients with DM. Several HRV complexity parameters (MSE at scales 2–4, Renyi entropy, NCI) were also significantly reduced in diabetics. MSE indices and compression entropy did not correlate with linear measures. Conclusions The magnitude and complexity of HRV are reduced in young patients with DM, indicating vagal dysfunction. Significance The quantification of HRV complexity in combination with its magnitude may provide an improved diagnostic tool for cardiovascular autonomic neuropathy in DM.Michal Javorka, Zuzana Trunkvalterova, Ingrid Tonhajzerova, Jana Javorkova, Kamil Javorka and Mathias Baumerthttp://www.elsevier.com/wps/find/journaldescription.cws_home/601528/description#descriptio

The differences between patients with panic disorder and healthy controls in psychophysiological stress profile

Antonia Kotianova,1,2 Michal Kotian,2 Milos Slepecky,1,2 Michaela Chupacova,2 Jan Prasko,1,3 Ingrid Tonhajzerova4,51Department of Psychology Sciences, Faculty of Social Science and Health Care, Constantine the Philosopher University in Nitra, Nitra, Slovak Republic; 2Psychagogia, Garbiarska, Liptovsky Mikulas, Slovak Republic; 3Department of Psychiatry, Faculty of Medicine and Dentistry, University Palacky Olomouc, University Hospital, Olomouc, Czech Republic; 4Department of Physiology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovak Republic; 5Biomedical Center Martin, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovak RepublicBackground: Alarming somatic symptoms, in particular, cardiovascular symptoms, are the characteristic feature of panic attacks. Increased cardiac mortality and morbidity have been found in these patients. Power spectral analysis of electrocardiogram R–R intervals is known to be a particularly successful tool in the detection of autonomic instabilities in various clinical disorders. Our study aimed to compare patients with panic disorder and healthy controls in heart rate variation (HRV) parameters (very-low-frequency [VLF], low-frequency [LF], and high-frequency [HF] band components of R–R interval) in baseline and during the response to the mental task.Subjects and methods: We assessed psychophysiological variables in 33 patients with panic disorder (10 men, 23 women; mean age 35.9±10.7 years) and 33 age- and gender-matched healthy controls (10 men, 23 women; mean age 35.8±12.1 years). Patients were treatment naïve. Heart rate, blood pressure, muscle tension, and HRV in basal conditions and after the psychological task were assessed. Power spectrum was computed for VLF (0.003–0.04 Hz), LF (0.04–0.15 Hz), and HF (0.15–0.40 Hz) bands using fast Fourier transformation.Results: In the baseline period, the VLF band was significantly lower in panic disorder group compared to controls (p<0.005). In the period of mental task, the LF/HF ratio was significantly higher in panic disorder patients compared to controls (p<0.05). No significant differences were found in the remaining parameters. There was a significant difference in ΔHF and ΔLF/HF ratio between patients and controls, with Δ increasing in patients and decreasing in controls.Conclusion: These findings revealed that patients suffering from panic disorder were characterized by relative sympathetic dominance (reactivity) in response to mental stress compared with healthy controls. Keywords: panic disorder, heart rate variability, pulse, blood pressure, muscle tension, psychological tas

Biofeedback – A Promising Non Pharmacological Tool of Stress – Related Disorders

Biofeedback is a therapeutic method of obtaining better awareness of physiological functions based on principles of operant conditioning and learning in general. While patient observes changes in physiological parameters in real-time (e.g. blood pressure, heart rate variability, temperature, electrodermal activity, etc.), he/she learns how to manipulate them at will. By means of this technique, individuals can improve their mental, emotional, and physical health. Clinical biofeedback training becomes popular for treating a variety of medical conditions, manage ment of disease symptoms, and improvement of overall health through training of stress management. There is no center or group to systematically deal with biofeedback methods in Slovakia, except the Slovak Institute of CBT (cognitive-behavioral therapy) that teaches biofeedback as a therapeutic method. However, biofeedback and its opportunities have a relatively long history of exploration and practice, which is the best precondition for positive changes in this area. The review article aims to provide an insight to biofeedback training as a non-pharmacological therapeutic tool in stress management and stress-related diseases and disorders. The article also describes biofeedback modalities and efficacy on various medical conditions