scholarly journals Acute effects of device-guided slow breathing on sympathetic nerve activity and baroreflex sensitivity in posttraumatic stress disorder

2018 ◽  
Vol 315 (1) ◽  
pp. H141-H149 ◽  
Author(s):  
Ida T. Fonkoue ◽  
Paul J. Marvar ◽  
Seth D. Norrholm ◽  
Melanie L. Kankam ◽  
Yunxiao Li ◽  
...  
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Posttraumatic Stress ◽  
Sympathetic Activity ◽  
Baroreflex Sensitivity ◽  
Sympathetic Nerve Activity ◽  
Sham Group ◽  
Stress Disorder ◽  
Burst Frequency ◽  
Nerve Activity ◽  
Slow Breathing

Patients with posttraumatic stress disorder (PTSD) have elevated sympathetic nervous system reactivity and impaired sympathetic and cardiovagal baroreflex sensitivity (BRS). Device-guided slow breathing (DGB) has been shown to lower blood pressure (BP) and sympathetic activity in other patient populations. We hypothesized that DGB acutely lowers BP, heart rate (HR), and improves BRS in PTSD. In 23 prehypertensive veterans with PTSD, we measured continuous BP, ECG, and muscle sympathetic nerve activity (MSNA) at rest and during 15 min of DGB at 5 breaths/min ( n = 13) or identical sham device breathing at normal rates of 14 breaths/min (sham; n = 10). Sympathetic and cardiovagal BRS was quantified using pharmacological manipulation of BP via the modified Oxford technique at baseline and during the last 5 min of DGB or sham. There was a significant reduction in systolic BP (by −9 ± 2 mmHg, P < 0.001), diastolic BP (by −3 ± 1 mmHg, P = 0.019), mean arterial pressure (by −4 ± 1 mmHg, P = 0.002), and MSNA burst frequency (by −7.8 ± 2.1 bursts/min, P = 0.004) with DGB but no significant change in HR ( P > 0.05). Within the sham group, there was no significant change in diastolic BP, mean arterial pressure, HR, or MSNA burst frequency, but there was a small but significant decrease in systolic BP ( P = 0.034) and MSNA burst incidence ( P = 0.033). Sympathetic BRS increased significantly in the DGB group (−1.08 ± 0.25 to −2.29 ± 0.24 bursts·100 heart beats−1·mmHg−1, P = 0.014) but decreased in the sham group (−1.58 ± 0.34 to –0.82 ± 0.28 bursts·100 heart beats−1·mmHg−1, P = 0.025) (time × device, P = 0.001). There was no significant difference in the change in cardiovagal BRS between the groups (time × device, P = 0.496). DGB acutely lowers BP and MSNA and improves sympathetic but not cardiovagal BRS in prehypertensive veterans with PTSD. NEW & NOTEWORTHY Posttraumatic stress disorder is characterized by augmented sympathetic reactivity, impaired baroreflex sensitivity, and an increased risk for developing hypertension and cardiovascular disease. This is the first study to examine the potential beneficial effects of device-guided slow breathing on hemodynamics, sympathetic activity, and arterial baroreflex sensitivity in prehypertensive veterans with posttraumatic stress disorder.

scholarly journals Eight weeks of device-guided slow breathing decreases sympathetic nervous reactivity to stress in posttraumatic stress disorder

2020 ◽  
Vol 319 (4) ◽  
pp. R466-R475 ◽  
Author(s):  
Ida T. Fonkoue ◽  
Yingtian Hu ◽  
Toure Jones ◽  
Monica Vemulapalli ◽  
Justin D. Sprick ◽  
...  
Keyword(s):  
Heart Rate ◽  
Posttraumatic Stress Disorder ◽  
Posttraumatic Stress ◽  
Stress Disorder ◽  
Burst Frequency ◽  
Sustained Effect ◽  
Increased Risk ◽  
Before And After ◽  
Slow Breathing

Posttraumatic stress disorder (PTSD) is characterized by increased risk for developing hypertension and cardiovascular disease. We recently showed that device-guided slow breathing (DGB) acutely lowers blood pressure (BP) and muscle sympathetic activity (MSNA) and improves baroreflex sensitivity (BRS) in PTSD. The aim of this study was to assess the long-term benefits of DGB on autonomic function at rest and during stress. We hypothesized that long-term DGB improves arterial BRS and lowers BP and MSNA in PTSD. Twenty-five veterans with PTSD were studied and randomized to either 8 wk of daily DGB ( n = 12) or 8 wk of sham device (Sham; n = 13). BP, heart rate (HR), and MSNA were measured at rest and during mental math. Arterial BRS was assessed using the modified Oxford technique. Resting MSNA, BP, and heart rate (HR) remained comparable before and after 8 wk in both groups (DGB and Sham). Likewise, the change in sympathetic and cardiovagal BRS was not different between the groups. Interestingly, DGB significantly decreased MSNA reactivity to mental math when expressed as burst frequency ( P = 0.012) or burst incidence ( P = 0.008) compared with Sham, suggesting a sustained effect of DGB on sympathetic reactivity to stress in PTSD. Contrary to our hypothesis, long-term DGB did not lower systolic BP, diastolic BP, or HR responses to stress compared with Sham. Likewise, pulse pressure reactivity after 8 wk ( P = 0.121) was also comparable. In summary, these data suggest that long-term use of DGB may lead to a sustained dampening of sympathetic reactivity to mental stress in PTSD.

Sildenafil acts on the central nervous system increasing sympathetic activity

2008 ◽  
Vol 104 (6) ◽  
pp. 1683-1689 ◽  
Author(s):  
Rubens Fazan ◽  
Domitila A. Huber ◽  
Carlos Alberto A. Silva ◽  
Valdo J. Dias da Silva ◽  
Maria Cristina O. Salgado ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Arterial Pressure ◽  
Sympathetic Activity ◽  
Baroreflex Sensitivity ◽  
Sympathetic Nerve Activity ◽  
Systolic Arterial Pressure ◽  
Nerve Activity ◽  
The Central Nervous System ◽  
Spontaneous Baroreflex

Sildenafil induces vasodilation and is used for treating erectile dysfunction. Although its influence on resting heart function appears to be minimal, recent studies suggest that sildenafil can increase sympathetic activity. We therefore tested whether sildenafil injected into the central nervous system alters the autonomic control of the cardiovascular system in conscious rats. The effect of sildenafil citrate injected into the lateral cerebral ventricle was evaluated in conscious rats by means of the recording of lumbar sympathetic nerve activity (LSNA), spectral analysis of systolic arterial pressure and heart rate variability, spontaneous baroreflex sensitivity, and baroreflex control of LSNA. Intracerebroventricular (ICV, 100 μg/5 μl) administration of sildenafil caused remarkable tachycardia without significant change in basal arterial pressure and was associated with a conspicuous increase (47 ± 14%) in LSNA. Spectral analysis demonstrated that systolic arterial pressure oscillations in the low frequency (LF) range were increased (from 6.3 ± 1.5 to 12.8 ± 3.8 mmHg2), whereas the high frequency (HF) range was not affected by ICV administration of sildenafil. Sildenafil increased pulse interval oscillations at LF and decreased them at HF. The LF-HF ratio increased from 0.04 ± 0.01 to 0.17 ± 0.06. Spontaneous baroreflex sensitivity measured by the sequence method and the baroreflex relationship between mean arterial pressure and LSNA were not affected by ICV administration of sildenafil. In conclusion, sildenafil elicited an increase in sympathetic nerve activity that is not baroreflex mediated, suggesting that this drug is able to elicit an autonomic imbalance of central origin. This finding may have implications for understanding the cardiovascular outcomes associated with the clinical use of this drug.

scholarly journals Device-guided slow breathing reduces blood pressure and sympathetic activity in young normotensive individuals of both sexes

2019 ◽  
Vol 127 (4) ◽  
pp. 1042-1049 ◽  
Author(s):  
Tessa E. Adler ◽  
Yasmine Coovadia ◽  
Domenica Cirone ◽  
Maha L. Khemakhem ◽  
Charlotte W. Usselman
Keyword(s):  
Blood Pressure ◽  
Body Mass Index ◽  
Body Mass ◽  
Sympathetic Nerve ◽  
Baroreflex Sensitivity ◽  
Sympathetic Nerve Activity ◽  
Muscle Sympathetic Nerve Activity ◽  
Nerve Activity ◽  
Main Effect ◽  
Slow Breathing

Slow breathing (SLOWB) is recommended for use as an adjuvant treatment for hypertension. However, the extent to which blood pressure (BP) responses to SLOWB differ between men and women are not well-established. Therefore, we tested the hypothesis that an acute bout of SLOWB would induce larger decreases in BP in males than in females, given that males typically have higher resting BP. We also examined autonomic contributors to reduced BP during SLOWB; that is, muscle sympathetic nerve activity and spontaneous cardiovagal (sequence method) and vascular sympathetic baroreflex sensitivity. We tested normotensive females ( n = 10, age: 22 ± 2 y, body mass index: 22 ± 2 kg/m2) and males ( n = 12, age: 23 ± 3 y, body mass index: 26 ± 4 kg/m2). Subjects were tested at baseline and during the last 5 min of a 15-min RESPeRATE-guided SLOWB session. Overall, SLOWB reduced systolic BP by 3.2 ± 0.8 mmHg (main effect, P < 0.01). Females had lower systolic BP (main effect, P = 0.02); we observed no interaction between sex and SLOWB. SLOWB also reduced muscle sympathetic nerve activity burst incidence by −5.0 ± 1.4 bursts/100 heartbeats (main effect, P < 0.01). Although females tended to have lower burst incidence (main effect, P = 0.1), there was no interaction between sex and SLOWB. Cardiovagal baroreflex sensitivity improved during SLOWB (21.0 vs. 36.0 ms/mmHg, P = 0.03) with no effect of sex. Despite lower overall BP in females, our data support a lack of basement effect on SLOWB-induced reductions in BP, as SLOWB was equally effective in reducing BP in males and females. Our findings support the efficacy of the RESPeRATE device for reducing BP in both sexes, even in young, normotensive individuals. NEW & NOTEWORTHY We provide support for the effectiveness of device-guided slow breathing for blood pressure reduction in young normotensive women and men. Despite having lower baseline blood pressure and sympathetic nerve activity, women experienced equivalent reductions in both measures in response to RESPeRATE-guided slow breathing as men. Thus, slow breathing appears to be effective in young healthy normotensive individuals of both sexes and may be an ideal preventative therapy against future hypertension.

P326Characteristic of sympathetic nerve activity in two subgroups of patients with heart failure (HFrEF and HFmrEF)

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
R Urbancsek ◽  
J Barta ◽  
I Forgacs ◽  
J Boczan ◽  
I Edes ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Sympathetic Nerve ◽  
Sympathetic Activity ◽  
Sympathetic Nerve Activity ◽  
Left Ventricular ◽  
Burst Frequency ◽  
Nerve Activity ◽  
Development Fund ◽  
Sympathetic Regulation

Abstract Introduction Sympathetic overactivity is a well documented in severe heart failure (HF) with reduced ejection fraction (HFrEF). The European Society of Cardiology has recently introduced a new HF category, i.e. HF with mid-range ejection fraction (HFmrEF), characterized by left ventricular EF of 40–49%. The sympathetic regulation in this new category has not been thoroughly described. Aims Characterization of the sympathetic regulation in patients with HFmrEF compared with data obtained from HFrEF patients and healthy volunteers. Method 14 HFrEF patients, 22 HFmrEF patients and 10 control subjects were enrolled (Table 1). Muscle sympathetic nerve activity, (MSNA) was recorded in the superficial peroneal nerve by microneurography, and processed by the Nerve Traffic Analyzer System (Model 662C-3, Iowa). Continuous ECG and non-invasive blood pressure (Finapres 2300) were digitized online (500 Hz/channel). Sympathetic burst frequency (bursts/minute) and burst incidence (bursts/100 heartbeats) were determined. The 6 min walking distances (6MWD) and NT proBNP levels in the HF subgroups were also assessed. Results Both burst frequency and incidence were significantly elevated in the HF subgroups compared to controls, and significant differences were also seen between the HFrEF and HFmrEF groups. The sympathetic burst activity in the HF populations significantly correlated with the NT proBNP level (R=0.53, p=0.003) and inversely correlated with the ejection fraction (R=−0.38, p=0.03). Table 1. Results EF <40% EF: 40–49% Healthy control group (HC) p p p (n=14) (n=22) (n=10) EF <40% vs. EF: 40–49% EF <40% vs. HC EF: 40–49% vs. HC NYHA   I–II 8 21 − − − −   III–IV 6 1 − − − − Age 58.36±12.31 62.23±9.74 52.44±10.41 0.302 0.247 0.019 BMI 29.65±3.77 29.84±4.19 − 0.895 − − NT proBNP [ng/L] 1574.75±1415.06 300.20±247.35 − 0.002 − − 6MWT [m] 476.88±63.53 496.53±76.59 − 0.503 − − EF [%] 44.47±3.34 26.78±8.58 − − − − Baseline   burst/min 59.29±14.18 39.55±9.48 25.78±8.47 <0.001 <0.001 0.001   burst/100 84.64±12.63 65.68±15.48 35.78±11.27 0.001 <0.001 <0.001 Conclusion Sympathetic activity is elevated in heart failure as compared to healthy controls. In patients with HFrEF both parameters of sympathetic activity were significantly higher as compared to patients with HFmrEF. Acknowledgement/Funding The work is supported by the GINOP-2.3.2-15-2016-00043 project. The project is co-financed by the EU and the European Regional Development Fund

scholarly journals Vascular Dysfunction and Posttraumatic Stress Disorder: Examining the Role of Oxidative Stress and Sympathetic Activity

2020 ◽  
Vol 34 (S1) ◽  
pp. 1-1
Author(s):  
Jennifer B. Weggen ◽  
Aaron S. Autler ◽  
Austin C. Hogwood ◽  
Ashley M. Darling ◽  
Kevin P. Decker ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Posttraumatic Stress Disorder ◽  
Posttraumatic Stress ◽  
Sympathetic Activity ◽  
Stress Disorder ◽  
Vascular Dysfunction

Posttraumatic Stress Disorder Exacerbates Emotional Complaints but not Cognitive Impairments in Individuals Suffering from Postconcussional Disorder after Mild Traumatic Brain Injury

2015 ◽  
Vol 26 (1) ◽  
pp. 35-50 ◽  
Author(s):  
Sara C. Schroeder ◽  
Ronald M. Ruff ◽  
Lutz Jäncke
Keyword(s):  
Traumatic Brain Injury ◽  
Posttraumatic Stress Disorder ◽  
Brain Injury ◽  
Posttraumatic Stress ◽  
Mild Traumatic Brain Injury ◽  
Test Performance ◽  
Stress Disorder ◽  
Negative Impact ◽  
Neuropsychological Test ◽  
Composite Scale

The aim of this study was to examine the effect of posttraumatic stress disorder (PTSD) on (a) neuropsychological test performance and (b) self-reported emotional complaints within individuals suffering from postconcussional disorder (PCD) after a mild traumatic brain injury (MTBI). A two-group comparative research design was employed. Two MTBI samples with and without PTSD were assessed with a neuropsychological test battery and the Ruff Neurobehavioral Inventory (RNBI). On the neurocognitive test performances no significant between group differences were found, but the MTBI group with PTSD endorsed a significantly greater number of emotional complaints, especially in the RNBI subscales of anxiety and depression. The patients with PTSD also endorsed a significantly greater number of premorbid sequelae in the RNBI emotional composite scale as well as the RNBI premorbid subscales of pain, anxiety and abuse. In sum, PTSD has a negative impact on emotional but not cognitive functioning within individuals suffering from PCD after a mild TBI.

Stehen kognitive Funktionen im Zusammenhang mit Angst, Depression und Posttraumatischer Belastungsstörung bei Brustkrebspatientinnen nach onkologischer Behandlung?

2009 ◽  
Vol 57 (1) ◽  
pp. 33-42 ◽  
Author(s):  
Lena Schirmer ◽  
Anja Mehnert ◽  
Angela Scherwath ◽  
Barbara Schleimer ◽  
Frank Schulz-Kindermann ◽  
...  
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Posttraumatic Stress ◽  
Stress Disorder ◽  
Depression Scale ◽  
Anxiety And Depression ◽  
Hospital Anxiety ◽  
Kognitive Funktionen

Die in mehreren Studien gefundenen kognitiven Störungen bei Tumorpatienten nach Chemotherapie werden zumeist mit der Zytostatikaneurotoxizität assoziiert. In der vorliegenden Arbeit wird der Zusammenhang von Angst, Depression und Posttraumatischer Belastungsstörung mit der kognitiven Leistungsfähigkeit bei Frauen mit Mammakarzinom untersucht. Insgesamt wurden 76 Brustkrebspatientinnen fünf Jahre nach Abschluss der onkologischen Behandlung mit neuropsychologischen Testverfahren sowie mit der Hospital Anxiety and Depression Scale – Deutsche Version (HADS-D) und der Posttraumatic Stress Disorder Checklist – Civilian Version (PCL-C) untersucht: 23 nach Standard- und 24 nach Hochdosistherapie sowie 29 nach Brustoperation und Strahlentherapie als Vergleichsgruppe. Signifikante Zusammenhänge sind vor allem zwischen kognitiven Funktionen und Intrusionssymptomen einer Posttraumatischen Belastungsstörung (PTBS) festzustellen. Bei Patientinnen nach Standardtherapie weisen Intrusionen der PTBS einen moderaten Zusammenhang mit der globalen kognitiven Beeinträchtigung auf. Die Ergebnisse der Studie deuten auf multidimensionale Einfluss- und moderierende Faktoren bei der Entwicklung kognitiver Defizite bei Brustkrebspatientinnen nach onkologischer Therapie hin.

Vorhersagbarkeit posttraumatischer Belastung bei Kindern und Jugendlichen nach traumatischen Ereignissen in der Schule

2008 ◽  
Vol 17 (4) ◽  
pp. 219-223 ◽  
Author(s):  
Barbara Frühe ◽  
Hans-Joachim Röthlein ◽  
Rita Rosner
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Los Angeles ◽  
Posttraumatic Stress ◽  
Stress Disorder ◽  
Reaction Index ◽  
Traumatische Ereignisse

Traumatische Ereignisse im schulischen Kontext treten vergleichsweise häufig auf. So ist die Bestimmung von Kindern und Jugendlichen, die aktuell und auch zu einem späteren Zeitpunkt einer psychologischen Betreuung bedürfen, im Rahmen der Fürsorgepflicht notwendig. 48 Jugendliche zwischen 12 und 17 Jahren wurden in der Schule zu zwei Messzeitpunkten zur akuten und posttraumatischen Symptomatik sowie zu verschiedenen Risikofaktoren befragt. Verwendet wurde die neu entwickelte Checkliste zur Akuten Belastung (CAB) und die deutsche Version des University of Los Angeles at California Posttraumatic Stress Disorder Reaction Index (UCLA CPTSD-RI). Eine Woche nach dem Ereignis betrug der Anteil klinisch bedeutsamer Belastung 21 % und nach 10 – 15 Wochen 10 %. Ein mittlerer Zusammenhang zwischen akuter und posttraumatischer Belastung konnte nachgewiesen werden. Als bedeutsame Risikofaktoren für die Entwicklung einer posttraumatischen Belastung stellten sich der Konfrontationsgrad, peritraumatisch erlebte Angst sowie akute Beeinträchtigung heraus. Im Kontext der Betreuung betroffener Jugendlicher nach traumatischen Ereignissen sollte den Risikofaktoren mehr Beachtung geschenkt werden.

Learning and Consolidation of Verbal Declarative Memory in Patients with Posttraumatic Stress Disorder

2010 ◽  
Vol 218 (2) ◽  
pp. 135-140 ◽  
Author(s):  
Slawomira J. Diener ◽  
Herta Flor ◽  
Michèle Wessa
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Posttraumatic Stress ◽  
Verbal Memory ◽  
Stress Disorder ◽  
Declarative Memory ◽  
Memory Performance ◽  
Verbal Learning ◽  
Depression Scale ◽  
Learning Performance ◽  
Ptsd Symptoms

Impairments in declarative memory have been reported in posttraumatic stress disorder (PTSD). Fragmentation of explicit trauma-related memory has been assumed to impede the formation of a coherent memorization of the traumatic event and the integration into autobiographic memory. Together with a strong non-declarative memory that connects trauma reminders with a fear response the impairment in declarative memory is thought to be involved in the maintenance of PTSD symptoms. Fourteen PTSD patients, 14 traumatized subjects without PTSD, and 13 non-traumatized healthy controls (HC) were tested with the California Verbal Learning Test (CVLT) to assess verbal declarative memory. PTSD symptoms were assessed with the Clinician Administered PTSD Scale and depression with the Center of Epidemiological Studies Depression Scale. Several indices of the CVLT pointed to an impairment in declarative memory performance in PTSD, but not in traumatized persons without PTSD or HC. No group differences were observed if recall of memory after a time delay was set in relation to initial learning performance. In the PTSD group verbal memory performance correlated significantly with hyperarousal symptoms, after concentration difficulties were accounted for. The present study confirmed previous reports of declarative verbal memory deficits in PTSD. Extending previous results, we propose that learning rather than memory consolidation is impaired in PTSD patients. Furthermore, arousal symptoms may interfere with successful memory formation in PTSD.

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