Central Hemodynamic Adjustments during Post-Exercise Hypotension in Hypertensive Patients with Ischemic Heart Disease: Concurrent Circuit Exercise versus High-Intensity Interval Exercise. A Preliminary Study

Concurrent aerobic plus resistance exercise (RAE) and high-intensity interval exercise (HIIE) are both effective at inducing post-exercise hypotension (PEH) in patients with hypertension. However, central hemodynamic changes associated with PEH in hypertensive subjects with underlying ischemic heart disease (IHD) have been poorly investigated. The study aim was to compare the acute effects produced by these two exercise modalities on left ventricular diastolic function and left atrial function. Twenty untrained male patients with a history of hypertension and IHD under stable pharmacological therapy were enrolled. Each patient underwent three exercise sessions: RAE, HIIE and a control session without exercise, each lasting 45 min. An echocardiography examination was performed before and between 30 min and 40 min from the end of the exercise sessions. Following the exercise sessions, BP values decreased in a similar way in RAE and HIIE and were unchanged after the control session. Compared to pre-session, the ratio between early filling velocity (E) and mitral annulus early diastolic velocity (E’). E/E’ increased after HIIE and remained unchanged after both RAE and control sessions (between-sessions p 0.002). Peak atrial longitudinal strain (PALS) increased slightly after RAE (+1.4 ± 1.1%), decreased after HIIE (−4.6 ± 2.4%) and was unchanged after the control session (between-sessions p 0.03). Peak atrial contraction strain (PACS) was mildly increased after RAE, was reduced after HIIE and was unchanged after the control session. Atrial volume was unchanged after both exercise sessions. Left ventricular and left atrial stiffness increased significantly after HIIE, but remained unchanged after the RAE and control sessions. Stroke volume and cardiac output increased after RAE, decreased after HIIE, and were unchanged after the control session. In conclusion, single session of RAE and HIIE brought about similar PEH in hypertensive subjects with IHD, while they evoked different central hemodynamic adjustments. Given its neutral effects on diastolic and atrial functions, RAE seems more suitable for reducing blood pressure in hypertensive patients with IHD.

Acute Cardiovascular Responses to Self-selected Intensity Exercise in Parkinson's Disease

Parkinson’s disease patients frequently present cardiovascular dysfunction. Exercise with a self-selected intensity has emerged as a new strategy for exercise prescription aiming to increase exercise adherence. Thus, the current study evaluated the acute cardiovascular responses after a session of aerobic exercise at a traditional intensity and at a self-selected intensity in Parkinson’s disease patients. Twenty patients (≥ 50 years old, Hoehn & Yahr 1–3 stages) performed 3 experimental sessions in random order: Traditional session (cycle ergometer, 25 min, 50 rpm, 60–80% maximum heart rate); Self-selected intensity: (cycle ergometer, 25 min, 50 rpm with self-selected intensity); and Control session (resting for 25 min). Before and after 30 min of intervention, brachial and central blood pressure (auscultatory method and pulse wave analysis, respectively), cardiac autonomic modulation (heart rate variability), and arterial stiffness (pulse wave analysis) were evaluated. Brachial and central systolic and diastolic blood pressure, heart rate, and the augmentation index increased after the control session, whereas no changes were observed after the exercise sessions (P<0.01). Pulse wave velocity and cardiac autonomic modulation parameters did not change after the three interventions. In conclusion, a single session of traditional intensity or self-selected intensity exercises similarly blunted the increase in brachial and central blood pressure and the augmentation index compared to a non-exercise control session in Parkinson’s disease patients.

The Effects of Group Therapeutic Singing on Cortisol and Motor Symptoms in Persons With Parkinson's Disease

The inclusion of music into the treatment plan for persons with Parkinson's disease (PD) may be a viable strategy to target multiple motor symptoms. However, potential mechanisms to explain why music has an impact on multiple motor symptoms in persons with PD remain understudied. The purpose of this study was to examine the acute effects of 1 h of group therapeutic singing (GTS) on physiological measures of stress and clinical motor symptoms in persons with PD. We posit that improvement in motor symptoms after GTS may be related to stress reduction. Seventeen participants with PD completed 1 h of GTS and eight participants completed 1 h of a quiet reading (control session). Cortisol was collected via passive drool immediately before and after the singing and control session. The Unified Parkinson's Disease Rating Scale (UPDRS) Part-III (motor examination) was also video-recorded immediately before and after the singing and control session and scored by two raters masked to time and condition. Secondary outcome measures for quality of life, depression, and mood were collected. Results revealed no significant change in cortisol or motor UPDRS scores, as well as no significant relationship between cortisol and motor UPDRS scores. There was a trend for the singing group to report feeling less sad compared to the control group after the 1-h session (effect size = 0.86), and heart rate increased in the singing group while heart rate decreased in the control group after the 1-h session. These results suggest that an acute session of GTS is not unduly stressful and promotes the use of GTS for persons with PD. Multiple mechanisms may underlie the benefits of GTS for persons with PD. Further exploring potential mechanisms by which singing improves motor symptoms in persons with PD will provide greater insight on the therapeutic use of music for persons with PD.

Physical exercise increases perceived musical pleasure: Modulatory roles of arousal, affect, or dopamine?

Music’s ability to influence exercise performance is well known, but the converse, how exercise influences music listening, remains largely unknown. Exercise can elevate arousal, positive affect, and neurotransmitters including dopamine, which are involved in musical pleasure. Here we examine how exercise influences music enjoyment, and test for a modulatory role of arousal, affect, and dopamine. Before and after exercise (12 min of vigorous running) and a rest control session, participants ( N = 20) listened to music clips and rated their enjoyment and subjective arousal; we also collected ratings of affect and eye-blink rates, an established predictor of dopamine activity. Ratings of musical enjoyment increased significantly after exercise, but not after the rest control condition. While changes in subjective arousal ratings did not differ between exercise and control conditions, change in subjective arousal correlated with change in music enjoyment. After exercise, the change in music enjoyment had a positive but non-significant correlation with change in eye-blink rates ( r = .36). Positive affect increased more after exercise than after the control session, but the change in positive affect did not correlate with change in music enjoyment. In sum, exercise leads to increased musical enjoyment, and this effect was related to changes in arousal.

048 Increased Cognitive Load Under Stress Modulates Sleep Spindles and Slow Oscillations in a Sleep-Stage Dependent Manner

Introduction The effect of increased cognitive load especially under duress has been known to affect brain rhythms in humans. However, this effect has been shown primarily in the awake brain; the effect of stressful cognitive load on sleep rhythms is yet unclear. We leveraged a unique opportunity to understand the effect of cognitive load under laboratory stress on sleep spindles and slow oscillations that are hallmark rhythms of NREM sleep. Methods Cortical 6-channel EEG nap data were collected from 45 subjects over two separate days: after a control session without laboratory stressors and after an experimental session in which they underwent fear condiitoning and negative-emotional-image viewing sessions. We detected sleep spindles (11-13Hz over frontal regions and 13-16Hz over centroposterior regions) and slow oscillations (0.16–1.25Hz oscillations) as discrete events at each of the six electrodes, and staged them by the sleep hypnogram. We evaluated the spindle rate in N2 sleep and the proportion of slow oscillations nested with a spindle in N3 sleep. Results Over all 6 EEG electrodes, N2 spindle rates increased on average by 14% in the experimental session compared to the control session (mixed-effect models p&lt;0.001). In addition, over all 6 electrodes, the proportion of slow oscillations in N3 nested with a spindle increased by 2.3% in the experimental session compared to the control session (mixed effect model, p=0.005). Conclusion We show for the first time how increased cognitive load under stressful laboratory conditions affects sleep rhythms. Such an increased response in sleep might correspond to a continued emotional response due to the cognitive load under duress. Ongoing work seeks to tie these findings to possible emotional memory consolidation. Support (if any) VA Career Development Award to Dr. Richards (5IK2CX000871-05)

Evaluation of an enrichment programme for a colony of long-tailed macaques (Macaca fascicularis) in a rescue centre

Long-tailed macaques are highly social primates that are commonly used in biomedical research as animal models. The aim of this study was to evaluate the effects of different kinds of enrichment on the behaviour and faecal cortisol metabolite (FCM) level in a colony of ex-laboratory long-tailed macaques during a programme of rehabilitation. The research was carried out in three periods, divided into two sessions each. Every period was composed of one control session (SC) and one session characterised by one type of enrichment: feeding enrichment (FE), manipulative enrichment (ME), and the last session during which manipulative and feeding enrichment were provided every day but in a mixed way (MIX). The results showed that manipulative and mixed enrichments caused positive changes to the activity budget of the colony, with a decrease in abnormal behaviour rates and an increase in play compared with control sessions. The rate of affiliative behaviours and low rate of aggression were probably because the group was composed mostly of females and it was stable, with a well-defined hierarchy. The research underlines the importance of a well-studied enrichment programme for the welfare of captive animals, which should exploit species-specific motivations.

Therapy Processes Associated With Sudden Gains in Cognitive Therapy for Depression: Exploring Therapeutic Changes in the Sessions Surrounding the Gains

Background: The frequency and clinical impact of Sudden Gains—large symptom improvements during a single between-session interval—in psychotherapy for depression have been well established. However, there have been relatively few efforts to identify the processes that lead to sudden gains.Aim: To explore therapy processes associated with sudden gains in cognitive therapy for depression by examining changes in the sessions surrounding the gains, and the session preceding the gain in particular.Methods: Using ratings of video-recordings (n = 36), we assessed the content, frequency and magnitude of within-session cognitive-, behavioral-, and interpersonal change, as well as the quality of the therapeutic alliance in the session prior to the gain (pre-gain session), the session after the gain (post-gain session) and a control session. After that, we contrasted scores in the pre-gain session with those in the control session. In addition, we examined changes that occurred between the pre- and post-gain session (between-session changes) and explored patients' attributions of change.Results: Although not statistically significant, within-session changes were more frequent and stronger in the pre-gain session compared to the control session. The largest difference between the pre-gain and control session was found in the behavioral domain, and reached the level of trend-significance. There were more, and more impactful between-session changes in the interval during which the gain occurred as compared to a control interval. Exploratory analysis of attributions of change revealed eight subcategories, all corresponding with the cognitive-, behavioral- and interpersonal- domain. The quality of the therapeutic alliance was high and almost identical in all sessions.Conclusion: In spite of its small sample size, our study provides relevant descriptive information about potential precipitants of, themes related to, and attributions given for sudden gains. Furthermore, our study provides clear suggestions for future research. A better understanding of session content in the sessions surrounding sudden gains may provide insight into the mechanisms of change in psychotherapy, hereby suggesting treatment-enhancing strategies. We encourage researchers to conduct research that could clarify the nature of these mechanisms, and believe the methods used in this study could serve as a framework for further work in this area.

Sustained Effects of High-Intensity Interval Exercise and Moderate-Intensity Continuous Exercise on Inhibitory Control

This study examined the immediate and sustained effects of high-intensity interval exercise (HIIE) and moderate-intensity continuous exercise (MICE) bouts on inhibitory control in young adults. Participants (n = 41) engaged in (1) a session of HIIE, involving 10 one-minute runs on a treadmill at an intensity targeting 85–90% HRmax interspersed with self-paced walking at 60% HRmax; (2) a session of MICE, involving a 20 min run on a treadmill at an intensity of 60–70% HRmax; and (3) a control session, involving 24 min of resting on separate days in a counterbalanced order. Using a flanker task, inhibitory control was assessed before the intervention (t0), immediately after the session (t1), and then at 30 min (t2), 60 min (t3), and 90 min (t4) after the session. During the flanker task, the response time (RT) for incongruent trials immediately after HIIE was significantly shortened compared to that before exercise. This shortened RT was sustained for 90 min post-exercise during recovery from HIIE. Interference scores of RT were also reduced after HIIE, benefitting inhibitory control, and were maintained for 90 min post-exercise. Reduced accuracy interference scores were recorded following HIIE compared to the control session. Improvements in inhibitory control elicited by HIIE were sustained for at least 90 min post-exercise. In contrast, an improvement in inhibitory control was not observed during the MICE session. HIIE might represent a time-efficient approach for enhancing inhibitory control.

Effects of Isometric Biceps Exercise on Blood Pressure in Adults with Hypertension

We investigated the acute effects of isometric biceps exercise on resting and ambulatory blood pressure in hypertensive adults. A total of 12 medicated hypertensive adults (aged 47±7 years; body mass index 27.2±2.7 kg/m2; resting blood pressure 123±12/74±6 mmHg) performed an isometric biceps exercise session (bilateral biceps exercise; 4×1 min at 30% of 1-RM, 2 min recovery) and a control session (without exercise) in a randomized order separated by a 7 to 10-day period. Resting blood pressure, heart rate, and heart rate variability indexes (SDNN, RMSSD, LF, HF, and LF/HF) were measured pre- and up to 30 min post-sessions. Next, ambulatory blood pressure was monitored during 22-hour post-sessions (awake and asleep periods). No significant changes were observed for resting blood pressure, heart rate, or heart rate variability indexes up to 30 min post-sessions (p>0.05). Furthermore, no significant differences were observed in average ambulatory blood pressure values in 22-hour (126±11/71±6 mmHg vs. 126±15/71±9 mmHg), awake (127±10/74±6 mmHg vs. 130±14/75±10 mmHg), and asleep (123±15/68±6 mmHg vs. 120±17/66±9 mmHg) periods between the control and isometric sessions, respectively (p>0.05). In conclusion, an isometric biceps exercise session does not elicit an acute antihypertensive effect in adults with hypertension, which suggests that its prescription to improve the acute BP control is limited.