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Depression has been associated with poor health–related quality of life (HRQoL) in patients with congestive heart failure (CHF). However, to date, whether somatic-affective and cognitive-depressive symptoms differently contribute to poor HRQoL and behavioral functional capacity in patients with CHF has yet to be investigated.

Depression is commonly reported in patients after cardiac surgery and increases the risk of postoperative cardiac morbidity or mortality or both. 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.

Postoperative cognitive decline (POCD) is a frequent complication after cardiac surgery. Although intraoperative events are risk factors for POCD, the role played by preoperative hypoperfusion in cognitive decline has not yet been investigated. It is also unknown whether the impact of preoperative hypoperfusion in the left or right middle cerebral arteries (MCAs) can differentially account for POCD. The main aims of this study were to investigate whether preoperative cerebral hypoperfusion was associated with early POCD and whether lateralized hypoperfusion would differentially affect POCD in patients after cardiac surgery.

A large body of literature sustains the association between long-lasting caregiving for impaired significant others and increased health risk. Depression, elevated heart rate, and blood pressure at rest are key measures of health risk, mostly cardiovascular, which have been generally studied in caregivers of patients affected by dementia or chronic illness. Limited research has been conducted on emotional and cardiovascular impact of family caregiving for terminally ill cancer patients.

The objective of this study was to investigate the effect of regular physical activity on the haemodynamic response to public speaking and to evaluate the long-term effect of exercise on development of hypertension.

Background and aims:Although pain in the elderly is a common and important problem, it is frequently underestimated and undertreated. Pain assessment in elderly people is often more difficult than in the general population, because of the occurrence of dementia and other cognitive impairments that may compromise the ability to communicate the presence and the intensity of pain to hospital staff. Recently, several observational tools have been developed in order to assess pain behaviors in non-communicative patients. The aim of the present study was to verify if the Italian version of the Non-Communicative Patient’s Pain Assessment Instrument (NOPPAIN) could be used in a hospital setting. Methods:Sixty severely demented patients (MMSE ≤12, language test score ≤3) and 42 cognitively intact ones (MMSE ≥23, language test score ≥4) were selected on the basis of their cognitive status and language skills. NOPPAIN forms were filled in at the same time by two nursing staff members after patients’ daily care activities; behavioral indicators of the affective state and communicative patients’ reports of pain were also collected. Results:Significant interrater agreement was found in the subscores of the four main sections of the NOPPAIN and also in the total score. In addition, in cognitively intact patients there was a moderate (about 0.50) but significant correlation between NOPPAIN ratings and pain self-reports. A positive correlation between pain scores and negative affective state scores was also found, especially in cognitively impaired patients. Conclusions:The preliminary data of the present study support the reliability and validity of the Italian version of the NOPPAIN, which appears to be an easy-to-use tool in the assessment of pain in hospitalized non-communicative patients.

Cataplexy is the key symptom of the narcoleptic syndrome. It is usually triggered by emotions, which play an important role in the manifestation and severity of the disease. Accordingly, we compared the psychophysiologic effects on patients with narcolepsy and healthy subjects of processing visual stimuli that have established emotional valences.

To compare the blood pressure (BP) response to doctor's visit with the BP reaction to a psycho-social challenge and with the difference between clinic and daytime BP (ΔC-D).

The autonomic basis of cardiac reactions to unpleasant film stimuli was investigated. Film clips depicting major surgery, threats of violence, and neutral material were presented to 46 subjects. Self-report measures of emotion were obtained, as well as heart rate, respiration rate, respiratory sinus arrhythmia, T-wave amplitude and skin conductance level. Resting vagal tone was estimated in a paced breathing task prior to film viewing. Spontaneous blink rate was also taken as a measure of visual engagement during film viewing. Coherent increases in sympathetic activation accompanied the film containing violent threats, whereas the surgery film yielded greater electrodermal activation, as well as heart rate deceleration and T-wave increase. These data support the hypothesis of differential autonomic response patterns to specifically unpleasant material. As compared with threat and neutral films, greater blink rate inhibition was observed during the surgery film. Individual differences in parasympathetic cardiac control measured at rest were able to discriminate cardiac response patterns during film viewing.

THE present study describes a patient, M.L., with right orbitofrontal lesion, who showed no impairment on main neuropsychological tests, including those measuring frontal functions. Nevertheless, he had deeply affected emotional responses. In line with Damasio's work, the patient had lower skin conductance during the projection of a standardized set of emotional slides. Furthermore, he showed altered facial expressions to unpleasant emotions, displaying low corrugator supercilii electromyographical activity associated with reduced recall of unpleasant stimuli. During a task focusing on imagery of emotional situations, M.L.'s heart rate and skin conductance responses were affected during both pleasant and unpleasant conditions. Facial expressions to unpleasant imagery scripts were also impaired. Thus, the orbitofrontal cortex proved to play a critical role in retrieval of psychophysiological emotional patterns, particularly to unpleasant material. These results provide the first evidence that orbitofrontal lesions are associated with emotional impairment at several psychophysiological levels.

Visual evoked potentials to emotional slides presented for 2 sec. were investigated in 13 subjects. 73 emotional slides (pleasant, unpleasant, and neutral) were selected from a standardized set of photographic slides, the 1988 International Affective Picture System of Lang, Öhman, and Vaitl. Visual evoked potentials were recorded from three head locations, frontal, central and parietal (Fz, Cz, and Pz). Analyses were performed in the two latency ranges: 300–400 msec. and 400–500 msec. Analyses showed an arousal effect, as indicated by a quadratic trend, indicating that emotional slides (both pleasant and unpleasant) gave higher cortical positivity than neutral ones, for all components. In addition, in the two latency epochs, larger positivities were found at Pz, compared to Fz and Cz, whereas Fz and Cz did not differ from each other.

The experiment assessed the effects of two film sequences, a pleasant documentary and a distressful scene, on electrogastrographic (EGG), electromyographic (EMG), and heart-rate responses during digestion by 30 healthy students. The physiological measures were recorded before and during the projection of each film sequence. At the end of each viewing period, subjects completed a self-rating questionnaire on the emotional experience. Analysis yielded a significant increase in heart-rate and EMG values during the viewing of the film sequences and a significant decrease in amplitude of the 3 cycles per minute (cpm) wave of EGG during the unpleasant film. The type of film sequence had also a statistically significant effect on the self-ratings of emotional states.

The experiment investigated the effects of two film sequences, one neutral and the other emotional, on the cardiac (ECG), electrogastrographic (EGG) and respiratory activities of 24 healthy students during digestion. The physiological activity was recorded before and during the projection of each film sequence. 12 subjects were shown a neutral film sequence and 12 an emotional film sequence. At the end of each viewing period, each subject completed a self-rating questionnaire on the emotional experience. Analysis indicated, with respect to the previewing (baseline) values, an increase in cardiac and respiratory rates and a decrease in electrogastrographic rates during the viewing of the film sequences. Changes in the EGG rate (baseline to viewing) were negatively correlated with the changes in ECG and respiratory rates, whereas the changes in these latter two were positively correlated. In comparing the effects of the neutral and emotional scenes the only significant result was the heart-rate increase in subjects watching the emotional sequence. Also, the self-rating of emotional experience varied with the emotional value of the sequence.

Binary visual biofeedback was administered for HR reduction while the subject was listening to music, a pure tone, or nothing. All 27 subjects received all 3 contexts in a completely counterbalanced order. Immediately following the biofeedback training, HR was recorded during each of the 3 contexts with no biofeedback.Significant HR reduction (over 4 BPM) occurred in all 3 contexts. This effect was also observed during the test without feedback immediately following training. But 24 hours later, HR was no longer significantly below baseline in any of the contexts. HR variability (between subjects) increased significantly in the second test. There was no difference due to context, either in training or transfer.

12 blood-phobic subjects, selected according to the Feat Survey Schedule and the Mutilation Questionnaire, and 50 control subjects performed a paced respiration task during which heart rate and respiration were recorded. Respiratory Sinus Arrhythmia (RSA) was analyzed as an autonomic index of vagal influence on the heart. Analysis showed a larger RSA in the blood-phobic group than the controls and points to a difference in vagal activity at rest between the groups.

ChemInform is a weekly Abstracting Service, delivering concise information at a glance that was extracted from about 200 leading journals. To access a ChemInform Abstract of an article which was published elsewhere, please select a “Full Text” option. The original article is trackable via the “References” option.

ChemInform is a weekly Abstracting Service, delivering concise information at a glance that was extracted from about 100 leading journals. To access a ChemInform Abstract of an article which was published elsewhere, please select a “Full Text” option. The original article is trackable via the “References” option.

In the present study, startle responses during resting states as well as during the presentation of a set of emotive slides were recorded from a 32-year-old male patient with a rare localized lesion of the right amygdala. The startle reflex is a response modulated by affective states: it has been reliably used in the literature to measure the aversiveness of emotive stimuli. The animal literature has shown that the circuit of this reflex is directly influenced by amygdala projections. The startle responses of the patient were compared with those of eight age-matched normal subjects. The patients startle amplitudes showed an overall impaired response and an inhibited reflex contralateral to the lesion. In addition, he failed to show the typical startle potentiation induced by an aversive emotive background. The data confirm, in the human, previous results from the literature in other species on amygdala involvement in startle and emotional responses. Furthemore, the observation of the importance of the right amygdala in the modulation of emotion is consistent with the hypothesis of right hemisphere specialization for aversive emotions. The results are discussed in the context of the literature on human amygdala lesions.