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Fibromyalgia is a long-term pain disorder that has been related to autonomic dysfunctions and reduced cardiovascular reactivity. We aimed to assess the dynamic short-term cardiovascular responses to postural changes in fibromyalgia. Thirty-eight women with fibromyalgia and thirty-six healthy women underwent the "Chronic Pain Autonomic Stress Test". Electrocardiogram, blood pressure and impedance cardiography were continuously recorded during active standing and lying down. Second-by-second values were derived over the first 30 s of each posture. Lower reactivity during the beginning of each position was observed in fibromyalgia sufferers compared to healthy women, with smaller responses seen during stand up in heart rate, blood pressure, cardiac output, total peripheral resistance, and pre-ejection period, and smaller changes during lying down in heart rate, cardiac output and total peripheral resistance. The magnitude of the autonomic adjustments to postural changes was inversely associated with the severity of clinical pain. These findings indicate an early impaired autonomic cardiovascular response to orthostatic and clinostatic challenges in fibromyalgia, suggesting less autonomic flexibility and adaptability to situational demands and challenges. Short-term second-by-second cardiovascular measures may be useful in the clinical assessment of fibromyalgia.

Supplementary material with aseries of analyses related to a manuscript titled"Impact of a homeostatic body’s hydration status as risk or resiliency factor, evaluated by hemodynamic measures, on different types of pain sensitization as pathways to a chronic pain syndrome" were conducted for indicating impact of de- and re-hydration events (evoked by within-subject ortho- and clino-static challenges) and hypo- and hyper-hydration states (assessed primary by between-subject variance in averaged cardiac output associated with age and body mass variances in the sample, and secondary by between-subject variance in the hair cortisol concentration) on blood volume-related cardiac and vascular mechanisms regulating blood pressure level.

The view that the cardiovascular system and systems regulating pain perception are closely interrelated was predicted by a variety of findings in the 1970s. This early viewpoint was later confirmed in numerous experimental, clinical, populational, and prospective studies. It is now evident that acute and persistent noxious stimuli and conditioned pain-related behavior, feelings, and thoughts may affect mechanisms regulating cardiovascular activity (e.g., provoke hypertension development). Moreover, the regulation of individual unconditioned and conditioned responses to noxious stimuli may be modified by common mechanisms also regulating cardiovascular and metabolic activity (e.g., by a central inhibition mechanism determining baroreflex bradycardia and by energy supply mechanisms in active and relaxing conditions determining coupling of the heart beating with muscle and respiration activities, respectively). Numerous baroreflex and related cardiovascular variables are suggested for predicting and indicating (as a pain-o-meter) pain severity, its duration and frequency along with pain coping (adaptation and resilience) mechanisms to improve profiling and correct management of individuals with chronic pain syndromes. Moreover, the baroreflex mechanisms are now used in pain control and management. This chapter discusses the history and modern viewpoints on mechanisms of the relationships between pain and cardiovascular systems.

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Objectives Although progress has been made in the regulation of hypertension over the past decades, the USA and some other countries have faced a significant rise in incidence of chronic pain management cases during the same period. Studies of the relationship between pain and blood pressure (BP) regulations propose that these two processes may be interconnected. Studies of effects of antihypertensive treatment on pain in general and its chronification have never been reviewed. Methods A narrative review of respective studies with analysis of credibility of the findings was conducted. Results Some studies have suggested that aggressive reduction of high BP may contribute to a return in pain symptoms and may require more aggressive, long-term pain management. Other studies propose that long-term antihypertensive medication could also increase the risk for new cases of chronic pain. Pain initiates a central neuroplastic resetting of the baroreceptor activation accounting for sustained increase of BP with an adaptive 'pain-killing' or maladaptive 'pain-complication' effect associated with pain chronification, and these mechanisms may be moderated by antihypertensive medications. However, different antihypertensive drugs and nondrug treatments may diversely affect pain mechanisms at different stages of treatments. Conclusion Uncontrollable reduction of high BP in some patients with hypertension could increase the risk for chronic pain incidence and its severity. Practical recommendations in BP control should be reconsidered to take into account patients' chronic pain. Further research is needed of moderation effects of different antihypertensive manipulations on pain to improve pain management in these patients.

Background Different physical exercise interventions for pain and other related symptoms largely follow non-personalized guidelines and show a high degree of variability in outcome. These interventions are considered to have different pathways toward improvement in autonomic regulation of energy metabolism. The current pilot study was conducted to assess the predictive value of individual cardiovascular (CV) activity markers at rest to predict clinical outcomes for two popular exercise-based interventions (walking and yoga) in patients with Irritable Bowel Syndrome (IBS). Methods Twenty-seven adult participants with IBS were randomly assigned to a 16-biweekly Iyengar yoga or walking program. They completed pre- and post-treatment assessments on IBS symptom severity, affective and somatic complaints, and various measures of resting autonomic function including blood pressure (BP), heart rate and its variability, baroreceptor sensitivity (BRS) to activations and inhibitions with gains of brady- and tachycardiac baro-responses, and BP start points for these spontaneous baroreflexes. Results Pretreatment BRS was differentially related to clinical response for the treatment groups. Specifically, a significant decrease in pain severity was found in response to yoga for those participants who had lower resting BRS to activations, but decreased pain severity was associated with higher resting BRS for those in the walking group. The effect was not related to affective symptom relief. Other CV measures showed similar associations with clinical outcomes for both groups. Conclusions The data suggest therefore that CV based phenotypes may be useful in personalizing clinical interventions for IBS. They may also point to autonomic mechanisms that are targets for such interventions.

Previous clinical and elderly population studies have found that affective well-being can be assessed by clino-orthostatic cardiovascular reactivity. This study explored this relationship in a young healthy sample, and with respect to cognitive appraisals of well-being. Four successive readings of blood pressure (BP) and heart rate (HR) after lying down (clinostatic probe) followed by four successive readings after standing up (orthostatic probe) were obtained from 52 healthy students along with questionnaire-reported well-being. Analyses indicated that a deeper drop of systolic BP (SBP) and mean arterial (MAP) pressure during supine was related to higher positive mood, but higher and more stable orthostatic MAP and HR response were related to lower negative mood. A higher diastolic BP while standing upright and lower SBP in general were associated with higher optimism and higher global life satisfaction, respectively. The findings confirm previous results and indicate that cognitive appraisals of well-being are also related to BP regulation.

Objective Objective markers of chronic pain severity are needed when examining and treating patients with chronic pain whose suffering may be overstated or underestimated. This study tested a hypothesis that the strength of cardiovascular (CV) reactivity in response to a social evaluative threat and orthostatic challenge is a reliable index of severity of pain-related complaints. Methods Measurement of CV reactivity and response styles in 34 men and 16 women with chronic pain from different bodily injuries, were retrieved from a larger database of patients. Measurement of CV reactivity in response to a postural challenge was repeated twice (sessions 1 and 2) on the same day of a medical examination which includes a psychosocial evaluation. Results A decrease in systolic blood pressure (SBP) from session 1 to session 2 was found in subjects with low pain severity scores, but not in those with high pain severity scores. High scores for pain catastrophizing/magnification and pain-related emotional distress were independently associated respectively with a SBP increase at an early-point in time and a SBP decrease at a mid-point in time after standing up from lying down. Stronger heart rate reactivity responses to orthostatic challenge indicated greater protection against the presence of these chronic pain symptoms. Conclusions This biobehavioral protocol enables measurement of chronic pain suffering and protection in three dimensions: physical, emotional, and cognitive.

Variations in heart rate variability (HRV) have been associated with major depressive disorder (MDD), but the relationship of baseline HRV to treatment outcome in MDD is unclear. We conducted a pilot study to examine associations between resting baseline HRV and MDD treatment outcome. We retrospectively tested several parameters of HRV in an MDD treatment study with escitalopram (ESC, N=26) to generate a model of how baseline HRV related to treatment outcome, and cross-validated the model in a separate trial of MDD treatment with Iyengar yoga (IY, N=16). Lower relative power of very low frequency (rVLF) HRV at baseline predicted improvement in depressive symptoms when adjusted for age and gender (R2>.43 and p

This study was conducted to test the hypothesis that differences in alexithymia would moderate coupling in physiological and subjective-experiential responses to two affective films, which were shown to induce a common negative (sad) feeling, but to provoke different hyper- or hypo-arousal physiological responses (e.g., heart rate acceleration or deceleration) associated with antipathic or empathic context, respectively (Davydov, Zech, & Luminet, 2011). Only women were studied as persons showing more reactivity to sad films than men. Reactivity was evaluated for facial behaviour, physiological arousal, and subjective experience. Some other affective and cognitive disposition factors (e.g., depression and defensiveness) were considered for evaluating their probable mediation of the alexithymia’s effects. While subjective experience was not affected by alexithymia, high scorers on the externally-oriented thinking factor showed reduced physiological reactivity in both film conditions. These effects were mediated through different disposition factors: either low affectivity (low depressed mood), which mediated alexithymia's effect on hyper-arousal responses (e.g., decrease of heart rate acceleration), or impression management (other-deception), which mediated alexithymia's effect on hypo-arousal responses (e.g., decrease of heart rate deceleration).

This commentary is in response to Drs. Feinberg and Brigham’s request for reader feedback of their 2014 revision of their 2006 “Guide to the Guides…” [1]. They teach that its use improves rating accuracy. We concur. Their 2014 revision generates impairment rating protocols in injured workers that are based on the AMA Guides to the Evaluation of Permanent Impairment, 5th Edition (GUIDES) [2]. In response to their request for feedback, we wish to bring attention to published rating inaccuracies in the GUIDES and the unreliability of measuring chronic pain based only on self-report [3–6]. We have two goals. One is to introduce a neuroscience-based metric and related protocol that eliminates all identified GUIDES defects when rating chronic pain whole-person impairment. A second is to stimulate evaluation of this neuroscience-based assessment protocol as a potential gold-standard diagnostic benchmark in chronic pain medicine that currently does not exist. The search for a reliable chronic pain metric is the “holy grail” in all of pain medicine that challenges pain medicine practitioners, patients, drug developers, and the medical-legal community at large [6]. Historically we learn that the GUIDES is developed, “ To enable physicians to evaluate functional impairment in an objective and consistent manner… ” (p. 286 [5]). Seabury et al. challenge its “ …controversial use when measuring impairment versus disability. ” They, along with others, identify numerous “Catch 22s” that question GUIDES-derived impairment ratings as reliable and address them in detail [3–5]. As an example, we cite Dr. Rondinelli’s 2010 “Commentary” [4]. He writes “…that the ratings themselves remain largely consensus-based …and subject to various stakeholder priorities and biases… (p. 1204 [4])” In our experience this invites speculative expert examiner opinions. Our first goal is to …

Previous studies are inconclusive with regard to the relationship between variations in blood pressure (BP) and affect. In the present study we evaluated the hypothesis that inconsistencies in previous findings may be attributed to the moderating role of variations in psychological or physical conditions during BP measurement. Change in depressive symptoms was examined in 1046 individuals at two points in time, at inclusion into the study, when BP was measured repeatedly under higher (standing posture or anticipation of interview) and lower (supine posture or recovery after interview) arousal conditions, and at 4year follow-up. We observed that higher systolic BP levels measured under high arousal conditions and lower systolic BP levels measured under low arousal conditions at inclusion were both associated with a decrease in depressive mood across time in the study sample. The results suggest that higher or lower cardiovascular activity as indexed by systolic BP corresponds with higher or lower negative mood as a function of situation-specific arousal levels. This biobehavioural association between mood and BP might be related to the moderating effect of adaptive processes on physiological activity in different situations, which may in turn be associated with resilience to adversity.

Gender difference in intensity of emotional response depending on the cognitive disclosure of the emotions were analyzed in detail. Texts with emotionally negative content were presented to the subjects, and the parameters of their cardiovascular activity were recorded either before or after filling a special checklist to assess the impression caused by the texts and to reveal changes in the physiological activation of the subjects in response to these texts. Unlike women, men intensified their affective involvement into processing the content of the texts after filling the checklist. The results are interpreted in the context of current research on physiological emotional processes during their cognitive disclosure; the role of gender differences in the regulation of these processes was also studied.

Objectives: Previous research suggests that mechanisms related to afferent and efferent components of the baroreflex are associated with blood pressure level and mood, and that mood as a component of subjective well-being may be mediated by changes in blood pressure. This study examines these mechanisms in 213 healthy women and men. Methods: Evaluation of spontaneous baroreflex activity using the sequence technique under resting conditions in the laboratory was followed by 2 days of 24-h ambulatory blood pressure recording and diary ratings of mood. Results: Patterns of components of the baroreflex loop were significant predictors of 24-h ambulatory blood pressure mean level, its circadian variability, and daily ratings of mood. Three mechanisms were found to be involved in the regulation: (1) interaction between gains of afferent and efferent cardiac components of the baroreflex, (2) gain of afferent signals related to fast cardiac responses to baroreceptor activation, and (3) gain of afferent signals related to late cardiac responses to baroreceptor inhibition. The interaction of afferent/efferent components of baroreflex loop appears to independently determine mean levels of systolic blood pressure and positive (happy) mood. The effect of the baroreceptor activation mechanism on subjective well-being (indexed by happy and alert moods) was mediated by the wake/sleep systolic blood pressure difference. Additionally, the baroreceptor inhibitory mechanism effect on subjective well-being (indexed by stressed and sleepy moods) was mediated by the wake/sleep diastolic blood pressure difference. Conclusions: Evaluation of the baroreflex components and their interaction provides important information about blood pressure and mood beyond that provided by baroreflex sensitivity and potential for the evaluation of risk for hypertension and mood disturbance in healthy people.

Objective This study was conducted to present evidence of differences in autonomic regulation of cardiovascular activity and its role in the severity of specific (disease-related) and non-specific (negative affect and chronic pain-related) symptoms in individuals with Irritable Bowel Syndrome (IBS). Methods Seventy-eight female patients with IBS and 27 healthy women age 18–62 years were assessed for IBS symptoms, negative affect, and baroreceptor sensitivity (BRS), blood pressure (BP), heart rate, and heart rate variability (HRV) at rest. Direct and indirect regression effects were examined with application of the bootstrap procedure to validate findings. Results IBS was reliably related to lower resting BRS, higher BP, and higher negative affect compared to healthy controls. Longer disease duration (chronicity) was related to BRS decrease coupled with systolic BP increase (95% CIs = − 0.14 to − 0.01). Three autonomic mechanisms associated with BRS decrease were found to further regulate severity of IBS symptoms. Lower BRS was related to higher IBS severity in general if the effect was transferred through the decrease of low frequency power of HRV (e.g., 95% CIs = − 0.039 to − 0.001 for abdominal pain severity). However, lower BRS was related to lower IBS severity in general if the effect was transferred through diastolic BP increase (95% CIs = 0.01–0.11 for abdominal pain severity). Lower BRS was related to higher abdominal pain severity coupled with high negative affect if the effect was transferred through the decrease of higher frequency power of HRV (95% CIs = − 0.026 to − 0.003). Conclusions These findings indicate that different cardiovascular mechanisms are associated with IBS development and the increase and decrease of severity of IBS symptoms. Their assessment suggests ways to personalize treatment of IBS.

Hypothesis Previous studies provide evidence that glycated haemoglobin (HbA1c) and fasting plasma glucose (FPG) should not be considered as interchangeable alternatives in the diagnosis of the same type 2 diabetes, but as indicators of its different pathogenetic subtypes. This study was conducted to determine whether a particularly high amount of glucose in either HbA1c form or in fasting plasma would be found in diabetic patients genetically predisposed for either intensive cognitive or intensive muscle metabolic activity, respectively. Methods HbA1c and FPG levels, polymorphisms of genes indicating the predisposition to different cognitive activity (the dopamine D2 receptor (DRD2/ANKK1)), muscle activity (peroxisome proliferator-activated receptor gamma, coactivator 1 alpha (PGC1A(PPARGC1A))), and vascular regulation of general metabolic activity (the angiotensin 1 converting enzyme (ACE)) were assessed in diabetic patients and nondiabetic controls. Results DRD2/ANKK1 polymorphism that affects baseline central arousal determined HbA1c variations uncorrelated with FPG in total and clinical groups. The mutation of PGC1A mainly affecting peripheral glucose metabolism had an effect on FPG correlated or uncorrelated with HbA1c depending on the effect assessment in the total sample or in the nondiabetic group, respectively. ACE insertion/deletion (I/D) gene polymorphism was associated with both HbA1c and FPG fluctuations, but only in diabetic patients. Conclusion The findings provide evidence that the HbA1c and FPG may predict the risks for different subtypes of type 2 diabetes associated with either brain or muscle metabolic activity in genetically vulnerable people.

Objective This study examined women's mood responsiveness associated with patterns of stress hormone levels in everyday situations. Methods Self-reports of negative, positive, and energy dimensions of mood were obtained from 203 nurses throughout the day on a workday and on an off-work day during the luteal and follicular phases of the menstrual cycle. Individual differences in daytime norepinephrine and cortisol were assessed. Results Patterns of norepinephrine and cortisol levels were associated with ratings of the following moods: tired, sad, and happy. Phase of the menstrual cycle and the day factor (workday, off-work day) modified the association of mood ratings and stress hormone patterns. Conclusion The experience of negative mood is associated with both hypoarousal and hyperarousal conditions. A homeostatic arousal-related concept of mood regulation is discussed.

Preliminary findings support the potential of yoga as a complementary treatment of depressed patients who are taking anti-depressant medications but who are only in partial remission. The purpose of this article is to present further data on the intervention, focusing on individual differences in psychological, emotional and biological processes affecting treatment outcome. Twenty-seven women and 10 men were enrolled in the study, of whom 17 completed the intervention and pre- and post-intervention assessment data. The intervention consisted of 20 classes led by senior Iyengar yoga teachers, in three courses of 20 yoga classes each. All participants were diagnosed with unipolar major depression in partial remission. Psychological and biological characteristics were assessed pre- and post-intervention, and participants rated their mood states before and after each class. Significant reductions were shown for depression, anger, anxiety, neurotic symptoms and low frequency heart rate variability in the 17 completers. Eleven out of these completers achieved remission levels post-intervention. Participants who remitted differed from the non-remitters at intake on several traits and on physiological measures indicative of a greater capacity for emotional regulation. Moods improved from before to after the yoga classes. Yoga appears to be a promising intervention for depression; it is cost-effective and easy to implement. It produces many beneficial emotional, psychological and biological effects, as supported by observations in this study. The physiological methods are especially useful as they provide objective markers of the processes and effectiveness of treatment. These observations may help guide further clinical application of yoga in depression and other mental health disorders, and future research on the processes and mechanisms.

BACKGROUND: Recent studies have shown that depressive disorder is associated with impaired baroreceptor or baroreflex sensitivity, which is proposed to be a predisposing factor for sudden death in patients with manifest cardiac disease. These studies have not evaluated the afferent and efferent components of the cardiac baroreflex loop or other baroreflex mechanisms that regulate target processes (cardiac metabolism and blood pressure variability) related to the impairment. The objective of this study was to gain more insight into autonomic functioning in depressive disorder to more fully examine the potential basis for increased cardiac mortality. METHODS: The subjects were 28 women and men with unipolar major depression who were taking antidepressant medications and who were in partial remission and free of cardiovascular or other serious disease, and 28 healthy control subjects matched for sex, age, and ethnicity. The two samples were compared for negative affective dispositions (anger expression, hostility, defensiveness, anxiety), spontaneous (closed-loop) baroreflex activity, heart rate, heart rate variability, systolic blood pressure, and heart rate-systolic blood pressure double product under resting conditions. RESULTS: Depressed patients showed a general disposition to anger suppression coupled with higher hostility and anxiety, and lower defensiveness. The patients showed higher general sympathetic activity (high levels of blood pressure, low-frequency heart rate variability) and lower parasympathetic-related activity (high heart rate and reduced high frequency heart rate variability) with affected cardiac metabolism estimated by the double product. Depressed patients had lower baroreflex sensitivity related to a higher gain of the afferent component of the baroreflex without respective gain adjustment of its efferent component (reflex gain 'de-afferentation'). It was coupled with a compensatory higher number of effective baroreflex reactions (reflex gating 're-afferentation'). Antidepressant agents and depressed mood had additional independent effects on baroreflex sensitivity through the efferent component of the cardiac baroreflex loop. CONCLUSIONS: The data indicate that different baroreflex components and mechanisms may be impaired in patients with depression and may contribute to their increased cardiac risk.

It was recently shown that cognitive functions requiring more widespread brain integration relate to slower EEG activity, whereas cognitive performance supported by local brain integration is associated with faster EEG components (Von Stein & Sarnthein, 2000). Associations were studied between performance on WAIS and resting EEG spectral parameters in heroin abusers and normal young males. The most prominent associations between WAIS and EEG variables were consistently registered in polar and lateral frontal/temporal derivations. WAIS subtests predominantly loading on retrieval from long-term memory stores were significantly associated with delta bands mean frequencies. Subtests with strong working memory component related to theta2 mean frequency at temporal leads. Subtests requiring problem-solving operations correlated with alpha bands parameters, whereas psychomotor speed was associated with beta power. The data are in agreement with the hypothesis of Von Stein & Sarnthein (2000).

Objective: This study examined women’s moods on work and off days during different phases of the menstrual cycle. Method: Self-reports of the moods angry, happy, sad, stressed, tired, and anxious were obtained on two work and two off days during the luteal and follicular phases of the menstrual cycle in 203 nurses. Individual differences in anger expression, anxiety, and hostility were assessed. Results: Ratings of anxious, stressed, and tired were higher and happy and sad were lower on the workday than the off day. Menstrual cycle phase was associated with mood differences depending on the day (work, off work) and individual differences in personality traits. Conclusions: The experience of moods in everyday life is affected by overall levels of stress and phase of the menstrual cycle. The findings suggest the need to refine sociopsychobiological and clinical models of mood regulation and of risk for disease.

From the standpoint of the social and behavioral sciences, hypertension has attracted a great deal of attention. It forms the backbone of the growing fields of health psychology and behavioral medicine. The evidence is supportive of the role and significance of psychosocial factors in the etiology, course, and treatment of hypertension. This knowledge has the potential for deepening our understanding of the mechanisms involved in hypertension, improving the effectiveness of both drug and non-drug treatment, and facilitating efforts for prevention. There is great need for further systematic research and especially for theoretical and empirical integration of psychosocial and biological knowledge of the disorder.

BACKGROUND Objective measures of pain severity remain ill defined, although its accurate measurement is critical. Reciprocal baroreflex mechanisms of blood pressure (BP) control were found to impact differently on pain regulation, and thus their asymmetry was hypothesized to also connect to chronic pain duration and severity. METHODS Seventy-eight female patients with irritable bowel syndrome (IBS) and 27 healthy women were assessed for IBS severity and chronicity, negative affect, and various measures of resting autonomic function including BP, heart rate and its variability (HRV), baroreceptor-sensitivity to activations and inhibitions, gains of brady- and tachy-cardiac baro-responses, gains of BP falls/rises, and BP start points for these spontaneous baroreflexes. KEY RESULTS IBS directly and indirectly (through increased negative affect) was associated with asymmetry between baroreceptor activations/inhibitions compared to symmetrical baroreflex reciprocity in the healthy women. In the IBS group, independently of specific IBS symptoms, pain chronicity was associated with (i) decreased BP falls coupled with either (a) decreased tachycardia associated with lower disease severity (earlier "pain resilience" mechanism), or (b) decreased bradycardia associated with higher disease severity (later "pain decompensation" mechanism), or (ii) increased BP start point for baroreceptor activations coupled with either (a) BP increase (delayed "pain adaptation" mechanism) or (b) affect-related HRV decrease (delayed "pain aggravation" mechanism). CONCLUSION AND INFERENCES We anticipate the findings to be a starting point for validating these autonomic metrics of pain suffering and pain coping mechanisms in other chronic pain syndromes to suggest them as biomarkers of its severity and duration for profiling and correct management of chronic pain patients.

A major challenge presently is not only to identify the genetic polymorphisms increasing risk to diseases, but to also find out factors and mechanisms, which can counteract a risk genotype by developing a resilient phenotype. The objective of this study was to examine acquired and innate vagal mechanisms that protect against physical challenges and haemorrhages in 19 athletes and 61 non-athletes. These include examining change in heart rate variability (HF-HRV; an indicator of vagus activity) in response to orthostatic challenge, platelet count (PLT), mean platelet volume (MPV) and single-nucleotide polymorphisms in genes that encode several coagulation factors, PAI-1 and MTHFR. Individual differences in PLT and MPV were significant predictors, with opposite effects, of the profiles of the HF-HRV changes in response to orthostasis. Regular physical training of athletes indirectly (through MPV) modifies the genetic predisposing effects of some haemostatic factors (PAI-1 and MTHFR) on vagal tone and reactivity. Individual differences in vagal tone were also associated with relationships between Factor 12 C46T and Factor 11 C22771T genes polymorphisms. This study showed that genetic predispositions for coagulation are modifiable. Its potential significance is promoting advanced protection against haemorrhages in a variety of traumas and injuries, especially in individuals with coagulation deficits.

The importance of certain neurotrophic proteins found in maternal blood and milk for breastfed infants has remained ambiguous. This study was conducted to present evidence of the impact of an induced deficit of active S100B protein on neonate development. Newborn mice from two groups of mothers, immunized or sham-immunized against S100B, were subjected to various behavioral tests, and the development of their morphological characteristics was recorded from birth until weaning. Morphological problems, including weight gain and fur coating, a delay in the maturation of neurobehavioral systems and a deficit in neuromotor functions, including visual abilities, somato-sensory and posture reactions, muscular strength, locomotion, and fear/orienting processes, were observed in pups of immunized mothers. The S100B protein of external or internal origin in infants may be considered to be a specific factor that determines neuro- and morphological development and a risk-avoidance ('homeward-bent' or fearful) phenotype. The suppression of activity of the S100B protein results in a slower neonatal development and the formation of a risk-tolerant (fearless) phenotype of the offspring. This study thus considers the mechanism of neuroplastic regulation on the extent of sensation-seeking or risk-taking (homeless-like or fearless) and sensation- or risk-avoidance (home-bound or fearful) features in individual phenotypes.

It has been suggested that high alexithymia scorers have an 'augmenter' profile which amplifies their physiological and subjective responses to highly arousing stimuli. The aim of this study was to test this theory using several physiological measures. Participants listened to musical excerpts either in a 'weak-to-strong' or a 'strong-to-weak' order of arousing levels of stimuli. The results show that alexithymia was associated with an augmenter profile for subjective reports for the most arousing stimulus and with stronger skin conductance level responses in the 'strong-to-weak' order. These results partially support the augmenter profile and reveal that alexithymia may be associated with higher anticipation for the most arousing excerpt.

This study was conducted to test the hypothesis that two films that induce a sad feeling would elicit different physiological responses depending on an additional context of the film contents related to either avoidance (disgust) or attachment (tenderness). Reactivity was evaluated for facial behavior, heart rate, pulse transit time, skin conductance, and subjective experience. Participants reported feeling less happy and showed increased facial activity related to the sad content of both films. The sad film related to avoidance induced an increase in skin conductance level and response rate. In contrast, the sad film related to attachment induced a decrease in amplitude of skin conductance responses and heart rate. The study showed that while the common sad content of both films disturbed mood or provoked negative feelings, additional affective contexts induced either a decrease or an increase in physiological arousal.

International audience; The relationship between disease and good health has received relatively little attention in mental health. Resilience can be viewed as a defence mechanism, which enables people to thrive in the face of adversity and improving resilience may be an important target for treatment and prophylaxis. Though resilience is a widely-used concept, studies vary substantially in their definition, and measurement. Above all, there is no common underlying theoretical construct to this very heterogeneous research which makes the evaluation and comparison of findings extremely difficult. Furthermore, the varying multi-disciplinary approaches preclude meta-analysis, so that clarification of research in this area must proceed firstly by conceptual unification. We attempt to collate and classify the available research around a multi-level biopsychosocial model, theoretically and semiotically comparable to that used in describing the complex chain of events related to host resistance in infectious disease. Using this underlying construct we attempt to reorganize current knowledge around a unitary concept in order to clarify and indicate potential intervention points for increasing resilience and positive mental health.

Recent studies suggest that ruminative thoughts may be mediators of the prolonged physiological effects of stress. We hypothesized that autonomic dysregulation plays a role in the relation between rumination and health. Rumination was induced by an anger-recall task in 45 healthy subjects. Heart rate variability (HRV), baroreflex sensitivity (BRS), and baroreflex effectiveness index (BEI) change scores were evaluated to obtain the autonomic phenotype of rumination. Personality traits and endothelial activation were examined for their relation to autonomic responses during rumination. Degree of endothelial activation was assessed by circulating soluble intercellular adhesion molecule-1 (sICAM-1). Vagal withdrawal during rumination was greater for women than men. Larger decreases in the high frequency component of HRV were associated with higher levels of anger-in, depression, and sICAM-1 levels. BRS reactivity was negatively related to trait anxiety. BEI reactivity was positively related to anger-in, hostility, anxiety, and depression. Lower BEI and BRS recovery were associated with lower social desirability and higher anger-out, anxiety, and depression. Findings suggest that the autonomic dysregulation that characterizes rumination plays a role in the relationships between personality and cardiovascular health.

The major goals of this study were (1) to determine consistency of autonomic response modes to different laboratory stressors, and (2) to evaluate the strength of the association between autonomic response modes and ambulatory heart rate and variability. The sample consisted of 45 healthy participants. Parasympathetic (PNS) and sympathetic (SNS) reactivity to and recovery from laboratory stressors (handgrip, logical-mathematical, mirror-tracing, and rumination tasks) were estimated by high frequency heart rate variability (HF-HRV), preejection period (PEP), and baroreflex sensitivity (BRS). Ambulatory HR was measured for 24 h on a work and a nonwork day, counterbalanced. As BRS was less reliable compared to PEP and HF-HRV, the latter two parameters were selected for the computation of SNS/PNS patterns. Autonomic modes were consistent across tasks and more stable during the recovery periods. Moreover, recovery appeared to be sensitive to the emotionality of tasks. Reactivity and recovery patterns differed as a function of gender, with women showing higher vagal tone at baseline, higher HR reactivity to the logical task, greater BRS decrease during the rumination task, and a larger decrease in vagal tone during recovery after the rumination task. After controlling for gender and baseline HR and variability, autonomic profiles during reactivity and recovery periods captured substantially different ambulatory information. Specifically, autonomic profiles during reactivity significantly predicted ambulatory HR level during waking hours, whereas autonomic profile during recovery was linked with ambulatory HRV. Coactivation of SNS and PNS activity was associated with the highest ambulatory HR levels and variability. Findings from the laboratory were consistent with a dimensional autonomic model viewing SNS and PNS contributions to heart rate on orthogonal axes and individual stress response stereotypy. Laboratory task-related autonomic reactivity and recovery may reflect parallel differences in HR level and variability in everyday life.

Background: The aim of the study was to determine the effects of asymmetric cerebral embolic load on cognitive functions. Methods: Thirty-six open heart surgery (OH) and 26 coronary artery bypass grafting (CABG) patients were evaluated by neuropsychological and transcranial Doppler tests. Results: OH was associated with a significantly larger microembolic load in comparison to CABG. In OH patients, the microembolic load at the left middle cerebral artery correlated with a verbal memory decline, whereas the microembolic load at the right middle cerebral artery correlated with a nonverbal memory deficit. CABG patients also showed a postoperative verbal memory decline which correlated with cardiopulmonary bypass length but not with microembolic load. Conclusion: Massive microembolic load during OH induces specific cognitive impairment in accordance to the brain region to which they are delivered. In atherosclerotic patients, the left temporal region is especially prone to perioperative ischemia.

Objective: This study examined women’s mood responsiveness on work and off days during different phases of the menstrual cycle. Methods: Self reports of negative, positive, and energy dimensions of mood were obtained throughout the day on two work and two off days during the luteal and follicular phases of the menstrual cycle in 203 women nurses. Individual differences in daytime and nighttime epinephrine, norepinephrine, and cortisol were assessed. Results: High daytime norepinephrine, epinephrine, and cortisol levels were associated with higher ratings of stress and tired, and with lower ratings of happy. Phase of the menstrual cycle and the day factor (work day, off day) were also associated with mood differences, and the direction of the effects depended on hormone levels and hormone sampling period. Conclusion: The experience of moods is affected by arousal-related interaction of hormone levels with phase of the menstrual cycle and occupational stress.

Planning function deficit is the most consistent finding in neuropsychological studies of heroin addicts. The performance on the Tower of London Test (TLT) correlated with the duration of daily heroin abuse (DDHA) in our previous study. Alpha2 mean frequency in anterior/central derivations was also predicted by DDHA in the same patient population. This retrospective study was undertaken in order to understand better the relationships between observed neurological deviations in heroin abusers. Thirty-three heroin addicts and 12 healthy males were evaluated with 14 neuropsychological tests and resting eyes-closed electroencephalography (EEG). Multivariate tests showed that performance on the difficult (five-move) problems of TLT was strongly predicted by the EEG alpha2 mean frequency shifts, and these relationships were generally mediated by chronic heroin length. However, post-hoc analyses at separate leads demonstrated that the relationships between cognitive variables and alpha2 mean frequencies in the left hemisphere were independent of chronic heroin effects, whereas elevation of alpha2 frequency in the right hemisphere was strongly predicted by chronic heroin intake length. The patients with extremely high alpha2 mean frequency at the left central region were especially prone to failure in TLT due to the inability of the hypothesized alpha2-generating network, which normally projects to the central and temporal derivations bilaterally and to the right posterior temporal derivation to function appropriately. Hence, it was concluded that planning dysfunction in heroin abusers is related to alpha2 mean frequency shifts predominantly at the central regions.

This study examined women's moods on work and off days during different phases of the menstrual cycle.Self-reports of the moods angry, happy, sad, stressed, tired, and anxious were obtained on two work and two off days during the luteal and follicular phases of the menstrual cycle in 203 nurses. Individual differences in anger expression, anxiety, and hostility were assessed.Ratings of anxious, stressed, and tired were higher and happy and sad were lower on the workday than the off day. Menstrual cycle phase was associated with mood differences depending on the day (work, off work) and individual differences in personality traits.The experience of moods in everyday life is affected by overall levels of stress and phase of the menstrual cycle. The findings suggest the need to refine sociopsychobiological and clinical models of mood regulation and of risk for disease.

Pulse rate and cephalic pulse volume were recorded from 17 male and 37 female normal subjects during performance of an attentional task under high and low stress conditions. Verbal threshold (perceptual sensitivity) and word recognition (attention) were assessed using a visual verbal recognition task. Subjects were divided at the median for pulse rate and pulse volume during baseline, instruction, and task periods and grouped in terms of these two measures to represent different patterns of parasympathetic (vagal) and sympathetic activity. Analysis of variance was used to examine the effects of gender, stress condition, and autonomic pattern on autonomic activity, perceptual sensitivity, and attentional performance. Gender showed significant effects for pulse rate with higher scores for women during the instruction and task periods. High stress reduced perceptual sensitivity and resulted in better attentional performance. Whereas stress-induced sympathetic activity was related to low perceptual sensitivity and good attentional performance, high sympathetic in conjunction with low vagal baseline activity predicted relatively high perceptual sensitivity and poor attentional performance. Low or high baseline activity in both autonomic systems predicted low perceptual sensitivity and good attentional performance. Predictions of perception and attention can be improved by examining the effects of patterns of sympathetic and parasympathetic activity.