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Previous research suggested that exposure to long‐lasting or repeated laboratory stressors may lead to rearrangement of cardiovascular control, with a shift of regulation mechanisms from dominant cardiac to dominant vascular influences between the early and late response phases, respectively. This study investigated whether similar rearrangement occurs during life stress accompanying chronic disease by analyzing also associations between cortisol level and cardiovascular variables in patients with fibromyalgia (FM). In 47 women with FM and 36 healthy women (HW), cardiovascular recordings were taken during active body posture changes (sitting, lying down, and standing). Moreover, hair cortisol concentration (HCC) was obtained. During standing, which involved orthostatic challenge, FM patients showed higher total peripheral resistance (TPR) but lower stroke volume (SV), cardiac output (CO), and baroreflex sensitivity than HW. During sitting and lying down, TPR was more closely associated with blood pressure (BP) than CO in FM patients; in contrast, CO was more closely associated with BP than TPR in HW. HCC correlated positively with TPR and BP in FM patients, but negatively with TPR and BP and positively with SV and CO in HW. Results suggest that chronic disease‐related stress is associated with alterations in cardiovascular regulation toward greater involvement of vascular than cardiac mechanisms in BP control. Stress‐related cortisol release may contribute to the long‐term rearrangement of autonomic regulation. At the behavioral level, the dominance of vascular over cardiovascular control may relate to reduced somatic mobilization during an active fight‐flight response in favor of passive and behaviorally immobile coping. [ABSTRACT FROM AUTHOR]

Fibromyalgia syndrome (FMS) is a chronic pain condition associated with a significant reduction in health-related quality of life (HRQoL). This study compared the different components of HRQoL between FMS and rheumatoid arthritis (RA) patients, and evaluated the relationships between HRQoL and clinical and emotional factors in FMS and RA patients. Women with FMS (n = 80), RA (n = 43) and healthy women (n = 67) participated in the study. HRQoL was assessed by the SF-36 survey. Associations between HRQoL and symptom severity were assessed by correlation and multiple linear regression analyses. FMS patients displayed lower values for all SF-36 variables than RA patients and healthy participants, while RA patients showed lower values for all SF-36 variables than healthy participants. These group differences persisted after statistically controlling for demographic, clinical and emotional variables. Clinical and emotional factors were inversely associated with SF-36 scores in the overall FMS + RA sample. Depression and fatigue were the strongest negative predictors. However, after the statistical control of the effect of diagnosis (FMS vs. RA) in the regression analysis, most of the associations disappear. The fact that group differences in HRQoL remained highly significant after statistically controlling of group differences in clinical symptom severity, and that associations between clinical symptoms and HRQoL disappear when the type of diagnosis was considered in the regression analysis, suggest that impairment of HRQoL could be considered a primary feature of FMS. [ABSTRACT FROM AUTHOR]

Changes in psychological variables in couples after successful in-vitro fertilization (IVF) have rarely been investigated. This paper describes follow-up assessments of a previously published study investigating changes in life satisfaction, stress and worry related to childbirth in couples undergoing IVF and those with natural pregnancy. Questionnaire data were obtained in 75 IVF couples and 70 couples with natural pregnancy before pregnancy, and at 6 and 12 months postpartum; follow-up data were recorded 18 and 24 months postpartum. IVF couples had less favourable baseline scores for all variables than those with natural pregnancy. Their life satisfaction increased, stress and worry decreased, during the first year postpartum. Couples with natural pregnancy reported transient worsening in all variables during this period. During follow-up, all variables remained largely stable in both groups; while life satisfaction and stress no longer differed between groups, worry was lower in IVF couples at month 24. Gender differences were small in both groups. In IVF couples, negative impacts of infertility may fully abate after childbirth; in naturally conceiving couples, initial negative changes in wellbeing are reversed and stabilized during the child´s first 2 years. Both groups may benefit from psychological support at different times during pregnancy and parenthood. [ABSTRACT FROM AUTHOR]

Functional Transcranial Doppler sonography (fTCD) has been applied to assess peak mean cerebral blood flow velocity (MFV) with a high temporal resolution during cognitive activation. Yet, little attention has been devoted to gender-related alterations of MFV, including spectral analysis. In healthy subjects, fTCD was used to investigate a series of cerebral hemodynamic parameters in the middle cerebral arteries (MCA) during the Trail Making Tests (TMT), a means of selective attention and complex cognitive functioning. In females, there was a frequency peak at 0.375 Hz in both MCA, and we observed a dynamic shift in hemispheric dominance during that condition. Further, after the start phase, there was an MFV decline during complex functioning for the entire sample. These novel results suggest condition-specific features of cerebral hemodynamics in females, and it adds to the notion that gender is a fundamental confounder of brain physiology.

Set shifting provokes specific alterations of cerebral hemodynamics in basal cerebral arteries. However, no gender differences have been reported. In the following functional transcranial Doppler study, we introduced cerebral hemodynamic modulation to the aspects of set shifting during Wisconsin Card Sorting Test (WCST). Twenty-one subjects underwent the WCST during insonation of the middle cerebral arteries. We examined gender effects on task performance and cerebral hemodynamic modulation. Further, we investigated the linkage between performance and cerebral hemodynamic modulation. In females, maximum positive modulation was restricted to the behaviorally relevant time point of set shifting, and there were time-locked associations between mental slowing during set shifting and rapid cerebral hemodynamic modulation exclusively in females. This study provides evidence of gender-related cerebral hemodynamic modulation during set shifting, and we detected time-locked brain-behavior relationship during cognitive control in females. (Contains 2 tables and 4 figures.)

In the present study, the authors investigated the relationship between low blood pressure (BP) and attentional performance through the application of a multidimensional diagnostic approach. The authors compared 40 subjects with essential hypotension (mean systolic BP = 97.6 mmHg) with 40 normotensive controls (mean systolic BP = 124.1 mmHg) using 6 computer-based tasks measuring tonic and phasic alertness; selective, divided, and sustained attention; and working memory. To control for possible confounders, the authors used a test battery examining motor performance and a mood questionnaire. BP was monitored continuously during the entire experiment. Hypotensives showed prolonged execution times in each of the attentional tasks (p less than 0.001). Moderately decreased accuracy was found in the tests assessing sustained attention (p = 0.059) and working memory (p = 0.012). Moreover, hypotensives showed smaller elevations in BP during the execution of the cognitive tasks. This study is the first to demonstrate the relationship between BP and cognitive performance while controlling for motor function and mood. (Contains 3 tables, 2 figures, and 2 notes.)

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