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      Respiratory sinus arrhythmia as a non-invasive index of ‘brain-heart’ interaction in stress

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          Abstract

          Respiratory sinus arrhythmia (RSA) is accepted as a peripheral marker of cardiac-linked parasympathetic regulation. According to polyvagal theory, the RSA is also considered as the index of emotion regulation. The neurovisceral integration model posits that parasympathetic modulation of the heart marked by RSA is related to complex nervous regulation associated with emotional and cognitive processing. From this perspective, high resting RSA amplitude associated with a greater withdrawal during stressors and subsequent recovery could represent a flexible and adaptive physiological response system to a challenge. Conversely, low resting RSA accompanied by an inadequate reactivity to stress might reflect maladaptive regulatory mechanisms. The RSA reactivity is different with various types of stressors: while the RSA decreases to cognitive tasks indicating a vagal withdrawal, the RSA magnitude increases to emotional challenge indicating an effective cognitive processing of emotional stimuli. The RSA reactivity to stress could have important implications for several mental disorders, e.g. depressive or anxiety disorder. It seems that the study of the RSA, as a non-invasive index of ‘brain-heart’ communication, could provide important information on the pathway linked to mental and physical health.

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          Most cited references73

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          Autonomic nervous system activity in emotion: A review

          Autonomic nervous system (ANS) activity is viewed as a major component of the emotion response in many recent theories of emotion. Positions on the degree of specificity of ANS activation in emotion, however, greatly diverge, ranging from undifferentiated arousal, over acknowledgment of strong response idiosyncrasies, to highly specific predictions of autonomic response patterns for certain emotions. A review of 134 publications that report experimental investigations of emotional effects on peripheral physiological responding in healthy individuals suggests considerable ANS response specificity in emotion when considering subtypes of distinct emotions. The importance of sound terminology of investigated affective states as well as of choice of physiological measures in assessing ANS reactivity is discussed. Copyright © 2010 Elsevier B.V. All rights reserved.
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            Orienting in a defensive world: mammalian modifications of our evolutionary heritage. A Polyvagal Theory.

            The vagus, the 10th cranial nerve, contains pathways that contribute to the regulation of the internal viscera, including the heart. Vagal efferent fibers do not originate in a common brainstem structure. The Polyvagal Theory is introduced to explain the different functions of the two primary medullary source nuclei of the vagus: the nucleus ambiguus (NA) and the dorsal motor nucleus (DMNX). Although vagal pathways from both nuclei terminate on the sinoatrial node, it is argued that the fibers originating in NA are uniquely responsible for respiratory sinus arrhythmia (RSA). Divergent shifts in RSA and heart rate are explained by independent actions of DMNX and NA. The theory emphasizes a phylogenetic perspective and speculates that mammalian, but not reptilian, brainstem organization is characterized by a ventral vagal complex (including NA) related to processes associated with attention, motion, emotion, and communication. Various clinical disorders, such as sudden infant death syndrome and asthma, may be related to the competition between DMNX and NA.
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              Toward understanding respiratory sinus arrhythmia: relations to cardiac vagal tone, evolution and biobehavioral functions.

              Respiratory sinus arrhythmia (RSA, or high-frequency heart-rate variability) is frequently employed as an index of cardiac vagal tone or even believed to be a direct measure of vagal tone. However, there are many significant caveats regarding vagal tone interpretation: 1. Respiratory parameters can confound relations between RSA and cardiac vagal tone.2. Although intraindividual relations between RSA and cardiac vagal control are often strong, interindividual associations may be modest.3. RSA measurement is profoundly influenced by concurrent levels of momentary physical activity, which can bias estimation of individual differences in vagal tone.4. RSA magnitude is affected by beta-adrenergic tone.5. RSA and cardiac vagal tone can dissociate under certain circumstances.6. The polyvagal theory contains evolution-based speculations that relate RSA, vagal tone and behavioral phenomena. We present evidence that the polyvagal theory does not accurately depict evolution of vagal control of heart-rate variability, and that it ignores the phenomenon of cardiac aliasing and disregards the evolution of a functional role for vagal control of the heart, from cardiorespiratory synchrony in fish to RSA in mammals. Unawareness of these issues can lead to misinterpretation of cardiovascular autonomic mechanisms. On the other hand, RSA has been shown to often provide a reasonable reflection of cardiac vagal tone when the above-mentioned complexities are considered. Finally, a recent hypothesis is expanded upon, in which RSA plays a primary role in regulation of energy exchange by means of synchronizing respiratory and cardiovascular processes during metabolic and behavioral change.
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                Author and article information

                Journal
                Indian J Med Res
                Indian J. Med. Res
                IJMR
                The Indian Journal of Medical Research
                Medknow Publications & Media Pvt Ltd (India )
                0971-5916
                December 2016
                : 144
                : 6
                : 815-822
                Affiliations
                [1 ] Department of Physiology, Jessenius Faculty of Medicine in Martin (JFM CU), Martin, Slovak Republic
                [2 ] Biomedical Center Martin JFM CU, Comenius University in Bratislava, Martin, Slovak Republic
                [3 ] Paediatric Cardiology, Martin, Slovak Republic
                Author notes
                Reprint requests: Dr Alexander Jurko, Paediatric Cardiology, Kollarova 13, 036 01 Martin, Slovak Republic e-mail: ltvsro@ 123456gmail.com
                Article
                IJMR-144-815
                10.4103/ijmr.IJMR_1447_14
                5433274
                28474618
                1040483b-79d9-4bfc-8b01-c75d9ac1da52
                Copyright: © 2017 Indian Journal of Medical Research

                This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.

                History
                : 30 September 2014
                Categories
                Review Article

                Medicine
                cognition,emotion,heart rate variability,respiratory sinus arrhythmia,stress
                Medicine
                cognition, emotion, heart rate variability, respiratory sinus arrhythmia, stress

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