National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina.
Cognitive Neuroscience Center (CNC), Universidad de San Andrés, Buenos Aires, Argentina.
Eur J Neurosci. 2022 May;55(9-10):2836-2850. doi: 10.1111/ejn.14979. Epub 2020 Dec 17.
Hypertensive disease (HTD), a prominent risk factor for cardiovascular and cerebrovascular diseases, is characterized by elevated stress-proneness. Since stress levels are underpinned by both cardiac and neural factors, multidimensional insights are required to robustly understand their disruption in HTD. Yet, despite their crucial relevance, heart rate variability (HRV) and multimodal neurocognitive markers of stress in HTD remain controversial and unexplored respectively. To bridge this gap, we studied cardiodynamic as well as electrophysiological and neuroanatomical measures of stress in HTD patients and healthy controls. Both groups performed the Trier Social Stress Test (TSST), a validated stress-inducing task comprising a baseline and a mental stress period. During both stages, we assessed a sensitive HRV parameter (the low frequency/high frequency [LF/HF ratio]) and an online neurophysiological measure (the heartbeat-evoked potential [HEP]). Also, we obtained neuroanatomical data via voxel-based morphometry (VBM) for correlation with online markers. Relative to controls, HTD patients exhibited increased LF/HF ratio and greater HEP modulations during baseline, reduced changes between baseline and stress periods, and lack of significant stress-related HRV modulations associated with the grey matter volume of putative frontrostriatal regions. Briefly, HTD patients presented signs of stress-related autonomic imbalance, reflected in a potential basal stress overload and a lack of responsiveness to acute psychosocial stress, accompanied by neurophysiological and neuroanatomical alterations. These multimodal insights underscore the relevance of neurocognitive data for developing innovations in the characterization, prognosis and treatment of HTD and other conditions with autonomic imbalance. More generally, these findings may offer new insights into heart-brain interactions.
高血压病（HTD）是心血管和脑血管疾病的主要危险因素，其特征是应激易感性增加。由于应激水平既受心脏因素又受神经因素的影响，因此需要多维的见解才能全面理解 HTD 中它们的破坏。然而，尽管它们具有至关重要的相关性，但 HTD 中的心率变异性（HRV）和多模态神经认知应激标志物分别仍然存在争议和未被探索。为了弥补这一差距，我们研究了 HTD 患者和健康对照者的心脏动力学以及电生理和神经解剖学应激标志物。两组人员均进行了特里尔社会应激测试（TSST），这是一种经过验证的应激诱导任务，包括基线和心理应激期。在这两个阶段，我们评估了一个敏感的 HRV 参数（低频/高频[LF/HF 比]）和一个在线神经生理测量值（心跳诱发电位[HEP]）。此外，我们通过体素形态计量学（VBM）获得了神经解剖学数据，以与在线标志物进行关联。与对照组相比，HTD 患者在基线期表现出 LF/HF 比增加和 HEP 调制增加，在基线期和应激期之间的变化减少，并且与假定的额纹状体区域的灰质体积相关的 HRV 应激调节缺乏显著相关性。简而言之，HTD 患者表现出与应激相关的自主神经失衡的迹象，这反映在潜在的基础应激过载和对急性社会心理应激的反应不足，同时伴有神经生理和神经解剖学改变。这些多模态的见解强调了神经认知数据在 HTD 和其他自主神经失衡疾病的特征描述、预后和治疗方面的创新发展中的相关性。更广泛地说，这些发现可能为心脑相互作用提供新的见解。
