Chaves Anna C S, Reis Felipe J J, Bandeira Pamela M, Fernandes Orlando, Arruda Sanchez Tiago
Postgraduate Program in Medicine (Cardiology), Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil.
Postgraduate Program in Radiology, Department of Radiology, Faculty of Medicine, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil.
Scand J Pain. 2021 Mar 17;21(3):530-538. doi: 10.1515/sjpain-2020-0132. Print 2021 Jul 27.
Emotions are involved in the identification of safety cues in the environment, and are also related to social interaction through recognition of emotional facial expressions. Heart rate variability (HRV) can be an indicator of the adaptive response of the autonomic nervous system to stressful conditions, including pain. This study aimed to investigate the emotional processing in a sample of patients with chronic musculoskeletal by measuring the resting-state HRV and the ability to recognize facial emotion expressions.
This cross-sectional study was composed of 40 participants with chronic musculoskeletal pain and 40 asymptomatic participants. Resting HRV was measured for 10 min. The facial emotion recognition task was presented in videos and included modification from a neutral expression to faces of fear, anger, sadness, happiness, and disgust. For the facial emotion recognition task, the hit rate (%) and response time for each emotional category were measured.
The symptomatic group had a mean high frequency (HF) lower (mean = 34.14; SD = 16.95; p<0.001) than the asymptomatic group (mean = 51.11; SD = 13.01; p<0.001). The emotional facial expressions of disgust ( (1, 80)=7.82; p<0.01), anger ( (1, 80)=13.56; p<0.01), sadness ( (1, 80)=6.58; p=0.01), and happiness ( (1, 80)=12.68; p<0.01) were those for which volunteers from the symptomatic group had a lower hit rate of correct answers compared to the asymptomatic group. The response time to corrected answers showed a major group effect ( (1.77)=21.11; p<0.001) and emotional category ( (4.308)=174.21; p<0.001), without presenting any interaction between the factors ( (4.308)=0.446; p=0.775). The symptomatic group was slower to perform the task of identifying facial emotional expression (7.066 s; SD = 1.188) than the participants in the asymptomatic group (6.298 s; SD = 1.203) for all emotional categories.
Participants with chronic musculoskeletal pain presented a lower vagal activity evidenced by HRV. Participants in the symptomatic group showed lower ability to recognize faces of disgust, anger, and sadness when compared to asymptomatic participants. Considering that individuals with low resting HF-HRV have difficulties with regulating their emotions, the lower vagal activity and lower ability to recognize faces of emotional expressions observed in chronic musculoskeletal pain may suggest alterations in emotional processing. This study may shed light on changes in the emotional processing and in the autonomic nervous system in this population.
情绪参与环境中安全线索的识别，并且还通过对情绪化面部表情的识别与社会互动相关。心率变异性（HRV）可以作为自主神经系统对包括疼痛在内的应激条件的适应性反应的一个指标。本研究旨在通过测量静息状态下的HRV以及识别面部情绪表情的能力，来调查慢性肌肉骨骼疾病患者样本中的情绪加工情况。
这项横断面研究由40名患有慢性肌肉骨骼疼痛的参与者和40名无症状参与者组成。测量静息HRV 10分钟。面部情绪识别任务以视频形式呈现，包括从中性表情到恐惧、愤怒、悲伤、快乐和厌恶表情的变化。对于面部情绪识别任务，测量每个情绪类别的命中率（%）和反应时间。
有症状组的平均高频（HF）低于无症状组（有症状组：平均值 = 34.14；标准差 = 16.95；p<0.001；无症状组：平均值 = 51.11；标准差 = 13.01；p<0.001）。厌恶（t(1, 80)=7.82；p<0.01）、愤怒（t(1, 80)=13.56；p<0.01）、悲伤（t(1, 80)=6.58；p=0.01）和快乐（t(1, 80)=12.68；p<0.01）这些情绪化面部表情，与无症状组相比，有症状组的志愿者对其正确答案的命中率较低。对正确答案的反应时间显示出显著的组效应（F(1.77)=21.11；p<0.001）和情绪类别效应（F(4.308)=174.21；p<0.001），但各因素之间未呈现任何交互作用（F(4.308)=0.446；p=0.775）。对于所有情绪类别，有症状组在执行识别面部情绪表情任务时比无症状组的参与者更慢（有症状组：7.066秒；标准差 = 1.188；无症状组：6.298秒；标准差 = 1.203）。
慢性肌肉骨骼疼痛的参与者表现出较低的迷走神经活动，这由HRV证明。与无症状参与者相比，有症状组的参与者识别厌恶、愤怒和悲伤表情的能力较低。鉴于静息HF-HRV较低的个体在情绪调节方面存在困难，在慢性肌肉骨骼疼痛中观察到的较低迷走神经活动和较低的识别情绪表情的能力可能表明情绪加工存在改变。本研究可能有助于揭示该人群情绪加工和自主神经系统的变化。
