Onita Cristiana Amalia, Matei Daniela-Viorelia, Trandafir Laura-Mihaela, Petrescu-Miron Diana, Corciova Calin, Fuior Robert, Manole Lorena-Mihaela, Mihai Bogdan-Mircea, Dascalu Cristina-Gena, Tarcea Monica, Bouchard Stéphane, Mocanu Veronica
Center for Obesity BioBehavioral Experimental Research, Department of Morpho-Functional Sciences II (Pathophysiology), "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iaşi, Romania.
Faculty of Medical Bioengineering, "Grigore T. Popa" University of Medicine and Pharmacy, 700588 Iaşi, Romania.
Nutrients. 2025 Jul 30;17(15):2492. doi: 10.3390/nu17152492.
: The aim was to identify patterns of autonomic and neuroendocrine reactivity to an immersive virtual reality (VR) social-emotional stressor and explore their associations with perceived stress and eating behavior. : This one-group pretest-posttest study included 30 children and adolescents with obesity (15 boys and 15 girls), aged 8 to 17 years. The VR protocol consisted of two consecutive phases: a 5 min relaxation phase using the Forest application and a 5 min stimulation phase using a cognitively engaging VR game designed to elicit social-emotional stress. Physiological responses were measured using heart rate variability (HRV) indices and salivary stress biomarkers, including cortisol and alpha amylase. Subjective stress and eating responses were assessed via visual analogue scales (VAS) administered immediately post-exposure. The Three-Factor Eating Questionnaire (TFEQ-R21C) was used to evaluate cognitive restraint (CR), uncontrolled eating (UE), and emotional eating (EE). : The cortisol reactivity was blunted and may reflect both the attenuated HPA axis responsiveness characteristic of pediatric obesity and the moderate psychological challenge of the VR stressor used in this study. Two distinct autonomic response patterns were identified via exploratory factor analysis: (1) parasympathetic reactivity, associated with increased RMSSD and SDNN and decreased LF/HF, and (2) sympathetic activation, associated with increased heart rate and alpha-amylase levels and reduced RR intervals. Parasympathetic reactivity was correlated with lower perceived stress and anxiety, but also paradoxically with higher uncontrolled eating (UE). In contrast, sympathetic activation was associated with greater cognitive restraint (CR) and higher anxiety ratings. : This study demonstrates that immersive VR game exposure elicits measurable autonomic and subjective stress responses in children and adolescents with obesity, and that individual differences in physiological reactivity are relevantly associated with eating behavior traits. The findings suggest that parasympathetic and sympathetic profiles may represent distinct behavioral patterns with implications for targeted intervention.
目的是确定对沉浸式虚拟现实（VR）社会情感应激源的自主神经和神经内分泌反应模式，并探讨它们与感知压力和饮食行为的关联。
这项单组前后测研究纳入了30名8至17岁的肥胖儿童和青少年（15名男孩和15名女孩）。VR方案包括两个连续阶段：使用“森林”应用程序进行5分钟的放松阶段，以及使用一款旨在引发社会情感压力的认知参与性VR游戏进行5分钟的刺激阶段。使用心率变异性（HRV）指标和唾液应激生物标志物（包括皮质醇和α淀粉酶）测量生理反应。在暴露后立即通过视觉模拟量表（VAS）评估主观压力和饮食反应。使用三因素饮食问卷（TFEQ-R21C）评估认知抑制（CR）、无节制饮食（UE）和情绪化饮食（EE）。
皮质醇反应迟钝，这可能既反映了小儿肥胖症患者下丘脑-垂体-肾上腺（HPA）轴反应性减弱的特征，也反映了本研究中使用的VR应激源的中等心理挑战程度。通过探索性因素分析确定了两种不同的自主神经反应模式：（1）副交感神经反应性，与RMSSD和SDNN增加以及LF/HF降低相关；（2）交感神经激活，与心率和α淀粉酶水平增加以及RR间期缩短相关。副交感神经反应性与较低的感知压力和焦虑相关，但也反常地与较高的无节制饮食（UE）相关。相比之下，交感神经激活与更大的认知抑制（CR）和更高的焦虑评分相关。
这项研究表明，沉浸式VR游戏暴露会在肥胖儿童和青少年中引发可测量的自主神经和主观应激反应。而且生理反应的个体差异与饮食行为特征相关。研究结果表明，副交感神经和交感神经特征可能代表不同的行为模式，对针对性干预具有启示意义。
