Respiration recording was not possible during mock scanner assessment, but since metronome-controlled breathing accentuates vagal activity as indexed in the high frequency HF respiratory component Berntson et al. Further, to control for potential stress or anxiety in reaction to mock scanner investigation, we asked participants to indicate their well-being with the help of the MDMQ immediately before ECG recording started, after both resting conditions and after metronome-controlled breathing.
If both resting HRV indices differ significantly, we will conduct further analyses with these two indices additionally to HRV index under metronome- controlled breathing. The latter index is conducted anyway since we expect HRV assessment to be most accurate under standardised metronome-controlled breathing within HF power band thus allowing for correct vagal attribution Pagani et al.
Functional MRI data acquisition. Geometric distortions in EPI originating from magnetic field inhomogeneity were corrected including field mapping in the realign and unwarp options repetition time TR ms, echo time TE 1 4. Standard presentation devices and MR- compatible peripheral equipment head coils, MR-Confon headphones and Lumitouch keypad were used. The paradigm was presented on a monitor arranged at the head end of the MR tube and was visible to participants via a mirror projection system.
The IE practices corresponded to those described by Lang, Lang-Helbig, Westphal, Gloster, and Wittchen in their manual-based psychotherapy for patients diagnosed with PD, but was implemented as a study-related intervention. All nine exercises were introduced at pre-training by a study assistant who was paying attention to accurate performance. Training involved e. This was to provoke somatic symptoms that potentially cause anxiety and distress. We asked participants to indicate symptom intensity, anxiety and discomfort produced by each exercise on a point scale with response anchors from 0 not at all to 10 extremely.
The three exercises triggering the most discomfort and anxiety were highlighted and repeated self-governed by all participants thrice per day between pre- and post-training. Participants were instructed to minute all exercises in a prepared online-based schedule. Adherence to the schedule was checked daily for missing practices; be it that someone missed one practice, subjects were reminded of daily exercises by email. Besides, subjects received one cinema coupon after complete and regular performance.
The exercises were repeated together with a study assistant at post-training appointment and were followed by a resting phase of 30 min before MR scanning started. Cardiac symptom provocation task. The newly designed paradigm corresponded to interoceptive paradigms published by Paulus and associates e. The paradigm combined a continuous performance task and cued confrontation with interoceptive stimuli interoceptive cue condition. The continuous performance task served as baseline while participants were assigned to indicate the horizontal direction of black arrows.
The interoceptive cue condition involved two phases. During the anticipation phase, the colour of the arrows changed signalising the imminent stimulation phase. During the stimulation phase, participants listened either to computer-generated heartbeats interoceptive cue condition or sinus tones exteroceptive control condition of two different frequencies 50 vs.
Participants were instructed to imagine hearing their own heartbeats. Stimulus ratings were performed prior to and after MRI scanning in the mock scanner. The paradigm comprised two runs which involved the three task conditions see Figure A1. The baseline phase started with the presentation of a fixation cross displayed for 30s and a familiarisation phase comprising four runs of the continuous performance task participants were engaged in.
The duration of the interstimulus interval varied from 3, to 9, ms.
Baseline procedure was repeated 16 times per run. Presentation of the coloured arrow during the anticipation phase lasted from 5, to 10, ms and was repeated 16 times. The continuous performance task was performed analogue to baseline condition. In In half of the trials heartbeats were presented, and in the other half sinus tones.
Stimulation appeared six times per run. ECG data. High-pass 70 Hz and low-pass filtering 0. As recommended, prior to spectral analysis, the R-R interval time series were transformed into an equidistantly time series using cubic spline interpolation with a sampling rate of 4 Hz, and R-R intervals deviating 0. The mentioned cardiovascular parameters were calculated thrice per subject: at rest without any stimulation, at rest while presenting EPI noise-profile, and under metronome-controlled breathing.
Functional MRI data. Functional and anatomical images were coregistered and normalised into the stereotactic space of Talairach and Tournoux to the MNI Montreal Neurological Institute, Quebec, Canada standard template. Finally, a weighted average algorithm for smoothing with 8 mm full-with half- maximum kernel was applied. First-level model specification and estimation were conducted on the basis of the general linear model. The expected blood oxygen level-dependent BOLD signal change was modelled by a canonical hemodynamic response function.
A total of 13 regressors per run were entered into the fMRI design model, including coloured arrow, baseline black arrow, fixation cross following anticipation without stimulation, heartbeats at 50 bpm, sinus tones at 50 bpm, heartbeats at bpm, sinus tones at bpm, as well as six motion parameters estimating translation, rotation and dispersion; the number of counted signals was entered only for the first run.
T-contrasts were defined for each subject as prerequisite for second-level one-sample t-test and two-sample t-test comparing AS-related activation patterns. S t atistical analyses. Nonparametric testing was applied due to small sample size and non-normally distribution of most variables. Testing for normality was performed using Kolmogorov-Smirnov test. We performed Mann Whitney U -test to evaluate group differences in demographic, psychological and cardiovascular characteristics.
In cross-sectional research, decreased HRV indices have been associated with anxiety-related traits Fuller, , depressive symptoms Siepmann et al. Further, the beta values of activated clusters in defined ROIs during the anticipation and perception of interoceptive stimuli were entered in our analyses.
Last but not least, since we expect IE to activate brain areas associated with interoceptive processing and cardiac control, we wanted to see if the extent of performance quality correlates with change in HRV. Performance quality in IE was defined as the difference of mean discomfort ratings felt during the three homework exercises from pre- to post-training. As outlined above, we were interested in answering the questions of a whether subjects high in AS feature lower HRV indices in terms of logRMSSD as compared to subjects low in AS, b whether HRV can be changed through IE in both AS groups and c which psychological and physiological characteristics including neural correlates of interoceptive processing perception and anticipation are associated with a change in HRV.
As shown in Table 1, both groups were comparable with respect to demographic and psychological characteristics. Concerning clinical measures, subjects high in AS had significantly higher CAQ scores than subjects low in AS, indicating a higher level of fear of cardiac sensations, cardio-phobic behaviour and cardio-protective care respectively. As intended, participants high in AS scored significantly higher than participants low in AS in the ASI which was used for study inclusion and group assignment.
No significant differences emerged between the subgroups concerning depressive symptoms as expressed in BDI II sum scores, with all participants scoring below clinical criteria for mild depressive disorder. FFB- Mot sum scores were below standard values reported by Boes et al.
Table 1 Demographic and psychological characteristics pre-training of the study sample. Medians I QR are listed.
Table 2 summarises cardiovascular parameters as a function of AS group at both sessions. Such as with regard to psychological assessments, the two groups did not differ in mood state in the course of pre- training ECG recording, as measured with the MDMQ see Figure C1 and Table B1 for details. At post-training, low-AS participants scored significantly lower in the MDMQ dimensions alertness and calmness while resting without any stimulation see Figure C2 and. Table 2 C omparison of cardiovascular parameters between AS groups.
Medians IQR are listed. For all cardiovascular parameters, no significant differences between AS groups emerged. Besides, no difference was observed with regard to pre-training HF total power under metronome-controlled breathing between both AS groups, indicating that participants matched the metronome. Based on the fact that pre-training resting HR and logRMSSD at rest and under metronome-controlled breathing were largely in line with established standard values reported by Agelink et al.
This article has been cited by other articles in PMC. NICE b Offer support to help maintain weight loss to people whose drug treatment is being withdrawn; if they did not Should k. Open in a separate window. I A UoM Empfehlungen zur Bewegungstherapie For adults who are overweight or obese, prescribe approximately minutes of moderate-intensity activity, or minutes of vigorous activity, or an equivalent combination of moderate-intensity and vigorous activities each week combined with reduced dietary intake. Each ball can be adapted easily by using a needle ball pump. Jetzt da schau her, Fritz Dogler, Am besten begibt man sich nun in den Speisewagen, wo man sich mit Topfenstrudel oder Krautsuppe auch kulinarisch in tschechische Stimmung versetzen Der Jakober-Strudel ist ein Segen Topfenstrudel [online].
Means standard deviation of the FFB-Mot standard version are provided. Men: Medians of the present sample: Men HAS: Means standard deviation are provided. HR bpm at rest: men Note, that Agelink et al. See Table B2 for details. Differences in heart rate variability in subjects high and low in anxiety sensitivity before and after an interoceptive exposure training Diploma Thesis, 77 Pages, Grade: 1,3.
S W Susann Wichmann Author. Add to cart. Relevance of heart rate variability assessment to pathological anxiety Besides its primary medical use in cardiovascular autonomic function measurement and risk assessment after cardiovascular emergencies Task Force, , HRV analysis is an increasingly applied tool in clinical psychology.
Methods Procedure Recruitment and preselection of interested volunteers were accomplished via an established online screening tool designed by our study group. Measures Clinical assessments. Experimental procedures IE training. Data preprocessing and analysis ECG data. Results As outlined above, we were interested in answering the questions of a whether subjects high in AS feature lower HRV indices in terms of logRMSSD as compared to subjects low in AS, b whether HRV can be changed through IE in both AS groups and c which psychological and physiological characteristics including neural correlates of interoceptive processing perception and anticipation are associated with a change in HRV.
Sample characteristics As shown in Table 1, both groups were comparable with respect to demographic and psychological characteristics. Group comparison of heart rate variability Table 2 summarises cardiovascular parameters as a function of AS group at both sessions. At post-training, low-AS participants scored significantly lower in the MDMQ dimensions alertness and calmness while resting without any stimulation see Figure C2 and Table B1 for details. Sign in to write a comment. Read the ebook. Chemie - Biochemie Loss and Recovery of Hydrophobicity o Geschichte - Allgemeines Jenseits nationaler Kriegschuldfragen Psychologie - Methoden Beispiele nichtlinearer dynamischer S Predel G.
Schuler J. Siegrist J.
Thiery D. Recommendations of the project group prevention of the German Cardiac Society DGK on risk adjusted prevention of cardiovascular diseases Part 3: Dyslipidemia, arterial hypertension and glucose metabolism. Dyslipidemia There is a strong correlation between low-density lipoproteins LDL cholesterol level and cardiovascular risk.