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See detailPolymorphisms of genes related to the hypothalamic-pituitary-adrenal axis influence the cortisol awakening response as well as self-perceived stress
Li-Tempel, T.; Larra, M. F.; Winnikes, U. et al

in Biological Psychology (2016), 119(1), 112-121

The hypothalamus-pituitary-adrenal (HPA) axis is a crucial endocrine system for coping with stress. A reliable and stable marker for the basal state of that system is the cortisol awakening response (CAR ... [more ▼]

The hypothalamus-pituitary-adrenal (HPA) axis is a crucial endocrine system for coping with stress. A reliable and stable marker for the basal state of that system is the cortisol awakening response (CAR). We examined the influence of variants of four relevant candidate genes; the mineralocorticoid receptor gene (MR), the glucocorticoid receptor gene (GR), the serotonin transporter gene (5-HTT) and the gene encoding the brain-derived neurotrophic factor (BDNF) on CAR and self-perceived stress in 217 healthy subjects. We found that polymorphisms of GR influenced both, the basal state of the HPA axis as well as self-perceived stress. MR only associated with self-perceived stress and 5-HTT only with CAR. BDNF did not affected any of the investigated indices. In summary, we suggest that GR variants together with the CAR and supplemented with self reports on perceived stress might be useful indicators for the basal HPA axis activity. [less ▲]

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See detailInterozeption bei Anorexia nervosa: Befunde auf subjektiver und elektrophysiologischer Ebene
Lutz, Annika UL; Schulz, André UL; Voderholzer, Ulrich et al

Scientific Conference (2016, September)

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See detailCardiac modulation of startle is altered in depersonalization-/derealization disorder: evidence for impaired brainstem representation of baro-afferent neural traffic
Schulz, André UL; Matthey, J. H.; Vögele, Claus UL et al

in Psychiatry Research (2016), 240(1), 4-10

Patients with depersonalization-/derealization disorder (DPD) show altered heartbeat-evoked brain potentials, which are considered psychophysiological indicators of cortical representation of visceral ... [more ▼]

Patients with depersonalization-/derealization disorder (DPD) show altered heartbeat-evoked brain potentials, which are considered psychophysiological indicators of cortical representation of visceral-afferent neural signals. The aim of the current investigation was to clarify whether the impaired CNS representation of visceral-afferent neural signals in DPD is restricted to the cortical level or is also present in sub-cortical structures. We used cardiac modulation of startle (CMS) to assess baro-afferent signal transmission at brainstem level in 22 DPD and 23 healthy control individuals. The CMS paradigm involved acoustic startle stimuli (105 dB(A), 50 ms) elicited 0, 100, 200, 300, 400 and 500 ms after a cardiac R-wave. In healthy control individuals, we observed lower startle responses at 100 and 300 ms than at 0 and 400 ms after an R-wave. In DPD patients, no effect of the cardiac cycle on startle response magnitude was found. We conclude that the representation of visceral-afferent neural signals at brainstem level may be deficient in DPD. This effect may be due to increased peripheral sympathetic tone or to dysregulated signal processing at brainstem level. [less ▲]

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See detailVerhaltensmedizinische Modelle bei körperlicher Erkrankung
Vögele, Claus UL; Schulz, André UL

in Psychotherapie im Dialog (2016), 17(1), 30-33

Die Annahme, dass psychische Faktoren zur Entwicklung körperlicher Krankheiten beitragen könnten, hat eine lange Tradition in den Gesundheitswissenschaften. Verschiedene Teildisziplinen der Psychologie ... [more ▼]

Die Annahme, dass psychische Faktoren zur Entwicklung körperlicher Krankheiten beitragen könnten, hat eine lange Tradition in den Gesundheitswissenschaften. Verschiedene Teildisziplinen der Psychologie wie die Klinische Psychologie und die Gesundheitspsychologie sowie interdisziplinäre Fachgebiete wie die Verhaltensmedizin widmen sich der Untersuchung ätiologisch bedeutsamer oder aufrechterhaltender Faktoren des menschlichen Verhaltens und Erlebens. Mithilfe der gewonnenen Erkenntnisse über Ursache-Wirkungs-Zusammenhänge können Diagnose- und Behandlungsmethoden entwickelt werden. [less ▲]

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See detailInterozeption bei Anorexia nervosa: Befunde auf subjektiver und elektrophysiologischer Ebene
Lutz, Annika UL; Schulz, André UL; Voderholzer, Ulrich et al

in 15. Kongress der Deutschen Gesellschaft für Verhaltensmedizin und Verhaltensmodifikation. Verhaltensmedizin 2.0 - von eHealth zu mHealth. 25. bis 27. Februar 2016, Johannes Gutenberg-Universität Mainz. Abstractband (2016, February)

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See detailInteroception in anorexia nervosa: evidence at cortical and self-report levels
Lutz, Annika UL; Schulz, André UL; Voderholzer, Ulrich et al

in Appetite (2016), 107

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See detailInterozeption bei Depersonalisations-/Derealisationsstörung: veränderte Repräsentation afferenter Körpersignale auf Ebene des Kortex und des Hirnstamms
Schulz, André UL; Matthey, J. H.; Köster, S. et al

in Kubiak, T.; Wessa, M.; Witthöft, M. (Eds.) et al 15. Kongress der Deutschen Gesellschaft für Verhaltensmedizin und Verhaltensmodifikation - Abstractband (2016)

Die Depersonalisations-/Derealisationsstörung (DPD) ist durch eine subjektiv erlebte Distanz von Emotionen, sowie von Empfindungen des eigenen Körpers charakterisiert. Während viele neurophysiologische ... [more ▼]

Die Depersonalisations-/Derealisationsstörung (DPD) ist durch eine subjektiv erlebte Distanz von Emotionen, sowie von Empfindungen des eigenen Körpers charakterisiert. Während viele neurophysiologische Befunde ein verändertes Emotionserleben stützen, gibt es bislang keine neurophysiologischen Korrelate für eine veränderte Interozeption bei DPD. 27 Patienten mit DPD, sowie 27 gesunde Kontrollprobanden absolvierten zwei Herzschlagwahrnehmungstests: eine Herzschlagzählaufgabe (Schandry) und einen Test, bei dem zwischen Herzschlägen und exterozeptiven Signalen diskriminiert werden musste (Whitehead). Außerdem absolvierten die Probanden zwei psychophysiologische Verfahren, die interozeptive Signalübermittlung reflektieren: (1.) Herzschlag- evozierte Potenziale (HEPs), Indikatoren für die kortikale Verarbeitung afferenter Signale vom kardiovaskulären System und (2.) die kardiale Modulation der Schreckreaktion (CMS), welche als Index für die Verarbeitung kardio-afferenter Signale auf Ebene des Hirnstamms gilt. In den Herzschlagwahrnehmungstests gab es keine Gruppenunterschiede zwischen Patienten mit DPD und gesunden Kontrollprobanden, jedoch eine gegenläufige Tendenz beider Gruppen hinsichtlich der Genauigkeit über den Zeitverlauf (negative Lernkurve bei DPD). Bei der Kontrollgruppe zeigte sich ein intakter CMS-Effekt (geringere Schreckreaktionen während der frühen kardialen Phase), während sich bei den DPD-Patienten überhaupt kein CMS-Effekt beobachten ließ (Interaktion: p=.041). Ebenso wurden Gruppenunterschiede im HEP-Pattern beobachtet: gesunde Kontrollprobanden zeigten höhere HEP-Amplituden während der Aufmerksamkeitslenkung auf Körpersignale als während Ruhe. Dieser Effekt konnte bei DPD-Patienten nicht gefunden werden (Interaktion: p=.027). Die gegenläufigen Trends über den Zeitverlauf in verhaltensbasierten Indikatoren für Interozeption (Herzschlagwahrnehmung) bei DPD-Patienten gegenüber Kontrollprobanden impliziert, dass es Patienten weniger gut gelingt, ihre Aufmerksamkeit über längere Zeit auf Körperempfindungen zu fokussieren. Dieser Unterschied lässt sich auf veränderte Repräsentation afferenter Signale des kardiovaskulären Systems auf Hirnstammebene und auf kortikaler Ebene zurückführen. [less ▲]

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See detailReduced early visual processing of own body images in anorexia nervosa: An event-related potentials study
Lutz, Annika UL; Herbert, Cornelia; Schulz, André UL et al

Poster (2016)

Introduction. Although body image distortion in anorexia nervosa (AN) has been extensively studied over the past decades, its underlying mechanisms are not yet fully understood. Neuro-imaging studies have ... [more ▼]

Introduction. Although body image distortion in anorexia nervosa (AN) has been extensively studied over the past decades, its underlying mechanisms are not yet fully understood. Neuro-imaging studies have identified functional and structural alterations in brain areas involved in visual body perception, but the time course of visual body processing in AN remains mostly unexplored. The current study used event-related brain potentials (ERPs) to investigate single processing steps along the time course, particularly the visual processing of physical body image characteristics (featural processing, P1) and the recognition of a body as such (configural processing, N1). Methods. Twenty in-patients with AN, and 20 healthy women viewed photographs of themselves, of another woman’s body and of their own and another woman’s standardized object (cup) with concurrent EEG recording. Results. Body images elicited an accentuation of the P1 component (105-160 ms), which was absent for the comparison between own-body and own-cup images in the AN group. Results regarding the N1 component suggest alterations in object processing in AN. Conclusions. Our results demonstrate that individuals with AN show reduced featural processing of their own body image, a process which, due to its position early in the visual processing stream, is unlikely to involve higher cognitive stimulus processing. This suggests a possible role of previously undetected pre-conscious mechanisms in body image disturbance. [less ▲]

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See detailRespiratory modulation of startle eye blink: a new approach to assess afferent signals from the respiratory system
Schulz, André UL; Schilling, T. M.; Vögele, Claus UL et al

in Philosophical Transactions : Biological Sciences (2016), 371(1708),

Current approaches to assess interoception of respiratory functions cannot differentiate between the physiological basis of interoception, i.e. visceral-afferent signal processing, and the psychological ... [more ▼]

Current approaches to assess interoception of respiratory functions cannot differentiate between the physiological basis of interoception, i.e. visceral-afferent signal processing, and the psychological process of attention focusing. Furthermore, they typically involve invasive procedures, e.g. induction of respiratory occlusions or the inhalation of CO2 enriched air. The aim of the current study was to test the capacity of startle methodology to reflect respiratory-related afferent signal processing, independent of invasive procedures. Forty-two healthy participants were tested in a spontaneous breathing and in a 0.25 Hz paced breathing condition. Acoustic startle noises of 105 dB(A) intensity (50 ms white noise) were presented with identical trial frequency at peak and on-going inspiration and expiration, based on a new pattern detection method, involving the online processing of the respiratory belt signal. The results show the highest startle magnitudes during on-going expiration compared to any other measurement points during the respiratory cycle, independent of whether breathing was spontaneous or paced. Afferent signals from slow adapting phasic pulmonary stretch receptors may be responsible for this effect. The current study is the first to demonstrate startle modulation by respiration. These results offer the potential to apply startle methodology in the non-invasive testing of interoception-related aspects in respiratory psychophysiology. [less ▲]

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See detailSelbstberichteter psychosozialer Stress und chronische Besorgnis, sowie Low-Frequency-Herzratenvariabilität, aber nicht Morgen- oder Tagescortisolspiegel, sagen somatoforme Symptome vorher
Schulz, André UL; Larra, M.; Rost, Silke UL et al

in Kubiak, T.; Wessa, M.; Witthöft, M. (Eds.) et al 15. Kongress der Deutschen Gesellschaft für Verhaltensmedizin und Verhaltensmodifikation - Abstractband (2016)

Im positiven Feedback-Modell zu Interozeption und Stress (Schulz & Vögele, 2015) wird postuliert, dass chronischer Stress zu einer Dysregulation der beiden physiologischen Stressachsen (HPA-Achse, ANS ... [more ▼]

Im positiven Feedback-Modell zu Interozeption und Stress (Schulz & Vögele, 2015) wird postuliert, dass chronischer Stress zu einer Dysregulation der beiden physiologischen Stressachsen (HPA-Achse, ANS) führt, was wiederum durch veränderte Interozeption zur Entstehung körperlicherSymptome beitragen kann. Dieser postulierte Zusammenhang basiert jedoch bislang auf einer Integration von Einzelbefunden und wurde bisher noch nicht an einer gemeinsamen Stichprobe überprüft. Bei einer studentischen Stichprobe (N=217; 113 w; Alter: 18-33 [M=23.0; SD=2.9] Jahre; BMI=22.2 [SD=2.8]) wurden selbstberichteter chronischer Stress (Trierer Inventar für Chronischen Stress/TICS) und somatoforme Symptome (Screening für Somatoforme Störungen/SOMS-2) erhoben. Alle Probanden lieferten Cortisol-Aufwachreaktionen (Erwachen,+15,+30,+45,+60 Min.) an zwei aufeinanderfolgenden Tagen, sowie ein Cortisol-Tagesprofil. Zusätzlich wurde im Labor in einer 10-minütigen Ruhemessung EKG zur Bestimmung der Ruhe-Herzratenvariabilität (RMSSD, pNN50, SDNN; Low- [0.06-0.14 Hz] und High-Frequency [0.15-0.4 Hz]) als Indikatoren des zentralen sympathischen und parasympathischen Tonus erfasst. Diejenigen TICS-Skalen, die psychosozialen Stress reflektieren, sowie „Chronische Besorgnis“ waren zwischen r=.16 und .26 mit somatoformen Symptomen korreliert. Die Skala „Chronische Besorgnis“ korrelierte außerdem positiv mit dem Tagescortisolspiegel (r=.19), sowie negativ mit SDNN (r=-.20), RMSSD (r=-.17), pNN50 (r=-.17), LF-Power (r=-.19) und HF-Power (r=-.16; alle ps < .05). Somatoforme Symptome korrelierten hingegen nicht mit Indikatoren der physiologischen Stressachsen. In einem Regressionsmodell mit Somatisierungsindex als Kriterium zeigte sich nur für die TICS-Skalen „Mangel an sozialer Anerkennung“ (b=.19) und „chronische Besorgnis“ (b=.25), sowie LF-HRV (b=.20) signifikante Vorhersagekraft. Die Annahmen des Modells zu Interozeption und Stress konnten nur teilweise bestätigt werden. Selbstberichteter Stress, vor allem „Besorgnis“, ist bei gesunden Probanden der beste Prädiktor für somatoforme Symptome. Auch höherer sympathischer Tonus könnte für somatoforme Symptome eine Rolle spielen. [less ▲]

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See detailBlood pressure and the perception of illusive pain
Scheuren, Raymonde UL; Duschek, Stefan; Schulz, André UL et al

in Psychophysiology (2016), 53(8), 1282-1291

Numerous studies have documented an inverse relationship between blood pressure and sensitivity to experimental nociceptive stimulation. The present study aimed to investigate possible associations ... [more ▼]

Numerous studies have documented an inverse relationship between blood pressure and sensitivity to experimental nociceptive stimulation. The present study aimed to investigate possible associations between blood pressure and the occurrence and intensity of paradoxical pain induced by the thermal grill paradigm. Thirty-one healthy subjects were stimulated three times for 1 minute with the non-noxious temperatures of 15°C and 41°C set at the interlaced cold and warm bars of a water bath-driven thermal grill. Blood pressure and heart rate were recorded concomitantly. On account of previous observations of an association between the sensitivity of the cardiac baroreflex and pain perception, this parameter was additionally obtained. Numerical rating scales were used to quantify subjective pain intensity and pain unpleasantness; subjects were classified as responders and non-responders to thermal grill stimulation based on pain intensity ratings. Responders exhibited lower systolic and diastolic blood pressure than non-responders, and inverse linear associations arose between blood pressure and pain intensity and unpleasantness. Baroreflex sensitivity was unrelated to pain ratings. The findings confirmed the hypothesis of a blood pressure dependence of paradoxical pain and support the notion that the cardiovascular and pain regulatory systems interact not only in the processing of pain elicited by noxious input, but also in non-noxiously generated illusive pain. While this finding is not consistent with the assumption of an involvement of the baroreflex system in mediating the observed interaction, psychological traits and neurochemical factors are alternatively considered. [less ▲]

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See detailGastrische Modulation der Schreckreaktion und gastrisch-evozierte Potenziale: zwei neue psychophysiologische Indikatoren für Interozeption des gastrointestinalen Systems
Schulz, André UL; Schaan, L.; Van Dyck, Zoé UL et al

in Kathmann, N. (Ed.) 42. Tagung Psychologie und Gehirn Abstractband (2016)

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See detailMaking sense of what you sense: Disentangling interoceptive awareness, sensibility and accuracy
Forkmann, Thomas; Scherer, Anne; Meessen, Judith et al

in International Journal of Psychophysiology (2016), 109(1), 71-80

Garfinkel and Critchley (2013) recently proposed a three level model of interoception. Only few studies, however, have empirically tested this theoretical model thus far. The present study aimed at ... [more ▼]

Garfinkel and Critchley (2013) recently proposed a three level model of interoception. Only few studies, however, have empirically tested this theoretical model thus far. The present study aimed at investigating (1) the central assumptions of this model, i.e. that Accuracy, Sensibility and Awareness are distinguishable facets of interoception and that Interoceptive Accuracy is the basic level of interoception, and (2) whether cardiovascular activation (as indexed by heart rate) is differentially related to the three facets of interoception. Analyses were conducted on a total sample of N=159 healthy participants (118 female [74.2%]; mean age = 23.9 years, SD = 3.3, range = 19-45) who performed either the heartbeat tracking task, the heartbeat discrimination task or both. The results suggest that Accuracy, Sensibility and Awareness are empirically distinct facets of interoception, showing no correlation when based on heartbeat tracking, but moderate correlations when based on heartbeat discrimination. The assumption that Interoceptive Accuracy is the basic level of interoception could only be partially confirmed. Instead, we conclude that the level of objective physiological states should be considered as the most basic level of interoceptive signal processing. [less ▲]

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See detailInter-individual differences in cardiovascular reactivity and the perception of the thermal grill illusion of pain
Scheuren, Raymonde UL; Duschek, Stefan; Schulz, André UL et al

Speeches/Talks (2015)

Background: Evidence has been given that there exists a functional relationship between the cardiovascular and the pain regulatory system. Alterations in blood pressure and concomitant changes in ... [more ▼]

Background: Evidence has been given that there exists a functional relationship between the cardiovascular and the pain regulatory system. Alterations in blood pressure and concomitant changes in baroreceptor activation contribute to the modulation of pain sensitivity It could be shown that blood pressure, baroreflex sensitivity, and cardiac vagal tone (indexed by heart rate variability, HRV) are inversely associated to pain sensitivity. We aimed assessing the same cardiovascular parameters in a thermal grill paradigm to test the assumption of a relationship between inter-individual differences in autonomic cardiac control and the perception of the thermal grill illusion of pain (TGI). Methods: All participants (N = 52) were stimulated three times during one minute with the temperatures of 15°C and 41°C set at the interlaced cold and warm bars of the water-bath driven thermal grill. Blood pressure and heart rate were recorded concomitantly. Numerical rating scales (NRS; 0–100) were used to quantify subjective paradoxical pain intensity and pain unpleasantness perceptions. Results: A positive association between cardiac vagal tone and paradoxical pain sensitivity could be revealed. Higher resting HRV, as expressed by higher respiratory sinus arrhythmia (RSA), made it overall more likely to perceive the TGI. In contrast, blood pressure and the susceptibility to the TGI were inversely related. Volunteers displaying higher spontaneous blood pressure values in the first thermal grill stimulation phase did not feel the illusive pain as compared to those who presented significantly lower sympathetic arousal and perceived the TGI. Conclusion: The present physiological findings complement previous evidence of an impact of psychological characteristics on the individual disposition to paradoxical pain perceptions. [less ▲]

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See detailRelationship between cardiovascular reactivity and the perception of the thermal grill illusion of pain
Scheuren, Raymonde UL; Duschek, Stefan; Schulz, André UL et al

Poster (2015, September 03)

Alterations in blood pressure (BP) and concomitant changes in baroreceptor activation contribute to the modulation of pain sensitivity to warrant homeostatic regulation processes [1][2]. Numerous pain ... [more ▼]

Alterations in blood pressure (BP) and concomitant changes in baroreceptor activation contribute to the modulation of pain sensitivity to warrant homeostatic regulation processes [1][2]. Numerous pain studies have described an inverse relationship between BP and nociceptive sensitivity [3][4][5]. It is not known whether a similar relationship plays a role in the framework of the induction of pain in the absence of noxious stimulation. The thermal grill (TG) paradigm is commonly used to trigger this type of paradoxical pain also termed thermal grill illusion of pain (TGI). The goal of the present study was to explore the relationship between cardiovascular activity/reactivity and paradoxical pain sensitivity to get additional insight in the variability of responsiveness (responders and non-responders) to TG stimulation described in the literature [6][7]. We hypothesized that higher BP would be associated with stronger pain inhibitory effects in participants not perceiving the thermal grill illusion of pain (TGI). We moreover expected that the perception of paradoxical pain in the responder group would be paired with lower BP. We tested this hypothesis by comparing both groups with respect to their spontaneous cardiovascular activity (recorded in resting conditions) and their cardiovascular responses to TG stimulation. [less ▲]

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See detailInteroception and Stress
Schulz, André UL; Vögele, Claus UL

in Frontiers in Psychology (2015), 6(1), 993

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See detailZentralnervöse Verarbeitung von Körpersignalen bei Anorexia nervosa
Lutz, Annika UL; Schulz, André UL; Voderholzer, Ulrich et al

Scientific Conference (2015, April)

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See detailAltered patterns of heartbeat-evoked potentials in depersonalization/derealization disorder: neurophysiological evidence for impaired cortical representation of bodily signals
Schulz, André UL; Köster, S.; Beutel, M. E. et al

in Psychosomatic Medicine (2015), 77(5), 506-516

OBJECTIVE: Core features of depersonalization-/derealization disorder (DPD) are emotional numbing and feelings of disembodiment. While there are several neurophysiological findings supporting subjective ... [more ▼]

OBJECTIVE: Core features of depersonalization-/derealization disorder (DPD) are emotional numbing and feelings of disembodiment. While there are several neurophysiological findings supporting subjective emotional numbing, the psychobiology of disembodiment remains unclear. METHODS: Heartbeat-evoked potentials (HEPs), which are considered psychophysiological indicators for the cortical representation of afferent signals originating from the cardiovascular system, were assessed in 23 patients with DPD and 24 healthy control individuals during rest and while performing a heartbeat perception task. RESULTS: Absolute HEP amplitudes did not differ between groups. Nevertheless, healthy individuals showed higher HEPs during the heartbeat perception task than during rest, while no such effect was found in DPD patients (p = .031). DPD patients had higher total levels of salivary alpha-amylase than healthy individuals (9626.6±8200.0 vs. 5344.3±3745.8 kUmin/l; p = .029), but there were no group differences in cardiovascular measures (heart rate: 76.2±10.1 vs. 74.3 ±7.5 bpm, p = .60; nLF HRV: .63±.15 vs. .56 ±.15 n.u., p = .099; LF/HF ratio: 249.3±242.7 vs. 164.8 ±108.8, p = .10), salivary cortisol (57.5±46.7 vs. 55.1±43.6 nmolmin/l, p = .86) or cortisone levels (593.2±260.3 vs. 543.8±257.1 nmolmin/l, p = .52). CONCLUSION: These results suggest altered cortical representation of afferent signals originating from the cardiovascular system in DPD patients, which may be associated with higher sympathetic tone. These findings may reflect difficulties of DPD patients to attend to their actual bodily experiences. [less ▲]

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See detailInteroception
Schulz, André UL

in Wright, J. D. (Ed.) International Encyclopedia of the Social and Behavioral Sciences (2015)

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See detailShort-term food deprivation increases amplitudes of heartbeat-evoked potentials
Schulz, André UL; Ferreira de Sá, D. S.; Dierolf, Angelika UL et al

in Psychophysiology (2015), 52(5), 695-703

Nutritional state, i.e. fasting or non-fasting, may affect the processing of interoceptive signals, but mechanisms underlying this effect remain unclear. We investigated 16 healthy women on two separate ... [more ▼]

Nutritional state, i.e. fasting or non-fasting, may affect the processing of interoceptive signals, but mechanisms underlying this effect remain unclear. We investigated 16 healthy women on two separate days: when satiated (standardized food intake) and after an 18 h food deprivation period. On both days, heartbeat-evoked potentials (HEPs) and cardiac and ANS activation indices (heart rate, nLF HRV) were assessed. The HEP is an EEG pattern that is considered an index of cortical representation of afferent cardiovascular signals. Average HEP activity (R-wave +455-595 ms) was enhanced during food deprivation compared to normal food intake. Cardiac activation did not differ between nutritional conditions. Our results indicate that short-term food deprivation amplifies an electrophysiological correlate of the cortical representation of visceral-afferent signals originating from the cardiovascular system. This effect could not be attributed to increased cardiac activation, as estimated by heart rate and nLF HRV, after food deprivation. [less ▲]

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