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See detailHeartbeat evoked potentials in patients with posttraumatic stress disorder: an unaltered neurobiological regulation system?
Schmitz, Marius; Müller, Laura E.; Seitz, Katja I. et al

in European Journal of Psychotraumatology (2021), 12(1), 1987686

Background: Early life maltreatment is a risk factor for psychiatric disorders, including posttraumatic stress disorder (PTSD). Posttraumatic stress disorder is a severe and heterogeneous disorder with ... [more ▼]

Background: Early life maltreatment is a risk factor for psychiatric disorders, including posttraumatic stress disorder (PTSD). Posttraumatic stress disorder is a severe and heterogeneous disorder with fluctuating states of emotional over- and undermodulation including hypervigilance, dissociation, and emotion regulation deficits. The perception and regulation of emotions have been linked to interoception, the cortical representation and sensing of inner bodily processes. Although first therapeutic approaches targeting bodily sensations have been found effective in patients with PTSD, and deficits in interoceptive signal representation have been reported in other trauma-related disorders such as borderline personality disorder (BPD), the role of interoception remains largely unexplored for PTSD. Objective: The objective was to investigate the cortical representation of cardiac interoceptive signals in patients with PTSD and its associations with early life maltreatment, trait dissociation, and emotion dysregulation. Methods: Twenty-four medication-free patients with PTSD and 31 healthy controls (HC) completed a 5-min resting electrocardiogram (ECG) with parallel electroencephalogram (EEG). Heartbeat evoked potential (HEP) amplitudes as a measure for cortical representation of cardiac interoceptive signals were compared between groups and correlated with self-report questionnaires. Results: We did not find significantly different mean HEP amplitudes in patients with PTSD compared to HC, although HEPs of patients with PTSD were descriptively higher. No significant associations between mean HEP amplitudes and early life maltreatment, trait dissociation or emotion dysregulation were obtained within the groups. Conclusion: The current finding does not indicate deficits in interoceptive signal representation at rest in individuals with PTSD. Whether patients with PTSD show altered HEP modulations during emotion regulation tasks and might benefit from therapeutic approaches aiming at changing the perception of bodily signals, needs to be investigated in future studies. [less ▲]

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See detailOn the construct validity of interoceptive accuracy based on heartbeat counting: cardiovascular determinants of absolute and tilt-induced change scores
Schulz, André UL; Back, Sarah N.; Schaan, Violetta K. et al

in Biological Psychology (2021), 164(1), 108168

Interoceptive accuracy (IAcc) as assessed with the heartbeat counting task (IAccHBCT) may be affected by a range of factors including (1.) the ability to adequately detect cardiac signals, indicated by ... [more ▼]

Interoceptive accuracy (IAcc) as assessed with the heartbeat counting task (IAccHBCT) may be affected by a range of factors including (1.) the ability to adequately detect cardiac signals, indicated by IAcc in a heartbeat discrimination task (IAccHBDT), (2.) cardiac signal properties, affected by sympathetic and parasympathetic tone, and (3.) non-interoceptive processes, including time estimation accuracy (TEAcc). In the current study we investigated the contribution of these factors to absolute and Δ IAccHBCT scores, induced by passive head-up and head-down tilt in 49 healthy individuals. A set of hierarchical regression models showed IAccHBDT scores as the strongest and, across different orthostatic (tilt) conditions, most stable (positive) predictor of absolute and Δ IAccHBCT scores. Neither indicators of cardiac signal properties (except for HR in head-down-tilt), nor TEAcc predicted absolute or Δ IAccHBCT scores. These findings support the convergent and discriminant validity of absolute and Δ IAccHBCT scores. [less ▲]

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See detailCardiac cycle phases affect auditory-evoked potentials, startle eye blink and pre-motor reaction times in response to acoustic startle stimuli
Schulz, André UL; Vögele, Claus UL; Bertsch, Katja et al

in International Journal of Psychophysiology (2020), 157(1), 70-81

Startle stimuli evoke lower responses when presented during the early as compared to the late cardiac cycle phase, an effect that has been called ‘cardiac modulation of startle’ (CMS). The CMS effect may ... [more ▼]

Startle stimuli evoke lower responses when presented during the early as compared to the late cardiac cycle phase, an effect that has been called ‘cardiac modulation of startle’ (CMS). The CMS effect may be associated with visceral-afferent neural traffic, as it is reduced in individuals with degeneration of afferent autonomic nerves. The aim of this study was to investigate whether the CMS effect is due a modulation of only early, automatic stages of stimulus processing by baro-afferent neural traffic, or if late stages are also affected. We, therefore, investigated early and late components of auditory-evoked potentials (AEPs) to acoustic startle stimuli (105, 100, 95 dB), which were presented during the early (R-wave +230 ms) or the late cardiac cycle phase (R +530 ms) in two studies. In Study 1, participants were requested to ignore (n=25) or to respond to the stimuli with button-presses (n=24). In Study 2 (n=23), participants were asked to rate the intensity of the stimuli. We found lower EMG startle response magnitudes (both studies) and slower pre-motor reaction times in the early as compared to the late cardiac cycle phase (Study 1). We also observed lower N1 negativity (both studies), but higher P2 (Study 1) and P3 positivity (both studies) in response to stimuli presented in the early cardiac cycle phase. This AEP modulation pattern appears to be specific to the CMS effect, suggesting that early stages of startle stimulus processing are attenuated, whereas late stages are enhanced by baro-afferent neural traffic [less ▲]

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