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See detailDistraction from Pain in Aging – the Impact of Acute Stress
Dierolf, Angelika UL; van der Meulen, Marian UL; Schulz, André UL et al

in Heinrichs, Markus; Schönauer, Monika (Eds.) 47. Jahrestagung Psychologie und Gehirn (2022)

While older people report acute and chronic pain more often than younger people, and, therefore, would benefit significantly from non-pharmacological pain treatment, little is known about how age affects ... [more ▼]

While older people report acute and chronic pain more often than younger people, and, therefore, would benefit significantly from non-pharmacological pain treatment, little is known about how age affects psychological strategies of pain modulation. Distraction from pain by cognitive engagement, an efficient pain modulation strategy, relies on the prefrontal cortex (PFC). The PFC, however, is an area affected by age-related cognitive decline, which might lead to reduced pain relief through distraction in older adults. Acute stress, a common concomitant phenomenon of pain, might additionally reduce the pain relief effect by its negative impact on PFC and PFC-based executive functions. Healthy young (18-30 years) and older participants (65+ years) performed a pain distraction task before and after acute stress induction using the Trier Social Stress Test, or a respective control condition. An n-Back working memory task with low and high cognitive load served as the distraction paradigm, during which participants received non-painful and moderately painful stimuli. These stimuli were individually adjusted transdermal electrical pulse trains to the inner forearm and participants rated them regarding their intensity and unpleasantness. Pain-related evoked potentials were recorded with a 64-channel EEG, and several saliva samples were collected to measure hormonal stress responses. First analyses on the currently small sample suggest a negative impact of acute stress on distraction from pain in both age groups. Our final results will contribute to a deeper understanding on the efficacy of pain modulation in aging and potential influencing factors, helping to optimize pain treatments in this population. [less ▲]

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See detailHigher cardiovascular activation, but normal heartbeat-evoked potentials and cardiac interoceptive accuracy in somatoform disorders and major depressive disorder
Schulz, André UL; Dierolf, Angelika UL; Lutz, Annika UL et al

in Psychiatry Research Communications (2022), 2(3), 100052

The perception-filter model posits that the generation of medically-unexplained symptoms is associated with (I.) more intense afferent bodily signals, (II.) impaired filter system activity to ... [more ▼]

The perception-filter model posits that the generation of medically-unexplained symptoms is associated with (I.) more intense afferent bodily signals, (II.) impaired filter system activity to differentiate relevant from irrelevant signals, and (III.) altered perception of bodily signals. We tested these assumptions for cardiac perception in patients with somatoform disorders (SFD), patients with major depressive disorder (MDD) and healthy control (HC) individuals. Heart rate (variability; HR/HRV) and blood pressure served as indicators of bodily signals (I.); heartbeat-evoked potentials (HEPs) assessed during a heartbeat counting task (HCT) and a distraction task indicated filter system activity (II.); interoceptive accuracy (IAc) in the HCT was interpreted as an index of perception (III.). All indicators were assessed before and after a socially-evaluated cold pressor stress task (SECPT) and a control intervention. SFD patients (n ​= ​24) showed higher average HR and diastolic blood pressure, as well as lower HRV than HC individuals (n ​= ​22), but there were no differences in HEPs or IAc. Neither were there significant differences between the SFD and the MDD groups (n ​= ​24), nor any stress effect on HEPs or IAc. Our findings suggest that increased intensity of bodily signals (I.) is the only model assumption that could be supported for patients with fully-developed SFD. [less ▲]

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See detailLess efficient cognitive pain modulation in healthy older adults – the impact of executive functions, chronic stress, and physical activity
Heiler, Ann-Sophie; van der Meulen, Marian UL; Miltner, Wolfgang et al

in Heinrichs, Markus; Schönauer, Monika (Eds.) 47. Jahrestagung Psychologie und Gehirn (2022)

Demographic change and the associated increasing prevalence of chronic pain have contributed to increased research interest in the field of aging. Aging has been associated with less efficient pain ... [more ▼]

Demographic change and the associated increasing prevalence of chronic pain have contributed to increased research interest in the field of aging. Aging has been associated with less efficient pain inhibition through cognitive distraction. As pain modulation and executive functioning mainly involve the prefrontal cortical network, which shows age-related atrophy, we hypothesized an association between deteriorating cognitive modulation of pain in healthy older adults and reduced executive functions. As chronic stress can decrease executive functioning through prefrontal cortical impairment, we expected a negative impact on distraction from pain. In contrast, physical activity can have a stress-buffering effect and positively influences executive functions in older age. Therefore, increased physical activity should lead to better distraction from pain. Healthy young (18 -30 years) and older adults (65+ years) took part in a pain distraction paradigm (N-back) while receiving non-painful and moderately painful electric stimuli. Before, we examined executive functions, including response inhibition (Go/No-Go-task), inhibitory control (Stroop task), and working memory (Sternberg task). Additionally, chronic stress and physical activity were assessed using self-report questionnaires, supported by physiological measurements (heart rate variability). Preliminary results indicate a negative impact of chronic stress on distraction from pain particular in young participants, while physical fitness was related to more successful pain modulation in older adults. Our final results will contribute to a more differentiated view on executive functioning and pain modulation in aging, thereby leading to a better understanding of the impact of aging on non-pharmacological pain treatment and to better adapted pain therapies in this population. [less ▲]

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See detailPain Processing in Older Age – Evidence from Event-Related Potentials
Dierolf, Angelika UL; Rischer, Katharina Miriam UL; González-Rolán, Ana Maria et al

Scientific Conference (2021, June)

Aging is known to affect neurobiological and physiological aspects of pain perception and has been associated with reduced pain sensitivity and a deterioration of descending pain inhibitory mechanisms. To ... [more ▼]

Aging is known to affect neurobiological and physiological aspects of pain perception and has been associated with reduced pain sensitivity and a deterioration of descending pain inhibitory mechanisms. To investigate age differences in neural electrophysiological correlates of pain processing, we induced acute pain in healthy older (60 yrs+) and younger adults (18 to 35 yrs), using short transdermal electrical pulses administered to the inner forearm, with individually adjusted stimulation intensities. Participants received alternating blocks of painful and non-painful control stimulation and rated the intensity and unpleasantness of each stimulus on two visual analog scales. Pain-related evoked potentials were recorded with a 64-channel EEG. Preliminary results indicate that younger and older participants rated painful stimuli more intensive and unpleasant compared to the control stimulation, with older adults showing a slight habituation over time. In younger adults, ERP amplitudes (N2, P2 P3) of painful stimulation were enhanced compared to non- painful stimulation. In contrast, older participants showed generally reduced ERPs, no difference between pain and non-painful stimulation and by tendency longer latencies for painful stimulation. This suggests that nociceptive neural processing is altered in aging, while the reported pain perception is unaffected. Given that aging is also associated with a decline of cognitive functions and PFC volume and activity changes, this could have implications for the efficacy of cognitive pain modulation. Altogether, our results highlight the need for a deeper understanding of the mechanisms underlying pain processing in older adults, and how these age-related changes affect (cognitive) pain treatments in this population. [less ▲]

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See detailCognitive distraction from pain: An fMRI study on the role of age and executive functions
Rischer, Katharina Miriam UL; Dierolf, Angelika UL; González-Roldán, Ana M. et al

Scientific Conference (2021, June)

Completing a cognitive task has been shown to be a powerful strategy to reduce concurrent pain. This reduction in pain is assumed to result from a competition between the painful stimulus and the ... [more ▼]

Completing a cognitive task has been shown to be a powerful strategy to reduce concurrent pain. This reduction in pain is assumed to result from a competition between the painful stimulus and the distractive task for attentional and executive resources mediated by the prefrontal cortex (PFC), a region that is particularly affected by age-related grey matter atrophy. In the present study, we investigated the role of age-related changes in gray matter volume and executive functions in modulating the efficacy of distraction from pain. In a first session, young and older adults completed a battery of neuropsychological tests. In a second session, we acquired functional brain images while participants completed a working memory task with two levels of cognitive load (low vs. high load) and concurrently received individually adjusted heat stimuli (innocuous vs. painful) to their lower arm. While we found no age-related differences in the distraction effect size on the behavioural level, young adults showed a larger neural distraction effect in several regions involved in pain processing, including the insula, caudate and midcingulate cortex. Interestingly, older adults with better executive functions, particularly, better inhibitory control abilities, showed a larger neural distraction effect in the insula, thalamus and primary somatosensory cortex, and more activation in frontal clusters during the high load task. Taken together, these findings suggest that age alters the neural mechanisms underlying cognitive distraction from pain, and that the magnitude of these changes may be dependent on the preservation of executive functions. [less ▲]

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See detailVerbessern Entspannungsverfahren die Interozeptionsfähigkeit? – Eine 1-wöchige Intervention
Dierolf, Angelika UL; Gräfin von Königsmark, Benita; Gorji, Lilia et al

Poster (2021, June)

Verbessern Entspannungsverfahren die Interozeptionsfähigkeit? – Eine 1-wöchige Intervention Interozeption, die Wahrnehmung und Verarbeitung körpereigener Signale, ist ein zentraler Aspekt von Gesundheit ... [more ▼]

Verbessern Entspannungsverfahren die Interozeptionsfähigkeit? – Eine 1-wöchige Intervention Interozeption, die Wahrnehmung und Verarbeitung körpereigener Signale, ist ein zentraler Aspekt von Gesundheit und Krankheit. Eine gestörte Interozeptionsfähigkeit zeigt sich bei verschieden psychischen Erkrankungen, wie Depression oder auch Essstörungen. In der vorliegenden Studie wurde an 76 gesunden Studenten untersucht, ob sich die interozeptive Genauigkeit und das interozeptive Bewusstsein durch eine 5-tägige körperbezogene Imaginationsübung per Audiodatei verbessern lassen. Als Kontrollbedingung diente eine nicht-körperbezogene Traumreise und nicht-entspannungsbezogene Podcasts der Serie ZeitWissen. Die Erhebung erfolgte online. Vor und nach der 5-tägigen Intervention wurden interozeptive Genauigkeit (Interoceptive Accuracy Scale (IAs)) und interozeptives Bewusstsein (Multidimensional Assessment of Interoceptive Awareness (MAIA)) erfasst. Erste Ergebnisse zeigen eine interventionsunabhängige Zunahme der interozeptiven Genauigkeit und des interozeptiven Bewusstsein nach allen Interventionen. Unabhängig von Intervention und Messzeitpunkt scheinen allerdings depressive, Angst- und Stresssymptome, gemessen mit Depressions-Angst-Stress-Skalen (DASS), sowie psychische Belastungen durch die aktuelle Covid-19 Pandemie insbesondere interozeptives Bewusstsein und in geringerem Ausmaß interozeptive Genauigkeit negativ zu beeinflussen. Die wöchentliche Häufigkeit, mit der generell eigene Achtsamkeits- oder Entspannungsübungen durchgeführt werden, wirkt sich positiv auf das interozeptive Bewusstsein aus. Insgesamt scheint Interozeptionsfähigkeit auch durch eine körperbezogene kurze, intensive imaginative Entspannungsübung in gesunden jungen Erwachsenen nicht verbessert zu werden, im Gegensatz zu regelmäßigem Yoga-, Mediations- oder Achtsamkeitstraining, welches interozeptives Bewusstsein positiv beeinflusst. [less ▲]

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See detailNegative mood increases desire to eat, but not event-related potentials, for food images in bulimia nervosa
Lutz, Annika UL; Georgii, Claudio; Blechert, Jens et al

Scientific Conference (2021, March 12)

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See detailPlacebo Analgesie im Alter
Dierolf, Angelika UL; Rischer, Katharina Miriam UL; van der Meulen, Marian UL

Scientific Conference (2020, January)

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See detailAltered interoceptive awareness in high habitual symptom reporters and patients with somatoform disorders
Flasinski, Tabea; Dierolf, Angelika UL; Rost, Silke et al

in Frontiers in Psychology (2020), 11(1), 1859

Objective. Altered interoception may play a major role in the etiology of medically unexplained symptoms (MUS). It remains unclear, however, if these alterations concerns noticing of signals or if they ... [more ▼]

Objective. Altered interoception may play a major role in the etiology of medically unexplained symptoms (MUS). It remains unclear, however, if these alterations concerns noticing of signals or if they are limited to the interpretation of signals. We investigated whether individuals with MUS differ in interoceptive awareness as assessed with the Multidimensional Assessment of Interoceptive Awareness (MAIA) questionnaire. Methods. Study 1: 486 individuals completed the Screening for Somatoform Disorders (SOMS-2). 32 individuals each of the upper and lower decile of the SOMS distribution (low symptom reporters/LSR, high symptom reporters/HSR) completed the MAIA. Study 2: MAIA scores of individuals diagnosed with somatoform disorder (SFD; n = 26) were compared to individuals with major depressive disorder (MDD; n = 25) and healthy controls (HC; n = 26). Results. HSR had lower scores than LSR on the MAIA scales Not-Distracting and Not-Worrying. The SFD and MDD groups showed lower scores than HC on the MAIA scales Not-Distracting, Self-Regulation, and Trusting. The MDD group scored lower than the other two groups on the scales Body Listening and Attention Regulation. There were no group differences on the scale Noticing. Conclusion. HSR, SFD and MDD patients do not differ from HC in the awareness of noticing of interoceptive signal processing, whereas cognitive facets of interoception, such as distraction or self-regulation are differentially affected. This highlights the necessity of including specifically targeted interventions, which improve interoceptive awareness, in the prevention and treatment of SFDs. [less ▲]

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See detailThe destruction of distraction? Neural mechanisms of reduced task-related analgesia with aging.
Rischer, Katharina Miriam UL; Dierolf, Angelika UL; Gonzalez-Roldan, Ana Maria et al

Poster (2019, September 06)

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See detailThe role of executive functions in task-related analgesia
Rischer, Katharina Miriam UL; Gigl, Sandra; Dierolf, Angelika UL et al

Poster (2019, March)

Introduction: Recent research suggests that weaker executive functions may be linked to a higher risk of pain chronicity. However, little is known about how executive functions affect the modulation of ... [more ▼]

Introduction: Recent research suggests that weaker executive functions may be linked to a higher risk of pain chronicity. However, little is known about how executive functions affect the modulation of acute pain. The present study aimed to investigate the impact of inhibitory control on the success of cognitive distraction from pain. Methods: Participants completed a battery of cognitive tasks (Go/NoGo, Color Stroop, Eriksen Flanker), assessing their cognitive inhibition and selective attention abilities. Additionally, self-report measures of pain catastrophizing and fear of pain were administered. In a pain distraction paradigm, participants completed either a cognitively demanding working memory task (2-back task) or a visually matched easy control task (target response task) while receiving warm or painful thermal stimuli to their left forearm. Nociceptive stimulus intensity was individually calibrated for each participant. Moreover, to maintain a similar level of task difficulty across participants, task speed was continuously adapted based on the participant's performance in the previous trials. Following each trial, participants rated the perceived intensity and unpleasantness of the thermal stimuli on visual analogue scales. Results: As expected, preliminary results indicate that the 2-back task, but not the target response task, successfully distracted participants from thermal pain, manifesting in significantly lower intensity and unpleasantness ratings. Importantly, the magnitude of the distraction effect was negatively associated with the Flanker effect. Discussion: In line with previous research, engaging in a cognitively demanding task led to significantly lower pain intensity and unpleasantness ratings when compared to an easy control task. Moreover, results indicate that better interference control abilities may predict greater task-related analgesia. Taken together, the results of the present study suggest that it is crucial to assess executive functions to develop a better understanding of the mechanisms behind cognitive distraction from pain. [less ▲]

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See detailErhöhte Reaktivität Herzschlag-evozierter Potenziale während der Aufmerksamkeits- fokussierung auf den eigenen Herzschlag und erhöhte kardiovaskuläre Aktivität bei Personen mit hoher somatoformer Symptombelastung
Schulz, André UL; Rost, S.; Dierolf, Angelika UL et al

in Kirschbaum, C. (Ed.) 45. Jahrestagung Psychologie und Gehirn - Abstractband (2019)

Die psychobiologischen Mechanismen der Entstehung körperlicher Symptome bei somatoformen Störungen sind weitgehend unklar. Im Perception-Filter-Modell wird postuliert, dass (1.) verstärkte ... [more ▼]

Die psychobiologischen Mechanismen der Entstehung körperlicher Symptome bei somatoformen Störungen sind weitgehend unklar. Im Perception-Filter-Modell wird postuliert, dass (1.) verstärkte Signalübermittlung von Körperorganen und (2.) verringerte Filterfunktion im ZNS zu (3.) verstärkter Wahrnehmung von Symptomen führt. Bislang existiert jedoch keine Evidenz, die diesen Zusammenhang an einer von somatoformen Symptomen belasteten Population unterstützt. Um diesen Sachverhalt aufzudecken, wurden zunächst 486 Personen aus der Allgemeinbevölkerung anhand einer Online- Version des Screenings für Somatoforme Störungen (SOMS-2) anhand des oberen und unteren Centils in Personen mit hoher (HSB) und niedriger somatoformer Symptombelastung (NSB) geteilt. Jeweils 29 NSB- (21 Frauen; 26,0 J.) und HSBPersonen (27 Frauen; 28,4 J.) wurden im Labor anhand (1.) verstärkter Körpersignale hinsichtlich kardiovaskulärer Aktivität und Cortisol-Aufwachreaktion, sowie (2.) Filterfunktionen im ZNS hinsichtlich Herzschlag-evozierter Potentiale (HEPs) während der Durchführung eines Herzschlagwahrnehmungstests und während Ruhe untersucht. HEPs reflektieren die Repräsentation kardio-afferenter Signale im ZNS. Die HSB-Gruppe zeigte eine höhere Ruhe-Herzrate (72,7 vs. 66,8 bpm) und eine geringere Herzratenvariabilität (RMSSD: 36,8 vs. 52,5 ms) als die LSB-Gruppe. Außerdem zeigten die HSB-Personen bei der Aufmerksamkeitsfokussierung auf den eigenen Herzschlag eine höhere Reaktivität der HEP-Amplitude als die LSB-Personen. Es gab keine Gruppenunterschiede hinsichtlich der Cortisol-Aufwachreaktion. Die Ergebnisse belegen sowohl (1.) die verstärkte Signalübermittlung von Körperorganen, als auch (2.) verringerte Filterfunktionen bei Personen mit hoher somatoformer Symptombelastung. Dies spricht für die Gültigkeit des Perception-Filter-Modells. Die erhöhte HEP-Reaktivität bezüglich der Aufmerksamkeitsfokussierung auf Körperprozesse könnte einen Biomarker für Personen mit hohem Risiko für die Entwicklung von somatoformen Störungen darstellen. [less ▲]

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See detailImpact of a hypnotic trance on the physiological and subjective stress response to an acute stressor
Dierolf, Angelika UL; Wortmeier, Theresa; Zeyer, Reinhold et al

in Kirschbaum, C. (Ed.) 45. Jahrestagung Psychologie und Gehirn - Abstractban (2019)

Clinical hypnosis is a valuable therapeutic tool in the treatment of phobias and acute pain. These conditions have in common that stress constitutes a crucial factor in the genesis and frightening or ... [more ▼]

Clinical hypnosis is a valuable therapeutic tool in the treatment of phobias and acute pain. These conditions have in common that stress constitutes a crucial factor in the genesis and frightening or painful situations. The present study was aimed to investigate whether hypnotic trance has a positive immediate impact on the psychological and physiological responses to an acute stressor. 48 men and women underwent the socially-evaluated cold pressor test and a warm water control procedure in two separated sessions. Beforehand, hypnotic suggestibility was tested with the Harvard Group Scale of Hypnotic Susceptibility. Participants were randomly assigned to three groups: to a hypnotic trance group, an active control group, and a natural history group. Before the stress and the control procedures, the hypnotic trance group received a hypnotic trance strengthening stress resilience and stress coping. The active control group received a non-fictional text together with a suggestion to strengthen resilience. The natural history group received no intervention. After both procedures, participants performed a working memory task. Hormonal, cardiovascular, respiratory, and subjective measures were taken throughout the sessions. Results show that the hypnotic trance affected hormonel and cardiovascular parameters differently. While cortisol and alpha amylase were generally reduced in the hypnotic trance group, cardiovascular parameters and subjective stress were specifically altered in the stress procedure and modulated by suggestibility. Our results show the potential of a short hypnotic intervention to positively influence the stress response and the restoration of the homeostasis. [less ▲]

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See detailGood to be stressed? Improved response inhibition and error processing after acute stress in young and older men
Dierolf, Angelika UL; Schoofs, Daniela; Hessas, Eve-Mariek et al

in Neuropsychologia (2018), 119

own on whether and how age modulates stress effects on executive functions and their neural correlates. The current study investigated the effect of acute stress on response inhibition and error ... [more ▼]

own on whether and how age modulates stress effects on executive functions and their neural correlates. The current study investigated the effect of acute stress on response inhibition and error processing and their underlying cortical processes in younger and older healthy men, using EEG. Forty-nine participants (30 young) were stressed with the Trier Social Stress Test (16 young, 9 older) or underwent a friendly control procedure (14 young, 10 older) and subsequently performed a Go/No-Go task with two levels of task difficulty while performance (reaction time, error rate), stimulus-locked (N2, P3) and response-locked (Ne, Pe) ERPs were measured. Previous results on age-related cognitive deficits were replicated, with slower responses and reduced and delayed N2 and P3 components, as well as reduced Ne and Pe components in older participants. Independent of age, acute stress improved response inhibition, reflected in higher accuracy for compatible trials and enhanced inhibition-related components (N2, P3 and N2d, P3d of the difference waves No-Go minus Go), and improved error processing, reflected in enhanced error-related components (Ne, Pe and Ne_d, Pe_d of the difference waves error minus correct trial). Our findings indicate that acute stress leads to a reallocation of cognitive resources, strengthening inhibition and error processing in young and older healthy men to a similar degree. Neural generators of the analyzed ERPs are mainly part of the salience network, which is upregulated immediately after stress. This offers an explanation as to why response inhibition, in contrast to other executive functions, improves after acute stress. [less ▲]

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See detailLate heartbeat-evoked potentials are associated with survival after cardiac arrest
Schulz, André UL; Stammet, P.; Dierolf, Angelika UL et al

in Resuscitation (2018), 126(1), 7-13

RATIONALE: Cardiac arrest (CA) is a serious condition characterized by high mortality rates, even after initial successful resuscitation, mainly due to neurological damage. Whether brain-heart ... [more ▼]

RATIONALE: Cardiac arrest (CA) is a serious condition characterized by high mortality rates, even after initial successful resuscitation, mainly due to neurological damage. Whether brain-heart communication is associated with outcome after CA is unknown. Heartbeat-evoked brain potentials (HEPs) represent neurophysiological indicators of brain-heart communication. The aim of this study was to address the association between HEPs and survival after CA. METHODS: HEPs were calculated from resting EEG/ECG in 55 CA patients 24 hours after resuscitation. All patients were treated with targeted temperature management and a standardized sedation protocol during assessment. We investigated the association between HEP amplitude (180- 320 ms, 455-595 ms, 860-1000 ms) and 6-month survival. RESULTS: Twenty-five of 55 patients (45%) were still alive at 6-month follow-up. Survivors showed a higher HEP amplitude at frontopolar and frontal electrodes in the late HEP interval than non-survivors. This effect remained significant after controlling for between-group differences in terms of age, Fentanyl dose, and time lag between resuscitation and EEG assessment. There were no group differences in heart rate or heart rate variability. CONCLUSION: Brain-heart communication, as reflected by HEPs, is associated with survival after CA. Future studies should address the brain-heart axis in CA. [less ▲]

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See detailKardiale Modulation der Schreckreaktion bei hoher gegenüber niedriger Symptombelastung: afferente Signalübermittlung auf der Hirn-Körper-Achse beein usst frühe Stimulus-Verarbeitung bei hoher Symptombelastung
Dierolf, Angelika UL; Rost, Silke; Lutz, Annika UL et al

in Hennig, J.; Stark, R. (Eds.) Abstractband Psychologie und Gehirn 2018 (2018)

Somatische Belastungsstörungen (SBS) sind oftmals durch andauernde medizinisch- unerklärte Symptome gekennzeichnet, deren Entstehung größtenteils ungeklärt ist. Diese Studie hatte zum Ziel, die empirisch ... [more ▼]

Somatische Belastungsstörungen (SBS) sind oftmals durch andauernde medizinisch- unerklärte Symptome gekennzeichnet, deren Entstehung größtenteils ungeklärt ist. Diese Studie hatte zum Ziel, die empirisch bislang unbeantwortete Frage zu klären, ob Symptomentstehung auf veränderte Signalübermittlung auf der Hirn-Körper-Achse zurückzuführen ist. Zunächst wurden 486 Personen aus der Allgemeinbevölkerung anhand des SOMS-2 in Personen mit hoher Symptombelastung (HSB; unterstes Perzentil) und niedriger Symptombelastung (NSB; oberstes Perzentil) unterteilt. Personen mit HSB stellen eine besondere Risikogruppe für SBS dar. 28 HSB- und 31 NSB-Personen durchliefen ein Paradigma der kardialen Modulation der Schreckreaktion (CMS), ein Verfahren, das kardio-afferente Signalübermittlung prä-attentiv abbilden kann. Ihnen wurden je zehn akustische Schreckreize (105 dB) in sechs Zeitpunkten nach der kardialen R-Zacke (0, 100, 200, 300, 400, 500 ms) präsentiert. Als Indikator für die Schreckreaktion wurden die N1- und P2-Amplitude der auditorisch-evozierten Potenziale über Cz gemessen, da der Effekt der Hirn-Körper-Signalübermittlung im Kortex abgebildet werden sollte. Es zeigten sich geringere N1-Amplituden auf die Schreckreize, die während der systolischen Phase (200, 300 ms) im Vergleich zur diastolischen Phase (0 ms) präsentiert wurden (p=.0002), was für das Vorliegen eines CMS-Effekts spricht. Die HSB-Gruppe zeigte höhere P2-Amplituden als die NSB-Gruppe. Es zeigte sich außerdem, dass der CMS-Effekt bezüglich der N1-Komponente in der HSB-Gruppe geringer ist (p=.035), jedoch bezüglich der P2-Komponente stärker ist als in der NSB-Gruppe (p=.031). Afferente Signalübermittlung auf der Hirn-Körper-Achse könnte bei Personen mit HSB bereits frühe, automatischeWahrnehmungsprozesse verändern, die durch späte, aufmerksamkeits-gesteuerte Prozesse kompensiert werden. Diese prä-attentive Beeinflussung der Stimulus-Verarbeitung könnte ein Mechanismus der Symptomentstehung bei Personen mit HSB und SBS sein. [less ▲]

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See detailSensing Your Body: Interoceptive Awareness and Medically Unexplained Symptoms
Flasinski, Tabea UL; Dierolf, Angelika UL; Voderholzer, Ulrich et al

in Abtracts of the 32nd Annual Conference of the European Health Psychology Society (2018)

According to contemporary theories of medically unexplained symptoms (MUS), alterations in interoception play a major role in symptom development and maintenance. Nevertheless, the mechanisms underlying ... [more ▼]

According to contemporary theories of medically unexplained symptoms (MUS), alterations in interoception play a major role in symptom development and maintenance. Nevertheless, the mechanisms underlying this relationship remains unclear. To address this unresolved issue, we investigated whether individuals with varying degrees of MUS differ in different facets of interoceptive awareness as assessed with the Multidimensional Assessment of Interoceptive Awareness (MAIA) questionnaire. In study 1, 486 individuals were screened with an online version of the Screening for Somatoform Disorders (SOMS-2). Individuals with a SOMS index below 5 (low reporter, n=32) and above 20 (high reporter, n=32) were invited to fill in the MAIA. High symptom reporter had lower scores on the Not-Distracting, Not-Worrying, and Trusting subscales, and higher scores on the Emotional Awareness subscale (Cohen´s d=.70–1.16). In study 2, individuals with DSM-IV somatoform disorder (SFD; n=25) were compared to individuals with major depressive disorder (MDD; n=24) and healthy controls (HC; n=25). The SFD and MDD groups had lower scores on the Not-Distracting, Attention Regulation, Self-Regulation, and Trusting subscales than HC. The MDD group had lower scores than the SFD and HC groups on the Body Listening subscale (partial eta-squared=.18-.26). No differences with regard to Noticing of bodily sensations were found. Groups with subclinical SFD, SFD and MDD do not differ from healthy individuals in terms of actual body perception, whereas cognitive facets of interoception, such as distraction or self-regulation are differentially affected. This highlights the necessity of including specifically targeted mindfulness-based interventions [less ▲]

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See detailLate heartbeat-evoked potentials, indicators of cortical representation of interoceptive signal processing, are associated with survival after cardiac arrest
Schulz, André UL; Stammet, Pascal; Dierolf, Angelika UL et al

in Abstractband Psychologie und Gehirn 2018 (2018)

Rationale: Cardiac arrest (CA) is a serious condition characterized by high mortality rates, even after initial successful resuscitation, mainly due to neurological damage. Whether brain-heart ... [more ▼]

Rationale: Cardiac arrest (CA) is a serious condition characterized by high mortality rates, even after initial successful resuscitation, mainly due to neurological damage. Whether brain-heart communication is associated with outcome after CA is unknown. Heartbeat-evoked brain potentials (HEPs) represent neurophysiological indicators of brain-heart communication, as they reflect cortical representation of interoceptive signal processing. The aim of this study was to address the association between HEPs and survival after CA. Methods: HEPs were calculated from resting EEG/ECG in 55 CA patients 24 h after resuscitation. All patients were treated with targeted temperature management and a standardized sedation protocol during assessment. We investigated the association between HEP amplitude (180{320 ms, 455{595 ms, 860{1000 ms) and 6-month survival. Results: Twenty-five of 55 patients (45%) were still alive at 6-month follow-up. Survivors showed a higher HEP amplitude at frontopolar and frontal electrodes in the late HEP interval than non-survivors. This effect remained significant after controlling for between-group differences in terms of age, Fentanyl dose, and time lag between resuscitation and EEG assessment. There were no group differences in heart rate or heart rate variability. Conclusion: Brain-heart communication, as reflected by HEPs, is associated with survival after CA. Cardiovascular autonomic arousal may not be involved in mediating this e ect. Adequate cortical representation of interoceptive signals may be essential to preserve cariovascular health and should be in the focus of prevention strategies. Future studies should address the brain-heart axis in CA. [less ▲]

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See detailImpaired filter function in patients with somatoform disorders and major depression, as reflected by auditory evoked potentials in an oddball and an active distraction paradigm
Hutmacher, Djenna UL; Dierolf, Angelika UL; Lutz, Annika UL et al

in Abstractband Psychologie und Gehirn 2018 (2018)

Introduction: In the in influential perception-filter model of somatoform disorders (SD), three stages of symptom perception are postulated: (1) bodily signals, which may be amplified by stress, (2) a ... [more ▼]

Introduction: In the in influential perception-filter model of somatoform disorders (SD), three stages of symptom perception are postulated: (1) bodily signals, which may be amplified by stress, (2) a filter system, which distinguishes between relevant and irrelevant stimuli, and (3) cortical perception of physical symptoms. As there is dearth of evidence so far supporting the relationship between (1) bodily signals and (2) filter processes in SD, this study investigated if filter processes are altered in SD and if stress may affect filter mechanisms. Methods: Twenty-four patients with SD, 24 with depression and 24 healthy control individuals were assessed. Event-related potentials (ERPs) with two different auditory distraction procedures were recorded over four blocks, one before and three after either a socially evaluated cold pressor test (SECPT) or a control procedure. We manipulated both the frequency of and the attentional focus on stimuli to reflect filter processes. Results: We found smaller P3b amplitudes (reflecting memory storage) in patients with depression and SD, as compared to healthy controls. Furthermore, both patient groups showed a smaller P3a amplitude (reflecting attention), when counting the infrequent tone ("Oddball task") and a smaller N1 amplitude when counting the frequent tone ("active distraction"). In patients with SD, the SECPT had a decreasing effect on P3a amplitudes. Conclusions: Both late filter processes, reflecting attention (P3a) and memory storage (P3b), may be impaired in SD and depression. As acute stress affected attention in SD patients only, the impact of bodily signals (1) on filter processes (2) may be specific for SD. [less ▲]

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See detailLate heartbeat-evoked potentials, indicators of cortical representation of interoceptive signal processing, are associated with survival after cardiac arrest
Schulz, André UL; Stammet, Pascal; Dierolf, Angelika UL et al

in Hennig, J.; Stark, R. (Eds.) Abstractband Psychologie und Gehirn 2018 (2018)

Rationale: Cardiac arrest (CA) is a serious condition characterized by high mortality rates, even after initial successful resuscitation, mainly due to neurological damage. Whether brain-heart ... [more ▼]

Rationale: Cardiac arrest (CA) is a serious condition characterized by high mortality rates, even after initial successful resuscitation, mainly due to neurological damage. Whether brain-heart communication is associated with outcome after CA is unknown. Heartbeat-evoked brain potentials (HEPs) represent neurophysiological indicators of brain-heart communication, as they reflect cortical representation of interoceptive signal processing. The aim of this study was to address the association between HEPs and survival after CA. Methods: HEPs were calculated from resting EEG/ECG in 55 CA patients 24 h after resuscitation. All patients were treated with targeted temperature management and a standardized sedation protocol during assessment. We investigated the association between HEP amplitude (180{320 ms, 455{595 ms, 860{1000 ms) and 6-month survival. Results: Twenty-five of 55 patients (45%) were still alive at 6-month follow-up. Survivors showed a higher HEP amplitude at frontopolar and frontal electrodes in the late HEP interval than non-survivors. This effect remained significant after controlling for between-group differences in terms of age, Fentanyl dose, and time lag between resuscitation and EEG assessment. There were no group differences in heart rate or heart rate variability. Conclusion: Brain-heart communication, as re ected by HEPs, is associated with survival after CA. Cardiovascular autonomic arousal may not be involved in mediating this effect. Adequate cortical representation of interoceptive signals may be essential to preserve cariovascular health and should be in the focus of prevention strategies. Future studies should address the brain-heart axis in CA. [less ▲]

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