Cardio-respiratory coupling indicates suppression of vagal activity in acute schizophrenia

Altered amygdala activity in patients with schizophrenia can influence respiratory patterns and consequently cardiovascular parameters. Hence, we examined respiration and heart rate time series complexity as well as coupling of both signals. Electrocardiograms and respiratory signals were obtained from 25 unmedicated patients with schizophrenia and controls. Approximate entropy (ApEn) was calculated for heart and respiratory rates as well as cross-ApEn reflecting coupling of both signals. Coupling was decreased indicating diminished vagal modulation at the brain stem level. Regularity of breathing correlated with disease severity. These data might reflect a lack of inhibitory control over brainstem centers in schizophrenia.

[1]  S M Pincus,et al.  Approximate entropy as a measure of system complexity. , 1991, Proceedings of the National Academy of Sciences of the United States of America.

[2]  H. Sauer,et al.  Decreased baroreflex sensitivity in acute schizophrenia. , 2007, Journal of applied physiology.

[3]  H. Kazemi,et al.  Acetylcholine and central respiratory control: perturbations of acetylcholine synthesis in the isolated brainstem of the neonatal rat , 1995, Brain Research.

[4]  J. Feldman,et al.  PreBötzinger complex and pacemaker neurons: hypothesized site and kernel for respiratory rhythm generation. , 1998, Annual review of physiology.

[5]  I. Homma,et al.  Breathing rhythms and emotions , 2008, Experimental physiology.

[6]  Sandy Berger,et al.  Acute psychosis leads to increased QT variability in patients suffering from schizophrenia , 2007, Schizophrenia Research.

[7]  A. Malliani,et al.  Heart rate variability. Standards of measurement, physiological interpretation, and clinical use , 1996 .

[8]  K. Bär,et al.  Non-linear complexity measures of heart rate variability in acute schizophrenia , 2007, Clinical Neurophysiology.

[9]  M. Tancer,et al.  Nonlinear Measures of Respiration: Respiratory Irregularity and Increased Chaos of Respiration in Patients with Panic Disorder , 2002, Neuropsychobiology.

[10]  D. Johnson,et al.  The central respiratory effects of acetylcholine vary with CSF pH. , 1997, Journal of the autonomic nervous system.

[11]  D L Eckberg,et al.  Sympathetic restraint of respiratory sinus arrhythmia: implications for vagal-cardiac tone assessment in humans. , 2001, American journal of physiology. Heart and circulatory physiology.

[12]  S. Kay,et al.  The positive and negative syndrome scale (PANSS) for schizophrenia. , 1987, Schizophrenia bulletin.

[13]  H. Kazemi,et al.  Ventilatory output and acetylcholine: perturbations in release and muscarinic receptor activation. , 1994, Journal of applied physiology.

[14]  Dirk Hoyer,et al.  Altered diurnal autonomic variation and reduced vagal information flow in acute schizophrenia , 2006, Clinical Neurophysiology.

[15]  G. Breithardt,et al.  Heart rate variability: standards of measurement, physiological interpretation and clinical use. Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology. , 1996 .

[16]  G. Wagner,et al.  Loss of efferent vagal activity in acute schizophrenia. , 2005, Journal of psychiatric research.

[17]  Andreas Voss,et al.  The interaction between pupil function and cardiovascular regulation in patients with acute schizophrenia , 2008, Clinical Neurophysiology.

[18]  I. Homma,et al.  Effects of Left Amygdala Lesions on Respiration, Skin Conductance, Heart Rate, Anxiety, and Activity of the Right Amygdala During Anticipation of Negative Stimulus , 2003, Behavior modification.

[19]  Leanne M Williams,et al.  Dysregulation of arousal and amygdala-prefrontal systems in paranoid schizophrenia. , 2004, The American journal of psychiatry.

[20]  S. Pincus,et al.  Assessing sequential irregularity of both endocrine and heart rate rhythms. , 1998, Current opinion in obstetrics & gynecology.

[21]  M. First,et al.  Structured clinical interview for DSM-IV axis I disorders : SCID-I : clinical version : scoresheet , 1997 .

[22]  J. Feldman,et al.  Modulation of respiratory frequency by peptidergic input to rhythmogenic neurons in the preBötzinger complex. , 1999, Science.

[23]  R Balon,et al.  Fractal dimension of heart rate time series: an effective measure of autonomic function. , 1993, Journal of applied physiology.

[24]  Steven M. Pincus Assessing Serial Irregularity and Its Implications for Health , 2001, Annals of the New York Academy of Sciences.

[25]  P. Lalley Opioidergic and dopaminergic modulation of respiration , 2008, Respiratory Physiology & Neurobiology.

[26]  N. Andreasen,et al.  Correlational studies of the Scale for the Assessment of Negative Symptoms and the Scale for the Assessment of Positive Symptoms: an overview and update. , 1995, Psychopathology.

[27]  J D Veldhuis,et al.  Females secrete growth hormone with more process irregularity than males in both humans and rats. , 1996, The American journal of physiology.

[28]  M. Haxhiu,et al.  CNS innervation of vagal preganglionic neurons controlling peripheral airways: a transneuronal labeling study using pseudorabies virus. , 1999, Journal of the autonomic nervous system.

[29]  S M Pincus,et al.  Irregularity and asynchrony in biologic network signals. , 2000, Methods in enzymology.

[30]  K Miyoshi,et al.  The influence of psychotic states on the autonomic nervous system in schizophrenia. , 1998, International journal of psychophysiology : official journal of the International Organization of Psychophysiology.

[31]  Steven M. Pincus,et al.  Older males secrete luteinizing hormone and testosterone more irregularly, and jointly more asynchronously, than younger males. , 1996, Proceedings of the National Academy of Sciences of the United States of America.

[32]  Ki H Chon,et al.  Chemical activation of pre-Bötzinger complex in vivo reduces respiratory network complexity. , 2005, American journal of physiology. Regulatory, integrative and comparative physiology.

[33]  M. Toichi,et al.  Influences of an Anticholinergic Antiparkinsonian Drug, Parkinsonism, and Psychotic Symptoms on Cardiac Autonomic Function in Schizophrenia , 2003, Journal of clinical psychopharmacology.