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The phrenic component of acute schizophrenia--a name and its physiological reality.

Bär KJ, Rachow T, Schulz S, Bassarab K, Haufe S, Berger S, Koch K, Voss A - PLoS ONE (2012)

Bottom Line: We hypothesized that increased breathing rates and reduced cardio-respiratory coupling in patients with acute schizophrenia would be associated with low vagal function.Cardio-respiratory coupling was reduced in patients only, while HRV was decreased in patients and healthy relatives in comparison to controls.These results are invaluable for researchers studying changes of biological signals prone to the influence of breathing rate and rhythm (e.g., functional imaging).

View Article: PubMed Central - PubMed

Affiliation: Pain and Autonomic Integrative Research, Department of Psychiatry and Psychotherapy, University Hospital, Jena, Germany. Karl-Juergen.Baer@med.uni-jena.de

ABSTRACT
Decreased heart rate variability (HRV) was shown for unmedicated patients with schizophrenia and their first-degree relatives, implying genetic associations. This is known to be an important risk factor for increased cardiac mortality in other diseases. The interaction of cardio-respiratory function and respiratory physiology has never been investigated in the disease although it might be closely related to the pattern of autonomic dysfunction. We hypothesized that increased breathing rates and reduced cardio-respiratory coupling in patients with acute schizophrenia would be associated with low vagal function. We assessed variability of breathing rates and depth, HRV and cardio-respiratory coupling in patients, their first-degree relatives and controls at rest. Control subjects were investigated a second time by means of a stress task to identify stress-related changes of cardio-respiratory function. A total of 73 subjects were investigated, consisting of 23 unmedicated patients, 20 healthy, first-degree relatives and 30 control subjects matched for age, gender, smoking and physical fitness. The LifeShirt®, a multi-function ambulatory device, was used for data recording (30 minutes). Patients breathe significantly faster (p<.001) and shallower (p<.001) than controls most pronouncedly during exhalation. Patients' breathing is characterized by a significantly increased amount of middle- (p<.001), high- (p<.001), and very high frequency fluctuations (p<.001). These measures correlated positively with positive symptoms as assessed by the PANSS scale (e.g., middle frequency: r = 521; p<.01). Cardio-respiratory coupling was reduced in patients only, while HRV was decreased in patients and healthy relatives in comparison to controls. Respiratory alterations might reflect arousal in acutely ill patients, which is supported by comparable physiological changes in healthy subjects during stress. Future research needs to further investigate these findings with respect to their physiological consequences for patients. These results are invaluable for researchers studying changes of biological signals prone to the influence of breathing rate and rhythm (e.g., functional imaging).

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The figure indicates parameters of HRV in patients, relatives and controls.Increased mean heart rates of patients and relatives are depicted in A. Decreased parasympathetic modulation is shown in B by means of the RMSSD and in C using the high frequency band of heart rate. Reduced complexity is shown for patients and relatives in D. Respiratory sinus arrhythmia (E) indicates low cardiac vagal modulation in patients and relatives. Transfer function (F) shows that decreased cardiac vagal modulation in patients and relatives is independent from the respiratory rate. Boxes indicate data between the 25th and 75th percentile with the horizontal bar reflecting the median (□ = mean; - = 1st and 99th percentile; x = minimum and maximum of data). Significant differences of Bonferoni corrected pair-wise comparisons are indicated: * p<.05; ** p<.01; *** p<.001.
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pone-0033459-g002: The figure indicates parameters of HRV in patients, relatives and controls.Increased mean heart rates of patients and relatives are depicted in A. Decreased parasympathetic modulation is shown in B by means of the RMSSD and in C using the high frequency band of heart rate. Reduced complexity is shown for patients and relatives in D. Respiratory sinus arrhythmia (E) indicates low cardiac vagal modulation in patients and relatives. Transfer function (F) shows that decreased cardiac vagal modulation in patients and relatives is independent from the respiratory rate. Boxes indicate data between the 25th and 75th percentile with the horizontal bar reflecting the median (□ = mean; - = 1st and 99th percentile; x = minimum and maximum of data). Significant differences of Bonferoni corrected pair-wise comparisons are indicated: * p<.05; ** p<.01; *** p<.001.

Mentions: A second MANCOVA was applied using the factor GROUP (controls, patients, relatives) for parameters of HRV (mean heart rate, RMMSDHRV, LFHRV, HFHRV, HcHRV and RSA) of relatives, control subjects, and patients suffering from schizophrenia. Age was used as a covariate. ANCOVAs followed by Bonferroni-Holm corrected pair-wise comparisons as post-hoc analyses were performed in a similar way to the analysis of respiratory parameters. Results are indicated in figure 2 and table 2.


The phrenic component of acute schizophrenia--a name and its physiological reality.

Bär KJ, Rachow T, Schulz S, Bassarab K, Haufe S, Berger S, Koch K, Voss A - PLoS ONE (2012)

The figure indicates parameters of HRV in patients, relatives and controls.Increased mean heart rates of patients and relatives are depicted in A. Decreased parasympathetic modulation is shown in B by means of the RMSSD and in C using the high frequency band of heart rate. Reduced complexity is shown for patients and relatives in D. Respiratory sinus arrhythmia (E) indicates low cardiac vagal modulation in patients and relatives. Transfer function (F) shows that decreased cardiac vagal modulation in patients and relatives is independent from the respiratory rate. Boxes indicate data between the 25th and 75th percentile with the horizontal bar reflecting the median (□ = mean; - = 1st and 99th percentile; x = minimum and maximum of data). Significant differences of Bonferoni corrected pair-wise comparisons are indicated: * p<.05; ** p<.01; *** p<.001.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3306403&req=5

pone-0033459-g002: The figure indicates parameters of HRV in patients, relatives and controls.Increased mean heart rates of patients and relatives are depicted in A. Decreased parasympathetic modulation is shown in B by means of the RMSSD and in C using the high frequency band of heart rate. Reduced complexity is shown for patients and relatives in D. Respiratory sinus arrhythmia (E) indicates low cardiac vagal modulation in patients and relatives. Transfer function (F) shows that decreased cardiac vagal modulation in patients and relatives is independent from the respiratory rate. Boxes indicate data between the 25th and 75th percentile with the horizontal bar reflecting the median (□ = mean; - = 1st and 99th percentile; x = minimum and maximum of data). Significant differences of Bonferoni corrected pair-wise comparisons are indicated: * p<.05; ** p<.01; *** p<.001.
Mentions: A second MANCOVA was applied using the factor GROUP (controls, patients, relatives) for parameters of HRV (mean heart rate, RMMSDHRV, LFHRV, HFHRV, HcHRV and RSA) of relatives, control subjects, and patients suffering from schizophrenia. Age was used as a covariate. ANCOVAs followed by Bonferroni-Holm corrected pair-wise comparisons as post-hoc analyses were performed in a similar way to the analysis of respiratory parameters. Results are indicated in figure 2 and table 2.

Bottom Line: We hypothesized that increased breathing rates and reduced cardio-respiratory coupling in patients with acute schizophrenia would be associated with low vagal function.Cardio-respiratory coupling was reduced in patients only, while HRV was decreased in patients and healthy relatives in comparison to controls.These results are invaluable for researchers studying changes of biological signals prone to the influence of breathing rate and rhythm (e.g., functional imaging).

View Article: PubMed Central - PubMed

Affiliation: Pain and Autonomic Integrative Research, Department of Psychiatry and Psychotherapy, University Hospital, Jena, Germany. Karl-Juergen.Baer@med.uni-jena.de

ABSTRACT
Decreased heart rate variability (HRV) was shown for unmedicated patients with schizophrenia and their first-degree relatives, implying genetic associations. This is known to be an important risk factor for increased cardiac mortality in other diseases. The interaction of cardio-respiratory function and respiratory physiology has never been investigated in the disease although it might be closely related to the pattern of autonomic dysfunction. We hypothesized that increased breathing rates and reduced cardio-respiratory coupling in patients with acute schizophrenia would be associated with low vagal function. We assessed variability of breathing rates and depth, HRV and cardio-respiratory coupling in patients, their first-degree relatives and controls at rest. Control subjects were investigated a second time by means of a stress task to identify stress-related changes of cardio-respiratory function. A total of 73 subjects were investigated, consisting of 23 unmedicated patients, 20 healthy, first-degree relatives and 30 control subjects matched for age, gender, smoking and physical fitness. The LifeShirt®, a multi-function ambulatory device, was used for data recording (30 minutes). Patients breathe significantly faster (p<.001) and shallower (p<.001) than controls most pronouncedly during exhalation. Patients' breathing is characterized by a significantly increased amount of middle- (p<.001), high- (p<.001), and very high frequency fluctuations (p<.001). These measures correlated positively with positive symptoms as assessed by the PANSS scale (e.g., middle frequency: r = 521; p<.01). Cardio-respiratory coupling was reduced in patients only, while HRV was decreased in patients and healthy relatives in comparison to controls. Respiratory alterations might reflect arousal in acutely ill patients, which is supported by comparable physiological changes in healthy subjects during stress. Future research needs to further investigate these findings with respect to their physiological consequences for patients. These results are invaluable for researchers studying changes of biological signals prone to the influence of breathing rate and rhythm (e.g., functional imaging).

Show MeSH
Related in: MedlinePlus