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Higher heart rate variability (HRV) at rest is associated with better emotion regulation ability. While the neurovisceral integration model explains this by postulating that HRV can index how the brain adaptively modulates responses to emotional stimuli, neuroimaging studies directly supporting this idea are scarce. We examined the neural correlates of regulating negative and positive emotion in relation to resting HRV based on the neuroimaging and heart rate data of one hundred young adults. The results showed that those with higher HRV better recruit the medial prefrontal cortex while intensifying positive compared to negative emotion. We also examined how individual differences in resting HRV are associated with adjusting brain activity to repeated emotional stimuli. During repeated viewing of emotional images, subjects with higher resting HRV better reduced activity in the medial prefrontal cortex, posterior cingulate gyrus, and angular gyrus, most of which overlapped with the default mode network. This HRV-DMN association was observed during passively viewing emotional images rather than during actively regulating emotion. While the regulating trials can better detect task-induced changes, the viewing trials might approximate resting state, better revealing individual differences. These findings suggest two possibilities: people with higher resting HRV might have a tendency to spontaneously engage with emotion regulation or possess a trait helping emotional arousal fade away.

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Conceptual models of psychosocial influences on short-term changes (i.e., reactivity) in vagally-mediated heart rate variability (vmHRV) emphasize self-regulatory effort and social threat versus comfort. However, these two general perspectives have been tested separately in nearly all cases, limiting conclusions about the relative importance or possible interactive effects of effortful self-regulation and social stress. The present study compared effects of effort to regulate emotional expression and social stress versus safety on vmHRV reactivity during an interpersonal interaction, in a 2 (self-regulate emotion vs. express emotion freely) × 3 (positive vs. neutral vs. negative interaction valence) × 2 (male vs. female) between-subjects randomized factorial design. A sample of 180 undergraduates (90 women; 69 % White) discussed a current events topic (i.e., human-caused climate change) with a prerecorded partner, presented as a live interaction over a computer. Self-reports of affective responses, self-regulation effort, and appraisals of the partner's behavior, as well as observer ratings of participants' behavior during the interaction, supported the effectiveness of self-regulation and interaction valence manipulations, although the former manipulation may have been somewhat weaker than the latter. Primary analyses of high-frequency heart rate variability (HF-HRV) and root mean square of successive differences (RMSSD) in heart beat intervals recorded at baseline and during the interaction revealed larger decreases in vmHRV during negative than neutral or positive interactions, but no effects of self-regulation instructions. Overall, results indicated more robust effects of social stress on vmHRV reactivity, relative to effects of self-regulatory effort.

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The Neurovisceral Integration Model posits that shared neural networks support the effective regulation of emotions and heart rate, with heart rate variability (HRV) serving as an objective, peripheral index of prefrontal inhibitory control. Prior neuroimaging studies have predominantly examined both HRV and associated neural functional connectivity at rest, as opposed to contexts that require active emotion regulation. The present study sought to extend upon previous resting-state functional connectivity findings, examining task-related HRV and corresponding amygdala functional connectivity during a cognitive reappraisal task. Seventy adults (52 older and 18 younger adults, 18-84 years, 51% male) received instructions to cognitively reappraise negative affective images during functional MRI scanning. HRV measures were derived from a finger pulse signal throughout the scan. During the task, younger adults exhibited a significant inverse association between HRV and amygdala-medial prefrontal cortex (mPFC) functional connectivity, in which higher task-related HRV was correlated with weaker amygdala-mPFC coupling, whereas older adults displayed a slight positive, albeit non-significant correlation. Furthermore, voxelwise whole-brain functional connectivity analyses showed that higher task-based HRV was linked to weaker right amygdala-posterior cingulate cortex connectivity across older and younger adults, and in older adults, higher task-related HRV correlated positively with stronger right amygdala-right ventrolateral prefrontal cortex connectivity. Collectively, these findings highlight the importance of assessing HRV and neural functional connectivity during active regulatory contexts to further identify neural concomitants of HRV and adaptive emotion regulation.

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BACKGROUND: This study examined the connection between two prominent deficits in schizophrenia: the deficit in parasympathetic regulation and the deficit in cognitive inhibitory control, within the framework of the Neurovisceral Integration Model (NIM). STUDY DESIGN: Thirty healthy controls and 30 patients with schizophrenia performed the internationally standardized antisaccade protocol while their electrocardiographic data were recorded. The interaction between the group, the cognitive inhibitory control as measured with error rate (ER) in the antisaccade task and parasympathetic activity as measured with the High Frequency power component of Heart Rate Variability (HF-HRV) was tested. STUDY RESULTS: Findings confirmed that decreased HF-HRV was specifically related to increased ER in patients with schizophrenia. In contrast, patient deficits in other oculomotor function measures such as reaction time and reaction time variability related to volitional movement control and cognitive stability respectively were not linked to the deficit in parasympathetic regulation. CONCLUSIONS: Our study validates the theory behind NIM proposing that cognitive inhibition has common physiological substrate with parasympathetic regulation. Future research could test this brain-heart link in other mental disorders especially those with a prominent deficit in inhibitory cognitive function.

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Several studies have suggested a correlation between heart rate variability (HRV), emotion regulation (ER), psychopathological conditions, and cognitive functions in the past two decades. Specifically, recent data seem to support the hypothesis that low-frequency heart rate variability (LF-HRV), an index of sympathetic cardiac control, correlates with worse executive performances, worse ER, and specific psychopathological dimensions. The present work aims to review the previous findings on these topics and integrate them from two main cornerstones of this perspective: Porges' Polyvagal Theory and Thayer and Lane's Neurovisceral Integration Model, which are necessary to understand these associations better. For this reason, based on these two approaches, we point out that low HRV is associated with emotional dysregulation, worse cognitive performance, and transversal psychopathological conditions. We report studies that underline the importance of considering the heart-brain relation in order to shed light on the necessity to implement psychophysiology into a broader perspective on emotions, mental health, and good cognitive functioning. This integration is beneficial not only as a theoretical ground from which to start for further research studies but as a starting point for new theoretical perspectives useful in clinical practice.

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Mental fatigue alters cognitive performance and autonomic regulation. The neurovisceral model proposes that forebrain structures associated to cognitive control abilities influences heart rate variability. Parasympathetic mediated heart rate variability indices reduction during mental fatigue experience is well-described in previous studies, but the contribution of heart-brain axis to cardiac autonomic adaptation remains unknown. This study investigates the association between root mean square of successive differences between RR intervals (rMSSD) and N2 event-related potential component during visual prolonged odd/ball task (≅ 60min.). The comparison between task blocks shows that rMSSD (p = 0.004) and N2 (p = 0.04) decreased with time on task. Pearson correlation shows that ΔrMSSD is associated with ΔN2 (p = 0.007). Our results support the neurovisceral integration model showing that cognitive control contributes to cardiac autonomic tone adaptation during mental fatigue experience.

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Heart rate variability (HRV) rapidly gains attention as an important marker of cardiovascular autonomic modulation. Moreover, there is evidence for a link between the autonomic deficit measurable by reduced HRV and the hypoactivity of the cholinergic system, which is prominently affected in Alzheimer's disease (AD). Despite the positive influence of physical exercise on cognition and its promising association with HRV, previous studies did not explore the effect of long-term physical exercise in older adults with AD. Taking advantage of a longitudinal study we analyzed the effect of a 20-week dual task training regime (3 × 15-min per week) on the vagal mediated HRV index RMSSD (root mean square of successive RR interval differences) during physical exercise and the short-term memory performance in a AD cohort (N = 14). Each training contained physical exercise on a bicycle ergometer while memorizing 30 successively presented pictures as well as the associated post-exercise picture recognition memory test. Linear-mixed modeling revealed that HRV-RMSSD significantly increased over the intervention time. Moreover, the reaction time in the picture recognition task decreased while the accuracy remained stable. Furthermore, a significantly negative relationship between increased fitness measured by HRV-RMSSD and decreased reaction time was observed. This feasibility study points to the positive effects of a dual task regime on physical and cognitive fitness in a sample with impaired cognitive performance. Beyond this, the results show that the responsiveness of parasympathetic system as measured with HRV can be improved in patients with dementia.

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Decision-making is one of the most crucial cognitive processes in daily life. An adaptable, rapid, and flexible decision requires integration between brain and body. Heart rate variability (HRV) indexes this brain-body connection and appears to be related to cognitive performance. However, its relationship with decision-making is poorly analyzed. This study investigates the relationship between HRV and the decision-making process, assessed through the Iowa Gambling Task (IGT). One hundred and thirty healthy university students (mean age = 23.35 ± 2.50) participated in the study. According to IGT performance, they were divided into high decision-makers (n = 79) and low decision-makers (n = 51). Heart rate variability was measured in the resting, reactivity (i.e., during IGT), and recovery phases. Higher vagally mediated HRV (vmHRV; indexed in frequency domain measures) was evidenced in good decision-makers in the resting, reactivity, and recovery phases. During the task, a higher vagal modulation after a first evaluation was highlighted in good decision-makers. In conclusion, HRV proves to be a valid index of inhibitory circuit functioning in the prefrontal cortex. The relationship with cognitive functions was also confirmed, considering the ability to inhibit disadvantageous responses and make better decisions.

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Efforts in optimizing transcutaneous vagus nerve stimulation (tVNS) are crucial to further develop its potential in improving cognitive and autonomic regulation. The present study focused on this topic. The aim was to compare for the first time the main stimulation areas of the ear currently used in studies with tVNS, taking cognitive as well as neurophysiological effects into account. The main areas to be compared with one another were tragus, cymba conchae, and earlobe (sham) stimulation. Post-error slowing, which has already been shown to be influenced by tVNS, was used to investigate the cognitive effects of tVNS when applied on the different auricular areas. On the neurophysiological level, we measured pupillary responses as an index of norepinephrine activity during post-error slowing, and cardiac vagal activity to investigate the activation of neural pathways involved in post-error slowing. Stimulation of different auricular areas led to no differences in post-error slowing and in pupillary responses. However, the neurological processes involved in post-error slowing could be observed, since norepinephrine activity increased after committing an error. Further, there was an increase in cardiac vagal activity over the test period that was independent of the stimulation areas. The results suggest that tVNS targeting the ear might have a non-specific effect on the processing of error commission, on pupillary responses, and on cardiac vagal activity. We conclude that it is necessary to consider alternatives for sham conditions other than electrical earlobe stimulation.

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BACKGROUND: Individuals are able to perform goal-directed behaviors thanks to executive functions. According to the neurovisceral integration model, executive functions are upregulated by brain areas such as the prefrontal and cingulate cortices, which are also crucially involved in controlling cardiac vagal activity. An array of neuroimaging studies already showed that these same brain areas are activated by transcutaneous vagus nerve stimulation (tVNS). Despite evidence toward effects of tVNS on specific executive functions such as inhibitory control, there have been no studies investigating what type of inhibition is improved by tVNS by systematically addressing them within the same experiment. Furthermore, the effect of tVNS on another core executive function, cognitive flexibility, has not yet been investigated. OBJECTIVE: We investigated the effects of tVNS on core executive functions such as inhibitory control and cognitive flexibility. METHODS: Thirty-two participants (nine women, M age = 23.17) took part in this study. Vagally mediated heart rate variability parameters (root mean square of successive differences, RMSSD, and high frequency, HF) were measured while participants performed four different cognitive tasks that mainly rely on different aspects of both the aforementioned executive functions. RESULTS: Despite clear conflict effects in the four tasks, only performance on the task used to measure set-shifting paradigm was improved by tVNS, with switch costs being lower during tVNS than during sham stimulation. Furthermore, HF increased during each of the cognitive flexibility tasks, although HF during tVNS did not differ from HF during sham stimulation. CONCLUSION: The results indicate for the first time (a) that tVNS can increase cognitive flexibility in a set-shifting paradigm, and (b) that tVNS may exert a stronger effect on cognitive flexibility than inhibition. The present study provides only partial evidence for the neurovisceral integration model. Future studies should address further paradigms that demand cognitive flexibility, thus investigating this new hypothesis on the specificity of the tVNS effects on cognitive flexibility.

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The cortical and subcortical circuit regulating both cognition and cardiac autonomic interactions are already well established. This circuit has mainly been analyzed from cortex to heart. Thus, the heart rate variability (HRV) is usually considered a reflection of cortical activity. In this paper, we investigate whether HRV changes affect cortical activity. Short-term local autonomic changes were induced by three breathing strategies: spontaneous (Control), normal (NB) and slow paced breathing (SB). We measured the performance in two cognition domains: executive functions and processing speed. Breathing maneuvres produced three clearly differentiated autonomic states, which preconditioned the cognitive tasks. We found that the SB significantly increased the HRV low frequency (LF) power and lowered the power spectral density (PSD) peak to 0.1[Formula: see text]Hz. Meanwhile, executive function was assessed by the working memory test, whose accuracy significantly improved after SB, with no significant changes in the response times. Processing speed was assessed by a multitasking test. Consistently, the proportion of correct answers (success rate) was the only dependent variable affected by short-term and long-term breath pacing. These findings suggest that accuracy, and not timing of these two cognitive domains would benefit from short-term SB in this study population.

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PURPOSE: Humans evolved within the mammalian line as a highly social species. Indeed, sociality has been a major driver of human social intelligence. From birth, social relationships have emotional and self-regulating properties and operate through different body systems. This paper will explore how heart rate variability (HRV), an index of the vagal regulation of the heart and a central element of the physiological underpinnings of sociality, is related to mental health problems, with important implications for psychotherapy. METHODS: We conducted a narrative review of the literature on the bi-directional links between prosocial motivations, HRV, and psychophysiological functioning. RESULTS: HRV is associated not only with the ability to downregulate physiological arousal, but also with a variety of psychological and behavioural variables which are usually the target of psychotherapeutic interventions. A modern neurovisceral integration model can be employed to explain the complex intercorrelation between HRV and psychophysiological functioning. In particular, the link between HRV, the experience of inter- and intrapersonal safeness, and the inhibitory function of the prefrontal cortex will be explored in the context of prosocial motives, such as compassion, that alleviate and help prevent mental health difficulties. CONCLUSIONS: Our knowledge of the social brain and its physiological underpinnings might influence important elements of a therapeutic intervention, from the initial assessment of patient's difficulties to the evaluation of therapy outcomes. PRACTITIONER POINTS: Social relationships have emotional and self-regulating properties. The experience of inter- and intrapersonal safeness is connected to prosocial motives, such as compassion, and the inhibitory function of the prefrontal cortex. Social relationships and compassion influence different body systems, such as the vagus nerve. Many forms of psychopathology represent the activation of evolved, defensive strategies especially in contexts where there are few stimuli indicating safeness and social support. Heart rate variability predicts psychotherapy outcome.

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Breathing techniques are part of traditional relaxation methods; however, their influence on psychophysiological variables related to sleep is still unclear. Consequently, the aim of this paper was to investigate the influence of a 30-day slow-paced breathing intervention compared to social media use on subjective sleep quality and cardiac vagal activity (CVA, operationalized via high-frequency heart rate variability). Healthy participants (n = 64, 33 male, 31 female, M = 22.11, SD = 3.12) were randomly allocated to an experimental or control group. In the experimental group, they had to perform slow-paced breathing for 15 min each evening across a 30-day period. This was administered through a smartphone application. The control group used social media (e.g., Facebook, Instagram, Whatsapp) for the same duration. The night before and after the intervention, their CVA was assessed via a light portable Electrocardiogram (ECG) device, and they had to fill out the Pittsburgh Sleep Quality Index questionnaire. Results showed that in comparison to the use of social media, the slow-paced breathing technique improved subjective sleep quality and increased overnight CVA, while a tendency was observed for morning awakening CVA. Slow-paced breathing appears a promising cost-effective technique to improve subjective sleep quality and cardiovascular function during sleep in young healthy individuals.

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Heart rate variability (HRV) indexes functioning of the vagus nerve, arguably the most important nerve in the human body. The Neurovisceral Integration Model has provided a structural framework for understanding brain-body integration, highlighting the role of the vagus in adaptation to the environment. In the present paper, we emphasise a temporal framework in which HRV may be considered a missing, structural link between psychological moments and mortality, a proposal we label as Neurovisceral Integration Across a Continuum of Time (or NIACT). This new framework places neurovisceral integration on a dimension of time, highlighting implications for lifespan development and healthy aging, and helping to bridge the gap between clearly demarcated disciplines such as psychology and epidemiology. The NIACT provides a novel framework, which conceptualizes how everyday psychological moments both affect and are affected by the vagus in ways that have long-term effects on mortality risk. We further emphasize that a longitudinal approach to understanding change in vagal function over time may yield novel scientific insights and important public health outcomes.

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OBJECTIVE: To investigate placebo effects on heart rate (HR) and heart rate variability (HRV) in recovery from a psychosocial stressor. METHODS: A healthy sample underwent two mental arithmetic stress tests in one experimental session. After undergoing the baseline test, participants were randomized into control or placebo groups. Prior to the second stress test, the placebo group received an intranasal dose of 'serotonin' (placebo) with the suggestion that it would enhance recovery. HR and HRV were assessed throughout procedures. RESULTS: There was an increase in vagally-mediated HRV in the placebo group. The change in HR did not differ between groups. CONCLUSIONS: Placebo suggestion can enhance autonomic recovery after psychosocial stress. Findings are consistent with the notion of top-down mechanisms of placebo effects, but further research would need to specifically examine the role of top-down regulatory pathways as possible mediators of placebo-induced changes in autonomic function.

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The aim of this study was twofold: first, to examine the influence of decision reinvestment on decision-making performance using an option-generation task, and second to investigate its neurophysiological basis with heart rate variability. Forty-two male participants performed an option-generation task (i.e., where participants are required to generate their own options rather than being asked to decide from a set of options) under low- and high-pressure conditions. Results showed that the decision-making performance of low and high decision reinvesters was similar in the low-pressure condition, however in the high-pressure condition low reinvesters decided faster than their high reinvester counterparts. Moreover, we found that the pressure-induced reduction in parasympathetic activity was more pronounced in high reinvesters in comparison to low reinvesters. Findings are interpreted in light of the neurovisceral integration model, assuming a positive relationship between cognitive performance and parasympathetic activity. These findings offer a physiological insight into a psychological phenomenon and may also suggest a way to counteract the detrimental effects of decision reinvestment by utilizing interventions that target the parasympathetic activity, such as heart rate variability biofeedback.

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