Giampaolo Perna1, Alice Riva2, Archie Defillo3, Erika Sangiorgio2, Maria Nobile4, Daniela Caldirola5. 1. Department of Biomedical Sciences, Humanitas University, 20090, Pieve Emanuele, Milan, Italy; Department of Clinical Neurosciences, Hermanas Hospitalarias, Villa San Benedetto Menni Hospital, 22032, Albese con Cassano Como, Italy; Department of Psychiatry and Neuropsychology, Faculty of Health, Medicine and Life Sciences, Maastricht University, 6200, Maastricht, The Netherlands; Department of Psychiatry and Behavioral Sciences, Leonard Miller School of Medicine, Miami University, 33136 -1015, Miami, FL, USA. Electronic address: giampaolo.perna@hunimed.eu. 2. Department of Clinical Neurosciences, Hermanas Hospitalarias, Villa San Benedetto Menni Hospital, 22032, Albese con Cassano Como, Italy. 3. Medibio Limited, United States HQ, 8696 Eagle Creek Circle, Savage, MN 55378, USA. 4. Scientific Institute IRCCS Eugenio Medea, Bosisio Parini 23842, Lecco, Italy. 5. Department of Biomedical Sciences, Humanitas University, 20090, Pieve Emanuele, Milan, Italy; Department of Clinical Neurosciences, Hermanas Hospitalarias, Villa San Benedetto Menni Hospital, 22032, Albese con Cassano Como, Italy.
Abstract
BACKGROUND: Stress resilience influences mental well-being and vulnerability to psychiatric disorders. Usually, measurement of resilience is based on subjective reports, susceptible to biases. It justifies the need for objective biological/physiological biomarkers of resilience. One promising candidate as biomarker of mental health resilience (MHR) is heart rate variability (HRV). The evidence for its use was reviewed in this study. METHODS: We focused on the relationship between HRV (as measured through decomposition of RR intervals from electrocardiogram) and responses to laboratory stressors in individuals without medical and psychiatric diseases. We conducted a bibliographic search of publications in the PubMed for January 2010-September 2018. RESULTS: Eight studies were included. High vagally mediated HRV before and/or during stressful laboratory tasks was associated with enhanced cognitive resilience to competitive/self-control challenges, appropriate emotional regulation during emotional tasks, and better modulation of cortisol, cardiovascular and inflammatory responses during psychosocial/mental tasks. LIMITATIONS: All studies were cross-sectional, restricting conclusions that can be made. Most studies included only young participants, with some samples of only males or females, and a limited array of HRV indexes. Ecological validity of stressful laboratory tasks remains unclear. CONCLUSIONS: Vagally mediated HRV may serve as a global index of an individual's flexibility and adaptability to stressors. This supports the idea of HRV as a plausible, noninvasive, and easily applicable biomarker of MHR. In future longitudinal studies, the implementation of wearable health devices, able to record HRV in naturalistic contexts of real-life, may be a valuable strategy to gain more reliable insight into this topic.
BACKGROUND: Stress resilience influences mental well-being and vulnerability to psychiatric disorders. Usually, measurement of resilience is based on subjective reports, susceptible to biases. It justifies the need for objective biological/physiological biomarkers of resilience. One promising candidate as biomarker of mental health resilience (MHR) is heart rate variability (HRV). The evidence for its use was reviewed in this study. METHODS: We focused on the relationship between HRV (as measured through decomposition of RR intervals from electrocardiogram) and responses to laboratory stressors in individuals without medical and psychiatric diseases. We conducted a bibliographic search of publications in the PubMed for January 2010-September 2018. RESULTS: Eight studies were included. High vagally mediated HRV before and/or during stressful laboratory tasks was associated with enhanced cognitive resilience to competitive/self-control challenges, appropriate emotional regulation during emotional tasks, and better modulation of cortisol, cardiovascular and inflammatory responses during psychosocial/mental tasks. LIMITATIONS: All studies were cross-sectional, restricting conclusions that can be made. Most studies included only young participants, with some samples of only males or females, and a limited array of HRV indexes. Ecological validity of stressful laboratory tasks remains unclear. CONCLUSIONS: Vagally mediated HRV may serve as a global index of an individual's flexibility and adaptability to stressors. This supports the idea of HRV as a plausible, noninvasive, and easily applicable biomarker of MHR. In future longitudinal studies, the implementation of wearable health devices, able to record HRV in naturalistic contexts of real-life, may be a valuable strategy to gain more reliable insight into this topic.
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