Early contingent negative variation of the EEG and attentional flexibility are reduced in hypotension

doi:10.1016/S0167-8760(02)00032-6

International Journal of Psychophysiology

Volume 45, Issue 3, September 2002, Pages 253-260

https://doi.org/10.1016/S0167-8760(02)00032-6 Get rights and content

Abstract

This study explored the question as to whether hypotension is related to decreased attentional performance and reduced cortical activation. A total of 50 females aged 19–44 years participated in the study. Attentional performance was assessed using three subtests of the Attentional and Cognitive Efficiency (ACE) battery. Contingent negative variation (CNV) as a measure of cortical activation was registered during a constant fore-period reaction time paradigm: two conditions were defined using tones as S1 (80 or 60 dB) and S2 (70 dB). The following results were obtained. Hypotensive patients performed significantly more poorly on one subtest of the ACE, which indicates a reduced speed for switching from a routine to a controlled response (quantifying attentional flexibility). They also had longer reaction times and revealed a significantly smaller amplitude of the early CNV component. In addition, a significant correlation was observed between systolic blood pressure and the amplitude of the early CNV component. The data support previous findings that hypotension can be related to lowered cortical activation and indicate that specific aspects of attentional performance might be negatively affected by hypotension.

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Acknowledgements

We thank Prof Dr Thomas Elbert for helpful critical remarks on earlier versions of the manuscript.

References (39)

C.H. Brunia
Movement and stimulus preceding negativity
Biol. Psychol.
(1988)
J.P. Mialet et al.
Two-dimensional anxiety: a confirmation using a computerized neuropsychological testing of attentional performance
Eur. Psychiatry
(1996)
P. Montoya et al.
Heartbeat-evoked potentials (HEP): topography and influence of cardiac awareness and focus of attention
Electroencephalogr. Clin. Neurophysiol.
(1993)
T.F. Sanquist et al.
Slow potential shifts of human brain during forewarned reaction
Electroencephalogr. Clin. Neurophysiol.
(1981)
D. Schalling et al.
Blood pressure and personality
Pers. Individ. Differences
(1984)
G.J. Van Boxtel et al.
Motor and non-motor aspects of slow brain potentials
Biol. Psychol.
(1994)
A. Baddeley
Your Memory. A User's Guide
(1982)
H.W. Baenkler et al.
Innere Medizin
(1999)
D. Berry et al.
Blood pressure and personality
Psychol. Rep.
(1997)
N. Birbaumer et al.
Slow potentials of the cerebral cortex and behavior
Physiol. Rev.
(1990)

R. Brickenkamp

Test d2, Aufmerksamkeits-Belastungs-Test

(1994)

M.W. Chapleau et al.

Peripheral and central mechanisms of baroreflex resetting

Clin. Exp. Pharmacol. Physiol.

(1989)

R.A Cohen et al.

Attentional control: subcortical and frontal lobe influences

M. Costa et al.

Contingent negative variation and cognitive performance in hypotension

Psychophysiology

(1998)

K. Dembowsky et al.

Arterial baroreceptor reflexes

B.R Dworkin et al.

Baroreceptor activation reduces reactivity to noxious stimulation: implications for hypertension

Science

(1979)

T. Elbert et al.

Modulation of slow cortical potentials by instrumentally learned blood pressure responses

Psychophysiology

(1992)

E. Koushanpour

Baroreceptor discharge behavior and resetting

J.I. Lacey

The visceral systems in psychology

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It is prevalent in women and is associated with impaired quality of life and lower mental and somatic well-being [3]. Physiological correlates of chronic hypotension include reduced body weight, creatinine and hemoglobin [4], cortical activation [5,6], cerebral perfusion [7–10], body temperature [4], as well as generalized day- and night-time cardiovascular down-regulation [11–14]. Moreover, several studies revealed that hypotensives suffer from cognitive difficulties, mainly in the attention and memory domains [5,6,10,15–17].
Although low blood pressure has been associated with lower affect and higher depressive symptoms in the elderly, the presence of possible impairment in emotional reactivity in chronic hypotensive individuals in early adulthood remains largely unexplored. Using a combination of transcranial Doppler sonography, beat-to-beat blood pressure recording and impedance cardiography we assessed central and peripheral hemodynamic changes in 15 undergraduate women with chronic hypotension (Age: 23.9 ± 2.7 years) and 15 normotensive controls (Age: 23.7 ± 3.1 years) during sustained exposure to pleasant, unpleasant and neutral pictures. Overall, systolic blood pressure (SBP) increased in normotensives and decreased in hypotensives during picture viewing as compared to baseline. Also, compared to normotensives, in hypotensives mean cerebral blood flow velocity increased to a lesser extent during the viewing of pleasant pictures and the magnitude of this increase was negatively associated with subjective emotional arousal. In addition, in hypotensives screening SBP was positively associated with valence rating of pleasant contents. These findings indicate a close association between chronic low blood pressure and reduced processing of pleasant stimuli in young adulthood.
Cardiac autonomic profile during rest and working memory load in essential hypotensive women
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A slight reduction in cognitive performance (see Table 2) characterized the task performance of hypotensives. Even if there is no strong evidence of a pronounced cognitive impairment related to this condition (see Schatz, 2007), several studies revealed a certain degree of cognitive impairment, first reported by Stegagno et al. (1996) (Costa et al., 1998; Duschek et al., 2007, 2005, 2003; Duschek and Schandry, 2004, 2007; Stegagno et al., 1996; Weisz et al., 2002). Even if we failed to find any significant group differences, an interesting result was the enhanced cognitive performance (an increase in total and target accuracy) exhibited by hypotensives in the morning compared to the evening session.
To our knowledge, no previous study has provided reliable data supporting a different modulation of the Neurovegetative system in essential hypotension. Our purpose was to provide, in essential hypotensive women compared to normotensives, evidence of a distinct sympathetic and parasympathetic cardiac control. Cardiovascular and autonomic indexes derived by impedance cardiography (heart rate, HR; pre-ejection period, PEP), photoplethysmographic technique (blood pressure, BP) and heart rate variability analysis (high and low frequencies power, HF and LF) were continuously collected during rest and mental stress condition. Hypotensives, compared to normotensives, exhibited prolonged PEP (low sympathetic tone) and elevated HF (high vagal involvement) during rest. In addition, they showed cardiovascular (reduced increases in BP and HR) and sympathetic (lower reductions of PEP) hypo-reactivity to the task. Furthermore, a lower sympathetic reactivity in hypotensives was associated to a poorer task performance. Essential hypotension was characterized by a low sympathetic and high parasympathetic tone. In addition, a reduced sympathetic nervous system reactivity suggests the main role of the Neurovegetative system in mediating the relationship between blood pressure and cognitive performance in hypotensives.
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The association between blood pressure and cognitive functioning, for instance, has an inverted u-shape with a decline in performance at both ends of the spectrum (Duschek et al., 2003; Duschek et al., 2005; Qiu et al., 2005; Waldstein et al., 2005). Also, cortical activation, as well as cerebral blood flow have repeatedly been shown to be reduced both in individuals with elevated and low blood pressure (Baumbach and Heistad, 1988; Duschek and Schandry, 2004; Duschek et al., 2006; Hajdu and Baumbach, 1994; Stegagno et al., 2007; Weisz et al., 2002). As a secondary aim, the study investigated a possible link between the function of the arterial baroreceptor system and the perception of heat pain.
While in elevated blood pressure reduced sensitivity to acute pain has been well established, little is known about possible alterations in pain perception within the lower range of blood pressure. In this study, sensitivity to heat pain was assessed in 40 subjects with chronic hypotension (mean blood pressure 96.5/57.7 mmHg) and 40 normotensive control persons (mean blood pressure 121.8/77.2 mmHg). Employing a contact thermode, heat stimuli were applied to the forearm. Pain threshold and tolerance were determined. Participants furthermore rated subjective intensities and unpleasantness of tonic heat stimuli (45.5–47.5 °C) on visual analogue scales and in a questionnaire. Possible confounding of sensitivity to heat pain with skin temperature, temperature sensitivity and mood was controlled for. In addition to blood pressure, functional features of the arterial baroreceptor system were related to pain experience. Therefore, estimates for the input on the baroreceptors, as well as baroreflex sensitivity were obtained. Hypotensive individuals exhibited markedly reduced pain threshold and pain tolerance, as well as increased sensory and affective pain experience. The measures related to the baroreceptor system were not associated with pain experience, suggesting that no significant modulation of heat pain occurs through this system. The results of this study complete the findings on hypertension-related hypoalgesia and suggest an inverse relationship between blood pressure and pain sensitivity across the whole blood pressure spectrum. Furthermore, increased proneness of hypotensive individuals to clinical pain may be discussed.
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A number of studies have provided evidence for reduced cognitive performance due to chronically low blood pressure. The present studies explored whether these deficits can be reduced by pharmacological blood pressure elevation. Effects of the Camphor–Crataegus berry extract combination (Korodin^®) were investigated in two studies with 40 and 48 hypotensive women based on a randomized, placebo controlled double blind design. The participants were presented with different tasks assessing performance in attention and cognition. Blood pressure was measured repeatedly during the experiment.
The administration of the drug led to positive and differential effects on blood pressure and cognitive performance as compared to placebo. These effects were already visible within the time range of 2–5 min. A positive correlation between blood pressure increase and performance enhancement could be demonstrated for two of the four tasks.
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The present study explored the impact of pharmacological blood pressure elevation on cortical activation and reaction time in chronic hypotension. Effects of the sympathomimetic etilefrine were investigated in 50 hypotensive persons based on a randomized, placebo-controlled double blind design. As an indicator of cortical excitability, the contingent negative variation (CNV), induced by a constant foreperiod reaction time task, was assessed at frontal (F3, Fz, F4) and central (C3, Cz, C4) scalp sites. Etilefrine provoked a decrease in the frontal and central CNV. In contrast, shorter reaction times were observed following drug administration. The degree of pharmacologically induced blood pressure elevation was correlated to CNV attrition as well as to performance enhancement. Inhibitory effects of baroreceptor activation on cortical excitability and enhanced cerebral blood flow are considered to be involved in mediating the effects of blood pressure elevation on cerebral functioning. Implications for the treatment of chronic hypotension are discussed.

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Short communicationEarly contingent negative variation of the EEG and attentional flexibility are reduced in hypotension

Abstract

Section snippets

Acknowledgements

Biol. Psychol.

Eur. Psychiatry

Electroencephalogr. Clin. Neurophysiol.

Electroencephalogr. Clin. Neurophysiol.

Pers. Individ. Differences

Biol. Psychol.

Your Memory. A User's Guide

Innere Medizin

Blood pressure and personality

Psychol. Rep.

Slow potentials of the cerebral cortex and behavior

Physiol. Rev.

Test d2, Aufmerksamkeits-Belastungs-Test

Peripheral and central mechanisms of baroreflex resetting

Clin. Exp. Pharmacol. Physiol.

Attentional control: subcortical and frontal lobe influences

Contingent negative variation and cognitive performance in hypotension

Psychophysiology

Arterial baroreceptor reflexes

Baroreceptor activation reduces reactivity to noxious stimulation: implications for hypertension

Science

Modulation of slow cortical potentials by instrumentally learned blood pressure responses

Psychophysiology

Baroreceptor discharge behavior and resetting

The visceral systems in psychology

Short communication
Early contingent negative variation of the EEG and attentional flexibility are reduced in hypotension