Autonomic Cardiovascular Control in Children and Adolescents

This thesis investigated the impact of pubertal maturation and sex on cardiovagal baroreflex sensitivity (BRS) and arterial properties of the common carotid artery (CCA), and the relationship between CCA arterial properties and BRS. This thesis also investigated the effect of orthostatic stress on arterial properties of the CCA and carotid sinus (CS), as well as their impact on BRS in response to orthostatic stress. Children and adolescents between the ages of 8-18 years were examined. To assess pubertal maturation participants were organized into five pubertal groups based on the criteria of Tanner. BRS was assessed by transfer function analysis in the low frequency range (0.05 – 0.15Hz). Pulse pressure (PP) was measured at the CCA (PPCCA) and CS (PPCS) using applanation tonometry, and at the finger (PPFinger) using photoplethysmography. Ultrasound sonography and applanation tonometry were used to determine the distensibility coefficient (DC) at the CCA (DCCCA) and CS (DCCS). A moderate posture stimulus was implemented by passively moving participants into a 50° seated-recumbent (SR) position. The results demonstrated a sex-by-maturation interaction on BRS (p= 0.019). BRS decreased from early- to post-puberty in males (p<0.01), and remained unchanged in females. Females demonstrated greater BRS compared to males post-puberty (p<0.05). CCA distensibility was not affected by sex or maturation and was not related to BRS. PPCS was greater than PPCCA (p<0.001), while PPFinger was greater than both PPCCA (p<0.001) and PPCS (p<0.001). In response to SR, the relative change in PPFinger was significantly different than the relative change in PPCCA (p<0.001) and PPCS (p<0.001), while the relative change between PPCCA and PPCS were not different. Finally, in response to SR there was a significant decrease in DCCS (p=0.001), but not DCCCA. The relative change in BRS in response to SR was significantly correlated to the relative change in DCCS (p=0.004), but not DCCCA. The findings demonstrated an important sex-dependent maturation effect on BRS in children and adolescents that was not explained by CCA distensibility. Also, the CS and CCA responded differently to orthostatic stress. The CS was more suitable to evaluate the effect of arterial distensibility on BRS in response to posture change.

The Influence of Sex on the Relationship Between Arterial Mechanical Properties and Cardiovagal Baroreflex Sensitivity

Cardiovagal baroreflex sensitivity (cvBRS) demonstrates a strong relationship with arterial mechanical properties. Both cvBRS and arterial mechanics differ by sex such that males demonstrate greater cvBRS, yet lower large artery elasticity than females. Whether the relationship between cvBRS and arterial mechanics is similar in males and females remains unexamined. As a result, it is unclear whether arterial mechanics contribute to sex differences in cvBRS. This study investigated the cross-sectional relationship between cvBRS and arterial mechanical properties of the common carotid, carotid sinus and aortic arch (AA) in 36 (18 females) young, healthy normotensives. The cvBRS-arterial mechanics relationship did not reach statistical significance and did not differ by sex. Both cvBRS and AA distensibility were greater in females than males. Sex differences in cvBRS were eliminated after controlling for AA distensibility. These findings suggest that in this sample, AA elasticity may contribute to the greater cvBRS in females than males.

Cortical and autonomic modulation of attentional control /

Whereas the role of the anterior cingulate cortex (ACC) in cognitive control has received considerable attention, much less work has been done on the role of the ACC in autonomic regulation. Its connections through the vagus nerve to the sinoatrial node of the heart are thought to exert modulatory control over cardiovascular arousal. Therefore, ACC is not only responsible for the implementation of cognitive control, but also for the dynamic regulation of cardiovascular activity that characterizes healthy heart rate and adaptive behaviour. However, cognitive control and autonomic regulation are rarely examined together. Moreover, those studies that have examined the role of phasic vagal cardiac control in conjunction with cognitive performance have produced mixed results, finding relations for specific age groups and types of tasks but not consistently. So, while autonomic regulatory control appears to support effective cognitive performance under some conditions, it is not presently clear just what factors contribute to these relations. The goal of the present study was, therefore, to examine the relations between autonomic arousal, neural responsivity, and cognitive performance in the context of a task that required ACC support. Participants completed a primary inhibitory control task with a working memory load embedded. Pre-test cardiovascular measures were obtained, and ontask ERPs associated with response control (N2/P3) and error-related processes (ERN/Pe) were analyzed. Results indicated that response inhibition was unrelated to phasic vagal cardiac control, as indexed by respiratory sinus arrhythmia (RSA). However, higher resting RSA was associated with larger ERN ampUtude for the highest working memory load condition. This finding suggests that those individuals with greater autonomic regulatory control exhibited more robust ACC error-related responses on the most challenging task condition. On the other hand, exploratory analyses with rate pressure product (RPP), a measure of sympathetic arousal, indicated that higher pre-test RPP (i.e., more sympathetic influence) was associated with more errors on "catch" NoGo trials, i.e., NoGo trials that simultaneously followed other NoGo trials, and consequently, reqviired enhanced response control. Higher pre-test RPP was also associated with smaller amplitude ERNs for all three working memory loads and smaller ampUtude P3s for the low and medium working memory load conditions. Thus, higher pretest sympathetic arousal was associated with poorer performance on more demanding "catch" NoGo trials and less robust ACC-related electrocortical responses. The findings firom the present study highlight tiie interdependence of electrocortical and cardiovascular processes. While higher pre-test parasympathetic control seemed to relate to more robust ACC error-related responses, higher pre-test sympathetic arousal resulted in poorer inhibitory control performance and smaller ACC-generated electrocortical responses. Furthermore, these results provide a base from which to explore the relation between ACC and neuro/cardiac responses in older adults who may display greater variance due to the vulnerabihty of these systems to the normal aging process.

Non-invasive measurement of trigeminal nerve somatosensory evoked potentials

Whiplash injuries are common yet enigmatic to substantiate clinically. Trigeminal somatosensory evoked potentials (TSEPs) were posited as an indicator of trigeminal nerve conduction damage resulting from whiplash. Alternating polarity square-wave current stimuli were applied transcutaneously in the facial region. 379 recorded pilot trials from 27 participants (8 male and 19 female) were utilized to develop a non-invasive recording capability for TSEPs. Stimulus intensity and artifact, cortical recording sites, stimulation electrode design and placement were explored. Statistically significant differences in amplitude of TSEP waveform components at 13, 19 and 27 ms between uninjured and whiplashed participants were noted. Increased stimulus intensity in whiplashed participants was observed to increase TSEP amplitude. The present methodology and hardware are discussed and directions for future advancement of the current process are outlined.

The acute effects of systemic cytokines on peripheral nerve function in humans

Cytokines have been shown to cause a reduction in nerve conduction when examined using animal models. Such effects, if shown in humans, could result in detrimental effects to physical function during periods heightened systemic cytokine concentrations. The study investigated the acute effects of cytokines on nerve conduction velocity (NCV) and functional measures. Measures were taken under both basal and elevated cytokine concentrations to determine any corresponding changes to NCV. A significant positive correlation was found between the cytokine IL-6 and NCV at 2 hours post-exercise (r=0.606, p=0.048). A significant negative correlation was found between IL-1ra and NCV at 24 hours post-exercise (r=-0.652, p=0.021). A significant positive correlation was also found between IL-1ra and endurance at 1 hour post-exercise (r=0.643, p=0.033). As such, it would seem that IL-6 may potentially act to enhance nerve function while other cytokines such as IL-1ra may have negative effects and reduce NCV.

Respiratory Sinus Arrhythmia and Emotional Responding to Dyadic Discussions of a Disagreement as Predictors of Helping Related Subjective Well-Being in Older Mothers and Their Adult Daughters

The current study considered affect-related variables as predictors of the quality of helping relationships between older mothers and their adult daughters. Specifically, self-reported and observed emotional responses to the dyadic discussion of a disagreement between mothers and daughters, as well as baseline measures of respiratory sinus arrhythmia were considered as predictors of mothers' and daughters' satisfaction with their helping relationships. Relationship satisfaction was measured by considering mothers' and daughters' subjective well-being specifically in regards to the help they gave and received. Overall, these variables predicted more variance in mothers' satisfaction with their helping relationships than daughters', and RSA (respiratory sinus arrhythmia) was a stronger predictor than the self-reported or observed emotional reactions to the dyadic discussion of a disagreement. Implications of these findings and limitations to the current study are discussed.