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Emotional orienting during interoceptive threat in orthostatic intolerance: dysautonomic contributions to psychological symptomatology in the postural tachycardia syndrome and vasovagal syncope
journal contribution
posted on 2023-06-09, 12:48 authored by Andrew P Owens, David A Low, Hugo CritchleyHugo Critchley, Christopher J MathiasCognitive and emotional processes are influenced by interoception (homeostatic somatic feedback), particularly when physiological arousal is unexpected and discrepancies between predicted and experienced interoceptive signals may engender anxiety. Due to the vulnerability for comorbid psychological symptoms in forms of orthostatic intolerance (OI), this study investigated psychophysiological contributions to emotional symptomatology in 20 healthy control participants (13 females, mean age 36?±?8?years), 20 postural tachycardia syndrome (PoTS) patients (18 females, mean age 38?±?13?years) and 20 vasovagal syncope (VVS) patients (15 females, mean age 39?±?12?years). We investigated indices of emotional orienting responses (OR) to randomly presented neutral, pleasant and unpleasant images in the supine position and during the induced interoceptive threat of symptom provocation of head-up tilt (HUT). PoTS and VVS patients produced greater indices of emotional responsivity to unpleasant images and, to a lesser degree, pleasant images, during interoceptive threat. Our findings are consistent with biased deployment of response-focused emotion regulation (ER) while patients are symptomatic, providing a mechanistic underpinning of how pathological autonomic overexcitation predisposes to anxiogenic traits in PoTS and VVS patients. This hypothesis may improve our understanding of why orthostasis exacerbates cognitive symptoms despite apparently normal cerebral autoregulation, and offer novel therapeutic targets for behavioural interventions aimed at reducing comorbid cognitive-affective symptoms in PoTS and VVS.
History
Publication status
- Published
File Version
- Accepted version
Journal
Autonomic Neuroscience: Basic and ClinicalISSN
1566-0702Publisher
ElsevierExternal DOI
Volume
212Page range
42-47Department affiliated with
- BSMS Neuroscience Publications
Research groups affiliated with
- Sackler Centre for Consciousness Science Publications
Full text available
- Yes
Peer reviewed?
- Yes
Legacy Posted Date
2018-04-10First Open Access (FOA) Date
2019-02-03First Compliant Deposit (FCD) Date
2018-04-10Usage metrics
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