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Neurovisceral Integration: Implications for Cognition, Emotion, and Health

Laboratory of Personality and Cognition, NIA (2001-12-21) Julian F. Thayer, Ph.D.

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Comment by Ray Lutz:
After hearing John Dean give a lecture on his book Conservatives without Conscience, I ran into this research which seems to relate to why, from a physiological standpoint, some people may find following an authoritarian leader satisfying. Indeed, for some people with poor heart period variability, it may be absolutely necessary follow authoritarian leaders, to avoid the stress of "flip floppers" and thereby avoid serious health problems associated with those whose heart rates do not return to healthy variability after experiencing stress.

John Dean pointed out that authoritarian followers tend to be Republicans and evangelicals. If these people can be trained to have healthy stress recovery, they may be "cured" and could embrace progressive viewpoints that would be too stressful otherwise.

Autonomic Balance

  • Predictor of Mortality and Morbidity
  • Underlies a broad range of responses linked to allostatic load
  • Associated with central nervous system
  • may explain how psychosocial factors are instantiated in physiology and disease
  • may explain known health disparities (ethnic / gender differences)

Mortality vs. heart rate chart

  • The frontal cortex developed to perform off-line problem solving.
  • Must keep information on line.
  • Must inhibit autonomic responses.
  • Worry and rumination is negative aspects of off-line problem solving.

Components of self-regulation

  • Affective regulation
  • Attentional Regulation
  • Autonomic Regulation

Heart Period Variability: An Index of Self-Regulatory Ability

  • central-peripheral feedback
  • related to attention
  • related to emotion

Central-Peripheral Feedback

  • The Central Autonomic Network (CAN)
  • anterior cingulate, insular, and prefrontal cortices
  • primary out via stellate ganglia and vagus nerve

(Figure of structures)

  • Anterior cingulate cortex
  • insular cortex
  • paraventricular nucleus
  • central nucleus of the amygdala
  • Lateral hypothalamic area
  • Periquaductal gray matter
  • Parabrachial region
  • Nucleus of the tractus solitarius
  • Nucleus ambiguus
  • Ventrolateral medullla

(Figure of influencing factors, from JP Salsworth)

  • Respiratory influences
  • Cardiopulmonary receptors.
  • all flow over vagus nerve.

(Figure of waveforms)

  • Two components
  • Respiration -- 0.25 hz -- Almost exclusively due to vagus influences.
  • 0.1 Hz Barireceptor blood pressure

Autonomic Regulation

  • the central autonomic network
  • cerebral blood flow and heart period variability

  • Frontal cortex tonically inhibits brain stem sympathic saluatory circuits

  • First experiment, performs on 80 patients undergoing treatment for epilepsy, (WADA test) which involved the inactivation of each hemisphere by the injection of sodium amylbarbitol into the middle cerebral artery. (Numb one hemisphere of the brain) to see what happens to the cardiovascular response.
    • From baseline in the first minute or so, there is an increase in heart rate, fight-or-flight hormones are released.
    • Left / Right are slightly different.
    • curve goes up, levels off, then declines.
    • Decreases more with right-hemisphere.
    • inactivation occurs on beat-by-beat basis

Central Autonomic Network

  • Under tonic inhibitory control via GABA
  • Reciprocally interconnected
  • Parallel, distributed pathways
  • Direct and indirect pathways
  • sensitive to initial conditions

Another test

  • 12 healthy women
  • Variables
    • cerebral blood flow (CBF) measured by H2(15)O and PET
      • A measure of local brain activity
    • High frequency component of heart rate variability (HRV)
      • A measure of vagal tone
  • Experimental Design
    • 12 scans per subject
    • 2 stimulus modalities: film, recall
    • 6 stimulus conditions: happy, sad, disgust, neutral (3)
  • Correlations (film - recall)
    • HRV x CBF during neutral conditions
    • HRV x CBF during emotion-minus-neutral conditions

  • During neutral conditions: Activation of right frontal cortex showing correlation with HRV
  • During emotional arousal: Medial prefrontal cortex and the anterior insular cortex

Conclusions of studies

  • We think HRV can be used to index activity in the frontal cortex.
  • Both studies indicate that changes in HRV map onto fairly localized structures in the brain.

Blood Pressure Regulation

  • Inverse relationship between HRV and BPV
  • Blood pressure is a risk factor for cardiovascular disease
  • HRV tends to buffer BPV.

Affective Regulation (emotional)

  • the "emotion circuit", Damasio, 1998
    • (same exact structures already discussed)
    • Use music to induce emotion in the lab.
  • emotion and heart period variability

First study

  • Done at penn state.
  • Patients with generalized anxiety disorder (GAD) and controls.
  • Asked them to relax, and then to worry "as you normally do." (no further instructions were needed).
  • GAD patients had lower HRV than controls.
  • Both reduced HRV when worrying.
  • taking the frontal cortex off-line by occupying it with ineffective problem solving, disinhibited the sympathic saluatory circuit

Sleep lab study

  • About 60
  • Half were told they were going to give a speech.
  • Other half (controls) were told they could read the newspaper in the morning.
  • Controls had greater HRV than test group.
  • The effect changed throughout the night.
  • Normal change throughout the night was blunted in those individuals in test group.

Sleep disorder

  • Major cause of insomnia is worry
  • Decrease of HRV disturbs sleep.

Neural circuits can be primed

  • 90 females in Spain.
  • can be primed to react differently under stimulus.
  • Exposed to pleasant stimulus, attenuates startle response relative to neutral
  • Exposed to negative stimulus, potentiates startle response relative to neutral
  • Negative image: gruesome hand in blood
  • Neutral: basket
  • Positive: man kissing woman above breast.

  • Split 90 into quartiles of HRV
  • lowest HRV - potentiated startle
  • higher HRV - attenuated startle

Attentional Regulation

  • The anterior executive region/rostral limbic system
  • Attention and heart period variability


  • Describe stress reactivity to different types of fear exposure in odontophobics (dental phobias)
  • Exposed to video of dental procedures
  • Test differences in patients characterized by high or low HRV on a modified Stroop task
    • Traditional stroop is colors names written in opposite colors.
    • Modified has feared stimulus written colored ink.


  • Subjects: 20 patients
  • Apparatus: AMS, Modified Stroop Test, Video of dental procedures
  • heart rate shows this is stressful and the rate does not recover very well.
  • Divided the group into four groups based on HRV.

Performance Data

  • Reaction times were longer to threat word vs. congruent or incongruent word.
  • High HRV group had faster responses


  • Both cardiovascular and electrodermal responses reactive to conditions, but only electrodermal responses showed recovery.
  • Odontophobics showed longer RT (reaction time) to threat compared to neutral words
  • HRV a predictor of performance on attentional task with poorer performance (longer RT) in the low HRV group

Study one (the problems)

  • Clinical group
    • pre and co-mobidity as confounding factor
  • Stroop Test
    • Test of attention
    • often referred to as involving executive function (we wanted to get a bit more specific)

Next study

  • HRV as measure of reactivity
  • Correlations between HRV and cognitive tasks
  • No studies of HRV as predictor variable for cognitive performance in adults.


  • HRV as predictor for sustained attention in healthy adults
  • Follow-up on executive vs. non-executive functions
  • reactivity to cognitive stress


  • Subjects: 40 sailors of the R No N
  • All healthy adults.


  • Heart rate variability decreases even in anticipation of the task.
  • Reaction time quicker with higher HRV
  • Greater accuracy in memory or reaction with higher HRV

Stress Reactivity -- Cortisol Response

  • No difference in morning or evening cortisol in High vs. Low HRV
  • Low HRV showed increased cortisol response to the performance of the actual task
  • High HRV were "innoculated" against the stress response.
  • Cortisol is stress hormone that may be controlled by frontal cortex.


  • HRV efficient as predictor for performance on attentional and memory tasks in healthy adults.
  • HRV linked to executive functions
  • HRV predictive of stress tolerance - Those individuals who are less sensitive to stress have high HRV at rest.

Threat Study

  • Aims - Test the influence of HRV on cognitive performance in threat and non-threat situations
  • Methods - 50 sailors of the R No N;
  • Some were told they would be shocked if not done right. use electric shock as threat.


  • Sustained attention -- Accuracy
    • High HRV - Fewer errors, not modulated by the threat of shock
    • Low HRV - More errors; increased when threatened by shock.
  • Working Memory Task (# correct)
    • High HRV - about the same result without shock threat, slight decrease with shock threat (insignificant).
    • Low HRV - result drastically reduced with threat of shock. (Less stress tolerant).


  • High HRV showed stable performance over conditions
  • Replicated findings from study 2
  • Low HRV group showed decreased performance on working memory during threat.

Recent studies

  • Elderly African Americans
  • Identify in sentences what emotions were being represented.
  • Same for faces.
  • and another Caucasian sample.
  • African americans do not recover after the task as do Caucasian individuals.

Diastolic Blood Pressure

  • Those with High HRV do recover, even in the sample of African Americans who generally do not recover.
  • Those with Low HRV don't recover.

Total peripheral resistance

  • Shows large differences between High/Low HRV in terms of recovery.


  • Neural circuitry for autonomic regulation, attentional regulation, and affective regulation is the same.
  • heart period variability is an index of central-peripheral feedback (neurovisceral integration).
  • HPV useful as a measure of self-regulation across a broad range of circumstances
  • the importance of inhibition - this circuit is inhibitory.
  • the heart is primarily under parasympathetic control

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Title Neurovisceral Integration: Implications for Cognition, Emotion, and Health
Publisher Laboratory of Personality and Cognition, NIA
Author Julian F. Thayer, Ph.D.
Pub Date 2001-12-21
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Note This is a very technical video that may explain why authoritarian personalities exist
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Topic revision: r5 - 2011-09-26, RaymondLutz
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