Key result
High symptom reporters demonstrated higher heart rate, lower heart rate variability, and stronger increases in heartbeat-evoked potentials during attention focus than low symptom reporters.
Why the study?
The neurophysiological processes involved in the generation of medically-unexplained symptoms remain unclear.
Do high symptom reporters exhibit increased bodily signal strength, decreased filter function, and increased perception compared to low symptom reporters?
Cross-Sectional
Do high symptom reporters exhibit increased bodily signal strength, decreased filter function, and increased perception compared to low symptom reporters?
High symptom reporters show altered autonomic activity and increased attentional allocation to heartbeats without improved perception accuracy, providing a potential neurophysiological mechanism for medically-unexplained symptoms.
Altered autonomic and attentional processing in high symptom reporters supports the perception-filter model for MUS; hypothesis-generating without causal or practice implications.
OBJECTIVE: The neurophysiological processes involved in the generation of medically-unexplained symptoms (MUS) remain unclear. This study tested three assumptions of the perception-filter model contributing to MUS: (I.) increased bodily signal strength (II.) decreased filter function, (III.) increased perception. METHODS: = 28.4 years). Mean heart rate (HR) and heart rate variability (HRV), and cortisol awakening response (CAR) were assessed as indicators of bodily signal strength (I.). Heartbeat-evoked potentials (HEPs) were assessed during rest and a heartbeat perception task. HEPs reflect attentional resources allocated towards heartbeats and served as index of filter function (II.). Interoceptive accuracy (IAc) in heartbeat perception was assessed as an indicator of perception (III.). RESULTS: HSR showed higher HR and lower HRV (RMSSD) than LSR (I.), but no differences in CAR. HSR exhibited a stronger increase of HEPs when attention was focused on heartbeats than LSR (II.); there were no group differences in IAc (III.). CONCLUSIONS: The perception-filter model was partially confirmed in that HSR showed altered bodily signals suggesting higher sympathetic activity (I.); higher HEP increases indicated increased filter function for bodily signals (II.). As more attentional resources are mobilized to process heartbeats, but perception accuracy remains unchanged (III.), this overflow could be responsible for detecting minor bodily changes associated with MUS.
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Schulz et al. (2020) conducted a cross-sectional in Medically-unexplained symptoms. High symptom reporters vs. Low symptom reporters was evaluated on Bodily signal strength (HR, HRV, CAR), filter function (HEPs), and perception (IAc). High symptom reporters demonstrated higher heart rate, lower heart rate variability, and stronger increases in heartbeat-evoked potentials during attention focus than low symptom reporters.
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