What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Healthy (n=20). Intervention: Stroop test and mental arithmetic test vs. Baseline and between-test comparison. Primary outcome: Reactivity of sympathetic vascular index (LF-SAP) and cardio-sympathetic index (0V%) (p=<0.001).

December 14, 2015Open Access

Cardiovascular Sympathetic Arousal in Response to Different Mental Stressors

Q: What are the key findings of this study?

The Stroop test induced a significantly greater increase in both the sympathetic vascular index (LF-SAP) and the cardio-sympathetic index (0V%) compared to the mental arithmetic test (p<0.001).

MMMichal MestanikMartin University Hospital AMAndrea MestanikovaMartin University Hospital ZVZuzana VišňovcováComenius University Bratislava

Key Result

The Stroop test induced a significantly greater increase in both the sympathetic vascular index (LF-SAP) and the cardio-sympathetic index (0V%) compared to the mental arithmetic test (p<0.001).

Study Design

Type

Cross-Sectional (n=20)

Multicenter

Structured PICO

Do different mental stressors (Stroop test vs mental arithmetic) elicit different cardiovascular sympathetic arousal responses in healthy young adults?

Population

20 healthy, nonobese medical students (mean age 23.1 years, 55% female) evaluated for cardiovascular sympathetic arousal in response to different mental stressors.

Intervention

Mental stressors: Stroop color word test and mental arithmetic test (6 minutes each).

Comparator

Baseline resting phase.

Outcome

Cardiovascular sympathetic arousal measured by spectral power of low frequency band of systolic arterial pressure variability (LF-SAP) and symbolic dynamics heart rate variability index 0V%.surrogate

Different cognitive stressors elicit distinct patterns of cardiovascular sympathetic arousal, highlighting the complex central-peripheral interactions in stress responses.

Main Result

p-value: p=<0.001

Limitations

Relatively small homogeneous group of healthy young adults
Lack of a control group undergoing the procedure without mental tasks to detect potential effects of environment and examining staff
Lack of direct invasive assessment of sympathetic neural activity

Abstract

The altered regulation of autonomic response to mental stress can result in increased cardiovascular risk. The laboratory tests used to simulate the autonomic responses to real-life stressors do not necessarily induce generalized sympathetic activation; therefore, the assessment of regulatory outputs to different effector organs could be important. We aimed to study the cardiovascular sympathetic arousal in response to different mental stressors (Stroop test, mental arithmetic test) in 20 healthy students. The conceivable sympathetic vascular index--spectral power of low frequency band of systolic arterial pressure variability (LF-SAP) and novel potential cardio-sympathetic index--symbolic dynamics heart rate variability index 0V% were evaluated. The heart and vessels responded differently to mental stress--while Stroop test induced increase of both 0V% and LF-SAP indices suggesting complex sympathetic arousal, mental arithmetic test evoked only 0V% increase compared to baseline (p<0.01, p<0.001, p<0.01, respectively). Significantly greater reactivity of LF-SAP, 0V%, heart rate (HR) and mean arterial pressure (MAP) were found in response to Stroop test compared to mental arithmetic test potentially indicating the effect of different central processing (0V%, LF-SAP: p<0.001; HR, MAP: p<0.01). The different effectors' sympathetic responses to cognitive stressors could provide novel important information regarding potential pathomechanisms of stress-related diseases.

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