Blunted vagal reactivity predicts stress-precipitated tobacco smoking
Blunted vagal reactivity predicts stress-precipitated tobacco smoking
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DOI：
10.1007/s00213-011-2473-3
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发表时间：
2012-03-01
影响因子：
3.4
通讯作者：
McKee, Sherry A.
中科院分区：
文献类型：
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作者：
Ashare, Rebecca L.;Sinha, Rajita;McKee, Sherry A.
长期吸烟可导致自主神经功能的改变，包括迷走神经张力降低和应激反应改变。不能适应压力的一个指标可能是迷走神经反应迟钝。压力是吸烟复发的主要机制，但导致压力诱发复发的机制尚不清楚。目的采用应激诱发吸烟行为的实验范式，研究自主反应是否介导应激与吸烟之间的关系。评估了高频心率变异性（HF-HRV）和低频与高频心率变异性（LF/HF）之比（交感病理迷走神经平衡的一种衡量指标）。方法采用受试者内设计，将32名尼古丁依赖，15小时戒烟的吸烟者（McKee等人的一个亚组（J Psychopharmacol 25(4):490-502, 2011））暴露于个性化的剧本驱动的压力和放松场景图像中，并评估其抵抗吸烟和随后的即兴吸烟的能力。在每次实验期间（成像后最多60分钟）监测心率变异。结果如预期的那样，压力和吸烟会降低HF- hrv，增加LF/HF。反映迷走神经反应性降低的应激诱导的HF-HRV反应减弱与开始吸烟的时间缩短和吸烟的渴望缓解和强化增加有关。这些关系是压力后的HF- hrv所特有的，因为基线HF- hrv、放松意象后的HF- hrv或LF/HF都不能预测吸烟行为。目前的研究结果首次通过实验证明，压力引起的迷走神经反应性下降可以预测人抵抗吸烟的能力。研究结果表明，使早期戒烟者迷走神经反应正常化的策略可能会改善戒烟结果。
Rationale Long-term smoking can lead to changes in autonomic function, including decreased vagal tone and altered stress responses. One index of the inability to adapt to stress may be blunted vagal reactivity. Stress is a primary mechanism involved in relapse to smoking, but mechanisms leading to stress-precipitated relapse are not well understood.Objectives Using an experimental paradigm of stress-precipitated smoking behavior, we examined whether autonomic reactivity mediates the relationship between stress and smoking. High-frequency heart rate variability (HF-HRV), a putative measure of vagal tone, and the ratio of low-to-high frequency HRV (LF/HF), a measure of sympathovagal balance, were assessed.Methods Using a within-subjects design, 32 nicotine-dependent, 15-h abstinent smokers (a subgroup from McKee et al. (J Psychopharmacol 25(4):490-502, 2011)) were exposed to individualized script-driven imagery of stressful and relaxing scenarios and assessed on the ability to resist smoking and subsequent ad-lib smoking. HRV was monitored throughout each laboratory session (maximum 60 min following imagery).Results As expected, stress and ad-lib smoking additively decreased HF-HRV and increased LF/HF. Blunted stress-induced HF-HRV responses reflecting decreased vagal reactivity were associated with less time to initiate smoking and increased craving relief and reinforcement from smoking. These relationships were specific to HF-HRV following stress as neither baseline HF-HRV, HF-HRV following relaxing imagery, or LF/HF predicted smoking behavior.Conclusions The current findings are the first to experimentally demonstrate that stress-precipitated decreased vagal reactivity predicts the ability to resist smoking. Findings suggest that strategies that normalize vagal reactivity in early abstinent smokers may lead to improved smoking cessation outcomes.