Bruce D. Miller, MD, Beatrice L

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Presentation transcript:

Depressed children with asthma evidence increased airway resistance: “Vagal bias” as a mechanism? Bruce D. Miller, MD, Beatrice L. Wood, PhD, JungHa Lim, PhD, Mark Ballow, MD, ChiunYu Hsu, BS Journal of Allergy and Clinical Immunology Volume 124, Issue 1, Pages 66-73.e10 (July 2009) DOI: 10.1016/j.jaci.2009.04.038 Copyright © 2009 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 1 Vagal reactivity, sympathetic reactivity, and vagal bias in response to emotional scenes. Vagal (RSA) reactivity (A), sympathetic (PEP) reactivity (B), and shows vagal bias (Zvagal reactivity –Zsympathetic reactivity) (C) of the ND (n = 45) and D (n = 45) groups to the 11 preselected emotional scenes of the movie. Data are mean values; error bars indicate SE. RSA values are directly related to level of vagal activation, whereas PEP values are inversely related to sympathetic activation. Therefore, for ease of interpretation, all PEP change scores were inversed (ie, multiplied by –1) so that graphic representations of vagal and sympathetic reactivity (ie, activation and withdrawal) would be in the same direction. Journal of Allergy and Clinical Immunology 2009 124, 66-73.e10DOI: (10.1016/j.jaci.2009.04.038) Copyright © 2009 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 2 Differences in respiratory resistance between the D and ND groups. Respiratory resistance (Rint) for the subset of subjects (ND, n = 12; D, n = 12) whose airways are more reactive (nonmedicated FEV1 <80% predicted). P values are for the differences in respiratory resistance between the D and ND group. Data are mean values; error bars indicate SE. Journal of Allergy and Clinical Immunology 2009 124, 66-73.e10DOI: (10.1016/j.jaci.2009.04.038) Copyright © 2009 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 3 Associations among depressive symptoms, vagal bias, and respiratory resistance. Scatter plots showing the correlations (for all subjects with nonmedicated FEV1<80% predicted) between depressive symptoms (CDI) and respiratory resistance (Rint) (A), between CDI and vagal bias B at scene 3 (family distress/loss) (B), and between vagal bias at scene 3 and postmovie Rint (C). Journal of Allergy and Clinical Immunology 2009 124, 66-73.e10DOI: (10.1016/j.jaci.2009.04.038) Copyright © 2009 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Autonomi c (ANS) dysregulation model of emotional influence on asthma. Journal of Allergy and Clinical Immunology 2009 124, 66-73.e10DOI: (10.1016/j.jaci.2009.04.038) Copyright © 2009 American Academy of Allergy, Asthma & Immunology Terms and Conditions