The many faces of psychophysiology

The work of the psychophysiology group at the University of NSW highlights the many facets of psychophysiological research and reiterates the inherent relationship between psychological processes and physiological systems of the human body. Leading the group is Associate Professor Ute Vollmer-Conna, a brilliant researcher and colourful character whose early-career milestones included shepherding and carpentry.

At the surface, everything seems strange about this group. Their lab does not look like a lab - it's located in a labyrinth of an old Victorian mansion across the road from the University. A big staircase and a few winding corridors lead you to their psychophysiological lair. Likewise, the roads the key investigators took to their present location are not straight and narrow. Below the surface, you quickly discover their passion for research and insight into how the body and mind work together.

About Associate Professor Ute Vollmer-Conna

A/Prof Ute Vollmer-Conna left high school in Germany at an early age and her love for animals took her quickly into (milk and wool was good) and out of (meat production was not so great) a career as a shepherd. She then worked as a carpenter and a physiotherapist before embarking on a science degree and a subsequent medical research career in psychoneuroimmunology. Currently she is also an A/Professor in psychiatry.

One of Ute’s major career highlights was setting up, with colleague Professor Andrew Lloyd, a huge cohort study in the Dubbo region where individuals with acute infections were tracked for up to several years. The study commenced at the start of an infection and continued until complete recovery. A significant proportion of the patients failed to recover and developed a post-infective syndrome characterized by debilitating chronic fatigue. Their multidisciplinary research attracted international attention and funding, and subsequently both Ute and Andrew were invited to prestigious think tanks including several sponsored by the Centers for Disease Control and Prevention at the Cold Spring Harbor Laboratory. This is where Ute met some of her heroes, including James Watson, 1962 Nobel Prize Winner in Physiology or Medicine.

About Dr Alexander Burton

A recent addition to the group is Dr Alexander Burton. Trained as a nurse, Alex worked in a spinal injuries unit while studying for a Bachelor of Science degree. Through a chance meeting with Prof Vaughan Macefield during a lab tour, clinical experience with spinal injuries and an interest in physiology, Alex embarked to do honours in the field of autonomic dysreflexia, a dangerous and potentially fatal complication that often follows spinal cord injuries. It is believed that autonomic dysreflexia (where the cut-off sympathetic nervous system causes a large increase in blood pressure) is caused by noxious or painful stimuli originating below the level of spinal cord injury.

During his PhD and nursing career, Alex formed an interesting hypothesis. Contrary to the accepted clinical dogma, Alex observed that when some patients with a clinical history of autonomic dysflexia seriously injured themselves (e.g. bone fracture) below the spinal cord lesion, they did not necessarily exhibit autonomic dysreflexia. He tested this hypothesis by using small injections of sterile saline (known to be painful in healthy subjects) in spinal injured subjects and did not observe any symptoms of autonomic dysreflexia. When Alex presented subsequent study findings at a conference in front of many spinal patients, he noticed many nods of the head from the wheelchair bound individuals. A number came up and agreed with Alex’s hypothesis saying that many times autonomic dysflexia was triggered by subtle non-painful events. Alex is now hoping to have a similar experience with research on chronic fatigue.

The Group’s Current Work

The bulk of the UNSW psychophysiology group’s projects looks at the intrinsic relationship between the human mind and body.

  • Autonomic responses during the acute sickness response to infection
  • HRV during sleep in chronic fatigue syndrome and acute infection
  • Depression following acute coronary syndrome
  • Reading emotion in the eyes

Group Shot

Left to right: Cameron Handford, A/Prof Ute Vollmer-Conna, Dr Alex Burton, Udara Gunawardane

Group members include:

  • A/Prof Ute Vollmer-Conna – PhD
  • Dr Alexander Burton – PhD
  • Ms Poppy Rourke – BA (Psych) Research Assistant (Depression following acute coronary syndrome)
  • Mr Andrew Keech – Exercise Physiologist and PhD Student (Biological correlates of post-exertional fatigue in chronic fatigue syndrome(CFS))
  • Mr Udara Gunawardane – (Medical Science) Honours Student (Autonomic responses during acute infection)
  • Mr Cameron Handford – (Medicine) Honours Student (Emotion recognition and empathy)

Descriptions of each study as summarized by the researchers are below.

Autonomic responses to acute infection

From animal studies, it is well documented that stress-induced sympathetic activation itself engenders a set of changes similar to the host response to acute infections, including the secretion of pro-inflammatory cytokines, increase in body temperature and cardiovascular changes. Thus, substantive sympathetic activation during a severe, acute immune challenge may, in stressed individuals, result in an overly vigorous response that may disrupt the delicate balance required to defend against pathogens whilst protecting the ‘self’. We have started to examine the effects of exposure to a mild cognitive stressor (e.g. Stroop-Colour-Word task) during acute infection with Epstein-Barr virus. Figure 1 shows that compared to healthy control subjects (N=11; matched for age, sex and body mass index), subjects with acute infection showed increased cardiac reactivity to the stressor. Notably, the pattern of the cardiac response to the stressor differed significantly between the two groups. On initial exposure to the Stroop task, both subject groups showed a marked increase in heart rate (HR) from baseline, which was more pronounced in the infected subjects. However, over the duration of the test the HR of subjects with the acute infection increased linearly while the HR of healthy controls showed a small reduction in reactivity over the course of the test. These preliminary observations support previous reports on synergistic effects of immunogenic and psychosocial stressors and suggest that sympathetic activity and reactivity during immunologic challenges is augmented.

HRV during sleep in chronic fatigue syndrome and acute infection

The acute sickness response to infection includes symptoms strongly suggestive of vagal dominance such as increased slow wave sleep and psychomotor retardation. Sleep, in particular, is understood to serve a recuperative function. We have started to monitor HRV during nocturnal sleep in individuals with acute infection and healthy control subjects, and found significantly elevated HRV during acute infection (Fig 2). Moreover, in a previous sample of healthy individuals and subjects with post-infective fatigue (N=40) we additionally found that low HRV was the best predictor of poor sleep quality and correlated inversely with somatic and psychological symptom reports (Burton et al. 2010). Taken together, these findings suggest that classic vagal functions support may recuperative behaviours during sickness.

Depression following acute coronary disease

Recently there has been a great deal of interest in the links between coronary conditions and depression. This is not surprising considering the high incidence of both of these conditions and disease burden and disability worldwide. Research has shown that depression and acute coronary syndrome (ACS) are bid-directionally connected, with each increasing the risk of the other disorder occurring. A recent study by Parker et. al., (2008) has further revealed that depression that develops after acute coronary events (rather than ongoing depression) increases the risk of further cardiac events (or mortality) seven fold. The current project will provide a comprehensive investigation of the factors, which contribute to the development of depression after ACS and its influence on cardiac outcomes. We will focus on differences in pre-existing vulnerabilities, variation in severity of the actual ACS event as well as individual differences in the response to the trauma. This research aims particularly to focus on biological factors, which link depression and acute coronary syndrome including genetic polymorphisms; immunological factors such as inflammatory proteins; plasma fatty acids and autonomic functioning. The autonomic function of cardiac patients is assessed using ADInstruments 15T PowerLab equipment, which is setup at the bedside. Collection of these data will provide novel insight into interactions between autonomic, genetic, biological, psychological and psychosocial factors and their link to recovery post ACS. This research may aid in indentifying those at risk and contribute to the development of targeted treatment to reduce depression and mortality. This study is funded by NSW Health and is carried out in collaboration with Cardiology at Prince of Wales hospital ( Dr Warren Walsh) and the Black Dog Institute (Professor Gordon Parker)

Reading emotion in the eyes

Darwin in his writings on evolution cited the importance of facial expressions in human interaction. It was critical for the survival of the species to be able to rapidly communicate emotional states. Facial expressions not only allow an observer to understand the emotional state of another but also have the ability to invoke a similar emotion in the observer. The autonomic nervous system has a large role to play in emotion. Most people can recognize the systemic effect of being happy or sad; these emotions involve not only the mind but physiological responses of the body. Interestingly, the state of the body can also influence the emotional state of the mind. Therefore it is said that when we share the emotions of another, we share their physiological state as well.

In the medical field where patient outcomes and satisfaction hinge heavily on the doctor-patient relationship, it is critical that the doctor understands the emotional state of the patient. Research into the field of emotional recognition in doctors is limited. Some studies have shown that levels of physician empathy decline throughout medical training and subsequent careers; however this research was based on questionnaires only. In our research we approach the topic of emotion recognition in doctors from a new perspective. By combining autonomic measurements and emotion recognition tasks, we hope to profile the autonomic responses of doctors to emotion, at different stages of their training. Furthermore in lieu with the idea that sharing emotions is a sharing of physiology, we seek to investigate whether having a more astute awareness of one’s physiological state (called interoception) influences recognition of emotions in others.

Use of PowerLab and LabChart

The laboratory incorporates a dual computer setup – one running LabChart 7, the other running a battery of customized psychological tests such as the Stroop Colour Word, dual-attention and spatial memory tasks developed in conjunction with Dr Jim Lemon (UNSW).

At the heart of the system, a PowerLab 16/30 integrates incoming digital signals from the psychological testing computer into LabChart 7 providing an indication of the psychological tests’ starting and finishing times. R-wave threshold signals from an ECG connected to the PowerLab via a BioAmp provide a trigger for auditory cues for testing interoceptive sensitivity in awake human subjects. The flexibility of macros in LabChart 7 allows this research group to test subject responses and record observations with auditory and visual cues for the researcher. A PowerLab 15T, featuring an integrated bio-amplifer, is used with a laptop for recording ECG and HRV data from acute coronary disease patients at hospital. Its compact size is ideal for constant relocation. 

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