Anxiety symptoms co-occur with cardiovascular health problems, with increasing evidence suggesting the role of autonomic dysfunction. Yet, there is limited behavior genetic research on underlying mechanisms. In this twin study, we investigated the phenotypic, genetic and environmental associations between a latent anxiety factor and three cardiovascular autonomic function factors: interbeat interval (IBI, time between heart beats), heart rate variability (HRV, overall fluctuation of heart-beat intervals) and baroreflex sensitivity (BRS, efficiency in regulating blood pressure [BP]). Multivariate twin models were fit using data of female twins (N = 250) of the Twin Interdisciplinary Neuroticism Study (TWINS). A significant negative association was identified between latent anxiety and BRS factors (r = −.24, 95% CI [−.40, −.07]). Findings suggest that this relationship was mostly explained by correlated shared environmental influences, and there was no evidence for pleiotropic genetic or unique environmental effects. We also identified negative relationships between anxiety symptoms and HRV (r = −.17, 95% CI [−.34, .00]) and IBI factors (r = −.13, 95% CI [−.29, .04]), though these associations did not reach statistical significance. Findings implicate that higher anxiety scores are associated with decreased efficiency in short-term BP regulation, providing support for autonomic dysfunction with anxiety symptomatology. The baroreflex system may be a key mechanism underlying the anxiety–cardiovascular health relationship.

Marine n-3 PUFA may improve autonomic dysfunction by an increase in heart rate variability (HRV) and may reduce the risk of malignant ventricular arrhythmias. Only a few smaller studies have examined such effects in patients on chronic dialysis, who often have autonomic dysfunction and a high risk of sudden cardiac death, which accounts for almost 30 % of all deaths. This cross-sectional study investigated the association between the plasma phospholipid content of n-3 PUFA and 24-h HRV or ventricular arrhythmias in patients on chronic dialysis. A 48-h Holter monitoring was performed on 169 patients on in-centre dialysis (83 %), home haemodialysis (10 %) or peritoneal dialysis (7 %) obtaining data on arrhythmias (n 152) and 24-h HRV (n 135). The mean overall HRV (standard deviation of normal intervals (SDNN)) was low and 71 % had a reduced overall HRV (SDNN<100 ms) indicating autonomic dysfunction. No significant associations between plasma phospholipid content of total marine n-3 PUFA, EPA (22 : 5n-3) or DHA (22 : 6n-3) and time-domain or frequency-domain HRV were detected in crude or adjusted linear regression analysis. However, a higher plasma phospholipid content of DHA was associated with a significantly lower proportion of patients with ventricular tachycardia (higher DHA-tertile: 9 % v. lower DHA-tertile: 28 %, P=0·02). In conclusion, the content of marine n-3 PUFA in plasma phospholipids was not associated with 24-h HRV, but a higher plasma phospholipid content of DHA was associated with a lower occurrence of ventricular tachycardia suggesting an antiarrhythmic effect of marine n-3 PUFA in patients on chronic dialysis.

Axer H, Bernstein H-G, Keiner S, Heronimus P, Sauer H, Witte OW, Bogerts B, Bär K-J. Increased neuronal cell number in the dorsal motor nucleus of the vagus in schizophrenia.

Background: Eating problems occur frequently in patients with dementia, and almost half of all patients with Parkinson's disease have such problems. It has therefore been assumed that eating problems are also common in patients with dementia with Lewy bodies (DLB). However, few systematic studies have investigated eating problems in DLB patients. The aim of this study was to clarify the frequency and characteristics of eating problems in patients with DLB.

Methods: We examined 29 consecutive patients with DLB and 33 with Alzheimer's disease (AD) in terms of age, sex, education, Mini-mental State Examination, clinical dementia rating (CDR), neuropsychiatric inventory (NPI), Unified Parkinson disease rating scale (UPDRS), fluctuations in cognition, and usage of neuroleptic drugs / antiparkinsonian drugs. We employed a comprehensive questionnaire comprising 40 items and compared the scores between the two groups.

Results: DLB patients showed significantly higher scores than AD patients for “difficulty in swallowing foods,” “difficulty in swallowing liquids,” “coughing or choking when swallowing,” “taking a long time to swallow,” “suffering from sputum,” “loss of appetite,” “need watching or help,” and “constipation”. Only the UPDRS score significantly affected the scores for “difficulty in swallowing foods,” “taking a long time to swallow” and “needs watching or help” score, whereas only the NPI score affected the score for “loss of appetite.” The scores for UPDRS, NPI and CDR significantly affected the scores for “difficulty in swallowing liquids.” No significant independent variables affected the scores for “coughing or choking when swallowing,” “suffering from sputum” and “constipation.”

Conclusion: Although DLB patients show many eating problems, the causes of each problem vary, and the severity of dementia or Parkinsonism is not the only determinant.