Differential heart rate variability (HRV) measures obtained at intake predict neurocognitive outcomes on a test battery administered weeks later: Trait-like HRV and its clinical diagnostic-screening utility in clinical psychology, behavioral medicine and psychiatry

Roland Carlstedt, PhD

McLean Hospital

Scientific Abstract

Background: In this clinical archival study personality/behavioral (PB) measures associated with differential mental health/health status and disease vulnerability were analyzed in the context of cardiologic (HRV) and neurocognition (NC) biomarker correlates. The aim was to determine: 1) if subliminal attention (SA), subliminal reactivity (SR) and subliminal coping predicted baseline and stress test HRV and/or NC performance, 2) if HRV was associated with NC performance, 3) if PB and HRV interacted to predict NC performance, and 4) the conceptual consistency (CC) of findings relative to the High Risk Model of Threat Perception morbidity and resiliency hypotheses.

Methods: 56 adults (ages 18-35) completed the Tellegen Absorption (A), NEO-neuroticism (N), and Marlowe- Crown scales (RC) and underwent HRV baseline and stress testing. A neurocognitive test battery was administered four weeks later. Correlation and regression analyses were performed.

Results: Numerous predictive regression models emerged. The strongest and most conceptually consistent findings were as follows: 1. Baseline Low High-Stress Test (LH) ratio, Very Low-Stress Test (VL) frequencies, HR and Stress-Test SDNN (SDNN7) accounted for 59% of the variance in Visual Interference speed (all adj. r2) 2. SA and Stress-Test SDNN (SDNN7) accounted for 51% of the variance in Sustained Attention 3. Baseline HR and SDNN accounted for 44% of the variance in Switching of Attention Errors 4. SA, SR, baseline LH ratio and HR baseline vs. stress test differential (HR7 diff) accounted for 50% of the variance Emotional Recognition of Anger 4. SC, Stress-Test baseline LH ratio, HR7 diff and baseline HR accounted for 40% of the variance in Maze Learning Time (all above p values .000). Other strong findings of note will be listed in the full presentation and ranked in accord with a novel Conceptual Consistency Ranking “scorecard.”

Conclusions: This study established predictive associations among PB, HRV and NC measures that have been linked to health outcomes and underlying biomarker mechanisms. HRV may be a trait-like mediator of NC and useful screening tool especially in the context of brain health trajectories

SoundCloud Transcript

Hello. My name is Dr. Roland Carlstedt. I’m presenting on: “Differential heart rate variability measures obtained at intake predict neurocognitive outcomes on a test battery administered weeks later: Trait like heart rate variability and its clinical diagnostic screening utility in clinical psychology, behavioral medicine and psychiatry. My co- presenter is Ava White. Essentially ,we performed an archival study on personality and behavioral measures associated with differential mental health and health status, and disease vulnerability. We analyzed these measures in the context of cardiologic and neurocognition biomarker correlates. Our aim was to discover if any of the predictive variables were associated with neurocognition that implicated various brain regions.

We generated what I would say are very interesting and provocative findings suggesting that trait like heart rate variability can actually offer insight into brain fitness or brain functioning and possibly serve as an early diagnostic approach to cognitive fitness over the lifespan, meaning longitudinally. It can possibly signal early cognitive decline. These are some of the questions that have arisen based on these very interesting and in part unexpected findings. There is research going back to the Laceys in the sixties, in which they published a seminal paper on two way brain heart communication. Our take away here is that brain fitness and performance (both positive & negative contexts) may be associated with cardiologic status in the moment and across various life epochs

So we basically had 49 clinical subjects evaluated in a performance context (31 full datasets). They took intake personality and behavioral tests. Intake baseline and cognitive stress heart rate variability assessment was undertaken. Neurocognitive testing was administered about four to six weeks later (and that’s sort of the interesting part) namely, that heart rate variability was not measured concurrent to the neurocognitive tests. In our poster, we are presenting four of the strongest findings with R2s ranging from the .40s to .60s very significant findings. We are now compelled to advance a clinical explanatory model for these findings, which we will be doing in our Zoom session. Our initial global hypotheses were supported beyond expectations, numerous brain regions were impacted by heart rate variability and personality/behavior. They are presented in a sample chart in our poster. We recommend that heart rate variability and neurocognitive testing should be routinely administered in psychotherapeutic and preventive health and mental health care contexts.

I will elaborate and explicate on our findings in our Zoom session and posit some ideas and theoretical explanations for how cardiologic measures can impact baseline cognitive status for a number of brain regions. Our findings appear to open the door for new lines of research. Thank you and we look forward to answering your questions.


Live Zoom Session – April 21st

research Areas


Roland A. Carlstedt, Ph.D.