Neurovisceral phenotypes in the expression of psychiatric symptoms

Jessica A. Eccles, Andrew P. Owens, Christopher J. Mathias, Satoshi Umeda, Hugo D. Critchley

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

This review explores the proposal that vulnerability to psychological symptoms, particularly anxiety, originates in constitutional differences in the control of bodily state, exemplified by a set of conditions that include Joint Hypermobility, Postural Tachycardia Syndrome and Vasovagal Syncope. Research is revealing how brain-body mechanisms underlie individual differences in psychophysiological reactivity that can be important for predicting, stratifying and treating individuals with anxiety disorders and related conditions. One common constitutional difference is Joint Hypermobility, in which there is an increased range of joint movement as a result of a variant of collagen. Joint hypermobility is over-represented in people with anxiety, mood and neurodevelopmental disorders. It is also linked to stress-sensitive medical conditions such as irritable bowel syndrome, chronic fatigue syndrome and fibromyalgia. Structural differences in "emotional" brain regions are reported in hypermobile individuals, and many people with joint hypermobility manifest autonomic abnormalities, typically Postural Tachycardia Syndrome. Enhanced heart rate reactivity during postural change and as recently recognized factors causing vasodilatation (as noted post-prandially, post-exertion and with heat) is characteristic of Postural Tachycardia Syndrome, and there is a phenomenological overlap with anxiety disorders, which may be partially accounted for by exaggerated neural reactivity within ventromedial prefrontal cortex. People who experience Vasovagal Syncope, a heritable tendency to fainting induced by emotional challenges (and needle/blood phobia), are also more vulnerable to anxiety disorders. Neuroimaging implicates brainstem differences in vulnerability to faints, yet the structural integrity of the caudate nucleus appears important for the control of fainting frequency in relation to parasympathetic tone and anxiety. Together there is clinical and neuroanatomical evidence to show that common constitutional differences affecting autonomic responsivity are linked to psychiatric symptoms, notably anxiety.

Original languageEnglish
Article number04
JournalFrontiers in Neuroscience
Volume9
Issue numberFEB
DOIs
Publication statusPublished - 2015

Fingerprint

Joint Instability
Postural Orthostatic Tachycardia Syndrome
Anxiety Disorders
Psychiatry
Vasovagal Syncope
Phenotype
Anxiety
Syncope
Chronic Fatigue Syndrome
Phobic Disorders
Irritable Bowel Syndrome
Caudate Nucleus
Brain
Prefrontal Cortex
Mood Disorders
Individuality
Neuroimaging
Vasodilation
Brain Stem
Needles

Keywords

  • Anxiety
  • Joint hypermobility
  • Postural tachycardia syndrome
  • Psychiatry
  • Vasovagal syncope

ASJC Scopus subject areas

  • Neuroscience(all)

Cite this

Neurovisceral phenotypes in the expression of psychiatric symptoms. / Eccles, Jessica A.; Owens, Andrew P.; Mathias, Christopher J.; Umeda, Satoshi; Critchley, Hugo D.

In: Frontiers in Neuroscience, Vol. 9, No. FEB, 04, 2015.

Research output: Contribution to journalArticle

Eccles, Jessica A. ; Owens, Andrew P. ; Mathias, Christopher J. ; Umeda, Satoshi ; Critchley, Hugo D. / Neurovisceral phenotypes in the expression of psychiatric symptoms. In: Frontiers in Neuroscience. 2015 ; Vol. 9, No. FEB.
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