Cardiovascular Conditioning and Anticipatory Nausea and Vomiting in Cancer Patients

• Published in: Behavioral medicine (Washington, D.C.) D.C.), 1994-06, Vol.20 (2), p.78-83
• Main Authors: Kvale, Gerd, Psychol, Cand, Hugdahl, Kenneth
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Antineoplastic Combined Chemotherapy Protocols - adverse effects; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Arousal - physiology; Autonomic Nervous System - physiopathology; Biological and medical sciences; Cancer; cardiovascular reactivity; Cardiovascular response; Chemotherapy; Conditioning; Conditioning, Classical - physiology; Factors; Female; Fundamental and applied biological sciences. Psychology; Heart Rate - physiology; Human; Humans; Learning. Memory; Male; Middle Aged; nausea; Nausea - chemically induced; Nausea - physiopathology; Nausea - psychology; Neoplasms - drug therapy; Neoplasms - physiopathology; Neoplasms - psychology; Prospective Studies; Psychogenic nausea; Psychology. Psychoanalysis. Psychiatry; Psychology. Psychophysiology; Psychomotor Performance - physiology; Reaction Time - physiology; vomiting; Vomiting, Anticipatory - physiopathology; Vomiting, Anticipatory - psychology
• ISSN: 0896-4289; 1940-4026
• DOI: 10.1080/08964289.1994.9934620

Explanations of individual differences in susceptibility to learning of anticipatory nausea and/or vomiting (AN/V) in cancer patients have focused mainly on the patients who develop AN/V. On the basis of conditioning theory, however, one would expect that all patients who experience post-treatment nausea and/or vomiting (PN/V) should develop AN/V. Consistent with findings demonstrating that conditioned responses are more easily established in autonomic-reactive individuals, we have previously reported that patients who do not develop AN/V (noAN/V) are less autonomic reactive than the AN/V patients. Thus, we hypothesized that the noAN/V patients might not show classical conditioning to the same degree and extent as the AN/V patients and that conditioning may be the mediating mechanism in AN/V. This study presents data from 36 patients. Among the 28 patients who experienced PN/V, 16 developed AN/V. We found no systematic group differences in severity of PN/V or antiemetic treatment. Before chemotherapy, all patients were tested in a signaled reaction-time paradigm. We used two different tones (CSs), one of which was always followed by a noise (UCS) as a button-press signal. The patients who later developed AN/V demonstrated significantly shorter reaction times, and also showed enhanced cardiovascular reactivity to the tone followed by the UCS (CS+) in comparison with the nonsignal tone (CS-). The noAN/V patients did not show differential cardiovascular responses to the CS+ and CS-.