Insulin resistance and carotid intima-media thickness mediate the association between resting-state heart rate variability and executive function: A path modelling study

• Published in: Biological psychology 2016-05, Vol.117, p.216-224
• Main Authors: Kemp, Andrew H., López, Santiago Rodríguez, Passos, Valeria M.A., Bittencourt, Marcio S., Dantas, Eduardo M., Mill, José G., Ribeiro, Antonio L.P., Thayer, Julian F., Bensenor, Isabela M., Lotufo, Paulo A.
• Format: Article
• Language: English
• Subjects: Adult; Brazil; Carotid intima-media thickness; Carotid Intima-Media Thickness - psychology; Cognition; Cross-Sectional Studies; Executive function; Executive Function - physiology; Female; Heart Rate - physiology; Heart rate variability; HOMA-IR; Homeostasis model assessment index for insulin resistance; HRV; Humans; IMT; Insulin Resistance - physiology; Male; Mediation analyses; Middle Aged; Models, Biological; Models, Psychological; Path modelling; TMT; Trail making test
• ISSN: 0301-0511; 1873-6246
• DOI: 10.1016/j.biopsycho.2016.04.006

•HRV is associated with executive function, but causal pathways remain to be examined.•Available evidence provides a framework on which potential mechanisms are explored.•Insulin resistance and atherosclerosis mediated the HRV-cognition relationship in seriatim.•Results support a regulatory role of vagal function over downstream processes. Research has linked high-frequency heart rate variability (HF-HRV) to cognitive function. The present study adopts a modern path modelling approach to understand potential causal pathways that may underpin this relationship. Here we examine the association between resting-state HF-HRV and executive function in a large sample of civil servants from Brazil (N=8114) recruited for the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). HF-HRV was calculated from 10-min resting-state electrocardiograms. Executive function was assessed using the trail-making test (version B). Insulin resistance (a marker of type 2 diabetes mellitus) and carotid intima-media thickness (subclinical atherosclerosis) mediated the relationship between HRV and executive function in seriatim. A limitation of the present study is its cross-sectional design; therefore, conclusions must be confirmed in longitudinal study. Nevertheless, findings support that possibility that HRV provides a ‘spark’ that initiates a cascade of adverse downstream effects that subsequently leads to cognitive impairment.