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The four-dimensional stress test: psychological, sympathetic-adrenal-medullary, parasympathetic and hypothalamic-pituitary-adrenal responses following inhalation of 35% CO2.
Psychoneuroendocrinology. 2006 Jul; 31(6):736-47.P

Abstract

BACKGROUND

Hypercapnia is a threat to homeostasis and results in neuroendocrine, autonomic and anxiogenic responses. The inhalation of carbon dioxide (CO2) may, therefore, provide a good paradigm for exploring the pathways by which stress can lead to increased susceptibility to ill-health through physiological and psychological stress reactivity. The current study was designed, therefore, to assess the psychological and physiological responses to the inhalation of CO2.

METHODS

Healthy participants (N = 24) inhaled a single vital capacity breath of a mixture of CO2 (35%) and oxygen (65%). Blood pressure and heart rate were recorded for 5 min before and after the test and blood and saliva samples were taken immediately before and 2, 10, 20 and 30 min post-inhalation for the measurement of noradrenaline, salivary and serum cortisol and salivary alpha amylase. In addition, psychosomatic symptoms were recorded immediately before and after the test. The same protocol was repeated 4-6 weeks later at the same time of day.

RESULTS

A single inhalation of CO2 increased blood pressure, noradrenaline, salivary alpha amylase and psychosomatic symptoms, but decreased heart rate at both testing sessions. Analyses of salivary cortisol data revealed that 70% of the sample could be reliably classified as either responders (i.e. demonstrated a post-CO2 cortisol increase) or non-responders (i.e. responded with a decrease or no change in cortisol following CO2) at both test sessions. Responders also perceived the test to be more aversive than non-responders.

CONCLUSIONS

Inhalation of 35% CO2 reliably stimulated the key mechanisms involved in the human stress response. The inter-individual differences in the reactivity of the hypothalamic-pituitary-adrenal axis were also related to differences in the perception of the test.

Authors+Show Affiliations

MRC Health Services Research Collaboration, University of Bristol, Canynge Hall, Whiteladies Road, Bristol, UK. mark.wetherell@bristol.ac.ukNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't
Validation Study

Language

eng

PubMed ID

16621326

Citation

Wetherell, Mark A., et al. "The Four-dimensional Stress Test: Psychological, Sympathetic-adrenal-medullary, Parasympathetic and Hypothalamic-pituitary-adrenal Responses Following Inhalation of 35% CO2." Psychoneuroendocrinology, vol. 31, no. 6, 2006, pp. 736-47.
Wetherell MA, Crown AL, Lightman SL, et al. The four-dimensional stress test: psychological, sympathetic-adrenal-medullary, parasympathetic and hypothalamic-pituitary-adrenal responses following inhalation of 35% CO2. Psychoneuroendocrinology. 2006;31(6):736-47.
Wetherell, M. A., Crown, A. L., Lightman, S. L., Miles, J. N., Kaye, J., & Vedhara, K. (2006). The four-dimensional stress test: psychological, sympathetic-adrenal-medullary, parasympathetic and hypothalamic-pituitary-adrenal responses following inhalation of 35% CO2. Psychoneuroendocrinology, 31(6), 736-47.
Wetherell MA, et al. The Four-dimensional Stress Test: Psychological, Sympathetic-adrenal-medullary, Parasympathetic and Hypothalamic-pituitary-adrenal Responses Following Inhalation of 35% CO2. Psychoneuroendocrinology. 2006;31(6):736-47. PubMed PMID: 16621326.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The four-dimensional stress test: psychological, sympathetic-adrenal-medullary, parasympathetic and hypothalamic-pituitary-adrenal responses following inhalation of 35% CO2. AU - Wetherell,Mark A, AU - Crown,Anna L, AU - Lightman,Stafford L, AU - Miles,Jeremy N V, AU - Kaye,Joey, AU - Vedhara,Kavita, Y1 - 2006/04/18/ PY - 2005/03/01/received PY - 2006/02/15/revised PY - 2006/02/17/accepted PY - 2006/4/20/pubmed PY - 2006/8/4/medline PY - 2006/4/20/entrez SP - 736 EP - 47 JF - Psychoneuroendocrinology JO - Psychoneuroendocrinology VL - 31 IS - 6 N2 - BACKGROUND: Hypercapnia is a threat to homeostasis and results in neuroendocrine, autonomic and anxiogenic responses. The inhalation of carbon dioxide (CO2) may, therefore, provide a good paradigm for exploring the pathways by which stress can lead to increased susceptibility to ill-health through physiological and psychological stress reactivity. The current study was designed, therefore, to assess the psychological and physiological responses to the inhalation of CO2. METHODS: Healthy participants (N = 24) inhaled a single vital capacity breath of a mixture of CO2 (35%) and oxygen (65%). Blood pressure and heart rate were recorded for 5 min before and after the test and blood and saliva samples were taken immediately before and 2, 10, 20 and 30 min post-inhalation for the measurement of noradrenaline, salivary and serum cortisol and salivary alpha amylase. In addition, psychosomatic symptoms were recorded immediately before and after the test. The same protocol was repeated 4-6 weeks later at the same time of day. RESULTS: A single inhalation of CO2 increased blood pressure, noradrenaline, salivary alpha amylase and psychosomatic symptoms, but decreased heart rate at both testing sessions. Analyses of salivary cortisol data revealed that 70% of the sample could be reliably classified as either responders (i.e. demonstrated a post-CO2 cortisol increase) or non-responders (i.e. responded with a decrease or no change in cortisol following CO2) at both test sessions. Responders also perceived the test to be more aversive than non-responders. CONCLUSIONS: Inhalation of 35% CO2 reliably stimulated the key mechanisms involved in the human stress response. The inter-individual differences in the reactivity of the hypothalamic-pituitary-adrenal axis were also related to differences in the perception of the test. SN - 0306-4530 UR - https://www.unboundmedicine.com/medline/citation/16621326/The_four_dimensional_stress_test:_psychological_sympathetic_adrenal_medullary_parasympathetic_and_hypothalamic_pituitary_adrenal_responses_following_inhalation_of_35_CO2_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0306-4530(06)00032-1 DB - PRIME DP - Unbound Medicine ER -