In Europe 84 million people are estimated to be affected by mental illnesses, which are thus becoming a major issue. Stress is often the trigger for the arise of such illnesses: in fact, it has been observed that prolonged mental stress can impair Autonomic Nervous System’s functionalities and - in particular - the balance between the sympathetic and parasympathetic branches. The indicator most often employed to evaluate such balance is the Heart Rate Variability, which accounts for the capability of the ANS to regulate the cardiac rhythm. This mechanism has been observed to significantly vary according to sex, as well as the predisposition to different mental illness and as the reaction to psychopharmaceuticals. In such a context, understanding how - and if- sex differences account for a different impact on mental stress on HRV may help in providing specific therapies, as they would be targeted precisely for the individual based on their gender. This would allow a more accurate and personalized approach towards mental illnesses. To do so, we confronted the HRV - measured on 24-hours ECG recordings - of working man and women and their perceived stress, assessed through clinical standard surveys.

1. Sex difference in
Autonomic Nervous System
functionalities under stress
letizia.clementi@mail.polimi.it
luca.cerina@polimi.it
marco.santambrogio@polimi.it
05.17 - 06.01 2019
NECST Group Conference X

2. Antidepressant use in 27 European countries:associations with sociodemographic, culturaland economic
factorsDan Lewer, Claire O’Reilly, Ramin Mojtabai* and Sara Evans-Lacko*
2
A clinical problem
7.2%
population used psychiatric drugs at some point in life

3. https://www.apa.org/news/press/releases/stress/2010/gender-stress
3
A clinical problem
their effect changes with gender, ethnicity and age

4. STRESS AND HEALTH DISPARITIES Contexts, Mechanisms, and Interventions Among Racial/Ethnic Minority
and Low Socioeconomic Status Populations - American Psychological Association
4
A clinical problem
the trigger for such illnesses’ arisal is often stress
which affects autonomic nervous system functionalities

5. 5
Regulates involuntary activities of the body
Autonomic Nervous System

6. ○ parasympathetic (or vagal): more active during rest
Autonomic Nervous System
6

7. ○ parasympathetic (or vagal): more active during rest
○ sympathetic: increased activity
Autonomic Nervous System
6

8. Hall, Martica, et al. "Acute stress affects heart rate variability during sleep." Psychosomatic medicine 66.1
(2004): 56-62.
7
Autonomic profile
capability to regulate the distance between the peaks
Heart Rate Variability:

9. Hall, Martica, et al. "Acute stress affects heart rate variability during sleep." Psychosomatic medicine 66.1
(2004): 56-62.
7
Autonomic profile
capability to regulate the distance between the peaks
Heart Rate Variability:Heart Rate Variability:
Under stress this capability is impaired
and sympathetic nervous system
results overly activated

10. Wang, Jiongjiong, et al. "Gender difference in neural response to psychological stress." Social cognitive and
affective neuroscience 2.3 (2007): 227-239.
8
sex differences in stress response
Fight or Flight Tend and Befriend

11. Evaluating if males and females ANS are
differently affected by stress could help
developing more effective treatments
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12. Measurements
ANS profilePerceived stress
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13. Subjects
● 100 healthy subjects
● Aged 25 - 45
● Equally divided per sex and
presence of children
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14. ● Anamnesis
● Life style
● Heart rate
● Blood pressure
● VAS Scale
● Maslach Scale
● Personal Well Being
Scale
Perceived stressMedical examination
Preliminary analysis
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15. Preliminary analysis
stress perceived and sympathetic system activity indicatorsstress perceived and sympathetic system activity indicators
Sex differ in stress perception
which is unrelated to
lifestyle, blood pressure and heart rate
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16. ● Our results confirm a sex based difference in stress
perception;
● An in-depth analysis of HRV is necessary to assess the
impact of stress on ANS:
○ time domain analysis;
○ frequency domain analysis;
○ non-linear indicators;
Work direction
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17. Thanks for
your attention
letizia.clementi@mail.polimi.it
luca.cerina@polimi.it
marco.santambrogio@polimi.it
05.17 - 06.01 2019
NECST Group Conference