Research Article
Brain Oscillations Elicited by the Cold Pressor Test:
A Putative Index of Untreated Essential Hypertension
Christos Papageorgiou,
1
Efstathios Manios,
1
Eleftheria Tsaltas,
2
Eleni Koroboki,
1
Maria Alevizaki,
1
Elias Angelopoulos,
2,3
Meletios-Athanasios Dimopoulos,
1
Charalabos Papageorgiou,
2,3
and Nikolaos Zakopoulos
1
1
Department of Clinical Terapeutics, National and Kapodistrian University of Athens, Medical School, Athens, Greece
2
1st Department of Psychiatry, National and Kapodistrian University of Athens, Medical School, “Eginition” Hospital,
115 28 Athens, Greece
3
University Mental Health Research Institute (UMHRI), Athens, Greece
Correspondence should be addressed to Christos Papageorgiou; chrispapageorgio@gmail.com
Received 18 December 2016; Accepted 10 April 2017; Published 9 May 2017
Academic Editor: Tomohiro Katsuya
Copyright © 2017 Christos Papageorgiou et al. Tis is an open access article distributed under the Creative Commons Attribution
License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly
cited.
Objective. Essential hypertension is associated with reduced pain sensitivity of unclear aetiology. Tis study explores this issue
using the Cold Pressor Test (CPT), a reliable pain/stress model, comparing CPT-related EEG activity in frst episode hypertensives
and controls. Method. 22 untreated hypertensives and 18 matched normotensives underwent 24-hour ambulatory blood pressure
monitoring (ABPM). EEG recordings were taken before, during, and afer CPT exposure. Results. Signifcant group diferences in
CPT-induced EEG oscillations were covaried with the most robust cardiovascular diferentiators by means of a Canonical Analysis.
Positive correlations were noted between ABPM variables and Delta (1–4Hz) oscillations during the tolerance phase; in high-
alpha (10–12 Hz) oscillations during the stress unit and posttest phase; and in low-alpha (8–10 Hz) oscillations during CPT phases
overall. Negative correlations were found between ABPM variables and Beta2 oscillations (16.5–20Hz) during the posttest phase
and Gamma (28.5–45 Hz) oscillations during the CPT phases overall. Tese relationships were localised at several sites across the
cerebral hemispheres with predominance in the right hemisphere and lef frontal lobe. Conclusions. Tese fndings provide a starting
point for increasing our understanding of the complex relationships between cerebral activation and cardiovascular functioning
involved in regulating blood pressure changes.
1. Introduction
Hypertension is a leading risk factor for cardiovascular
disease and a major contributor to healthcare costs worldwide
[1]. Given that autonomic nervous system (ANS) activity
modulates transient changes in cardiovascular function,
autonomic dysfunction has been implicated in the pathogen-
esis of essential hypertension (EH) [2]. Increased sympathetic
activity [3] combined with parasympathetic inhibition may
contribute to increased cardiac activity and/or peripheral
vascular resistance and thereby to the early development of
hypertension [4], although patients with borderline to mild
hypertension ofen show normal vascular resistance at rest.
Te central nervous system (CNS) has also been impli-
cated in the aetiology and maintenance of some forms of
EH. Te CNS is a target of the disease which, if untreated,
progresses to blood pressure (BP) levels threatening the
integrity of cerebral vessels, potentially inducing stroke
[5].
Considerable evidence supports the connection between
pain perception and BP regulation. It has been proposed
that acute BP increases may reduce pain, thus establishing
hypertension through instrumental learning [6]. Hypoalgesia
has been noted in animals and humans with high BP [7],
but the issue of whether it precedes or follows hypertension
remains equivocal.
Hindawi
International Journal of Hypertension
Volume 2017, Article ID 7247514, 17 pages
https://doi.org/10.1155/2017/7247514