Emotional appraisal and psychophysiological responsivity in psychogenic syncope

Objective: The vasovagal syncope is characterized by short-lasting loss of consciousness and muscular tone. While it is widely-accepted that episodes are due to a sudden decrease of blood pressure, the actual cause of that decrease is still matter of debate. Given the link between vagal system and aff ective experience, this research aims at investigating the hypothesis of a psychogenic etiopathogenesis and at sketching a clearer picture of aff ective responses in syncope. Methods: Healthy control volunteers and patients took part to the study. In order to explore conscious and automatic processing of aff ective information, participants were asked to observe high-arousal stimuli inducing aff ective activation while their autonomic and electroencephalographic activities were recorded. Further, at the end of the task subjects were presented with psychometric and personality tests. Results: Patients’ psychometric and psychophysiological data highlighted peculiar and complex profi les with respect to the control group, with anomalous electroencephalographic, cardiovascular and electrodermal responses but spared emotional appraisal skills. Conclusions: The complexity of psychometric and psychophysiological pictures suggests that there may exist diff erent syncope subtypes, characterized by the dysregulation of autonomic responsivity. Key message: Comparing and integrating personality, psychometric and functional data may support the diagnostic process and defi nition of syncope-related clinical pictures.