Endocrine and haemodynamic stress responses to an arithmetic cognitive challenge

We aimed at developing and validating a simple, highly repeatable computer-based tool, which could be employed to simulate the effects of an acute mental stress on endocrine and haemodynamic stress responses.

Fifteen subjects underwent a mental cognitive challenge, employing an ad hoc designed web tool (available at http://bagame.altervista.org) that proposed a series of random arithmetic operations (addictions or subtractions) between one- to three-digit numbers for 10 minutes. We measured plasma epinephrine, norepinephrine, cortisol, and ACTH, in addition to heart rate (HR), systolic (SBP) and diastolic (DBP) blood pressure throughout the test.

The arithmetic mental challenge promptly activated the sympatho-adrenomedullary axis (epinephrine +112±24%, p<0.05; norepinephrine +37±13%, p<0.004) and the hypothalamic-pituitary-adrenocortical axis (cortisol +25±7%, p<0.008; ACTH +97±44%, p<0.008), which in turn exerted stimulatory effects on the cardiovascular system (HR +18±4%, p<0.05; SBP +112±24%, p<0.05; DBP +34±8%, p<0.05) in all subjects, without any symptoms and regardless of the individuals' mental arithmetic ability.

We developed and validated a computer-based tool that is effective for simulating endocrine and haemodynamic responses to an acute mental stress. This novel tool is easy-to-use, freely-accessible, and it can be employed to further investigate stress-related pathophysiological mechanisms and their role in cardiovascular diseases.