Daniela Palomba

• Doctor of Medicine
• Professor Emeritus at University of Padua

Depression is characterized by reduced physical activity and sleep-wake cycle disturbances, often considered important features of the disease. While a few studies have suggested that self-reported reduced physical activity and sleep-wake cycle disturbances might both be linked to depression vulnerability, actigraphy-based measures in vulnerable sa...

Depression is characterized by reduced physical activity and sleep-wake cycle disturbances, often considered important features of the disease, aligning with the Sensorimotor Systems and the Arousal and Regulatory Systems of the RDoC, respectively. Wrist-worn actigraphy can be leveraged to show objective sleep-wake and daily activity disturbances....

Introduction: Coronary heart disease (CHD) is strongly associated with cognitive impairment, which is a core feature of depression, highly prevalent in patients with CHD. Interestingly, patients with CHD and individuals with depression display reduced heart rate variability (HRV), which proxies a complex network integrating autonomic and attention...

The present study aimed to analyze the different components of state mathematics anxiety that students experienced while solving calculation problems by manipulating their stress levels. A computerized mathematical task was administered to 165 fifth‐graders randomly assigned to three different groups: positive, negative, and control conditions, in...

Considering that the classical categorical approach to mental disorders does not allow a clear identification of at-risk conditions, the dimensional approach provided by the Research Domain Criteria (RDoC) is useful in the exploration of vulnerability to psychopathology. In the RDoC era, psychophysiological models have an important role in the reco...

The COVID-19 pandemic is a unique period of stress that, in some cases, led to post-traumatic stress symptoms (PTSSs). Emotion regulation strategies are known to modulate the emotional response to stressful events. Expressive suppression (ES) is a maladaptive strategy related to the exacerbation of the physiological stress response. Heart rate vari...

Depressive symptoms are characterised by reduced cognitive control. However, whether depressive symptoms are linked to difficulty in exerting cognitive control in general or over emotional content specifically remains unclear. To better differentiate between affective interference or general cognitive control difficulties in people with depressive...

Mandatory quarantine during the COVID-19 pandemic had substantial negative consequences on psychological health in the general population. Depression, anxiety, and insomnia were reported to increase the morbidity and mortality risk in cardiac patients after cardiac interventions. Nonetheless, a gap in the evidence appeared regarding the effects of...

To date, affective and cognitive processing of emotional information in individuals with depressive symptoms have been examined through peripheral psychophysiological measures, event-related potentials, and time–frequency analysis of oscillatory activity. However, electrocortical correlates of emotional and cognitive processing of affective content...

Objective: Poor vagally-mediated heart rate variability (vmHRV) is a mechanism linking depression to coronary heart disease (CHD). Reduced vmHRV is also considered an index of emotion dysregulation - the frequent use of maladaptive emotion regulation strategies, one of the most important being expressive suppression - which is a key component of d...

Background Considering that the elevated distress caused by the COVID-19 pandemic, in some cases, led to post-traumatic stress symptoms (PTSS), it has been proposed as a specific traumatic event. The present longitudinal study investigated pre-pandemic motivated attention to emotional stimuli, as indexed by Late Positive Potential (LPP) amplitude,...

La Fibromialgia è una condizione di dolore muscoloscheletrico diffuso che si associa a fa-tigue, rigidità, insonnia, alterazioni dell'umore e comporta conseguenze importanti per la vita quotidiana. Ad oggi è ancora sottodiagnosticata e sono poco chiare sia l'eziopatogenesi sia la diagnosi differenziale con condizioni di Dolore Cronico Diffuso. Tra...

To date, affective disposition and cognitive processing of emotional stimuli in individuals with depressive symptoms have not been fully explored within the same framework. Time-frequency analysis of electroencephalographic activity allows to disentangle the brain's parallel processing of information. The present study employed a time-frequency app...

Objectives Maladaptive cognitive strategies and reduced autonomic flexibility have been reported in chronic pain conditions. No study to date addressed the effects of maladaptive coping and reduced autonomic flexibility, as indexed by heart rate variability (HRV), in chronic headaches. The present study aimed to assess the mediating role of pain ca...

The present study aimed to investigate emotional processing in dysphoria. To this end, the amplitude of the Late Positive Potential (LPP) and cardiac deceleration were assessed during the passive viewing of affective (pleasant, neutral, and unpleasant) pictures in 26 individuals with dysphoria and in 25 non-depressed controls. The group with dyspho...

Facilitated processing of negative information might contribute to the etiopathogenesis and maintenance of depressive symptoms. Cardiac vagal tone, indexed by heart rate variability (HRV), is believed to represent a proxy of the functional integrity of the neural networks implicated in brooding rumination, affective interference and depression. The...

Background: Heart rate variability (HRV) mirrors cardiac autonomic modulation, an index of well-being. Reduced HRV has been reported in depression, but few studies investigated HRV in individuals at-risk of or remitted from a full-blown depressive episode. The present study aimed at examining whether reduced HRV could be a potential indicator of vu...

Background: Heart rate variability (HRV) mirrors cardiac autonomic modulation, an index of well-being. Reduced HRV has been reported in depression, but few studies investigated HRV in individuals at-risk of or remitted from a full-blown depressive episode. The present study aimed at examining whether reduced HRV could be a potential indicator of vu...

Despite the positive impact on achievement, competition has been associated with elevated psychophysiological activation, potentially leading to a greater risk of cardiovascular diseases. Competitive biofeedback (BF) can be used to highlight the effects of competition on the same physiological responses that are going to be controlled through BF. H...

Aims The exercise stress test is commonly used to assess physical capacity and recovery in coronary artery disease (CAD) patients after percutaneous transluminal coronary angioplasty (PTCA). Despite depressive symptoms have been consistently associated with adverse outcomes in CAD patients, they are rarely considered as risk factors of poor exercis...

The present study investigated the interplay between attention and affective disposition during emotional processing in dysphoria. Attentional and affective startle modulation and cardiac deceleration were assessed during the viewing of emotional pictures in 38 individuals with dysphoria and in 52 controls. Startle probes during picture viewing wer...

Objective: Spontaneous or experimentally induced high blood pressure (BP) is associated with reduced pain perception, known as BP-related hypoalgesia. Despite its clinical implications, such as the interference with early detection of myocardial infarction in ‘at risk’ groups, the size of the association between high BP and pain has not yet been qu...

The capability model of alpha asymmetries posits that state emotional manipulations are a more powerful detector of depression-related motivational deficits than alpha activity at rest. The present study used a time-frequency approach to investigate the temporal dynamics of event-related changes in alpha power during passive viewing of emotional pi...

The current study investigated profiles of vagal withdrawal in response to a challenging task in preschoolers. Also, the association between those profiles and conceptual shifting ability was assessed. Electrocardiogram of 43 four‐year‐olds was registered during a sequence of games including a win phase and a lose phase, while conceptual shifting a...

Individuals who experienced traumatic work-related accidents frequently show cognitive deficits and biased processing of trauma-relevant information, which, in turn, could increase the risk of further accidents. The attention bias modification training (ABMT) is designed to reduce hypervigilance toward and enhance attentional disengagement from thr...

Objective: Depression is one of the leading causes of disability worldwide. Most previous studies have focused on major depression, and studies on subclinical depression, such as those on so-called dysphoria, have been overlooked. Indeed, dysphoria is associated with a high prevalence of somatic disorders, and a reduction of quality of life and li...

Introduction: Recent studies have suggested that patients suffering from either anorexia nervosa (AN) or bulimia nervosa (BN) exhibit abnormal performance in the ability to control cognitive interference in response selection. Method: We assessed the status of cognitive control in episodic memory by addressing the ability to inhibit interfering...

The link between autonomic stress reactivity and subjective urge/craving has been less systematically examined in behavioral addictions than in substance use disorders. The present study investigated whether problematic Internet users (PIU) show enhanced autonomic stress reactivity than non-PIU, indexed by lower Heart Rate Variability (HRV) and hig...

This study investigated the role of basal cardiac activity and inhibitory control at the beginning of the school year in predicting oral comprehension at the end of the year in pre-schoolers. Forty-three, 4-year-olds participated in the study. At the beginning of the school year children's electrocardiogram at rest was registered followed by the as...

Background: Heart Rate Variability (HRV) is reduced both in depression and in coronary heart disease (CHD) suggesting common pathophysiological mechanisms for the two disorders. Within CHD, cardiac surgery patients (CSP) with postoperative depression are at greater risk of adverse cardiac events. Therefore, CSP would especially benefit from depres...

Dysphoric patients show symptoms associated with Major Depression, although within a narrowed symptomatology spectrum. In prevailing practice, clinicians assess Dysphoria through psychological scores and questionnaires exclusively, therefore without taking into account objective biomarkers. In this study, we investigated heartbeat linear and nonlin...

Contrary to other phobias, individuals with blood phobia do not show a clear-cut withdrawal disposition from the feared stimulus. The study of response inhibition provides insights into reduced action disposition in blood phobia. Twenty individuals with and 20 without blood phobia completed an emotional go/no-go task including phobia-related pictur...

Several studies have examined the neural correlates of mood-related emotional processing in depression, showing a greater reduction of activity in the rostral anterior cingulate cortex (rACC) in response to pleasant relative to unpleasant stimuli in depressed individuals, and the opposite pattern in healthy controls. The present study aimed at exam...

Importance: Borderline personality disorder (BPD) is a debilitating condition, but several psychotherapies are considered effective. Objective: To conduct an updated systematic review and meta-analysis of randomized clinical trials to assess the efficacy of psychotherapies for BPD populations. Data sources: Search terms were combined for borde...

The present study explored the association between some psychological symptoms related to worry, metacognition, and autonomic activity, in a group of 13 patients with Anorexia Nervosa (AN) as compared to 13 healthy controls (HCs). Specifically, trait and state anxiety, obsessive-compulsive symptoms and metacognitive beliefs were assessed through se...

Frontal alpha asymmetry has been proposed to underlie the balance between approach and withdrawal motivation associated to each individual's affective style. Neurofeedback of EEG frontal alpha asymmetry represents a promising tool to reduce negative affect, although its specific effects on left/right frontal activity and approach/withdrawal motivat...

The study of emotional response inhibition could provide novel insight into dysphoria-related deficits in appetitive and aversive motivational systems. Therefore, dysphoric (N = 21) and nondysphoric (N = 21) participants completed an emotional Go/Nogo paradigm, including the presentation of pleasant, neutral and unpleasant pictures. Behavioral meas...

Background: Depression has been associated with poor health-related quality of life (HRQoL) in patients with congestive heart failure (CHF). However, to date, whether somatic-affective and cognitive-depressive symptoms differently contribute to poor HRQoL and behavioral functional capacity in patients with CHF has yet to be investigated. Objectiv...

Threat stimuli typically elicit a psychophysiological response pattern supporting the organism's preparation for active defence. Differently, blood stimuli prompt a distinctive autonomic response pattern and sustained processing, which do not call for clear-cut mobilisation for action. However, the contribution of motor disposition in these respons...

Background Medication overuse headache (MOH) is a major clinical concern and a common health risk. Recent literature stressed the need to manage chronic headache by using integrated biobehavioral approaches. Few studies evaluated how biofeedback can be useful in MOH. The aim of the study is to evaluate in a randomized, controlled, single-blind tria...

High work stress has been consistently associated with disturbed autonomic balance, specifically, lowered vagal cardiac control and increased sympathetic activity, which may lead to increased cardiovascular risk. Stress management procedures have been proposed to reduce autonomic dysfunctions related to work stress in different categories of worker...

The capacity to devote attentional resources in response to body-related signals provided by others is still largely unexplored in individuals with Anorexia Nervosa (AN). Here, we tested this capacity through a novel paradigm that mimics a social interaction with a real partner. Healthy individuals (Experiment 1) and individuals with AN (Experiment...

Objective: To examine whether preoperative biomedical risk and depressive symptoms were associated with physical and mental components of health-related quality of life (HRQoL) in patients 1year after cardiac surgery. Method: Seventy-five patients completed a psychological evaluation, including the Center for Epidemiological Study of Depression...

In recent years there has been a substantial increase in research on heart rate variability (HRV), as an index of autonomic nervous system regulation. HRV-Biofeedback has been applied in a number of medical, psychiatric or health related conditions characterised by reduced HRV. This review provides a general overview of HRV psychophysiology, method...

Several studies have examined the neural correlates of mood-dependent emotional processing in depression, showing a reduced activity in rostral anterior cingulate cortex (rACC) in response to pleasant vs. unpleasant stimuli in depressed individuals, but the opposite pattern in healthy controls. The present study aimed at examining whether frontal t...

Left and right cerebral hemispheres are differently involved in emotional processing. Asymmetry of the electroencephalographic alpha band (an inverse index of cortical activation) provides information on emotion-related cortical lateraliza-tion, as well as on mood changes and disturbances 1. Indeed, relatively less left-than right-sided cortical ac...

Studies on electroencephalographic (EEG) alpha band asymmetry at rest have reported that, compared to healthy controls, dysphoric and clinically depressed individuals often display relatively less left- than right-sided cortical activity at anterior scalp sites, and the opposite pattern at posterior scalp sites. It has also been shown that depressi...

Background: Somatic, but not cognitive–affective, symptoms of depression have been associated with reduced heart rate variability (HRV), and with poor prognosis in cardiovascular patients. However, factors concomitant with cardiovascular diseases may confound the relationship between somatic symptoms of depression and reduced HRV. Therefore, this s...

In any modern society killing is regarded as a severe violation of the legal codes that is subjected to penal judgment. Therefore, it is likely that people take legal consequences into account when deciding about the hypothetical killing of one person in classic moral dilemmas, with legal concerns contributing to decision-making. In particular, by...

Depression is conceptualized as a disorder of emotion. Accordingly, a growing number of studies have examined how depressed mood affects emotional responding, leading to the formulation of the negative potentiation, positive attenuation, and emotional context insensitiveness (ECI) hypotheses. At the physiological level, the support for each of thes...

The aim of this study was to examine the influence of depression on heart rate and heart rate variability (HRV) during emotional imagery in patients after cardiac surgery. Based on the scores of the Center for Epidemiological Studies of Depression (CES-D) scale, 28 patients after cardiac surgery were assigned either to the group with depression (CE...

To examine how impulsiveness influences the emotional modulation of behavioral and neural correlates of response inhibition. Twenty-nine healthy individuals scoring high (HI, N=16) or low (LI, N=13) on motor impulsiveness performed an emotional Go/Nogo task, including the presentation of pleasant, neutral and unpleasant pictures. Behavioral [reacti...

The present study investigated whether dysphoric individuals have a difficulty in disengaging attention from negative stimuli and/or reduced attention to positive information. Sad, neutral and happy facial stimuli were presented in an attention-shifting task to 18 dysphoric and 18 control participants. Reaction times to neutral shapes (squares and...

Objectives : Despite the well-established relation between cardiovascular disease, cognitive dysfunctions and emotion dysregulation, the criteria commonly used to predict cardiovascular risk do not include psychological risk factors. The main aim of this study was to examine the relation between Progetto Cuore score, cognitive functioning and emoti...

Heart rate variability (HRV), as an index of autonomic nervous system (ANS) functioning, is reduced by depression after cardiac surgery, but the underlying mechanisms of this relationship are poorly understood. Poor emotion regulation as a core symptom of depression has also been associated with altered ANS functioning. The present study aimed to e...

Depression and post-traumatic stress disorder frequently occur as a consequence of occupational accidents. To date, research has been primarily focused on high-risk workers, such as police officers or firefighters, and has rarely considered individuals whose occupational environment involves the risk of severe, but not necessarily life-threatening,...

Although pain in the elderly is a common and important problem, it is frequently underestimated and undertreated. Pain assessment in elderly people is often more difficult than in the general population, because of the occurrence of dementia and other cognitive impairments that may compromise the ability to communicate the presence and the intensit...

Traditional studies on moral judgement used resolutions of moral dilemmas that were framed in terms of acceptability of the consequentialist action promoting a greater good, thus overlooking the deontological implications (choices cannot be justified by their consequences). Recently, some authors have suggested a parallelism between automatic, unre...

This study investigated whether the parenting stress-child externalizing behavior link is moderated by children's emotional reactivity, as indexed by skin conductance responses (SCRs). Participants were 61 children aged 9-12 years and their mothers. Mothers completed measures of parenting stress and their children's externalizing symptoms; children...

Objective: The objective was to examine whether preexisting cognitive function rather than cognitive decline associated with intraoperative procedures may predict change in behavioral functional capacity in patients 1 year after cardiac surgery. Method: Forty-five patients completed a cognitive evaluation, including the Trail Making Test part B...

Objective Depression is commonly reported in patients after cardiac surgery and increases the risk of postoperative cardiac morbidity and/or mortality. Although preoperative depression has been implicated as the strongest predictor of depression after surgery, the characteristics thought to influence reactive or persistent depression have been poor...

This extension study investigated the association between preoperative cerebral blood flow (CBF) velocity and postoperative cognitive decline (POCD) at a three-month follow-up in patients who underwent cardiac surgery. Continuous transcranial Doppler ultrasound on both middle cerebral arteries (MCAs) was used preoperatively in 31 right-handed cardi...

The current study investigated whether biofeedback training aimed at increasing respiratory sinus arrhythmia (RSA), a measure of cardiac vagal modulation, can reduce depressive symptoms in patients after cardiac surgery. This randomized controlled study enrolled 26 patients after first-time cardiac surgery. The patients were randomly assigned to an...

The present descriptive study was aimed at evaluating posttraumatic and depressive symptoms and their cooccurrence, in a sample of victims of workplace accidents. Also, posttraumatic negative cognitions were assessed. Eighty-five injured workers were evaluated, using the PTSD Symptom Scale, the Beck Depression Inventory II, and the posttraumatic Co...

Our objective was to determine the role of asymmetry and the nature of microembolization on postoperative cognitive decline in patients who had undergone heart valve surgery. Continuous transcranial Doppler ultrasound was intraoperatively used for both middle cerebral arteries in 13 right-handed heart valve surgery patients to detect microembolizat...

The present study aimed at investigating whether the way offers are framed in the Ultimatum Game (UG) affects behavioral and autonomic responses in men and women. The "I give you" and "I take" expressions were used as gain and loss frames, respectively. Skin conductance and heart rate were recorded as indices of autonomic activation in response to...

This study investigated the temporal dynamics of emotional and cognitive processing underlying decision-making in moral judgment. Thirty-seven participants were presented with a set of 60 dilemmas varying in whether killing one individual was an intended means to save others (instrumental dilemmas) or a foreseen but unintended consequence (incident...

This case series investigates whether painful electrical stimulation increases the early prognostic value of both somatosensory-evoked potentials and functional magnetic resonance imaging in comatose patients after cardiac arrest. Three single cases with hypoxic-ischemic encephalopathy were considered. A neurophysiological evaluation with an electr...

Evidence has revealed that elevated blood pressure is associated with reduced sensitivity to noxious stimulation. The current study investigated the association between resting blood pressure and nociception during anesthesia in 32 patients undergoing cardiac surgery. Pain-related middle latency cortical somatosensory evoked potentials (MLCEPs) eli...

To investigate whether the electrocortical activity underlying the anticipation and processing of emotional stimuli is enhanced in individuals with recurrent episodes of vasovagal syncope (VVS). Fifteen fainters and 15 age-matched healthy controls were presented a S1-S2 task, where the content of high-arousal pleasant and unpleasant, and neutral pi...

Postoperative cognitive decline (POCD) is a frequent complication after cardiac surgery. Although intraoperative events are risk factors for POCD, the role played by preoperative hypoperfusion in cognitive decline has not yet been investigated. It is also unknown whether the impact of preoperative hypoperfusion in the left or right middle cerebral...

Gilles de la Tourette syndrome (TS) is characterized by motor and vocal tic manifestations, often accompanied by behavioral, cognitive and affective dysfunctions. Electroencephalography of patients with TS has revealed reduced Sensorimotor Rhythm (SMR) and excessive fronto-central Theta activity, that presumably underlie motor and cognitive disturb...

Although adverse neurologic outcomes are common complications of cardiac surgery, intraoperative brain monitoring has not received adequate attention. The aim of the present study was to evaluate the effectiveness of multimodal brain monitoring in the prevention of major brain injury and reducing the duration of mechanical ventilation, intensive ca...

The study was aimed at examining the effect of a short Heart Rate-Biofeedback (HR-BF) protocol on systolic (SBP) and diastolic (DBP) blood pressure levels and BP emotional reactivity. Twenty-four unmedicated outpatients with pre- and stage 1 hypertension, were randomly assigned to active treatment (BF-Training) or control (BP-Monitoring) group. Sub...

The present preliminary study was aimed at investigating the electrocortical correlates of attentional allocation toward emotional stimuli in children and adolescents with migraine by means of the event-related potentials. The electroencephalogram was continuously recorded in 7 migrainous children and 8 healthy controls while they were looking at a...

Consequentialists typically say that killing one person in order to save several others may be the right thing to do. Deontologists, in contrast, typically say that it is wrong to kill one person for the benefit of others. In traditional studies on moral judgment, participants were asked to evaluate the appropriateness or the moral acceptability of...

Several composite risk score indices, the most common being the Stroke Index and the European System for Cardiac Operative Risk Evaluation (EuroSCORE), have been developed to predict perioperative events such as cerebrovascular accidents or death. The main aim of the present study was to compare the preoperative associations between the Stroke Inde...

No specific and sensitive method is available in routine clinical practice to detect pain in anaesthetised patients during surgery. The main aim of the present study was to investigate whether intraoperative somatosensory evoked potentials, the bispectral index, electroencephalogram, blood pressure and heart rate change during painful stimulation i...

A large body of literature sustains the association between long-lasting caregiving for impaired significant others and increased health risk. Depression, elevated heart rate, and blood pressure at rest are key measures of health risk, mostly cardiovascular, which have been generally studied in caregivers of patients affected by dementia or chronic...

To investigate the blood pressure (BP) reaction to public speaking performed according to different emotionally distressing scenarios in stage 1 hypertension. METHODS. We assessed 64 hypertensive and 30 normotensive subjects. They performed three speech tasks with neutral, anger and anxiety scenarios. BP was assessed with the Finometer beat-to-beat...

The presence of an attentional bias towards disorder-related stimuli has not been consistently demonstrated in blood phobics. The present study was aimed at investigating whether or not an attentional bias, as measured by event-related potentials (ERPs), could be highlighted in blood phobics by inducing cognitive-emotional sensitization through the...

The investigation of cognitive functions in individuals who developed post-traumatic symptoms after occupational accidents has been overlooked in the relevant literature. The present study was aimed at assessing attention, memory and executive functions in individuals with post-traumatic symptoms after a workplace accident. Moreover, possible prese...

Previous research has shown that in healthy individuals blood-related stimuli elicit a distinctive autonomic response pattern and heightened processing as compared with other unpleasant and arousing visual stimuli. In addition, growing evidence suggests that information processing of disorder-related stimuli is also different in blood phobia as com...

Objective: To examine the effect of dynamic resistance exercise training on blood pressure (BP) and other cardiovascular risk factors in healthy sedentary adults. Design and Methods: Meta-analysis of studies retrieved from four electronic databases as well as cross-referencing from identified articles. Inclusion criteria were as follows: randomized...

The objective of this study was to investigate the effect of regular physical activity on the haemodynamic response to public speaking and to evaluate the long-term effect of exercise on development of hypertension. We assessed 75 sedentary and 44 active participants screened for stage 1 hypertension with consistent activity habits and 63 normotens...