Investigation of heart rate variability in major depression patients using wavelet packet transform

Feature of Heart Rate Variability and Metabolic Mechanism in Female College Students with Depression

Purpose

To explore the effects of depression on cardiac autonomic nerve function and related metabolic pathways, the heart rate variability (HRV) and urinary differential metabolites were detected on the college students with depression.

Methods

12 female freshmen with depression were filtered by the Beck Depression Inventory (BDI-II) and Self-rating Depression Scale (SDS). By wearing an HRV monitoring system, time domain indexes and frequency domain indexes were measured over 24 hours. Liquid chromatography–mass spectrometry (LC-MS) was used to detect their urinary differential metabolites. Differential metabolites were identified by principal component analysis (PCA) and orthogonal projections to latent structures discriminant analysis (OPLS-DA). The metabolic pathways related to these differential metabolites were analyzed by the MetPA database.

Results

Stress time was significantly increased, and recovery time was markedly decreased in the depression group compared with the control group (p < 0.001). Standard deviation of the normal-to-normal R interval (SDNN), root mean square of the beat-to-beat differences (RMSSD), high frequency (HF), and low frequency (LF) were decreased significantly (p < 0.001). Standard deviation of the normal-to-normal R interval (SDNN), root mean square of the beat-to-beat differences (RMSSD), high frequency (HF), and low frequency (LF) were decreased significantly (

Conclusion

Some autonomic nervous system disruption, high stress, and poor fatigue recovery were confirmed in college students with depression. The metabolic mechanism involved the disruption of coenzyme Q biosynthesis, glycine-serine-threonine metabolism, tyrosine metabolism, pyrimidine metabolism, and steroid metabolism under daily stress.

Effect of gender-related depression on heart rate variability during an autonomic nervous test

Patients with depression have lower heart rate variability (HRV) compared with controls. However, studies have indicated HRV difference between male and female controls. The gender effect might be interactive with the depression effect on the HRV, resulting in a low accuracy of recognising the patients with depression from the controls. Our study explores the effect of gender-related depression on HRV. Four ANS tests including resting, deep breathing, Valsalva, and orthostatic test are employed as stimuli. HRV were collected from 182 subjects comprising 91 depressive patients (33 females/58 males) and 91 controls (33 females/58 males) in the four tests. Time and frequency domains and nonlinear parameters are employed to quantify HRV. Two-way ANOVA is applied to evaluate the effect of gender-related depression. Most HRV parameters of the patients significantly differ from those of the controls, but some parameters indicate different depression effect between the males and females in the deep breathing and Valsalva test. Some HRV parameters illustrate significant difference between the male and female controls. Therefore, the effect of depression on HRV of each gender should be investigated.

Autonomic dysfunction of gastric motility in major depression

BACKGROUND

Patients suffering from major depressive disorder (MDD) often complain about somatic symptoms. Cardiac complaints have been examined predominantly. However, gastrointestinal complaints are also reported frequently and are associated with worse outcomes. The research concerning changes in gastric motility of these patients is rather sparse. The aim of our study was to determine dysfunction of gastric motility and gastrointestinal symptoms in MDD. The duration and severity of MDD were examined regarding its influence over gastric emptying.

METHODS

Gastric emptying was determined by a ¹³C-acetate breath test in patients with MDD (n = 29) and healthy control subjects (n = 51). Prior to this, depressive illness was operationalized using external and self-assessment scales (HAMD-21, MADRS, BDI, CGI). Whether the severity or duration of MDD influenced the gastric emptying parameters was examined using Spearman's correlation. In addition, autonomic complaints were recorded by means of an ANS score. Each ANS score item was determined using a Mann-Whitney U or Kruskal-Wallis test concerning the gastric emptying parameters.

RESULTS

There was a significant difference in the parameters of the maximum gastric emptying rate (T_max) and gastric half emptying time T_1/2b between patients with MDD and healthy control subjects (T_max 66.21min vs 53.35min, p < 0.006, T_1/2b 207.59min vs 133.27min, p < 0.005). There was a significant negative correlation between T_max and the severity of MDD determined with the depression rating scales BDI (Spearman's rank - 0.521, p = 0.013) and HAMD-21 (r - 0.384, p = 0.048). No correlation was found between the duration of MDD and the maximum gastric emptying rate (r - 0.125, p = 0.519) and gastric half emptying time (r - 0.62, p = 0.749).

CONCLUSION

Gastrointestinal motility is significantly impaired in patients with MDD compared to healthy control subjects. Autonomic complaints were indicated frequently in MDD patients. The duration of MDD had no influence over the time of gastric emptying. There was a significant negative correlation between the severity of MDD and T_max, indicating that the T_max was reached earlier with the progression of MDD. The slowing of gastric motility in MDD patients is likely a result of a dysfunction of the autonomic nervous system.