1
|
Darling AM, Dominguez CM, Skow RJ, Mogle J, Saunders EFH, Fadel PJ, Greaney JL. Cardiac autonomic function is preserved in young adults with major depressive disorder. Am J Physiol Heart Circ Physiol 2024; 326:H648-H654. [PMID: 38214903 PMCID: PMC11221799 DOI: 10.1152/ajpheart.00762.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 01/08/2024] [Accepted: 01/08/2024] [Indexed: 01/13/2024]
Abstract
The prevalence of major depressive disorder (MDD) is highest in young adults and contributes to an increased risk of developing future cardiovascular disease (CVD). However, the underlying mechanisms remain unclear. The studies examining cardiac autonomic function that have included young unmedicated adults with MDD report equivocal findings, and few have considered the potential influence of disease severity or duration. We hypothesized that heart rate variability (HRV) and cardiac baroreflex sensitivity (BRS) would be reduced in young unmedicated adults with MDD (18-30 yr old) compared with healthy nondepressed young adults (HA). We further hypothesized that greater symptom severity would be related to poorer cardiac autonomic function in young adults with MDD. Heart rate and beat-to-beat blood pressure were continuously recorded during 10 min of supine rest to assess HRV and cardiac BRS in 28 HA (17 female, 22 ± 3 yr old) and 37 adults with MDD experiencing current symptoms of mild-to-moderate severity (unmedicated; 28 female, 20 ± 3 yr old). Neither HRV [root mean square of successive differences between normal heartbeats (RMSSD): 63 ± 34 HA vs. 79 ± 36 ms MDD; P = 0.14] nor cardiac BRS (overall gain, 21 ± 10 HA vs. 23 ± 7 ms/mmHg MDD; P = 0.59) were different between groups. In young adults with MDD, there was no association between current depressive symptom severity and either HRV (RMSSD, R2 = 0.004, P = 0.73) or cardiac BRS (overall gain, R2 = 0.02, P = 0.85). Taken together, these data suggest that cardiac autonomic dysfunction may not contribute to elevated cardiovascular risk factor profiles in young unmedicated adults with MDD of mild-to-moderate severity.NEW & NOTEWORTHY This study investigated cardiac autonomic function in young unmedicated adults with major depressive disorder (MDD). The results demonstrated that both heart rate variability and cardiac baroreflex sensitivity were preserved in young unmedicated adults with MDD compared with healthy nondepressed young adults. Furthermore, in young adults with MDD, current depressive symptom severity was not associated with any indices of cardiac autonomic function.
Collapse
Affiliation(s)
- Ashley M Darling
- Department of Kinesiology, The University of Texas at Arlington, Arlington, Texas, United States
| | - Cynthia M Dominguez
- Department of Bioengineering, The University of Texas at Arlington, Arlington, Texas, United States
| | - Rachel J Skow
- Department of Kinesiology, The University of Texas at Arlington, Arlington, Texas, United States
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Jacqueline Mogle
- Department of Psychology, Clemson University, Clemson, South Carolina, United States
| | - Erika F H Saunders
- Department of Psychiatry and Behavioral Health, Penn State College of Medicine, Hershey, Pennsylvania, United States
| | - Paul J Fadel
- Department of Kinesiology, The University of Texas at Arlington, Arlington, Texas, United States
| | - Jody L Greaney
- Department of Kinesiology, The University of Texas at Arlington, Arlington, Texas, United States
- Department of Health Behavior and Nutrition Sciences, University of Delaware, Newark, Delaware, United States
| |
Collapse
|
2
|
Čukić M, Savić D, Sidorova J. When Heart Beats Differently in Depression: Review of Nonlinear Heart Rate Variability Measures. JMIR Ment Health 2023; 10:e40342. [PMID: 36649063 PMCID: PMC9890355 DOI: 10.2196/40342] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 11/28/2022] [Accepted: 12/06/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Disturbed heart dynamics in depression seriously increases mortality risk. Heart rate variability (HRV) is a rich source of information for studying this dynamics. This paper is a meta-analytic review with methodological commentary of the application of nonlinear analysis of HRV and its possibility to address cardiovascular diseases in depression. OBJECTIVE This paper aimed to appeal for the introduction of cardiological screening to patients with depression, because it is still far from established practice. The other (main) objective of the paper was to show that nonlinear methods in HRV analysis give better results than standard ones. METHODS We systematically searched on the web for papers on nonlinear analyses of HRV in depression, in line with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020 framework recommendations. We scrutinized the chosen publications and performed random-effects meta-analysis, using the esci module in jamovi software where standardized effect sizes (ESs) are corrected to yield the proof of the practical utility of their results. RESULTS In all, 26 publications on the connection of nonlinear HRV measures and depression meeting our inclusion criteria were selected, examining a total of 1537 patients diagnosed with depression and 1041 healthy controls (N=2578). The overall ES (unbiased) was 1.03 (95% CI 0.703-1.35; diamond ratio 3.60). We performed 3 more meta-analytic comparisons, demonstrating the overall effectiveness of 3 groups of nonlinear analysis: detrended fluctuation analysis (overall ES 0.364, 95% CI 0.237-0.491), entropy-based measures (overall ES 1.05, 95% CI 0.572-1.52), and all other nonlinear measures (overall ES 0.702, 95% CI 0.422-0.982). The effectiveness of the applied methods of electrocardiogram analysis was compared and discussed in the light of detection and prevention of depression-related cardiovascular risk. CONCLUSIONS We compared the ESs of nonlinear and conventional time and spectral methods (found in the literature) and demonstrated that those of the former are larger, which recommends their use for the early screening of cardiovascular abnormalities in patients with depression to prevent possible deleterious events.
Collapse
Affiliation(s)
- Milena Čukić
- Empa Materials Science and Technology, Empa Swiss Federal Institute, St Gallen, Switzerland
| | - Danka Savić
- Vinča Institute for Nuclear Physics, Laboratory of Theoretical and Condensed Matter Physics 020/2, Vinca Institute, University of Belgrade, Belgrade, Serbia
| | - Julia Sidorova
- Bioinformatics Platform, Hospital Clínic, Barcelona, Spain
| |
Collapse
|
3
|
Kobus S, Buehne AM, Kathemann S, Buescher AK, Lainka E. Effects of Music Therapy on Vital Signs in Children with Chronic Disease. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19116544. [PMID: 35682129 PMCID: PMC9180355 DOI: 10.3390/ijerph19116544] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 05/24/2022] [Accepted: 05/25/2022] [Indexed: 11/26/2022]
Abstract
Background: Recent research found evidence supporting music therapy for hospitalized children with chronic diseases. The aim of this study was to investigate the effect of music therapy on hospitalized children’s vital signs. Methods: In this prospective study, children with chronic gastroenterological and nephrological diseases received active or receptive music therapy two to four times a week until discharge from hospital at the pediatric special care unit (SCU) and pediatric intensive care unit (ICU). Baseline and post-therapy heart rate, oxygen saturation and blood pressure were recorded and analyzed as control values at three points on the same day when the children were alone in their patient room at rest. Results: A total of 83 children, median 3 age of years (range one month to eighteen years) received music therapy. In total, 377 music therapy sessions were treated: 200 receptive therapy (78 ICU, 122 SCU) and 177 with active therapy (0 ICU, 177 SCU). Music therapy interventions showed changes in vital signs during music therapy sessions. After music therapy, heart rates decreased by 18 beats per minute (95% confidence interval (CI), −19.4 to (−16.8)), oxygen saturation increased by 2.3% (95% CI, 2.2 to 2.5), systolic blood pressure decreased by 9.2 (95% CI, −10.6 to −7.7) and diastolic blood pressure decreased by 7.9 (95% CI, −9.6 to −6.3). When music therapy was applied at the SCU (ICU), heart rates significantly reduced by 17.9 (18.9) beats per min, oxygen saturation increased by 2.4% (2.1%) and blood pressure reduced by 9.2 (2.8) mmHg (systolic) and 7.9 (0.3) mmHg (diastolic). Almost all control values were better than directly before the intervention. However, after music therapy intervention, the children showed better values in vital signs compared to being alone in their patient room. Conclusion: Music therapy is an added value for children with kidney and liver/gastrointestinal diseases during their hospital stay.
Collapse
Affiliation(s)
- Susann Kobus
- Center of Artistic Therapy, University Medicine Essen, 45147 Essen, Germany
- Correspondence:
| | - Alexandra M. Buehne
- Clinic for Pediatrics II, University Children’s Hospital Essen, 45147 Essen, Germany; (A.M.B.); (S.K.); (A.K.B.); (E.L.)
| | - Simone Kathemann
- Clinic for Pediatrics II, University Children’s Hospital Essen, 45147 Essen, Germany; (A.M.B.); (S.K.); (A.K.B.); (E.L.)
| | - Anja K. Buescher
- Clinic for Pediatrics II, University Children’s Hospital Essen, 45147 Essen, Germany; (A.M.B.); (S.K.); (A.K.B.); (E.L.)
| | - Elke Lainka
- Clinic for Pediatrics II, University Children’s Hospital Essen, 45147 Essen, Germany; (A.M.B.); (S.K.); (A.K.B.); (E.L.)
| |
Collapse
|
4
|
Ahmed T, Qassem M, Kyriacou PA. Physiological monitoring of stress and major depression: A review of the current monitoring techniques and considerations for the future. Biomed Signal Process Control 2022. [DOI: 10.1016/j.bspc.2022.103591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
|
5
|
Voetterl H, Miron JP, Mansouri F, Fox L, Hyde M, Blumberger DM, Daskalakis ZJ, Vila-Rodriguez F, Sack AT, Downar J. Investigating EEG biomarkers of clinical response to low frequency rTMS in depression. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2021. [DOI: 10.1016/j.jadr.2021.100250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
|
6
|
Unursaikhan B, Tanaka N, Sun G, Watanabe S, Yoshii M, Funahashi K, Sekimoto F, Hayashibara F, Yoshizawa Y, Choimaa L, Matsui T. Development of a Novel Web Camera-Based Contact-Free Major Depressive Disorder Screening System Using Autonomic Nervous Responses Induced by a Mental Task and Its Clinical Application. Front Physiol 2021; 12:642986. [PMID: 34054567 PMCID: PMC8160373 DOI: 10.3389/fphys.2021.642986] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 04/23/2021] [Indexed: 12/28/2022] Open
Abstract
Background To increase the consultation rate of potential major depressive disorder (MDD) patients, we developed a contact-type fingertip photoplethysmography-based MDD screening system. With the outbreak of SARS-CoV-2, we developed an alternative to contact-type fingertip photoplethysmography: a novel web camera-based contact-free MDD screening system (WCF-MSS) for non-contact measurement of autonomic transient responses induced by a mental task. Methods The WCF-MSS measures time-series interbeat intervals (IBI) by monitoring color tone changes in the facial region of interest induced by arterial pulsation using a web camera (1920 × 1080 pixels, 30 frames/s). Artifacts caused by body movements and head shakes are reduced. The WCF-MSS evaluates autonomic nervous activation from time-series IBI by calculating LF (0.04-0.15 Hz) components of heart rate variability (HRV) corresponding to sympathetic and parasympathetic nervous activity and HF (0.15-0.4 Hz) components equivalent to parasympathetic activities. The clinical test procedure comprises a pre-rest period (Pre-R; 140 s), mental task period (MT; 100 s), and post-rest period (Post-R; 120 s). The WCF-MSS uses logistic regression analysis to discriminate MDD patients from healthy volunteers via an optimal combination of four explanatory variables determined by a minimum redundancy maximum relevance algorithm: HF during MT (HF MT ), the percentage change of LF from pre-rest to MT (%ΔLF(Pre-R⇒MT) ), the percentage change of HF from pre-rest to MT (%ΔHF(Pre-R⇒MT) ), and the percentage change of HF from MT to post-rest (%ΔHF(MT⇒Post-R) ). To clinically test the WCF-MSS, 26 MDD patients (16 males and 10 females, 20-58 years) were recruited from BESLI Clinic in Tokyo, and 27 healthy volunteers (15 males and 12 females, 18-60 years) were recruited from Tokyo Metropolitan University and RICOH Company, Ltd. Electrocardiography was used to calculate HRV variables as references. Result The WCF-MSS achieved 73% sensitivity and 85% specificity on 5-fold cross-validation. IBI correlated significantly with IBI from reference electrocardiography (r = 0.97, p < 0.0001). Logit scores and subjective self-rating depression scale scores correlated significantly (r = 0.43, p < 0.05). Conclusion The WCF-MSS seems a promising contact-free MDD screening apparatus. This method enables web camera built-in smartphones to be used as MDD screening systems.
Collapse
Affiliation(s)
- Batbayar Unursaikhan
- Graduate School of System Design, Tokyo Metropolitan University, Tokyo, Japan.,Machine Intelligence Laboratory, School of Engineering and Applied Sciences, National University of Mongolia, Ulaanbaatar, Mongolia
| | | | - Guanghao Sun
- Graduate School of Informatics and Engineering, The University of Electro-Communications, Tokyo, Japan
| | | | | | | | - Fumihiro Sekimoto
- Graduate School of Informatics and Engineering, The University of Electro-Communications, Tokyo, Japan
| | - Fumiaki Hayashibara
- Graduate School of System Design, Tokyo Metropolitan University, Tokyo, Japan
| | - Yutaka Yoshizawa
- Graduate School of System Design, Tokyo Metropolitan University, Tokyo, Japan
| | - Lodoiravsal Choimaa
- Machine Intelligence Laboratory, School of Engineering and Applied Sciences, National University of Mongolia, Ulaanbaatar, Mongolia
| | - Takemi Matsui
- Graduate School of System Design, Tokyo Metropolitan University, Tokyo, Japan
| |
Collapse
|
7
|
Nelson BW, Sheeber L, Pfeifer J, Allen NB. Psychobiological markers of allostatic load in depressed and nondepressed mothers and their adolescent offspring. J Child Psychol Psychiatry 2021; 62:199-211. [PMID: 32438475 PMCID: PMC8489515 DOI: 10.1111/jcpp.13264] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/21/2020] [Indexed: 12/21/2022]
Abstract
BACKGROUND A substantial body of research has emerged suggesting that depression is strongly linked to poor physical health outcomes, which may be partly due to increased allostatic load across stress response systems. Interestingly, health risks associated with depression are also borne by the offspring of depressed persons. Our aim was to simultaneously investigate whether maternal depression is associated not only with increased allostatic load across cardiac control, inflammation, cellular aging, but also if this is transmitted to adolescent children, possibly increasing the risk for early onset of psychiatric conditions and disease in these offspring. METHODS A preregistered, case-control study of 180 low-income mothers (50% mothers depressed, 50% mothers nondepressed) and their adolescent offspring was conducted to determine how depressed mothers and their adolescent offspring systematically differ in terms of autonomic, sympathetic, and parasympathetic cardiac control; inflammation; cellular aging; and behavioral health in offspring, which are indicators suggestive of higher allostatic load. RESULTS Findings indicate that depressed mothers and their adolescent offspring differ in terms of comorbid mental and physical health risk profiles that are suggestive of higher allostatic load. Findings indicate that depressed mothers exhibit elevated resting heart rate and decreased heart rate variability, and adolescent offspring of depressed mothers exhibit greater mental health symptoms, elevated heart rate, and accelerated biological aging (shorter telomeres). These effects persisted after controlling for a range of potential covariates, including medication use, sex, age, and adolescents' own mental health symptoms. CONCLUSIONS Findings indicate that maternal depression is associated with increased allostatic load in depressed women and their adolescent children, possibly increasing risk for early onset of psychiatric conditions and disease in these offspring. Future research is needed to delineate why some biological systems are more impacted than others and to explore how findings might inform preventative programs targeted at adolescent offspring of depressed mothers.
Collapse
Affiliation(s)
- Benjamin W. Nelson
- Department of Psychology, University of Oregon, Eugene, OR, USA
- Oregon Research Institute, Eugene, OR, USA
- School of Medicine, University of Washington, Seattle, WA, USA
| | | | | | | |
Collapse
|
8
|
Goswami N, Abulafia C, Vigo D, Moser M, Cornelissen G, Cardinali D. Falls Risk, Circadian Rhythms and Melatonin: Current Perspectives. Clin Interv Aging 2020; 15:2165-2174. [PMID: 33204081 PMCID: PMC7666981 DOI: 10.2147/cia.s283342] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Accepted: 11/03/2020] [Indexed: 01/31/2023] Open
Abstract
Aging is associated with weakening of the circadian system. The circadian amplitude of most physiological variables is reduced, while the circadian phase becomes more labile and tends to occur earlier with advancing age. As the incidence of falls in older persons could follow circadian variations, a better understanding of conditions in which falls occur can lead to the implementation of countermeasures (such as adjusting the scheduling of hospital staff, or changing the timing of anti-hypertensive medication if falls are related to undesirable circadian patterns of blood pressure and/or heart rate). This includes knowing the times of the day, days of the week, and times of the year when falls are more likely to occur at home or in the hospital. Additionally, the links between aging processes and factors associated with an increased risk of developing autonomic dysfunction are well established. A strong association between heart rate variability indexes and aging has been shown. Circadian rhythms of autonomous nervous system activity may play important role for maintenance of orthostatic tolerance. Whether one is concerned with disease prediction and prevention or maintenance of healthy aging, the study of circadian rhythms and the broader time structure underlying physiopathology is helpful in terms of screening, early diagnosis and prognosis, as well as the timely institution of prophylactic and/or palliative/curative treatment. Timing the administration of such treatment as a function of circadian (and other) rhythms also could lead to reduction of falls in older persons. Finally, a prominent circadian rhythm characterizes melatonin, which peaks during the night. The circadian amplitude of melatonin decreases as a function of age, raising the questions whether such a decrease in the circadian amplitude of melatonin relates to a higher risk of falls and, if so, whether melatonin supplementation may be an effective countermeasure. This narrative review assesses the relationships between fall risk and the potential role circadian rhythms and melatonin play in mitigating this risk. We aim to provide healthcare workers adequate information about fall risk in older persons, including the potential role of the circadian rhythms and/or melatonin, as well as to lay foundations for future fall prevention interventional studies.
Collapse
Affiliation(s)
- Nandu Goswami
- Physiology Division, Otto Loewi Research Center for Vascular Biology, Immunology and Inflammation, Medical University of Graz, Graz, Austria
| | - Carolina Abulafia
- Institute for Biomedical Research (BIOMED), Catholic University of Argentina (UCA) and National Scientific and Technical Research Council (CONICET), Autonomous City of Buenos Aires, Argentina
| | - Daniel Vigo
- Institute for Biomedical Research (BIOMED), Catholic University of Argentina (UCA) and National Scientific and Technical Research Council (CONICET), Autonomous City of Buenos Aires, Argentina
| | - Maximilian Moser
- Physiology Division, Otto Loewi Research Center for Vascular Biology, Immunology and Inflammation, Medical University of Graz, Graz, Austria
| | | | - Daniel Cardinali
- Institute for Biomedical Research (BIOMED), Catholic University of Argentina (UCA) and National Scientific and Technical Research Council (CONICET), Autonomous City of Buenos Aires, Argentina
| |
Collapse
|
9
|
Bair A, Marksteiner J, Falch R, Ettinger U, Reyes Del Paso GA, Duschek S. Features of autonomic cardiovascular control during cognition in major depressive disorder. Psychophysiology 2020; 58:e13628. [PMID: 32621782 DOI: 10.1111/psyp.13628] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 05/18/2020] [Accepted: 05/22/2020] [Indexed: 11/27/2022]
Abstract
Previous research has suggested reduced parasympathetic cardiac regulation during cognitive activity in major depressive disorder (MDD). However, little is known about possible abnormalities in sympathetic control and cardiovascular reactivity. This study aimed to provide a comprehensive analysis of autonomic cardiovascular control in the context of executive functions in MDD. Thirty six MDD patients and 39 healthy controls participated. Parameters of sympathetic (pre-ejection period, PEP) and parasympathetic control (high and low frequency heart rate variability, HF HRV, LF HRV; and baroreflex sensitivity, BRS) as well as RR interval were obtained at rest and during performance of executive function tasks (number-letter task, n-back task, continuous performance test, and Stroop task). Patients, as compared to controls, exhibited lower HF HRV and LF HRV during task execution and smaller shortenings in PEP and RR interval between baseline and tasks. They displayed longer reaction times during all conditions of the tasks and more omission errors and false alarms on the continuous performance test. In the total sample, on-task HF HRV, LF HRV and BRS, and reactivity in HF HRV, LF HRV, and PEP, were positively associated with task performance. As performance reduction arose independent of executive function load of the tasks, the behavioral results reflect impairments in attention and processing speed rather than executive dysfunctions in MDD. Abnormalities in cardiovascular control during cognition in MDD appear to involve both divisions of the autonomic nervous system. Low tonic parasympathetic control and blunted sympathetic reactivity imply reduced physiological adjustment resources and, by extension, provide suboptimal conditions for cognitive performance.
Collapse
Affiliation(s)
- Angela Bair
- Institute of Psychology, UMIT - University of Health Sciences, Medical Informatics and Technology, Hall in Tirol, Austria
| | - Josef Marksteiner
- Department of Psychiatry, County Hospital of Hall in Tirol, Hall in Tirol, Austria
| | - Reingard Falch
- Department of Psychiatry, County Hospital of Hall in Tirol, Hall in Tirol, Austria
| | | | | | - Stefan Duschek
- Institute of Psychology, UMIT - University of Health Sciences, Medical Informatics and Technology, Hall in Tirol, Austria
| |
Collapse
|
10
|
Fantini-Hauwel C, Batselé E, Gois C, Noel X. Emotion Regulation Difficulties Are Not Always Associated With Negative Outcomes on Women: The Buffer Effect of HRV. Front Psychol 2020; 11:697. [PMID: 32425846 PMCID: PMC7212345 DOI: 10.3389/fpsyg.2020.00697] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Accepted: 03/23/2020] [Indexed: 11/13/2022] Open
Abstract
The Heart Rate Variability (HRV) is regularly associated with depression and trait emotion regulation. However, the interaction between HRV and emotional disturbances is still debated. Only a few studies indicate that HRV moderates the effect of personality traits involved in psychopathological disorders. Since the regulation of emotions is a transdiagnostic factor for most psychological disorders, this study aimed to explore whether HRV moderates the relationship between trait emotion dysregulation and depressive symptoms. We collected data from 148 participants via online questionnaires and HRV measurements at rest. Results show for the 114 female remaining in the study that whereas high emotion regulation difficulties led to higher depressive symptoms severity when resting HRV is low, depressive symptoms remain stable in the same condition but when resting HRV is high. Overall, high resting HRV appears to dampen the consequences of trait emotion regulation difficulties. Further studies are needed to confirm this result, but this suggests that usual response tendencies could be overcome by deactivating or inhibitory processes such as those implied in cognitive flexibility reflected through HRV, according to the neurovisceral integration model.
Collapse
Affiliation(s)
- Carole Fantini-Hauwel
- Department of Psychology, Research Center for Clinical Psychology, Psychopathology and Psychosomatics, Université libre de Bruxelles, Brussels, Belgium
| | - Elise Batselé
- Department of Psychology, Research Center for Clinical Psychology, Psychopathology and Psychosomatics, Université libre de Bruxelles, Brussels, Belgium
| | - Cassandra Gois
- Department of Psychology, Research Center for Clinical Psychology, Psychopathology and Psychosomatics, Université libre de Bruxelles, Brussels, Belgium
| | - Xavier Noel
- Department of Medicine, Psychological Medicine Laboratory, Faculty of Medicine, Université libre de Bruxelles, Brussels, Belgium
| |
Collapse
|
11
|
Physical Activity, Nutritional Status, and Autonomic Nervous System Activity in Healthy Young Adults with Higher Levels of Depressive Symptoms and Matched Controls without Depressive Symptoms: A Cross-Sectional Study. Nutrients 2020; 12:nu12030690. [PMID: 32143525 PMCID: PMC7146113 DOI: 10.3390/nu12030690] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 03/01/2020] [Accepted: 03/02/2020] [Indexed: 01/22/2023] Open
Abstract
The aim of the present study was to comprehensively investigate physical activity (PA), nutritional status, and autonomic nervous system (ANS) activity in healthy young adults with higher levels of depressive symptoms and in sex- and age-matched controls without depressive symptoms. We recruited 35 healthy young adults with higher levels of depressive symptoms (DEP group) and 35 controls (CON group). Measurement items were daily number of steps, the duration and amount of PA ≥3 metabolic equivalents (METs), exercise habits, the consumption of tryptophan (TRP) and/or vitamin B6-rich foods, plasma levels of total TRP and vitamin B6 levels, and ANS activity. The DEP group had fewer daily steps, as well as duration and amount of PA ≥3 METs, than the CON group, while there was no difference in exercise habits. The intake frequency of TRP and/or vitamin B6-rich foods and plasma vitamin B6 levels of the DEP group were rather higher than those in the control group. Plasma TRP levels and ANS activity were comparable in the two groups. Our findings suggest that a decline in overall PA, including daily steps as well as duration and amount of moderate-to-vigorous-intensity PA, could be associated with higher levels of depressive symptoms in healthy young adults. Their dietary intake of TRP and/or vitamin B6-rich foods was adequate, and there was no ANS activity dysfunction.
Collapse
|
12
|
Rosenblum M, Frühwirth M, Moser M, Pikovsky A. Dynamical disentanglement in an analysis of oscillatory systems: an application to respiratory sinus arrhythmia. PHILOSOPHICAL TRANSACTIONS. SERIES A, MATHEMATICAL, PHYSICAL, AND ENGINEERING SCIENCES 2019; 377:20190045. [PMID: 31656138 PMCID: PMC6834001 DOI: 10.1098/rsta.2019.0045] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/28/2019] [Indexed: 05/17/2023]
Abstract
We develop a technique for the multivariate data analysis of perturbed self-sustained oscillators. The approach is based on the reconstruction of the phase dynamics model from observations and on a subsequent exploration of this model. For the system, driven by several inputs, we suggest a dynamical disentanglement procedure, allowing us to reconstruct the variability of the system's output that is due to a particular observed input, or, alternatively, to reconstruct the variability which is caused by all the inputs except for the observed one. We focus on the application of the method to the vagal component of the heart rate variability caused by a respiratory influence. We develop an algorithm that extracts purely respiratory-related variability, using a respiratory trace and times of R-peaks in the electrocardiogram. The algorithm can be applied to other systems where the observed bivariate data can be represented as a point process and a slow continuous signal, e.g. for the analysis of neuronal spiking. This article is part of the theme issue 'Coupling functions: dynamical interaction mechanisms in the physical, biological and social sciences'.
Collapse
Affiliation(s)
- M. Rosenblum
- Institute of Physics and Astronomy, University of Potsdam, Karl-Liebknecht-Str. 24/25, 14476 Potsdam-Golm, Germany
- Control Theory Department, Institute of Information Technologies, Mathematics and Mechanics, Lobachevsky University Nizhny Novgorod, Nizhny Novgorod, Russia
| | - M. Frühwirth
- Human Research Institute of Health Technology and Prevention Research, Franz Pichler Street 30, 8160 Weiz, Austria
| | - M. Moser
- Human Research Institute of Health Technology and Prevention Research, Franz Pichler Street 30, 8160 Weiz, Austria
- Physiology Division, Otto Loewi Research Center for Vascular Biology, Immunology and Inflammation, Medical University of Graz, Neue Stiftingtalstr. 6/D05, 8010 Graz, Austria
| | - A. Pikovsky
- Institute of Physics and Astronomy, University of Potsdam, Karl-Liebknecht-Str. 24/25, 14476 Potsdam-Golm, Germany
- Control Theory Department, Institute of Information Technologies, Mathematics and Mechanics, Lobachevsky University Nizhny Novgorod, Nizhny Novgorod, Russia
| |
Collapse
|
13
|
Jung W, Jang KI, Lee SH. Heart and Brain Interaction of Psychiatric Illness: A Review Focused on Heart Rate Variability, Cognitive Function, and Quantitative Electroencephalography. CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE 2019; 17:459-474. [PMID: 31671483 PMCID: PMC6852682 DOI: 10.9758/cpn.2019.17.4.459] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Revised: 11/30/2018] [Accepted: 12/19/2018] [Indexed: 12/26/2022]
Abstract
Heart rate variability (HRV) reflects beat-to-beat variability in the heart rate due to the dynamic interplay of the sympathetic and parasympathetic nervous systems. HRV is considered an index of the functional status of the autonomic nervous system. A decrease in HRV is thus observed in individuals with autonomic dysfunction. Abnormal HRV has been reported in a range of mental disorders. In this review, we give an overview of HRV in patients with major depressive disorder (MDD), schizophrenia, and posttraumatic stress disorder (PTSD), one of whose core symptoms is cognitive dysfunction. The association between HRV and cognitive function is highlighted in this review. This review consists of three main sections. In the first section, we examine how HRV in patients with MDD, schizophrenia, and PTSD is characterized, and how it is different when compared to that in healthy controls. In the second section, beyond the heart itself, we discuss the intimate connection between the heart and the brain, focusing on how HRV interacts with quantitative electroencephalography (qEEG) in the context of physiological changes in the sleep cycle. Lastly, we finish the review with the examination of the association between HRV and cognitive function. The overall findings indicate that the reduction in HRV is one of main manifestations in MDD, schizophrenia, and PTSD, and also more generally HRV is closely linked to the change in qEEG and also to individual differences in cognitive performance.
Collapse
Affiliation(s)
- Wookyoung Jung
- Department of Psychology, Keimyung University, Daegu, Korea
| | - Kuk-In Jang
- 2Department of Biomedicine and Health Sciences, College of Medicine, The Catholic University of Korea, Korea.,Institute of Biomedical Industry, The Catholic University of Korea, Seoul, Korea
| | - Seung-Hwan Lee
- Department of Psychiatry,Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea.,Clinical Emotion and Cognition Research Laboratory, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea
| |
Collapse
|
14
|
Grote V, Levnajić Z, Puff H, Ohland T, Goswami N, Frühwirth M, Moser M. Dynamics of Vagal Activity Due to Surgery and Subsequent Rehabilitation. Front Neurosci 2019; 13:1116. [PMID: 31827417 PMCID: PMC6849369 DOI: 10.3389/fnins.2019.01116] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Accepted: 10/02/2019] [Indexed: 12/16/2022] Open
Abstract
Background Vagal activity is critical for maintaining key body functions, including the stability of inflammatory control. Its weakening, such as in the aftermatch of a surgery, leaves the body vulnerable to diverse inflammatory conditions, including sepsis. Methods Vagal activity can be measured by the cardiorespiratory interaction known as respiratory sinus arrhythmia or high-frequency heart-rate variability (HRV). We examined the vagal dynamics before, during and after an orthopedic surgery. 39 patients had their HRV measured around the period of operation and during subsequent rehabilitation. Measurements were done during 24 h circadian cycles on ten specific days. For each patient, the circadian vagal activity was calculated from HRV data. Results Our results confirm the deteriorating effect of surgery on vagal activity. Patients with stronger pre-operative vagal activity suffer greater vagal withdrawal during the peri-operative phase, but benefit from stronger improvements during post-operative period, especially during the night. Rehabilitation seems not only to efficiently restore the vagal activity to pre-operative level, but in some cases to actually improve it. Discussion Our findings indicate that orthopedic rehabilitation has the potential to strengthen the vagal activity and hence boost inflammatory control. We conclude that providing a patient with a vagal reinforcement procedure prior to the surgery (“pre-habilitation”) might be a beneficial strategy against post-operative complications. The study also shows the clinical usefulness of quantifying the cardiorespiratory interactions.
Collapse
Affiliation(s)
- Vincent Grote
- Human Research Institute, Weiz, Austria.,Orthopedic Rehabilitation Center, Humanomed Center Althofen, Althofen, Austria.,Division of Physiology, Otto Loewi Research Center for Vascular Biology, Immunology and Inflammation, Medical University of Graz, Graz, Austria
| | - Zoran Levnajić
- Complex Systems and Data Science Lab, Faculty of Information Studies in Novo Mesto, Novo Mesto, Slovenia
| | - Henry Puff
- Orthopedic Rehabilitation Center, Humanomed Center Althofen, Althofen, Austria
| | - Tanja Ohland
- Orthopedic Rehabilitation Center, Humanomed Center Althofen, Althofen, Austria
| | - Nandu Goswami
- Division of Physiology, Otto Loewi Research Center for Vascular Biology, Immunology and Inflammation, Medical University of Graz, Graz, Austria
| | | | - Maximilian Moser
- Human Research Institute, Weiz, Austria.,Division of Physiology, Otto Loewi Research Center for Vascular Biology, Immunology and Inflammation, Medical University of Graz, Graz, Austria
| |
Collapse
|
15
|
Mestanikova A, Mestanik M, Ondrejka I, Hrtanek I, Cesnekova D, Jurko A, Visnovcova Z, Sekaninova N, Tonhajzerova I. Complex cardiac vagal regulation to mental and physiological stress in adolescent major depression. J Affect Disord 2019; 249:234-241. [PMID: 30780116 DOI: 10.1016/j.jad.2019.01.043] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 11/22/2018] [Accepted: 01/22/2019] [Indexed: 01/06/2023]
Abstract
BACKGROUND Cardiovagal control is known to be reduced in major depressive disorder (MDD), however, the neurocardiac reflex control to distinct types of stressors is still unclear. We aimed to study parasympathetically mediated cardiac reflex functioning in response to mental and physiological stressors using heart rate variability (HRV) linear and nonlinear analysis in adolescent MDD. METHODS We examined 60 adolescents (40 girls) with MDD (age 14.9 ± 0.3 years) and 60 age and gender-matched controls. ECG was continuously recorded during stress protocol: baseline, Go/NoGo test, recovery, supine position, and orthostasis. Evaluated HRV linear and nonlinear indices: RR interval, pNN50, rMSSD, HF-HRV, Poincaré plot (SD1), symbolic dynamics 2UV%. Cardiovagal reactivity expressed as percentual change (%) was calculated in response to both stressors. RESULTS In each phase of stress protocol, the MDD group had significantly reduced HRV parameters compared to controls, except for symbolic dynamics index 2UV% in supine position. The reactivity of HRV indices was significantly greater in response to orthostasis in MDD compared to controls. No significant differences were found in response to Go/NoGo test. LIMITATIONS The smoking status and the menstrual cycle phase potentially affecting the HRV parameters were not monitored. Future research is needed to expand a sample size with respect to sex and to study neurocardiac response to other different stressors in MDD. CONCLUSIONS This study revealed reduced resting cardiovagal regulation and greater vagal withdrawal indicating abnormal neurocardiac reflex functioning to physiological stressor (orthostasis) in adolescent MDD patients. Nonlinear HRV analysis was sensitive to detect cardiac-linked regulatory differences in adolescent depression.
Collapse
Affiliation(s)
- Andrea Mestanikova
- Biomedical Center Martin, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Mala Hora 4C, 036 01 Martin, Slovak Republic; Department of Physiology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Mala Hora 4C, 036 01 Martin, Slovak Republic.
| | - Michal Mestanik
- Biomedical Center Martin, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Mala Hora 4C, 036 01 Martin, Slovak Republic; Department of Physiology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Mala Hora 4C, 036 01 Martin, Slovak Republic.
| | - Igor Ondrejka
- Psychiatric Clinic, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, University Hospital Martin, Martin, Slovakia.
| | - Igor Hrtanek
- Psychiatric Clinic, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, University Hospital Martin, Martin, Slovakia.
| | - Dana Cesnekova
- Psychiatric Clinic, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, University Hospital Martin, Martin, Slovakia.
| | - Alexander Jurko
- Pediatric Cardiology, Kollarova 13, 036 01 Martin, Slovak Republic.
| | - Zuzana Visnovcova
- Biomedical Center Martin, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Mala Hora 4C, 036 01 Martin, Slovak Republic; Department of Physiology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Mala Hora 4C, 036 01 Martin, Slovak Republic.
| | - Nikola Sekaninova
- Biomedical Center Martin, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Mala Hora 4C, 036 01 Martin, Slovak Republic; Department of Physiology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Mala Hora 4C, 036 01 Martin, Slovak Republic.
| | - Ingrid Tonhajzerova
- Biomedical Center Martin, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Mala Hora 4C, 036 01 Martin, Slovak Republic; Department of Physiology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Mala Hora 4C, 036 01 Martin, Slovak Republic.
| |
Collapse
|
16
|
Calarge CA, Devaraj S, Shulman RJ. Gut permeability and depressive symptom severity in unmedicated adolescents. J Affect Disord 2019; 246:586-594. [PMID: 30605877 DOI: 10.1016/j.jad.2018.12.077] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Revised: 11/13/2018] [Accepted: 12/24/2018] [Indexed: 12/14/2022]
Abstract
OBJECTIVE This study examined gut permeability in unmedicated adolescents with and without major depressive disorder. METHOD Medically healthy, non-medicated, 12-17 year-old females in a major depressive episode (MDE) or healthy controls, without any psychiatric condition, were enrolled. They completed the Children's Depression Rating Scale-Revised (CDRS-R) and underwent a clinical interview. Preejection period (PEP) and respiratory sinus arrhythmia (RSA) data were collected to measure autonomic nervous system activity. Following an overnight fast, participants ingested lactulose and mannitol and collected urine for 4 hours while still fasting, to examine gut permeability. Plasma cytokines (interleukin 1β, interleukin 6, and tumor necrosis factor α) were measured. Correlational analyses were used to examine the associations between relevant variables. RESULTS 41 female participants (age: 14.8 ± 1.6 years, n = 25 with MDE) were enrolled. PEP, but not RSA, was inversely associated with neurovegetative symptom severity on the CDRS-R (r = -0.31, p < 0.06). In the 30 participants with gut permeability data, the lactulose to mannitol ratio (LMR) was significantly positively associated with depression severity, particularly neurovegetative symptom severity (r = 0.37, p < 0.05). Notably, the association between neurovegetative symptom severity and PEP was substantially reduced after adjusting for LMR. Additionally, depression severity was significantly associated with circulating cytokines. CONCLUSIONS This is the first study to examine gut permeability in unmedicated adolescents, offering preliminary support for a mechanistic pathway linking sympathetic nervous system activation to increased gut permeability and activation of the innate immune system, likely contributing to the emergence of neurovegetative symptoms of depression.
Collapse
Affiliation(s)
- Chadi A Calarge
- Menninger Department of Psychiatry and Behavioral Sciences and Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, 1102 Bates Ave, Suite 790 (C-0790.03) Houston, TX 77030, USA.
| | - Sridevi Devaraj
- Department of Pathology and Immunology, Baylor College of Medicine, Houston, TX, USA
| | - Robert J Shulman
- Department of Pediatrics, Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX, USA
| |
Collapse
|
17
|
Resting heart rate variability moderates the relationship between trait emotional competencies and depression. PERSONALITY AND INDIVIDUAL DIFFERENCES 2019. [DOI: 10.1016/j.paid.2018.09.020] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
|
18
|
Adolescent Girls’ Biological Sensitivity to Context: Heart Rate Reactivity Moderates the Relationship Between Peer Victimization and Internalizing Problems. EVOLUTIONARY PSYCHOLOGICAL SCIENCE 2018. [DOI: 10.1007/s40806-018-0176-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
|
19
|
Topçu Ç, Frühwirth M, Moser M, Rosenblum M, Pikovsky A. Disentangling respiratory sinus arrhythmia in heart rate variability records. Physiol Meas 2018; 39:054002. [DOI: 10.1088/1361-6579/aabea4] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
|
20
|
Associations between symptoms of depression and heart rate variability: An exploratory study. Psychiatry Res 2018; 262:482-487. [PMID: 28958456 DOI: 10.1016/j.psychres.2017.09.028] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2016] [Revised: 06/27/2017] [Accepted: 09/11/2017] [Indexed: 12/11/2022]
Abstract
Major depressive disorder (MDD) is associated with decreased heart rate variability (HRV), a predictor of cardiovascular morbidity by many, but not all studies. This inconsistency could be due to the association of HRV with specific depressive symptoms. Here, we investigated the association of HRV parameters with components of depressive symptoms from 120 MDD patients, at baseline of a published trial comparing the effect of sertraline to transcranial direct current stimulation. We used Principal Component Analysis to extract components of the Hamilton Rating Scale for Depression (HAM-D-17), the Montgomery Asberg Depression Rating Scale (MADRS) and the Beck Inventory for Depressive Symptomatology (BDI). We constructed one equation of multiple linear regression for each HRV parameter as the dependent variable, and the components of depressive symptoms of the three scales as the independent ones, adjusted for age and gender. A component of HAM-D-17 predicted LF/HF (low frequency/high frequency) and a component of MADRS predicted LF (low frequency). "Guilt" and "loss of interest/pleasure in activities" were present in the components of both scales, and the MADRS component also included "psychomotor retardation". These results suggest that melancholic features might be relevant for the association between MDD and HRV. Considering multiple comparisons, these results are preliminary.
Collapse
|
21
|
Schumann A, Andrack C, Bär KJ. Differences of sympathetic and parasympathetic modulation in major depression. Prog Neuropsychopharmacol Biol Psychiatry 2017; 79:324-331. [PMID: 28710030 DOI: 10.1016/j.pnpbp.2017.07.009] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Revised: 07/09/2017] [Accepted: 07/09/2017] [Indexed: 10/19/2022]
Abstract
Inconsistent results have been reported with respect to cardiac autonomic function in major depression. The aim of our study was to investigate autonomic function in various branches of the autonomic nervous system in order to better understand parasympathetic and sympathetic modulation in the disease. We investigated 29 unmedicated patients suffering from major depression (MD) in comparison to matched control subjects (gender, age, BMI). The autonomic assessment at rest included values of heart rate variability (HRV), blood pressure variability (BPV), baroreflex sensitivity (BRS), respiration, skin conductance (SC) as well as the calculation of pupillary diameter and the unrest index (PUI). Results were compared by means of a multivariate analysis of variance. In a classification analysis, we identified suitable parameters for patient - control separation. Finally, to analyze interrelations of pupillometric parameters and autonomic indices, we estimated Pearson correlation coefficients and fitted a linear regression model. Apart from a significantly increased heart rate (75±12 vs. 65±6min-1, p<0.001) and decreased BRS (14±13 vs. 20±15ms/mmHg, p<0.05), we observed a lack of significant differences in HRV and BPV analysis between patients and controls. However, pupillary diameter (left: 4.3±0.9 vs. 3.8±0.6, p<0.01; right: 4.3±0.9 vs. 3.7±0.6mm, p<0.01) and PUI (left: 14.8±6.0 vs. 10.7±4.5mm/min, p<0.01; right: 14.1±5.5 vs. 10.7±4.8mm/min, p<0.01), as well as the level (left: 7.3±6.2 vs. 4.3±4.4 μS, p<0.05) and fluctuations of skin conductance (left: 4.2±4.1 vs. 2.5±3.6, p<0.05; right: 4.2±4.4 vs. 2.6±3.2, p<0.05) were significantly different. The classification accuracy was 88.5% with high specificity (e=92.9%) and sensitivity (s=83.3%) including heart rate, PUI and skin conductance. HRV indices correlated to PUI in controls but not in patients. Our data add evidence to the current debate on autonomic function in major depression. We suggest that diverse results are mainly caused by methodological shortcomings, in particular by the application of HRV assessment only, which misses changes of sympathetic modulation. The application of broader analyzing tools will clarify the pattern of autonomic function in depression and ultimately its role in cardiac morbidity and mortality.
Collapse
Affiliation(s)
- Andy Schumann
- Psychiatric Brain and Body Research Group, Department of Psychiatry and Psychotherapy, University Hospital Jena, Jena, Germany
| | - Caroline Andrack
- Psychiatric Brain and Body Research Group, Department of Psychiatry and Psychotherapy, University Hospital Jena, Jena, Germany
| | - Karl-Jürgen Bär
- Psychiatric Brain and Body Research Group, Department of Psychiatry and Psychotherapy, University Hospital Jena, Jena, Germany.
| |
Collapse
|
22
|
Moser M, Frühwirth M, Messerschmidt D, Goswami N, Dorfer L, Bahr F, Opitz G. Investigation of a Micro-test for Circulatory Autonomic Nervous System Responses. Front Physiol 2017; 8:448. [PMID: 28785223 PMCID: PMC5519958 DOI: 10.3389/fphys.2017.00448] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Accepted: 06/13/2017] [Indexed: 12/22/2022] Open
Abstract
Aims and Objectives: The autonomic nervous system plays an important role in homeostasis and organismic recreation, control of immune function, inflammation, and bone growth. It also regulates blood pressure and orthostasis via vagal and sympathetic pathways. Besides recording of heart rate variability (HRV), which characterizes medium (1–5 min) and long term (circadian) autonomic tone or modulation, no gentle tests of short-term autonomic reactivity and control are available. In 1976 Nogier described a short time cardiovascular response (“Réflexe Auriculo Cardiaque”, RAC) which could be used to investigate short term autonomic reactions without changing system characteristics and thus being repeatable in short intervals. In this paper, we investigated the possible application of the Nogier reaction as a micro-test for the identification of a disturbed sensitivity or reactivity of the autonomic nervous system. Methods: We statistically analyzed cardiovascular signals derived during the application of small repeated stimuli utilizing methods of signal averaging to characterize the physiological background. Specifically, the Nogier reaction was investigated using simultaneous recordings of ECG, pulse waves, and respiration. Results: Significant fast (delay 1–5 s) and slower (delay 6–12 s) cardio-autonomic responses to different stimuli which characterize short term were observed. From time characteristics and type of signals where they occur we deduce that fast changes observed in heart rate are vagal reactions to the small stimuli whereas slower changes observed in pulse waves stem from sympathetic nervous system responses. Conclusions: The investigated autonomic micro-test opens the possibility to differentially investigate both limbs of the autonomic nervous system with minimal stimuli. It can be performed within seconds and does not change the set point of the system in opposition to less subtle tests such as Valsalva maneuver. Therefore, it is well-suited for quick, repeated measurements of autonomic nervous system reactivity.
Collapse
Affiliation(s)
- Maximilian Moser
- Human Research Institute of Health Technology and Prevention ResearchWeiz, Austria.,Institute of Physiology, Medical University GrazGraz, Austria
| | - Matthias Frühwirth
- Human Research Institute of Health Technology and Prevention ResearchWeiz, Austria
| | | | - Nandu Goswami
- Institute of Physiology, Medical University GrazGraz, Austria
| | - Leopold Dorfer
- Austrian Society for Controlled AcupunctureGraz, Austria
| | - Frank Bahr
- German Academy for AcupunctureMunich, Germany
| | | |
Collapse
|
23
|
Nelson BW, Byrne ML, Sheeber L, Allen NB. Does Context Matter? A Multi-Method Assessment of Affect in Adolescent Depression Across Multiple Affective Interaction Contexts. Clin Psychol Sci 2017; 5:239-258. [PMID: 28670504 DOI: 10.1177/2167702616680061] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This study utilized a multi-method approach (self-reported affect, observed behavior, and psychophysiology) to investigate differences between clinically depressed and non-depressed adolescents across three different affective interaction contexts with their parents. 152 adolescents (52 males, 14-18 y.o.), and their parents, participated in a laboratory session in which they discussed positive and negative aspects of their relationship, and reminisced on positive and negative memories. We found that across contexts depressed adolescents exhibited higher negative affect and behaviors, lower positive behaviors, and greater autonomic and sympathetic activity. Context specific findings indicated that depressed adolescents 1) exhibited greater persistence of negative affect and dysphoric behavior across the sequence of tasks, whereas these phenomena declined amongst their non-depressed peers, 2) depressed adolescents had greater increases in aggressive behaviors during negative interactions, and 3) depressed adolescents had greater parasympathetic withdrawal during negative interactions, while this response characterized the non-depressed group during positive interactions.
Collapse
|
24
|
Alvares GA, Quintana DS, Hickie IB, Guastella AJ. Autonomic nervous system dysfunction in psychiatric disorders and the impact of psychotropic medications: a systematic review and meta-analysis. J Psychiatry Neurosci 2016; 41:89-104. [PMID: 26447819 PMCID: PMC4764485 DOI: 10.1503/jpn.140217] [Citation(s) in RCA: 264] [Impact Index Per Article: 33.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Autonomic nervous system (ANS) dysfunction is a putative underlying mechanism for increased cardiovascular disease risk in individuals with psychiatric disorders. Previous studies suggest that this risk may be related to psychotropic medication use. In the present study we systematically reviewed and analyzed published studies of heart rate variability (HRV), measuring ANS output, to determine the effect of psychiatric illness and medication use. METHODS We searched for studies comparing HRV in physically healthy adults with a diagnosed psychiatric disorder to controls and comparing HRV pre- and post-treatment with a psychotropic medication. RESULTS In total, 140 case-control (mood, anxiety, psychosis, dependent disorders, k = 151) and 30 treatment (antidepressants, antipsychotics; k = 43) studies were included. We found that HRV was reduced in all patient groups compared to controls (Hedges g = -0.583) with a large effect for psychotic disorders (Hedges g = -0.948). Effect sizes remained highly significant for medication-free patients compared to controls across all disorders. Smaller and significant reductions in HRV were observed for specific antidepressants and antipsychotics. LIMITATIONS Study quality significantly moderated effect sizes in case-control analyses, underscoring the importance of assessing methodological quality when interpreting HRV findings. CONCLUSION Combined findings confirm substantial reductions in HRV across psychiatric disorders, and these effects remained significant even in medication-free individuals. Reductions in HRV may therefore represent a significant mechanism contributing to elevated cardiovascular risk in individuals with psychiatric disorders. The negative impact of specific medications on HRV suggest increased risk for cardiovascular disease in these groups, highlighting a need for treatment providers to consider modifiable cardiovascular risk factors to attenuate this risk.
Collapse
Affiliation(s)
| | | | | | - Adam J. Guastella
- Correspondence to: A.J. Guastella, Brain & Mind Centre, University of Sydney, 94 Mallett St, Camperdown NSW Australia;
| |
Collapse
|
25
|
LeMoult J, Yoon KL, Joormann J. Rumination and Cognitive Distraction in Major Depressive Disorder: An Examination of Respiratory Sinus Arrhythmia. JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2015; 38:20-29. [PMID: 27199505 DOI: 10.1007/s10862-015-9510-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Difficulty regulating emotions following stressful events is a hallmark of Major Depressive Disorder (MDD). Although individuals' ability to regulate their emotions is believed to have direct consequences for both emotional and physical wellbeing, few studies have examined the cardiovascular effects of different emotion regulation strategies in MDD. To the best of our knowledge, the current study is the first to examine the effects of two emotion regulation strategies, cognitive distraction and rumination, on both self-reported sadness and respiratory sinus arrhythmia (RSA) in individuals with MDD and healthy controls (CTLs). Following a forced-failure stressor, participants were randomly assigned to a rumination or cognitive distraction condition. As expected, rumination increased sadness and triggered RSA withdrawal for both MDDs and CTLs. Interestingly, although cognitive distraction reduced sadness, it also triggered RSA withdrawal. Moreover, cognitive distraction was associated with greater RSA withdrawal for MDDs than CTLs. Thus, although depressed individuals are able to use cognitive distraction to emotionally recover from stress, it may be associated with greater cognitive effort. Adding low-cost physiological measures such as RSA into assessments has the potential to offer new and important information about the effects of emotion regulation on mental and physiological health.
Collapse
|
26
|
Atypical patterns of respiratory sinus arrhythmia index an endophenotype for depression. Dev Psychopathol 2015; 26:1337-52. [PMID: 25422965 DOI: 10.1017/s0954579414001060] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Can atypical patterns of parasympathetic nervous system activity serve as endophenotypes for depression? Using respiratory sinus arrhythmia (RSA) as an index of parasympathetic nervous system function, we examined this question in two studies: one involving mothers with and without depression histories and their offspring (at high and low risk for depression, respectively), and a further study of adolescent sibling pairs concordant and discordant for major depression. In both studies, subjects were exposed to sad mood induction; subjects' RSA was monitored during rest periods and in response to the mood induction. We used Gottesman and Gould's (2003) criteria for an endophenotype and a priori defined "atypical" and "normative" RSA patterns (combinations of resting RSA and RSA reactivity). We found that atypical RSA patterns (a) predicted current depressive episodes and remission status among women with histories of juvenile onset depression and healthy controls, (b) predicted longitudinal trajectories of depressive symptoms among high- and low-risk young offspring, (c) were concordant across mothers and their juvenile offspring, (d) were more prevalent among never-depressed youth at high risk for depression than their low-risk peers, and (e) were more concordant across adolescent sibling pairs in which both versus only one had a history of major depression. Thus, the results support atypical RSA patterns as an endophenotype for depression. Possible mechanisms by which RSA patterns increase depression risk and their genetic contributors are discussed.
Collapse
|
27
|
Park AE, Huynh P, Schell AM, Baker LA. Relationship between obesity, negative affect and basal heart rate in predicting heart rate reactivity to psychological stress among adolescents. Int J Psychophysiol 2015; 97:139-44. [PMID: 26049136 PMCID: PMC4685043 DOI: 10.1016/j.ijpsycho.2015.05.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2014] [Revised: 05/20/2015] [Accepted: 05/27/2015] [Indexed: 11/29/2022]
Abstract
Reduced cardiovascular responses to psychological stressors have been found to be associated with both obesity and negative affect in adults, but have been less well studied in children and adolescent populations. These findings have most often been interpreted as reflecting reduced sympathetic nervous system response, perhaps associated with heightened baseline sympathetic activation among the obese and those manifesting negative affect. However, obesity and negative affect may themselves be correlated, raising the question of whether they both independently affect cardiovascular reactivity. The present study thus examined the separate effects of obesity and negative affect on both cardiovascular and skin conductance responses to stress (e.g., during a serial subtraction math task) in adolescents, while controlling for baseline levels of autonomic activity during rest. Both obesity and negative affect had independent and negative associations with cardiovascular reactivity, such that reduced stress responses were apparent for obese adolescents and those with high levels of negative affect. In contrast, neither obesity nor negative affect was related to skin conductance responses to stress, implicating specifically noradrenergic mechanisms rather than sympathetic mechanisms generally as being deficient. Moreover, baseline heart rate was unrelated to obesity in this sample, which suggests that heightened baseline of sympathetic activity is not necessary for the reduced cardiovascular reactivity to stress.
Collapse
Affiliation(s)
- Andres E Park
- Department of Psychology, Seeley G. Mudd Building Room 501, University of Southern California, 3620 South McClintock Ave., Los Angeles, CA 90007, United States
| | - Pauline Huynh
- Department of Psychology, Seeley G. Mudd Building Room 501, University of Southern California, 3620 South McClintock Ave., Los Angeles, CA 90007, United States
| | - Anne M Schell
- Department of Psychology, Occidental College, 1600 Campus Rd, Los Angeles, CA 90041, United States.
| | - Laura A Baker
- Department of Psychology, Seeley G. Mudd Building Room 501, University of Southern California, 3620 South McClintock Ave., Los Angeles, CA 90007, United States
| |
Collapse
|
28
|
Lewis GF, Hourani L, Tueller S, Kizakevich P, Bryant S, Weimer B, Strange L. Relaxation training assisted by heart rate variability biofeedback: Implication for a military predeployment stress inoculation protocol. Psychophysiology 2015; 52:1167-74. [PMID: 26095854 DOI: 10.1111/psyp.12455] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2014] [Accepted: 04/26/2015] [Indexed: 11/27/2022]
Abstract
Decreased heart rate variability (HRV) is associated with posttraumatic stress disorder (PTSD) and depression symptoms, but PTSD's effects on the autonomic stress response and the potential influence of HRV biofeedback in stress relaxation training on improving PTSD symptoms are not well understood. The objective of this study was to examine the impact of a predeployment stress inoculation training (PRESTINT) protocol on physiologic measures of HRV in a large sample of the military population randomly assigned to experimental HRV biofeedback-assisted relaxation training versus a control condition. PRESTINT altered the parasympathetic regulation of cardiac activity, with experimental subjects exhibiting greater HRV, that is, less arousal, during a posttraining combat simulation designed to heighten arousal. Autonomic reactivity was also found to be related to PTSD and self-reported use of mental health services. Future PRESTINT training could be appropriate for efficiently teaching self-help skills to reduce the psychological harm following trauma exposure by increasing the capacity for parasympathetically modulated reactions to stress and providing a coping tool (i.e., relaxation method) for use following a stressful situation.
Collapse
Affiliation(s)
- Gregory F Lewis
- RTI International, Research Triangle Park, North Carolina, USA
| | - Laurel Hourani
- RTI International, Research Triangle Park, North Carolina, USA
| | - Stephen Tueller
- RTI International, Research Triangle Park, North Carolina, USA
| | - Paul Kizakevich
- RTI International, Research Triangle Park, North Carolina, USA
| | | | - Belinda Weimer
- RTI International, Research Triangle Park, North Carolina, USA
| | - Laura Strange
- RTI International, Research Triangle Park, North Carolina, USA
| |
Collapse
|
29
|
Messerotti Benvenuti S, Buodo G, Mennella R, Palomba D. Somatic, but not cognitive-affective, symptoms are associated with reduced heart rate variability in individuals with dysphoria. Front Psychol 2015; 6:599. [PMID: 25999905 PMCID: PMC4423301 DOI: 10.3389/fpsyg.2015.00599] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2015] [Accepted: 04/22/2015] [Indexed: 01/01/2023] Open
Abstract
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 study examined whether reduced HRV was differentially associated with cognitive–affective and somatic symptoms of depression in medically healthy individuals with and without dysphoria. Methods: Self-reported cognitive–affective and somatic symptoms as measured with the Beck Depression Inventory-II questionnaire and time and frequency domain parameters of HRV were collected in 62 medically healthy individuals, of whom 25 with and 37 without dysphoria. Results: Somatic, but not cognitive–affective, symptoms of depression were inversely associated with SD of NN intervals (β = -0.476, p < 0.05), number of interval differences of successive NN intervals greater than 50 ms (NN50; β = -0.498, p < 0.03), and HRV total power (β = -0.494, p < 0.04) in the group with dysphoria, after controlling for sex, anxiety, and lifestyle factors. Cognitive–affective and somatic symptoms were not related to any of the HRV parameters in the group without dysphoria (all ps > 0.24). Conclusion: By showing that the relationship between somatic depressive symptoms and reduced HRV extends to medically healthy individuals with dysphoria, the present findings suggest that this association is independent of factors concomitant with cardiovascular diseases. The present study also suggests that individuals with somatic rather than cognitive–affective subsets of depressive symptoms may be at greater risk for developing cardiovascular diseases.
Collapse
Affiliation(s)
| | - Giulia Buodo
- Department of General Psychology, University of Padova Padova, Italy ; Center for Cognitive Neuroscience, University of Padova Padova, Italy
| | - Rocco Mennella
- Department of General Psychology, University of Padova Padova, Italy
| | - Daniela Palomba
- Department of General Psychology, University of Padova Padova, Italy ; Center for Cognitive Neuroscience, University of Padova Padova, Italy
| |
Collapse
|
30
|
Ha JH, Park S, Yoon D, Kim B. Short-term heart rate variability in older patients with newly diagnosed depression. Psychiatry Res 2015; 226:484-8. [PMID: 25747680 DOI: 10.1016/j.psychres.2015.02.005] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2014] [Revised: 02/10/2015] [Accepted: 02/11/2015] [Indexed: 11/17/2022]
Abstract
Dysfunction of the autonomic nervous system has been considered to be a risk factor for major depressive disorder (MDD) and cardiovascular disease (CVD). The aim of this study was to evaluate short-term heart rate variability (HRV) in elderly patients with newly diagnosed MDD. Thirty MDD patients over 60 years old newly diagnosed by a structured interview were enrolled, free from antidepressants. Socio-demographic data, blood tests, and heart rate variability (HRV) obtained from 5-min ECG were gathered. The MDD group showed significantly lower very low frequency power, low frequency power, high frequency power, and total power in frequency domain. In time domain analysis, the MDD group showed a significantly smaller standard deviation of the NN, root mean square of the differences of the successive NN, and NN50/total number of all NNs. These findings demonstrated a lower HRV in older patients who were newly diagnosed with depression without a history of CVD and antidepressants effect, compared with the control subjects. Low HRV may be an important predictor of both MDD and CVD in elderly. The use of HRV in elderly depressive patients could be a meaningful screening method for risk of CVD.
Collapse
Affiliation(s)
- Jee Hyun Ha
- Department of Psychiatry, School of Medicine, Konkuk University, Seoul, Republic of Korea
| | - Soyeon Park
- Department of Psychiatry, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - Daehyun Yoon
- Department of Psychiatry, Seoul National University Hospital Healthcare System Gangnam Center, Seoul, Republic of Korea
| | - Byungsu Kim
- Department of Psychiatry, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea; Stress Clinic, Health Promotion Center, Asan Medical Center, Seoul, Republic of Korea.
| |
Collapse
|
31
|
Dysphoria is associated with reduced cardiac vagal withdrawal during the imagery of pleasant scripts: Evidence for the positive attenuation hypothesis. Biol Psychol 2015; 106:28-38. [DOI: 10.1016/j.biopsycho.2014.11.017] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2014] [Revised: 11/10/2014] [Accepted: 11/30/2014] [Indexed: 11/22/2022]
|
32
|
Investigating the Effect of Mindfulness Training on Heart Rate Variability in Mental Health Outpatients: A Pilot Study. BEHAVIOUR CHANGE 2014. [DOI: 10.1017/bec.2014.14] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Depression is associated with increased cardiac morbidity and mortality in people with and without cardiac risk factors, and this relationship is, in part, mediated by heart rate variability (HRV). Increased heart rate and reduced HRV are common in depressed patients, which may explain their higher cardiac risk. This pilot study investigated whether mindfulness-based cognitive therapy (MBCT) promoted objective changes in (1) HRV, and (2) depressive symptoms and quality of life, in mental health outpatients. Twenty-seven adults meeting criteria for DSM-IV Axis I disorders completed an 8-week MBCT program. Data were collected on three occasions, 8 weeks apart; twice before and once after MBCT. Participants completed the Short Form-36 and the Center for Epidemiological Studies Depression Scale (CES-D) at each test period. Heart rate and HRV were measured during electrocardiographic monitoring before and after a cognitive stressor. At baseline, 78% of participants met criteria for depression (CES-D ≥16). Multivariate analyses revealed a significant treatment effect for SF-36 physical summary score and depression (as a dichotomous variable), but not for HRV. This pilot study highlights the immediate psychological and health benefits of MBCT. Low power may have influenced the lack of a finding of an association between HRV and MBCT. However, the feasibility of the study design has been established, and supports the need for larger and longer-term studies of the potential physiological benefits of MBCT for cardiac health.
Collapse
|
33
|
Groban L, Kitzman DW, Register TC, Shively CA. Effect of depression and sertraline treatment on cardiac function in female nonhuman primates. Psychosom Med 2014; 76:137-46. [PMID: 24470133 PMCID: PMC3971435 DOI: 10.1097/psy.0000000000000036] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
OBJECTIVE Depression is a proposed risk factor for heart failure based largely on epidemiological data; few experimental data addressing this hypothesis are available. METHODS Depression was evaluated in relation to cardiac structural and functional phenotypes assessed by transthoracic echocardiography in 42 adult female cynomolgus monkeys that consumed a Western-like diet for 3 years. Half of the monkeys were treated with sertraline HCl for 18 months, and depressive behavior was assessed for 12 months before echocardiography. RESULTS Depressed monkeys (the 19/42 with depressive behavior rates above the mean rate) had higher heart rates (HRs; 171 [4.1[ versus 152 [6.1]) and smaller body surface area (0.13 [0.003] versus 0.15 [0.004]), left ventricular (LV) end-systolic dimension (0.75 [0.05] versus 0.89 [0.04]), LV systolic (0.76 [0.08] versus 1.2 [0.11]) and diastolic (2.4 [0.23] versus 3.4 [0.26]) volumes, and left atrial volumes (1.15 [0.14] versus 1.75 [0.12]; p values < .05). Doppler profiles of depressed monkeys indicated greater myocardial relaxation (higher e' and higher e'/a' ratio) and lower filling pressures (lower E/e') compared to nondepressed monkeys (p values < .05). Although sertraline treatment reduced HR (150 [5.8] versus 171 [4.8]) and modestly increased chamber dimensions (LV end-systolic dimension: 0.91 [0.05] versus 0.74 [0.03]; LV end-diastolic dimension, body surface area adjusted 1.69 [0.05] versus 1.47 [0.06]; p values < .05), it did not overtly affect systolic or diastolic function (p values > .10). CONCLUSIONS These data suggest that behavioral depression in female primates is accompanied by differences in cardiac function, although not in ways classically associated with subclinical heart failure. Selective serotonin reuptakes show promise in supporting heart function by reducing HR and perhaps improving LV filling; however, further investigation is needed.
Collapse
Affiliation(s)
- Leanne Groban
- Department of Pathology, Section on Comparative Medicine, Wake Forest School of Medicine, Medical Center Blvd, Winston-Salem, NC 27157-1040.
| | | | | | | |
Collapse
|
34
|
Moon E, Lee SH, Kim DH, Hwang B. Comparative Study of Heart Rate Variability in Patients with Schizophrenia, Bipolar Disorder, Post-traumatic Stress Disorder, or Major Depressive Disorder. CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE 2013; 11:137-43. [PMID: 24465250 PMCID: PMC3897762 DOI: 10.9758/cpn.2013.11.3.137] [Citation(s) in RCA: 76] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/04/2013] [Revised: 05/27/2013] [Accepted: 06/10/2013] [Indexed: 01/10/2023]
Abstract
Objective Heart rate variability (HRV) changes as a function of psychiatric illness. This study aimed to evaluate HRV among patients with various psychiatric disorders. Methods The present study recruited patients with schizophrenia (n=35), bipolar disorder (n=41), post-traumatic stress disorder (PTSD; n=34), or major depressive disorder (n=34) as well as healthy controls (n=27). The time-domain analysis (the standard deviation of all RR intervals [SDNN] and the square root of the mean squared differences of successive normal sinus intervals [RMSSD]), the frequency-domain analysis (very low frequency, low frequency [LF], high frequency [HF], and total power [TP]), and a non-linear complexity measure the approximate entropy were computed. Results SDNN and HF were significantly reduced in patients with schizophrenia compared with healthy controls. SDNN, RMSSD, TP, LF, and HF were significantly reduced in bipolar patients compared with healthy controls. HF was significantly reduced in PTSD patients compared with healthy controls. Conclusion Our findings indicate that HRV is not sufficiently powerful to discriminate among various psychiatric illnesses. However, our results suggest that HRV, particularly HF, could be used as a tool for discriminating between psychiatric patients and healthy controls.
Collapse
Affiliation(s)
- Eunok Moon
- Clinical Emotion and Cognition Research Laboratory, Inje University Ilsan Paik Hospital, Goyang, Korea
| | - Seung-Hwan Lee
- Clinical Emotion and Cognition Research Laboratory, Inje University Ilsan Paik Hospital, Goyang, Korea. ; Department of Psychiatry, Inje University Ilsan Paik Hospital, Goyang, Korea
| | - Do-Hyung Kim
- Department of Psychiatry, Inje University Ilsan Paik Hospital, Goyang, Korea
| | - Boram Hwang
- Department of Psychiatry, Inje University Ilsan Paik Hospital, Goyang, Korea
| |
Collapse
|
35
|
Russoniello CV, Zhirnov YN, Pougatchev VI, Gribkov EN. Heart rate variability and biological age: implications for health and gaming. CYBERPSYCHOLOGY BEHAVIOR AND SOCIAL NETWORKING 2013; 16:302-8. [PMID: 23574369 DOI: 10.1089/cyber.2013.1505] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Accurate and inexpensive psychophysiological equipment and software are needed to measure and monitor the autonomic nervous system for gaming and therapeutic purposes. The purpose of this study was to determine whether heart rate variability (HRV) derived from photoplethesmography (PPG) technology was predictive of autonomic nervous system (ANS) aging or biological age. Second, we sought to determine which HRV variable was most predictive of ANS change and aging. To test our hypotheses, we first conducted a criterion related validity study by comparing parameters of a 5 minute resting HRV test obtained from electrocardiography (ECG), the current "gold standard," with PPG technologies, and found them to be significantly correlated (r≥0.92) on all parameters during a resting state. PPG was strongly correlated to ECG on all HRV parameters during a paced six breaths per minute deep breathing test (r≥0.98). Further analysis revealed that maximum variation of heart rate had the highest negative correlation (r=-0.67) with age. We conclude that PPG is comparable to ECG in accuracy, and maximum variation of heart rate derived from a paced breathing test can be considered a marker of biological aging. Therapeutic interventions and games designed to reduce dysfunction in the ANS can now be developed using accurate physiological data.
Collapse
Affiliation(s)
- Carmen V Russoniello
- Psychophysiology Lab and Biofeedback Clinic, Department of Recreation and Leisure Studies, College of Health and Human Performance, East Carolina University, Greenville, NC 27858, USA.
| | | | | | | |
Collapse
|
36
|
Is the blunted blood pressure reactivity in dysphoric individuals related to attenuated behavioral approach? Int J Psychophysiol 2013; 90:58-65. [DOI: 10.1016/j.ijpsycho.2013.01.015] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2012] [Revised: 01/25/2013] [Accepted: 01/28/2013] [Indexed: 11/24/2022]
|
37
|
Yaroslavsky I, Bylsma LM, Rottenberg J, Kovacs M. Combinations of resting RSA and RSA reactivity impact maladaptive mood repair and depression symptoms. Biol Psychol 2013; 94:272-81. [PMID: 23827087 DOI: 10.1016/j.biopsycho.2013.06.008] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2013] [Revised: 06/21/2013] [Accepted: 06/23/2013] [Indexed: 01/30/2023]
Abstract
We examined whether the combined indices of respiratory sinus arrhythmia at rest (resting RSA) and in response to a sad film (RSA reactivity) predict effective and ineffective responses to reduce sadness (adaptive vs. maladaptive mood repair) in women with histories of juvenile-onset depression (n=74) and no history of major mental disorders (n=75). Structural equation models were used to estimate latent resting RSA, depression, and adaptive and maladaptive mood repair and to test the study hypotheses. Results indicated that combinations of resting RSA+RSA reactivity (RSA patterns) predicted maladaptive mood repair, which in turn, mediated the effects of RSA pattern on depression. Further, RSA patterns moderated the depressogenic effects of maladaptive mood repair. RSA patterns were unrelated to adaptive mood repair. Our findings suggest that mood repair is one mechanism through which physiological vulnerabilities adversely affect mental health.
Collapse
Affiliation(s)
- Ilya Yaroslavsky
- University of Pittsburgh School of Medicine, Childhood Depression Research Studies, 4415 Fifth Avenue, Webster Hall Suite 134, Pittsburgh, PA 15213, United States.
| | | | | | | |
Collapse
|
38
|
Grote V, Kelz C, Goswami N, Stossier H, Tafeit E, Moser M. Cardio-autonomic control and wellbeing due to oscillating color light exposure. Physiol Behav 2013; 114-115:55-64. [DOI: 10.1016/j.physbeh.2013.03.007] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2012] [Revised: 11/28/2012] [Accepted: 03/06/2013] [Indexed: 11/28/2022]
|
39
|
SAKAKIBARA R, ITO T, YAMAMOTO T, UCHIYAMA T, YAMANISHI T, KISHI M, TSUYUSAKI Y, TATENO F, KATSURAGAWA S, KUROKI N. Depression, Anxiety and the Bladder. Low Urin Tract Symptoms 2013; 5:109-20. [DOI: 10.1111/luts.12018] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2012] [Revised: 02/20/2013] [Accepted: 02/20/2013] [Indexed: 12/21/2022]
Affiliation(s)
- Ryuji SAKAKIBARA
- Division of Neurology, Department of Internal Medicine, Sakura Medical Center; Toho University; Sakura Japan
| | - Takashi ITO
- Division of Neurology; Chiba University; Chiba Japan
| | | | | | | | - Masahiko KISHI
- Division of Neurology, Department of Internal Medicine, Sakura Medical Center; Toho University; Sakura Japan
| | - Yohei TSUYUSAKI
- Division of Neurology, Department of Internal Medicine, Sakura Medical Center; Toho University; Sakura Japan
| | - Fuyuki TATENO
- Division of Neurology, Department of Internal Medicine, Sakura Medical Center; Toho University; Sakura Japan
| | | | - Nobuo KUROKI
- Mental Health Clinic, Sakura Medical Center; Toho University; Sakura Japan
| |
Collapse
|
40
|
Dauphinot V, Rouch I, Kossovsky MP, Pichot V, Dorey JM, Krolak-Salmon P, Laurent B, Roche F, Barthélémy JC. Depressive symptoms and autonomic nervous system dysfunction in an elderly population-based study: the PROOF study. J Affect Disord 2012; 143:153-9. [PMID: 22910448 DOI: 10.1016/j.jad.2012.05.045] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2011] [Revised: 05/16/2012] [Accepted: 05/16/2012] [Indexed: 11/19/2022]
Abstract
BACKGROUND To assess the relationship between depressive symptoms, evaluated through self-reported history as well as current depressive symptoms, and impaired autonomic nervous system activity, evaluated by long-term heart rate variability and baroreflex sensitivity among elderly community residents, aged 65 years. METHODS Subjects from the Proof cohort Study were evaluated for depressive symptoms and self-reported history of depression at inclusion. Autonomic nervous system activity was assessed through 24-h heart rate variability and baroreflex sensitivity. Cross-sectional analyses were performed to study the relationship between the different status of depression and autonomic nervous system activity. RESULTS Among the 1011 Proof study participants, 823 subjects were included in the analyses. Current depressive symptoms were present among 67 subjects; history of depression was reported by 228 subjects. Psychoactive drugs were used by 59 subjects. Low frequency (p=0.02), very low frequency (p<0.01) and Low/High frequency ratio (p<0.001) were lower among subjects with depressive symptoms and history of depression, independently of antidepressant treatment. The association remained significant for Low/High frequency ratio after adjustment for gender and physical activity (p=0.004). CONCLUSION Current depressive symptoms may be linked to autonomic nervous system lower performances. A possible long-term effect of depressive symptoms at middle-age may influence later-life autonomic nervous system activity. Our results highlight the importance of taking into account the depressive symptoms in the cardiovascular risk, even in the elderly.
Collapse
|
41
|
Chang HA, Chang CC, Chen CL, Kuo TBJ, Lu RB, Huang SY. Major depression is associated with cardiac autonomic dysregulation. Acta Neuropsychiatr 2012; 24:318-27. [PMID: 25287173 DOI: 10.1111/j.1601-5215.2011.00647.x] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Chang H-A, Chang C-C, Chen C-L, Kuo TBJ, Lu R-B, Huang S-Y. Major depression is associated with cardiac autonomic dysregulation.Objective: Altered cardiac autonomic function has been proposed in patients with major depression (MD), but the results are mixed. Therefore, analyses with larger sample sizes and better methodology are needed.Methods: To examine whether cardiac autonomic dysfunction is associated with MD, 498 unmedicated patients with MD and 462 healthy volunteers, aged 18–65 years, were recruited for a case-control analysis. We used the Hamilton Depression Rating Scale (HAM-D) and the Beck Depression Inventory (BDI) to assess depression severity. Cardiac autonomic function was evaluated by measuring heart rate variability (HRV) parameters. Frequency-domain indices of HRV were obtained.Results: Patients with MD exhibited reduced cardiac vagal control compared to healthy volunteers, and depression severity was negatively correlated with cardiac vagal control. Stratified analyses by suicide ideation revealed more pronounced cardiac vagal withdrawal among MD patients with suicide ideation.Conclusion: This study shows that MD is associated with cardiac autonomic dysregulation, highlighting the importance of assessing HRV in currently depressed patients, given the higher risk for cardiac complications in these individuals. Taking into account that suicidal depressed patients had more adverse patterns of HRV, one might consider the treatment to restore the autonomic function for the patient population having increased susceptibility to autonomic dysregulation.
Collapse
Affiliation(s)
- Hsin-An Chang
- Department of Psychiatry, Tri-Service General Hospital, Taipei, Taiwan
| | - Chuan-Chia Chang
- Department of Psychiatry, Tri-Service General Hospital, Taipei, Taiwan
| | - Chih-Lun Chen
- Department of Psychiatry, Tri-Service General Hospital, Taipei, Taiwan
| | - Terry B J Kuo
- Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan
| | - Ru-Band Lu
- Institute of Behavioral Medicine and Department of Psychiatry, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - San-Yuan Huang
- Department of Psychiatry, Tri-Service General Hospital, Taipei, Taiwan
| |
Collapse
|
42
|
Berger S, Kliem A, Yeragani V, Bär KJ. Cardio-respiratory coupling in untreated patients with major depression. J Affect Disord 2012; 139:166-71. [PMID: 22386048 DOI: 10.1016/j.jad.2012.01.035] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2011] [Revised: 01/30/2012] [Accepted: 01/30/2012] [Indexed: 11/28/2022]
Abstract
BACKGROUND Depressive disorders are known to be associated with higher risks of cardiovascular diseases. Several studies have reported an imbalance within the autonomic nervous system (ANS) as one putative cause. Previous investigations showed decreased cardio-respiratory coupling in depressive patients that were treated with nortriptyline. We aimed to compare parameters of heart rate variability and cardio-respiratory coupling between unmedicated patients suffering from major depressive disorder (MDD) and healthy controls in order to further understand autonomic dysfunction in the disease. METHODS We investigated eighteen unmedicated patients with major depressive disorder and eighteen matched healthy controls. Electrocardiogram and respiratory signals were obtained during a twenty minute resting period. Time- and frequency based parameters of HRV, respiratory sinus arrhythmia (RSA), approximate entropy of heart rate (ApEn(RR)) and respiratory rate (ApEn(Resp)) were calculated. Additionally, cross-ApEn between RR-intervals and respiration time series was determined, reflecting coupling of both signals. RESULTS Patients showed an increased heart rate and LF/HF-ratio. Respiratory sinus arrhythmia (RSA) and ApEn(RR) were reduced in patients in comparison to controls. Breathing rate, ApEn(Resp) and cross-ApEn did not differ between the two groups. DISCUSSION Increased heart rate, increased LF/HF-ratio, reduced RSA and reduced ApEn(RR) indicate a decrease of cardiac vagal modulation in depressive patients. No difference of cardio-respiratory coupling was observed. Respiratory parameters and cross-ApEn did not differ between both groups, and thus we conclude that diminished vagal modulation is mainly limited to cardiac modulation.
Collapse
Affiliation(s)
- Sandy Berger
- Pain & Autonomics - Integrative Research (PAIR), Department of Psychiatry and Psychotherapy, University Hospital Jena, Germany
| | | | | | | |
Collapse
|
43
|
Sex differences in cardiac autonomic function of depressed young adults. Biol Psychol 2012; 90:179-85. [DOI: 10.1016/j.biopsycho.2012.03.016] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2011] [Revised: 02/04/2012] [Accepted: 03/21/2012] [Indexed: 11/21/2022]
|
44
|
Musser ED, Ablow JC, Measelle JR. Predicting maternal sensitivity: The roles of postnatal depressive symptoms and parasympathetic dysregulation. Infant Ment Health J 2012; 33:350-359. [PMID: 28520177 DOI: 10.1002/imhj.21310] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Previous research has established that maternal depression is a risk factor for a variety of negative developmental outcomes among infants and children. Although low levels of maternal sensitivity have been hypothesized to explain this risk, the biological mechanisms underlying the association between maternal depressive symptoms and low levels of maternal sensitivity have been largely underexplored. This study examined the roles of postnatal depressive symptoms and parasympathetic nervous system functioning as predictors of low levels of maternal sensitivity, during a stressful mother-infant interaction-the reunion phase of the Still-Face Paradigm. Depressive symptoms and traitlike predispositions toward parasympathetic dysregulation, as indexed by low resting levels of respiratory sinus arrhythmia, were associated independently with less sensitive parenting. Discussion considers that during stressful mother-infant interactions, both mothers with depressive symptoms and mothers predisposed to parasympathetic dysregulation may have fewer emotional, physiological, and psychological resources with which to respond sensitively to their infants' cues.
Collapse
Affiliation(s)
- Erica D Musser
- University of Oregon and Oregon Health and Science University
| | | | | |
Collapse
|
45
|
ITO T, SAKAKIBARA R, SHIMIZU E, KISHI M, TSUYUZAKI Y, TATENO F, UCHIYAMA T, YAMAMOTO T. Is Major Depression a Risk for Bladder, Bowel, and Sexual Dysfunction? Low Urin Tract Symptoms 2012; 4:87-95. [DOI: 10.1111/j.1757-5672.2011.00140.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
|
46
|
Nabi H, Kivimäki M, Empana JP, Sabia S, Britton A, Marmot MG, Shipley MJ, Singh-Manoux A. Combined effects of depressive symptoms and resting heart rate on mortality: the Whitehall II prospective cohort study. J Clin Psychiatry 2011; 72:1199-206. [PMID: 21208592 PMCID: PMC3226937 DOI: 10.4088/jcp.09m05901blu] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2009] [Accepted: 02/02/2010] [Indexed: 10/18/2022]
Abstract
OBJECTIVE To examine the combined effects of depressive symptoms and resting heart rate on mortality risk. METHOD Analysis was performed on data from 5,936 participants in the Whitehall II study with a mean ± SD age of 61 ± 6 years. Depressive symptoms were assessed from 2002 to 2004 using the Center for Epidemiologic Studies Depression Scale (cutoff score for depression at ≥ 16). Resting heart rate was measured at the same study phase via electrocardiogram. Participants were assigned to 1 of 6 risk-factor groups on the basis of depression status (yes/no) and resting heart rate categories (< 60, 60-80, and > 80 beats/minute [bpm]). All-cause mortality was the main outcome in our analysis. Mean follow-up for mortality was 5.6 years. RESULTS In mutually adjusted Cox regression models, depression (hazard ratio = 1.93, P < .001) and resting heart rate > 80 bpm (hazard ratio = 1.67, P < .001) were independent predictors of mortality. After adjustment for potential confounding and mediating variables, participants with both depression and high resting heart rate had a 3-fold higher (P < .001) risk of death compared to depression-free participants with resting heart rates ranging from 60 to 80 bpm. This risk is particularly marked in participants with prevalent coronary heart disease. CONCLUSIONS This study provides evidence that the coexistence of depressive symptoms and elevated resting heart rate is associated with substantially increased risk of death compared to those without these 2 factors. This finding suggests the possibility that treatments that improve both depression and resting heart rate might improve survival.
Collapse
Affiliation(s)
- Hermann Nabi
- INSERM, U.1018, Center for Research in Epidemiology and Population Health, Hôpital Paul Brousse, Bâtiment 15/16, 16 avenue Paul Vaillant Couturier, 94807 Villejuif Cedex, France.
| | - Mika Kivimäki
- Department of Epidemiology and Public Health
University College of London (UCL)1-19 Torrington Place London WC1E 6BT,GB,Finnish Institute of Occupational HealthHelsinki, FI,University of HelsinkiFI
| | - Jean-Philippe Empana
- Centre de Recherche Cardiovasculaire
Hôpital européen Georges PompidouINSERM : U970Université Paris DescartesFR
| | - Séverine Sabia
- CESP, Centre de recherche en épidémiologie et santé des populations
INSERM : U1018Université Paris Sud - Paris XIUniversité de Versailles-Saint Quentin en YvelinesINEDFR
| | - Annie Britton
- Department of Epidemiology and Public Health
University College of London (UCL)1-19 Torrington Place London WC1E 6BT,GB
| | - Michael G. Marmot
- Department of Epidemiology and Public Health
University College of London (UCL)1-19 Torrington Place London WC1E 6BT,GB,CESP, Centre de recherche en épidémiologie et santé des populations
INSERM : U1018Université Paris Sud - Paris XIUniversité de Versailles-Saint Quentin en YvelinesINEDFR
| | - Martin J. Shipley
- Department of Epidemiology and Public Health
University College of London (UCL)1-19 Torrington Place London WC1E 6BT,GB
| | - Archana Singh-Manoux
- Department of Epidemiology and Public Health
University College of London (UCL)1-19 Torrington Place London WC1E 6BT,GB,CESP, Centre de recherche en épidémiologie et santé des populations
INSERM : U1018Université Paris Sud - Paris XIUniversité de Versailles-Saint Quentin en YvelinesINEDFR,Centre de Gérontologie
Assistance publique - Hôpitaux de Paris (AP-HP)Hôpital Sainte PérineFR
| |
Collapse
|
47
|
Berger S, Schulz S, Kletta C, Voss A, Bär KJ. Autonomic modulation in healthy first-degree relatives of patients with major depressive disorder. Prog Neuropsychopharmacol Biol Psychiatry 2011; 35:1723-8. [PMID: 21651953 DOI: 10.1016/j.pnpbp.2011.05.018] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2011] [Revised: 05/10/2011] [Accepted: 05/24/2011] [Indexed: 11/29/2022]
Abstract
BACKGROUND Cardiac mortality is known to be increased in patients with major depression. Several studies have reported an imbalance within the autonomic nervous system (ANS) of patients with major depressive disorder (MDD) as one putative cause. Since a heritability of autonomic modulation was demonstrated in healthy subjects, we aimed to investigate autonomic modulation in first-degree relatives of patients with MDD to find potential autonomic imbalances. METHODS We included 30 patients with MDD, 30 of their first-degree relatives (siblings or offspring) and 30 matched healthy controls in our study. We obtained a high resolution electrocardiogram and beat to beat blood pressure measurements for 30 min at rest. Linear and nonlinear parameters of heart rate variability (HRV) and baroreflex sensitivity (BRS) were calculated. RESULTS Parameters of HRV and BRS did not differ significantly between relatives and controls. We found significant differences between patients and controls for some HRV and BRS parameters confirming results of previous studies. DISCUSSION Findings of our study suggest that an imbalance of autonomic function is related to patients with depression and not to first-degree relatives. Thus, a genetic background for autonomic dysfunction is rather unlikely.
Collapse
Affiliation(s)
- Sandy Berger
- Pain & Autonomics-Integrative Research, Department of Psychiatry and Psychotherapy, University Hospital, Philosophenweg 3, 07743 Jena, Germany
| | | | | | | | | |
Collapse
|
48
|
Yang AC, Tsai SJ, Yang CH, Kuo CH, Chen TJ, Hong CJ. Reduced physiologic complexity is associated with poor sleep in patients with major depression and primary insomnia. J Affect Disord 2011; 131:179-85. [PMID: 21195485 DOI: 10.1016/j.jad.2010.11.030] [Citation(s) in RCA: 67] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2010] [Revised: 11/29/2010] [Accepted: 11/29/2010] [Indexed: 11/25/2022]
Abstract
BACKGROUND Depression is known to be associated with altered cardiovascular variability and increased cardiovascular comorbidity, yet it is unknown whether altered cardiac autonomic function in depression is associated with insomnia, a common symptom comorbid with depression. This study aimed to investigate the long-term diurnal profile of autonomic function as measured by heart rate variability (HRV) in both major depression and primary insomnia patients. METHOD A total of 52 non-medicated patients with major depression, 47 non-medicated patients with primary insomnia, and 88 matched controls without insomnia were recruited. Each subject was assessed by means of sleep and mood questionnaires and underwent twenty-four-hour ambulatory electrocardiogram monitoring. Standard HRV analysis and a well-validated complexity measure, multiscale entropy, were applied to comprehensively assess the diurnal profiles of autonomic function and physiologic complexity in our study sample. RESULTS Compared with the controls, the patients with major depression and those with primary insomnia exhibited significant reductions in parasympathetic-related HRV indices, and this association was mainly driven by the presence of poor sleep. Both groups of patients also exhibited significant reductions in physiologic complexity during the sleep period as compared with the healthy controls. Alterations in HRV indices were correlated with perceived sleep questionnaire scores but not with depression scales. CONCLUSIONS Our findings suggest a pivotal role of sleep disturbance in regulating cardiovascular variability in major depression and primary insomnia patients. These findings could highlight the importance of treating insomnia as an independent disease rather than a symptom.
Collapse
Affiliation(s)
- Albert C Yang
- Department of Psychiatry, Chu-Tung Veterans Hospital, Hsin-Chu County, Taiwan; Center for Dynamical Biomarkers and Translational Medicine, National Central University, Chungli, Taiwan.
| | | | | | | | | | | |
Collapse
|
49
|
Cardiac vagal control in nonmedicated depressed women and nondepressed controls: impact of depression status, lifetime trauma history, and respiratory factors. Psychosom Med 2011; 73:336-43. [PMID: 21364194 PMCID: PMC3090496 DOI: 10.1097/psy.0b013e318213925d] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To evaluate the impact of acute stress and relationship-focused imagery on cardiac vagal control, as indicated by levels of respiratory sinus arrhythmia (RSA), in depressed and nondepressed women. Impairment in cardiac parasympathetic (vagal) control may confer risk for cardiac mortality in depressed populations. METHODS Electrocardiogram and respiratory rate were evaluated in 15 nonmedicated depressed women and 15 matched controls during two laboratory conditions: 1) a relationship-focused imagery designed to elicit vagal activation; and 2) a speech stressor designed to evoke vagal withdrawal. RESULTS As expected, the relationship-focused imagery increased RSA (F(3,66) = 3.79, p = .02) and the speech stressor decreased RSA (F(3,66) = 4.36, p = .02) across women. Depressed women exhibited lower RSA during the relationship-focused imagery, and this effect remained after control for respiratory rate and trauma history (F(1,21) = 5.65, p = .027). Depressed women with a trauma history exhibited the lowest RSA during the stress condition (F(1,22) = 9.61, p = .05). However, after controlling for respiratory rate, Trauma History × Task Order (p = .02) but not Trauma History × Depression Group (p = .12) accounted for RSA variation during the stress condition. CONCLUSION Depression in women is associated with lower RSA, particularly when women reflect on a close love relationship, a context expected to elicit vagal activation and hence increase RSA. In contrast, depression-related variation in stressor-evoked vagal activity seems to covary with women's trauma history. Associations between vagal activity and depression are complex and should be considered in view of the experimental conditions under which vagal control is assessed, as well as physiological and behavioral factors that may affect vagal function.
Collapse
|
50
|
Raison CL, Lowry CA, Rook GAW. Inflammation, sanitation, and consternation: loss of contact with coevolved, tolerogenic microorganisms and the pathophysiology and treatment of major depression. ACTA ACUST UNITED AC 2011; 67:1211-24. [PMID: 21135322 DOI: 10.1001/archgenpsychiatry.2010.161] [Citation(s) in RCA: 120] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
CONTEXT Inflammation is increasingly recognized as contributing to the pathogenesis of major depressive disorder (MDD), even in individuals who are otherwise medically healthy. Most studies in search of sources for this increased inflammation have focused on factors such as psychosocial stress and obesity that are known to activate inflammatory processes and increase the risk for depression. However, MDD may be so prevalent in the modern world not just because proinflammatory factors are widespread, but also because we have lost contact with previously available sources of anti-inflammatory, immunoregulatory signaling. OBJECTIVE To examine evidence that disruptions in coevolved relationships with a variety of tolerogenic microorganisms that were previously ubiquitous in soil, food, and the gut, but that are largely missing from industrialized societies, may contribute to increasing rates of MDD in the modern world. DATA SOURCES Relevant studies were identified using PubMed and Ovid MEDLINE. STUDY SELECTION Included were laboratory animal and human studies relevant to immune functioning, the hygiene hypothesis, and major depressive disorder identified via PubMed and Ovid MEDLINE searches. DATA EXTRACTION Studies were reviewed by all authors, and data considered to be potentially relevant to the contribution of hygiene-related immune variables to major depressive disorder were extracted. DATA SYNTHESIS Significant data suggest that a variety of microorganisms (frequently referred to as the "old friends") were tasked by coevolutionary processes with training the human immune system to tolerate a wide array of non-threatening but potentially proinflammatory stimuli. Lacking such immune training, vulnerable individuals in the modern world are at significantly increased risk of mounting inappropriate inflammatory attacks on harmless environmental antigens (leading to asthma), benign food contents and commensals in the gut (leading to inflammatory bowel disease), or self-antigens (leading to any of a host of autoimmune diseases). Loss of exposure to the old friends may promote MDD by increasing background levels of depressogenic cytokines and may predispose vulnerable individuals in industrialized societies to mount inappropriately aggressive inflammatory responses to psychosocial stressors, again leading to increased rates of depression. CONCLUSION Measured exposure to the old friends or their antigens may offer promise for the prevention and treatment of MDD in modern industrialized societies.
Collapse
Affiliation(s)
- Charles L Raison
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA 30322, USA.
| | | | | |
Collapse
|