Nahshoni Eitan, Aizenberg Dov, Sigler Mayanit, Strasberg Boris, Zalsman Gil, Imbar Shula, Adler Edgar, Weizman Abraham
Department of Cardiology, Rabin Medical Center, Petach Tikva, Israel.
J Psychosom Res. 2004 Jan;56(1):89-94. doi: 10.1016/S0022-3999(03)00037-0.
To evaluate the parasympathetic modulation in elderly inpatients with major depressive disorder (MDD) before and after electroconvulsive therapy (ECT) using both linear and nonlinear methods of heart rate variability (HRV) analysis.
A measure of local dimensional complexity (pointwise correlation dimension, PD2), as well as spectral analysis measures (LF, low-frequency range; HF, high-frequency range) were calculated for the heart rate time series of 10 elderly inpatients with MDD (70+/-7 years) before and after ECT. Hamilton Depression Rating Scale (HAM-D) was evaluated concomitantly.
Only the responders to ECT (n=7; >or=50% reduction in HAM-D) exhibited a significant increase in PD2 (P=.0035), which showed a tendency towards a correlation with symptom improvement (r=.73, P=.06). Spectral analysis measures did not show a significant difference after ECT.
Elderly patients with MDD, who respond to ECT, might show increased vagal modulation. Since nonlinear HRV measures have been shown to be reduced by aging, similar to cholinergic deficit, they might shed light on the increased risk for cardiac mortality in depression.
采用心率变异性（HRV）分析的线性和非线性方法，评估老年重度抑郁症（MDD）住院患者在电休克治疗（ECT）前后的副交感神经调制情况。
计算10例老年MDD住院患者（70±7岁）在ECT前后心率时间序列的局部维度复杂性测量值（逐点关联维数，PD2）以及频谱分析测量值（低频范围LF、高频范围HF）。同时评估汉密尔顿抑郁量表（HAM-D）。
仅ECT治疗有反应者（n = 7；HAM-D降低≥50%）的PD2显著增加（P = 0.0035），且显示出与症状改善的相关性趋势（r = 0.73，P = 0.06）。频谱分析测量值在ECT后未显示出显著差异。
对ECT有反应的老年MDD患者可能表现出迷走神经调制增加。由于非线性HRV测量值已被证明会因衰老而降低，类似于胆碱能缺陷，它们可能有助于解释抑郁症患者心脏死亡风险增加的原因。
