Department of Psychiatry and Psychotherapy, University Hospital of Erlangen, Erlangen, Germany.
Pharmacopsychiatry. 2010 Jan;43(1):7-11. doi: 10.1055/s-0029-1237374. Epub 2009 Dec 9.
Changes in the heart rate variability are well known among patients with depression. Amongst others, a modulation of the autonomic nervous system is discussed. An investigation of heart rate variability during terms of stimulation could give some insight in the central nervous effect of vagus nerve stimulation (VNS) and possible cardiac side effects.
The effects of VNS on heart rate (HR) and heart rate variability were studied (HRV) during stimulation in nine patients with major depression according to ICD-10.
When comparing treated depressive patients with a sex- and age-matched healthy control group, the analysis of heart rate revealed significantly (t=2.8; df=16, p=0.012) elevated heart rates during completely switched off conditions, during switched on VNS programme in stimulation-free intervals (5 min period) (t=3.0; p=0.009) and during stimulation conditions (30 s) (t=2.8, Levene corrected, p=0.015). The RMSSD (root mean square of successive differences) as a measure of the HRV increased significantly in switched on conditions during stimulation (30 s) in six patients compared to stimulation-free intervals (t=-4.7; df=5, p=0.006) and baseline.
Clinically relevant cardiac effects were not observed throughout the study. VNS induces reversible changes in heart rate variability in patients with major depression during stimulation conditions.
心率变异性的变化在抑郁症患者中是众所周知的。其中，讨论了自主神经系统的调制。对刺激期间心率变异性的研究可以深入了解迷走神经刺激（VNS）对中枢神经系统的影响以及可能的心脏副作用。
根据 ICD-10，我们研究了 9 名患有重度抑郁症的患者在刺激过程中 VNS 对心率（HR）和心率变异性（HRV）的影响。
当将接受治疗的抑郁患者与性别和年龄匹配的健康对照组进行比较时，心率分析显示，在完全关闭状态下（t=2.8；df=16，p=0.012）、在刺激间期（5 分钟）的打开 VNS 方案（t=3.0；p=0.009）和在刺激条件下（30 秒）（t=2.8，经莱文校正，p=0.015）心率显著升高。六个患者在刺激期间（30 秒）的 RMSSD（连续差异的均方根）作为 HRV 的测量值与刺激间期（t=-4.7；df=5，p=0.006）和基线相比显著增加。
在整个研究过程中未观察到临床相关的心脏效应。VNS 在刺激条件下可诱导重度抑郁症患者的心率变异性发生可逆变化。
