Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
Psychiatry Investig. 2013 Jun;10(2):121-30. doi: 10.4306/pi.2013.10.2.121. Epub 2013 May 30.
Decreased cardiac vagal control (CVC) has been proposed in posttraumatic stress disorder (PTSD), but the results are mixed. Analyses with larger sample sizes and better methodology are needed.
Thirty-two drug-naïve survivors with current PTSD, 32 survivors without PTSD and 192 matched controls were recruited for a case-control analysis. We used the PTSD checklist-civilian version (PCL-C) to assess posttraumatic symptoms severity. Cardiac autonomic function was evaluated by measuring heart rate variability (HRV) parameters. Frequency-domain indices of HRV were obtained. The obtained results were evaluated in association with personality traits assessed by the Tridimensional Personality Questionnaire (TPQ).
PTSD patients exhibited decreased LF-HRV and HF-HRV as compared to survivors without PTSD and to matched controls. The PTSD symptoms severity was associated with reduced mean RR intervals, Var-HRV, LF-HRV and HF-HRV. The harm avoidance score (which has been suggested to be associated with serotonergic activity) was negatively correlated with Var-HRV, LF-HRV and HF-HRV.
These data suggest that PTSD is accompanied by decreased CVC, highlighting the importance of assessing HRV in PTSD patients. In view of the increased risk for cardiovascular diseases in these vulnerable individuals, one might consider the treatment to restore their autonomic function while reducing PTSD symptoms.
创伤后应激障碍(PTSD)患者的心脏迷走神经控制(CVC)降低,但结果不一。需要进行更大样本量和更好方法学的分析。
招募了 32 名无药物治疗的 PTSD 幸存者、32 名无 PTSD 幸存者和 192 名匹配对照者进行病例对照分析。我们使用 PTSD 检查表-平民版(PCL-C)评估创伤后症状的严重程度。通过测量心率变异性(HRV)参数评估心脏自主神经功能。获得了频域 HRV 指数。将获得的结果与使用三维人格问卷(TPQ)评估的人格特质进行关联评估。
与无 PTSD 幸存者和匹配对照者相比,PTSD 患者的 LF-HRV 和 HF-HRV 降低。PTSD 症状严重程度与平均 RR 间隔、Var-HRV、LF-HRV 和 HF-HRV 减少有关。回避得分(与 5-羟色胺能活性有关)与 Var-HRV、LF-HRV 和 HF-HRV 呈负相关。
这些数据表明,PTSD 伴有 CVC 降低,强调了在 PTSD 患者中评估 HRV 的重要性。鉴于这些易受影响的个体患心血管疾病的风险增加,人们可能会考虑通过治疗来恢复其自主功能,同时减轻 PTSD 症状。