Kim Kyungwook, Lee Seul, Kim Jong-Hoon
Gachon University School of Medicine.
Department of Psychiatry, Gil Medical Center, Gachon University School of Medicine, Gachon University.
Neuropsychiatr Dis Treat. 2016 Dec 8;12:3111-3118. doi: 10.2147/NDT.S121533. eCollection 2016.
Generalized anxiety disorder (GAD) is a chronic and highly prevalent disorder that is characterized by a number of autonomic nervous system symptoms. The purpose of this study was to investigate the linear and nonlinear complexity measures of heart rate variability (HRV), measuring autonomic regulation, and to evaluate the relationship between HRV parameters and the severity of anxiety, in medication-free patients with GAD.
Assessments of linear and nonlinear complexity measures of HRV were performed in 42 medication-free patients with GAD and 50 healthy control subjects. In addition, the severity of anxiety symptoms was assessed using the State-Trait Anxiety Inventory and Beck Anxiety Inventory. The values of the HRV measures of the groups were compared, and the correlations between the HRV measures and the severity of anxiety symptoms were assessed.
The GAD group showed significantly lower standard deviation of RR intervals and the square root of the mean squared differences of successive normal sinus intervals values compared to the control group (<0.01). The approximate entropy value, which is a nonlinear complexity indicator, was also significantly lower in the patient group than in the control group (<0.01). In correlation analysis, there were no significant correlations between HRV parameters and the severity of anxiety symptoms.
The present study indicates that GAD is significantly associated with reduced HRV, suggesting that autonomic neurocardiac integrity is substantially impaired in patients with GAD. Future prospective studies are required to investigate the effects of pharmacological or non-pharmacological treatment on neuroautonomic modulation in patients with GAD.
广泛性焦虑障碍（GAD）是一种慢性且高度流行的疾病，其特征为多种自主神经系统症状。本研究旨在调查心率变异性（HRV）的线性和非线性复杂性测量指标（用于测量自主调节功能），并评估无药物治疗的GAD患者中HRV参数与焦虑严重程度之间的关系。
对42例无药物治疗的GAD患者和50名健康对照者进行了HRV的线性和非线性复杂性测量评估。此外，使用状态-特质焦虑量表和贝克焦虑量表评估焦虑症状的严重程度。比较了两组的HRV测量值，并评估了HRV测量值与焦虑症状严重程度之间的相关性。
与对照组相比，GAD组的RR间期标准差和连续正常窦性间期值的均方差平方根显著降低（<0.01）。作为非线性复杂性指标的近似熵值在患者组中也显著低于对照组（<0.01）。在相关性分析中，HRV参数与焦虑症状严重程度之间无显著相关性。
本研究表明，GAD与HRV降低显著相关，提示GAD患者的自主神经心脏完整性受到严重损害。未来需要进行前瞻性研究，以调查药物或非药物治疗对GAD患者神经自主调节的影响。
