Interdisciplinary Program in Bioengineering, Seoul National University, Seoul 03080, Republic of Korea; Institute of Medical and Biological Engineering, Medical Research Center, Seoul National University, Seoul 03080, Republic of Korea.
Interdisciplinary Program in Bioengineering, Seoul National University, Seoul 03080, Republic of Korea.
Psychiatry Res. 2019 Jan;271:291-298. doi: 10.1016/j.psychres.2018.11.021. Epub 2018 Nov 12.
We investigated the relationship between autonomic nervous system activity during each sleep stage and the severity of depressive symptoms in patients with major depressive disorder (MDD) and healthy control subjects. Thirty patients with MDD and thirty healthy control subjects matched for sex, age, and body mass index completed standard overnight polysomnography. Depression severity was assessed using the Beck Depression Inventory (BDI). Time- and frequency-domain, and fractal HRV parameters were derived from 5-min electrocardiogram segments during light sleep, deep sleep, rapid eye movement (REM) sleep, and the pre- and post-sleep wake periods. Detrended fluctuation analysis (DFA) alpha-1 values during REM sleep were significantly higher in patients with MDD than in control subjects, and a significant correlation existed between DFA alpha-1 and BDI score in all subjects. DFA alpha-1 was the strongest predictor for the BDI score, along with REM density as a covariate. This study found that compared with controls, patients with MDD show reduced complexity in heart rate during REM sleep, which may represent lower cardiovascular adaptability in these patients, and could lead to cardiac disease. Moreover, DFA alpha-1 values measured during REM sleep may be useful as an indicator for the diagnosis and monitoring of depression.
我们研究了自主神经系统活动与重度抑郁症（MDD）患者和健康对照组在各个睡眠阶段之间的严重程度之间的关系。 30 名 MDD 患者和 30 名性别、年龄和体重指数匹配的健康对照组完成了标准的整夜多导睡眠图。使用贝克抑郁量表（BDI）评估抑郁严重程度。从轻度睡眠、深度睡眠、快速眼动（REM）睡眠以及睡眠前和睡眠后清醒期的 5 分钟心电图片段中得出时间和频率域以及分形 HRV 参数。与对照组相比，MDD 患者 REM 睡眠时的去趋势波动分析（DFA）alpha-1 值显着更高，并且所有受试者的 DFA alpha-1 与 BDI 评分之间存在显着相关性。DFA alpha-1 是 BDI 评分的最强预测因子，而 REM 密度则作为协变量。这项研究发现，与对照组相比，MDD 患者在 REM 睡眠期间的心率复杂性降低，这可能代表这些患者的心血管适应性较低，可能导致心脏病。此外，在 REM 睡眠期间测量的 DFA alpha-1 值可作为诊断和监测抑郁症的指标。
