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心率变异性在治疗反应中的比较:重性抑郁障碍与惊恐障碍患者的 12 周随访研究。

Heart rate variability for treatment response between patients with major depressive disorder versus panic disorder: A 12-week follow-up study.

机构信息

Department of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Korea.

Bio-Medical IT Convergence Research Division, Electronics and Telecommunications Research Institute (ETRI), 218 Gajeong-ro, Daejeon, Korea.

出版信息

J Affect Disord. 2019 Mar 1;246:157-165. doi: 10.1016/j.jad.2018.12.048. Epub 2018 Dec 18.

DOI:10.1016/j.jad.2018.12.048
PMID:30583140
Abstract

BACKGROUND

Heart Rate Variability (HRV) parameters have been used to evaluate the autonomic nervous system. We hypothesized that patients with major depressive disorder (MDD) and panic disorder (PD) showed different HRV profiles compared to healthy controls. We also hypothesized that we could predict the responder groups in the MDD and PD patients, using differences in HRV indices between the stress and rest phases.

METHODS

28 MDD patients and 29 PD patients were followed for 12 weeks, and we also followed 39 healthy control subjects. We measured HRV parameters at the rest, stress, and recovery phases.

RESULTS

Patients with MDD and PD demonstrated lower pNN50 than controls during the stress (F = 7.49, p = 0.001), and recovery phases (F = 9.43, p = 0.0001). Patients with MDD and PD also showed higher LF/HF ratio than controls during the stress phase (F = 6.15, p = 0.002). Responders in the PD group presented a lower level of LF/HF ratio during the stress phase compared to non-responders (F = 10.14, p = 0.002), while responders in the MDD group showed a lower level of heart rate during all three phases, compared to non-responders. Additionally, we could predict treatment response in patients with MDD using ΔLF/HF ratio (OR: 1.33, 95% CI = 1.07-1.65, p = 0.011) and ΔpNN50 (OR: 1.49, 95% CI 1.09-1.77, p = 0.014).

CONCLUSION

The changes of HRV parameters of pNN50 and LF/HF ratio between the stress and recovery phase may be clinical markers of predictors of treatment responsiveness in MDD and PD patients.

摘要

背景

心率变异性 (HRV) 参数已被用于评估自主神经系统。我们假设与健康对照组相比,患有重度抑郁症 (MDD) 和惊恐障碍 (PD) 的患者表现出不同的 HRV 特征。我们还假设,我们可以通过在应激和休息阶段之间的 HRV 指数差异来预测 MDD 和 PD 患者的反应者群体。

方法

我们对 28 名 MDD 患者和 29 名 PD 患者进行了 12 周的随访,同时也对 39 名健康对照者进行了随访。我们在休息、应激和恢复阶段测量了 HRV 参数。

结果

与对照组相比,MDD 和 PD 患者在应激(F=7.49,p=0.001)和恢复阶段(F=9.43,p=0.0001)期间的 pNN50 更低。MDD 和 PD 患者在应激阶段的 LF/HF 比值也高于对照组(F=6.15,p=0.002)。PD 组的反应者在应激阶段的 LF/HF 比值低于非反应者(F=10.14,p=0.002),而 MDD 组的反应者在所有三个阶段的心率均低于非反应者。此外,我们可以使用 ΔLF/HF 比值(OR:1.33,95%CI=1.07-1.65,p=0.011)和 ΔpNN50(OR:1.49,95%CI 1.09-1.77,p=0.014)预测 MDD 患者的治疗反应。

结论

在应激和恢复阶段之间,pNN50 和 LF/HF 比值的 HRV 参数变化可能是 MDD 和 PD 患者治疗反应性预测的临床标志物。

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