Ge Fenfen, Yuan Minlan, Li Ying, Zhang Wei
Mental Health Center of West China Hospital, Sichuan University, Chengdu, China.
Embedded System and Intelligent Computing Laboratory, University of Electronic Science and Technology of China, Chengdu, China.
Psychiatry Investig. 2020 Jan;17(1):9-20. doi: 10.30773/pi.2019.0112. Epub 2020 Jan 25.
The functions of both the central and peripheral autonomic nervous system, indexed by heart rate variability (HRV), are affected by psychology and physiology. This review summarizes the results of studies comparing the evaluation of HRV parameters between individuals with posttraumatic stress disorder (PTSD) and healthy controls.
Eligible studies (n=499) were identified through literature searches of the EMBASE, Medline, PubMed and Web of Science databases. Nineteen studies met our inclusion criteria. A random effects model was used, and standardized mean differences for highfrequency HRV(HF-HRV), low-frequency HRV(LF-HRV) and the root mean square of successive R-R interval differences (RMSSD) were calculated.
Significant effects were found for HF-HRV [p<0.0001, Z=4.18; Hedges'g=-1.58, 95% confidence interval (CI) (-2.32, -0.84); k=14] and RMSSD [p<0.00001, Z=4.80; Hedges'g=-1.96, 95% CI (-2.76, -1.16); k=9] relative to healthy controls. Considerable heterogeneity was revealed, but the main effects for HF-HRV and RMSSD were robust in subsequent meta-regression and subgroup analyses.
Given the relationships among low vagal state, inflammation, and alterations in brain structure and function, including executive function and emotion regulation, reduced HRV may be regarded as an endophenotype in PTSD research.
以心率变异性（HRV）为指标的中枢和外周自主神经系统功能会受到心理和生理因素的影响。本综述总结了比较创伤后应激障碍（PTSD）患者与健康对照者HRV参数评估结果的研究成果。
通过对EMBASE、Medline、PubMed和Web of Science数据库进行文献检索，确定了符合条件的研究（n = 499）。19项研究符合我们的纳入标准。采用随机效应模型，计算高频HRV（HF-HRV）、低频HRV（LF-HRV）和逐次R-R间期差值的均方根（RMSSD）的标准化均值差异。
相对于健康对照者，HF-HRV [p < 0.0001，Z = 4.18；Hedges' g = -1.58，95%置信区间（CI）（-2.32，-0.84）；k = 14]和RMSSD [p < 0.00001，Z = 4.80；Hedges' g = -1.96，95% CI（-2.76，-1.16）；k = 9]存在显著效应。研究显示出相当大的数据异质性，但在随后的meta回归和亚组分析中，HF-HRV和RMSSD的主要效应仍然稳健。
鉴于低迷走神经状态、炎症与脑结构和功能改变（包括执行功能和情绪调节）之间的关系，HRV降低可能被视为PTSD研究中的一种内表型。
