Gündüz Nermin, Akpınar Aslan Esma, Eren Fatma, Sodan Turan Hatice, Öztürk Mustafa, Tural Ümit
Turk Psikiyatri Derg. 2019 Winter;30(4):236-244.
One of the METHODS used to assess autonomic nervous system dysfunction in the etiology of panic disorder (PD) is heart rate variability (HRV). HRV is controlled by the sympathetic and parasympathetic (vagal) branches of the autonomic nervous system and reflects the capacity of autonomic stimulation by the parasympathetic system. The aim of this study was to evaluate heart rate variability (HRV) time domain parameters based on twenty four hour holter ECG analysis among drug-naive patients with panic disorder (PD) without any other medical and psychiatric comorbidity.
The study group consisted of 41 patients with PD and 46 healthy controls. Participants were evaluated with SCID-1 for psychiatric diagnoses. Then Hamilton Depression Rating Scale (HDRS), Hamilton Anxiety Rating Scale (HARS), Panic Disorder Severity Scale (PDSS) and Clinical Global Impression Scale (CGI-S) were applied to participants. Twenty four hour Holter ECG outcomes were analyzed on a computer program and time domain parameters were evaluated.
Among the parameters analyzed from HRV, SDANN was significantly higher (p <0.001); duration of RMSSD, NN50 and pNN50 were lower in PD group than the control group (p = 0.003, p = 0.005, p = 0.047, respectively). In the correlation analysis, there was a moderate negative correlation between CGI-S and NN50 and pNN50. In logistic regression analysis, the increase in SDNN was found to increase the probability of PD by 1.11 (95% CI, 1.010-1.209); the increase in SDANN was found to decrease the probability of PD by 0.892 (95% CI, 0.818-0.973), and the increase in pNN50 was found to decrease the probability of PD by 0.523 (95% CI, 0.342-0.801).
The data obtained in our study confirm that there is a decrease in some HRV parameters like RMSSD, NN50 and pNN50 reflecting parasympathetic activity among patients with PD.
用于评估惊恐障碍（PD）病因中自主神经系统功能障碍的方法之一是心率变异性（HRV）。HRV受自主神经系统的交感神经和副交感神经（迷走神经）分支控制，反映副交感神经系统自主刺激的能力。本研究的目的是基于24小时动态心电图分析，评估未服用任何药物且无其他内科和精神科合并症的惊恐障碍（PD）患者的心率变异性（HRV）时域参数。
研究组由41例PD患者和46例健康对照组成。使用SCID-1对参与者进行精神疾病诊断评估。然后对参与者应用汉密尔顿抑郁量表（HDRS）、汉密尔顿焦虑量表（HARS）、惊恐障碍严重程度量表（PDSS）和临床总体印象量表（CGI-S）。在计算机程序上分析24小时动态心电图结果，并评估时域参数。
在从HRV分析的参数中，PD组的SDANN显著更高（p<0.001）；PD组的RMSSD、NN50持续时间和pNN50低于对照组（分别为p = 0.003、p = 0.005、p = 0.047）。在相关性分析中，CGI-S与NN50和pNN50之间存在中度负相关。在逻辑回归分析中，发现SDNN的增加使PD的概率增加1.11（95%CI，1.010 - 1.209）；发现SDANN的增加使PD的概率降低0.892（95%CI，0.818 - 0.973），并且发现pNN50的增加使PD的概率降低0.523（95%CI，0.342 - 0.801）。
我们研究中获得的数据证实，PD患者中反映副交感神经活动的一些HRV参数如RMSSD、NN50和pNN50有所降低。
