Institute of Psychology, University of Graz, Graz, Austria.
Psychol Med. 2020 Sep;50(12):1937-1948. doi: 10.1017/S003329172000207X. Epub 2020 Aug 28.
Changes in autonomic nervous system (ANS) function have been observed in a variety of psychological disorders, including posttraumatic stress disorder (PTSD). Analysis of heart rate variability (HRV) provides insight into the functioning of the ANS. Previous research on PTSD found lower HRV in PTSD patients compared to controls, indicating altered sympathetic and parasympathetic activity, but findings are inconsistent. The purpose of this meta-analysis was to examine differences in HRV indices between individuals with PTSD and healthy controls at baseline and during stress.
The included primary studies present an aggregate of studies analyzing different HRV indices. Examined HRV indices were standard deviation of the normalized NN-intervals (SDNN), root mean square of successive differences (RMSSD), low-frequency (LF) and high-frequency (HF) spectral components, LF/HF ratio, and heart rate (HR). Moderating effects of study design, HRV and PTSD assessment, and sample characteristics were examined via subgroup-analyses and meta-regressions.
Random-effects meta-analyses for HRV parameters at rest revealed significant group differences for RMSSD and HF-HRV, suggesting lower parasympathetic activity in PTSD. The aggregated effect size for SDNN was medium, suggesting diminished total variability in PTSD. A small effect was found for LF-HRV. A higher LF/HF ratio was found in the PTSD sample as compared to controls. Individuals with PTSD showed significantly higher HR. During stress, individuals with PTSD showed higher HR and lower HF-HRV, both indicated by small effect sizes.
Findings suggest that PTSD is associated with ANS dysfunction.
自主神经系统（ANS）功能的变化在各种心理障碍中都有观察到，包括创伤后应激障碍（PTSD）。心率变异性（HRV）的分析提供了对 ANS 功能的深入了解。以前关于 PTSD 的研究发现，与对照组相比，PTSD 患者的 HRV 较低，表明交感和副交感活动发生改变，但研究结果不一致。本荟萃分析的目的是检查 PTSD 患者和健康对照组在基线和应激期间 HRV 指标的差异。
纳入的主要研究提供了分析不同 HRV 指标的综合研究。检查的 HRV 指标包括正常化 NN 间期的标准差（SDNN）、连续差值的均方根（RMSSD）、低频（LF）和高频（HF）谱分量、LF/HF 比和心率（HR）。通过亚组分析和荟萃回归检验研究设计、HRV 和 PTSD 评估以及样本特征的调节作用。
静息状态下 HRV 参数的随机效应荟萃分析显示，RMSSD 和 HF-HRV 存在显著的组间差异，表明 PTSD 患者的副交感活动较低。SDNN 的综合效应大小为中等，表明 PTSD 患者的总变异性降低。LF-HRV 的效应较小。与对照组相比，PTSD 样本中的 LF/HF 比值较高。PTSD 个体的 HR 明显较高。在应激期间，PTSD 个体的 HR 较高，HF-HRV 较低，两者的效应大小均较小。
研究结果表明，PTSD 与 ANS 功能障碍有关。
