非线性心肺耦合指数在评估抑郁症中的附加价值。
The Added Value of Nonlinear Cardiorespiratory Coupling Indices in the Assessment of Depression.
出版信息
Annu Int Conf IEEE Eng Med Biol Soc. 2021 Nov;2021:5473-5476. doi: 10.1109/EMBC46164.2021.9631096.
The present study investigates the differences in autonomic nervous system (ANS) function and stress response between patients with major depressive disorder (MDD) and healthy subjects by measuring changes in ANS biomarkers. ANS-related parameters are derived from various biosignals during a mental stress protocol consisting of a basal, stress, and recovery phase. The feature set consists of ANS biomarkers such as the heart rate (HR) derived from the electrocardiogram, the respiratory rate derived from the respiration signal, vascular parameters obtained from a model-based photoplethysmographic pulse waveform analysis, and cardiorespiratory coupling indices derived from the joint analysis of the heart rate variability (HRV) and respiratory signals. In particular, linear cardiorespiratory interactions are quantified by means of time-frequency coherence, while interactions of quadratic nonlinear nature between HRV and respiration are quantified by means of real wavelet biphase. The intra-subject difference of a feature value between two phases of the protocol, the so-called autonomic reactivity, is considered as a ANS biomarker as well. The performance of ANS biomarkers on discriminating MDD patients is evaluated using a classification pipeline. The results show that the most discriminative ANS biomarkers are related with differences in HR and autonomic reactivity of both vascular and nonlinear cardiorespiratory coupling indices. Differences in autonomic reactivity imply that MDD and healthy subjects differ in their ability to cope with stress. Considering only HR and vascular characteristics a linear support-vector machine classifier yields to accuracy 72.5% and F1-score 73.2%. However, taking into account the nonlinear cardiorespiratory coupling indices, the classification performance improves, yielding to accuracy 77.5% and F1-score 78.0%.Clinical relevance- Changes in the nonlinear properties of the cardiorespiratory system during stress may yield additional information on the assessment of depression.
本研究通过测量自主神经系统（ANS）生物标志物的变化，来研究重度抑郁症（MDD）患者和健康受试者之间自主神经系统功能和应激反应的差异。ANS 相关参数是从精神应激协议的各个生物信号中得出的，该协议包括基础、应激和恢复阶段。特征集包括从心电图中得出的心率（HR）、从呼吸信号中得出的呼吸率、从基于模型的光体积脉搏波分析中获得的血管参数以及从心率变异性（HRV）和呼吸信号的联合分析中得出的心肺耦合指数。特别是，线性心肺相互作用通过时频相干性进行量化，而 HRV 和呼吸之间二次非线性相互作用通过实小波双相位进行量化。协议两个阶段之间特征值的个体内差异，即所谓的自主反应性，也被认为是 ANS 生物标志物。使用分类管道评估 ANS 生物标志物区分 MDD 患者的性能。结果表明，最具区分性的 ANS 生物标志物与 HR 和血管及非线性心肺耦合指数的自主反应性差异有关。自主反应性的差异意味着 MDD 和健康受试者在应对压力的能力上存在差异。仅考虑 HR 和血管特征，线性支持向量机分类器的准确率为 72.5%，F1 得分为 73.2%。然而，考虑到非线性心肺耦合指数，分类性能会提高，准确率为 77.5%，F1 得分为 78.0%。临床意义-应激期间心肺系统非线性特性的变化可能会提供有关抑郁评估的额外信息。
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