Doctoral School of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary; Institute of Psychology, ELTE, Eötvös Loránd University, Budapest, Hungary.
Department of Social, Work, and Differential Psychology, Complutense University of Madrid, Spain.
Neuroimage Clin. 2022;33:102933. doi: 10.1016/j.nicl.2021.102933. Epub 2021 Dec 31.
Frequent nightmares are highly prevalent and constitute a risk factor for a wide range of psychopathological conditions. Despite its prevalence and clinical relevance however, the pathophysiological mechanisms of nightmares are poorly understood. A recent study (Perogamvros et, al 2019) examined the heart beat evoked potential (HEP) in a small group of nightmare sufferers (N = 11) and matched healthy controls (N = 11) and observed markedly different (Hedges' g = 1.42 [0.62-2.22]) HEP response across the groups during Rapid Eye Movement (REM) sleep. Moreover, the HEP correlated with depression scores in the nightmare group only. The authors concluded that the HEP in REM sleep could be used as a trait-like biomarker reflecting pathological emotional-and sleep regulation in nightmare disorder. To replicate the above study, we performed the same analyses of HEPs in two separate, and larger databases comprising the polysomnographic recordings of nightmare sufferers and matched controls (N = 39 ; N = 41). In contrast to the original findings, we did not observe significant differences in HEP across the two groups in either of the two databases. Moreover, we found no associations between depression scores and HEP amplitudes in the relevant spatiotemporal cluster. Our data cast doubts on the utility of HEP as a biomarker in the diagnostic and treatment procedures of nightmare disorder and suggests that the interpretation of HEP as a marker of impaired arousal and emotional processing during REM sleep is premature and requires further validation.
频繁做噩梦的现象十分普遍，而且是许多精神病理状况的一个风险因素。然而，尽管其普遍性和临床相关性很强，但噩梦的病理生理机制仍了解甚少。最近的一项研究（Perogamvros 等人，2019 年）在一小群噩梦患者（N=11）和匹配的健康对照组（N=11）中检查了心跳诱发电位（HEP），并观察到 REM 睡眠期间两组之间的 HEP 反应明显不同（Hedges' g=1.42[0.62-2.22]）。此外，HEP 仅与噩梦组的抑郁评分相关。作者得出结论，REM 睡眠中的 HEP 可以作为一种特质样生物标志物，反映噩梦障碍中的病理性情绪和睡眠调节。为了复制上述研究，我们对包含噩梦患者和匹配对照的两个独立的更大数据库中的 HEP 进行了相同的分析（N=39；N=41）。与原始发现相反，我们在这两个数据库中的两个组中都没有观察到 HEP 存在显著差异。此外，我们在相关时空聚类中未发现抑郁评分与 HEP 幅度之间存在关联。我们的数据对 HEP 作为噩梦障碍诊断和治疗程序中的生物标志物的效用提出了质疑，并表明将 HEP 解释为 REM 睡眠期间唤醒和情绪处理受损的标志物为时过早，需要进一步验证。
