Moretta Tania, Kaess Michael, Koenig Julian
Department of General Psychology, University of Padua, Padua, Italy.
Clinic for Child and Adolescent Psychiatry, Centre for Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany.
J Neural Transm (Vienna). 2023 Feb;130(2):135-144. doi: 10.1007/s00702-022-02577-3. Epub 2023 Jan 11.
Major depressive disorder (MDD) is associated with autonomic nervous system (ANS) dysfunction, characterized by decreased parasympathetic (PNS) and increased sympathetic (SNS) activity. Although findings on reduced PNS activity in adult MDD have been replicated in adolescents, comprehensive studies assessing PNS and SNS proxies in underage patients with MDD are scarce. Proxies of resting PNS (heart rate variability (HRV) and SNS activity (skin conductance response [SCR] and salivary alpha amylase [sAA], as well as mixed activity (heart rate [HR]) were collected in adolescents with MDD (n = 29) and non-depressed controls (n = 29). Primary analyses addressed differences between groups and correlations with depression severity. Patients with MDD showed significantly decreased HRV (g = - 0.87; 95% CI [- 1.39; - 0.35]) and increased HR (g = 0.66; 95% CI [0.14; 1.18]). Proxies of pure SNS activity showed no significant differences between groups. HR (positive) and HRV (negative) were significantly correlated with self- and clinician-rated depression severity. Alterations of ANS activity are evident in adolescent MDD, but characterized by decreased PNS activity only. We found no evidence for altered SNS activity. Findings suggest that ANS dysfunction early in the course of MDD might be predominantly driven by decreased PNS activity.
重度抑郁症（MDD）与自主神经系统（ANS）功能障碍有关，其特征是副交感神经（PNS）活动减少和交感神经（SNS）活动增加。尽管在青少年中也重复了成人MDD患者副交感神经活动降低的研究结果，但评估未成年MDD患者副交感神经和交感神经替代指标的综合研究却很少。我们收集了患有MDD的青少年（n = 29）和非抑郁对照组（n = 29）的静息副交感神经替代指标（心率变异性[HRV]）、交感神经活动替代指标（皮肤电反应[SCR]和唾液α淀粉酶[sAA]）以及混合活动指标（心率[HR]）。主要分析探讨了组间差异以及与抑郁严重程度的相关性。MDD患者的HRV显著降低（g = - 0.87；95%置信区间[- 1.39；- 0.35]），HR升高（g = 0.66；95%置信区间[0.14；1.18]）。纯交感神经活动的替代指标在两组之间没有显著差异。HR（正相关）和HRV（负相关）与自我评定和临床医生评定的抑郁严重程度显著相关。青少年MDD患者存在明显的自主神经系统活动改变，但仅表现为副交感神经活动降低。我们没有发现交感神经活动改变的证据。研究结果表明，MDD病程早期的自主神经系统功能障碍可能主要是由副交感神经活动降低引起的。
