Department of Psychiatry, Shizuoka Saiseikai General Hospital, Shizuoka 422-8527, Japan.
Research Division, Saiseikai Research Institute of Health Care and Welfare, Tokyo 108-0073, Japan.
Sensors (Basel). 2023 Jun 4;23(11):5330. doi: 10.3390/s23115330.
Major depressive disorder (MDD) and chronic fatigue syndrome (CFS) have overlapping symptoms, and differentiation is important to administer the proper treatment. The present study aimed to assess the usefulness of heart rate variability (HRV) indices. Frequency-domain HRV indices, including high-frequency (HF) and low-frequency (LF) components, their sum (LF+HF), and their ratio (LF/HF), were measured in a three-behavioral-state paradigm composed of initial rest (Rest), task load (Task), and post-task rest (After) periods to examine autonomic regulation. It was found that HF was low at Rest in both disorders, but was lower in MDD than in CFS. LF and LF+HF at Rest were low only in MDD. Attenuated responses of LF, HF, LF+HF, and LF/HF to task load and an excessive increase in HF at After were found in both disorders. The results indicate that an overall HRV reduction at Rest may support a diagnosis of MDD. HF reduction was found in CFS, but with a lesser severity. Response disturbances of HRV to Task were observed in both disorders, and would suggest the presence of CFS when the baseline HRV has not been reduced. Linear discriminant analysis using HRV indices was able to differentiate MDD from CFS, with a sensitivity and specificity of 91.8% and 100%, respectively. HRV indices in MDD and CFS show both common and different profiles, and can be useful for the differential diagnosis.
重度抑郁症（MDD）和慢性疲劳综合征（CFS）有重叠的症状，因此区分这两种病症并施以恰当的治疗十分重要。本研究旨在评估心率变异性（HRV）指标的有用性。通过三个行为状态范式（初始休息期（Rest）、任务加载期（Task）和任务后休息期（After））来测量频域 HRV 指标，包括高频（HF）和低频（LF）分量、它们的总和（LF+HF）以及它们的比值（LF/HF），以检查自主调节。结果发现，两种疾病在 Rest 期的 HF 均较低，但 MDD 比 CFS 更低。仅在 MDD 中，LF 和 LF+HF 在 Rest 期较低。在两种疾病中均发现 LF、HF、LF+HF 和 LF/HF 对任务负荷的反应减弱，以及在 After 期 HF 过度增加。结果表明，在 Rest 期整体 HRV 降低可能支持 MDD 的诊断。在 CFS 中也发现了 HF 降低，但严重程度较轻。在两种疾病中均观察到 HRV 对 Task 的反应障碍，并且当基线 HRV 没有降低时，这可能提示 CFS 的存在。使用 HRV 指数的线性判别分析能够区分 MDD 和 CFS，敏感性和特异性分别为 91.8%和 100%。MDD 和 CFS 的 HRV 指数表现出既有共同点又有不同特征的模式，可用于鉴别诊断。
