Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich (PUK), University of Zurich, Zurich, Switzerland; Department of Psychology, University of Zurich, Zurich, Switzerland.
Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich (PUK), University of Zurich, Zurich, Switzerland; Department of Psychology, University of Zurich, Zurich, Switzerland.
J Psychiatr Res. 2023 Aug;164:235-242. doi: 10.1016/j.jpsychires.2023.06.006. Epub 2023 Jun 24.
The diagnostic assessment of autism spectrum disorders (ASD) in adults is a challenging and time-consuming procedure. In order to address the lack of specialised health-care professionals and improve the waiting time, we aimed to identify specific electrocardiogram (ECG) derived Heart Rate Variability (HRV) parameters that could be used for diagnostic purposes. 152 patients were diagnosed based on a standardised clinical procedure and assigned to one of three groups: ASD (n = 56), any other psychiatric disorder (OD) (n = 72), and patients with no diagnosis (ND) (n = 24). Groups were compared using ANOVA. Discriminative power of biological parameters and the clinical assessment were compared using receiver operating characteristic curves (ROCs). Patients with ASD showed reduced parasympathetic and increased sympathetic activity compared to ND. The accuracy determined by the area under the curve (AUC) of the biological parameters for discrimination between ASD vs. pooled OD/ND was 0.736 (95% CI = 0.652-0.820), compared to .856 (95% CI = 0.795-0.917) for the extensive clinical assessment. Our results confirmed the dysregulation of the autonomic nervous system in ASD with reduced parasympathetic and increased sympathetic activity as compared to ND. The discriminative power of biological markers including HRV was considerable and could supplement less sophisticated clinical assessments.
成人孤独症谱系障碍（ASD）的诊断评估是一项具有挑战性和耗时的过程。为了解决专业医疗保健人员短缺和等待时间长的问题，我们旨在确定可用于诊断目的的特定心电图（ECG）衍生心率变异性（HRV）参数。根据标准化临床程序对 152 名患者进行诊断，并将其分为三组：ASD（n=56）、任何其他精神障碍（OD）（n=72）和无诊断（ND）（n=24）。使用方差分析比较组间差异。使用接收者操作特征曲线（ROC）比较生物参数和临床评估的判别能力。与 ND 相比，ASD 患者的副交感神经活动减少，交感神经活动增加。生物参数区分 ASD 与合并 OD/ND 的曲线下面积（AUC）确定的准确性为 0.736（95%CI=0.652-0.820），而广泛临床评估的准确性为 0.856（95%CI=0.795-0.917）。我们的结果证实了 ASD 患者自主神经系统失调，与 ND 相比，副交感神经活动减少，交感神经活动增加。包括 HRV 在内的生物标志物的判别能力相当，可以补充不那么复杂的临床评估。
