Department of Kinesiology, The University of Texas at Arlington, Arlington, TX, United States of America.
Department of Kinesiology, The University of Texas at Arlington, Arlington, TX, United States of America; Department of Applied Clinical Research, The University of Texas Southwestern Medical Center, Dallas, TX, United States of America.
J Affect Disord. 2024 Sep 15;361:322-332. doi: 10.1016/j.jad.2024.06.053. Epub 2024 Jun 17.
Sympathetic and blood pressure (BP) hyper-reactivity to stress may contribute to increased cardiovascular disease (CVD) risk in adults with major depressive disorder (MDD); however, whether this is evident in young adults with MDD without comorbid disease remains unclear. We hypothesized that acute stress-induced increases in muscle sympathetic nerve activity (MSNA) and BP would be exaggerated in young adults with MDD compared to healthy non-depressed young adults (HA) and that, in adults with MDD, greater symptom severity would be positively related to MSNA and BP reactivity.
In 28 HA (17 female) and 39 young adults with MDD of mild-to-moderate severity (unmedicated; 31 female), MSNA (microneurography) and beat-to-beat BP (finger photoplethysmography) were measured at rest and during the cold pressor test (CPT) and Stroop color word test (SCWT).
There were no group differences in resting MSNA (p = 0.24). Neither MSNA nor BP reactivity to either the CPT [MSNA: ∆24 ± 10 HA vs. ∆21 ± 11 bursts/min MDD, p = 0.67; mean arterial pressure (MAP): ∆22 ± 7 HA vs. ∆21 ± 10 mmHg MDD, p = 0.46)] or the SCWT (MSNA: ∆-4 ± 6 HA vs. ∆-5 ± 8 bursts/min MDD, p = 0.99; MAP: ∆7 ± 8 HA vs ∆9 ± 5 mmHg MDD; p = 0.82) were different between groups. In adults with MDD, symptom severity predicted MAP reactivity to the CPT (β = 0.78, SE = 0.26, p = 0.006), but not MSNA (p = 0.42).
The mild-to-moderate symptom severity reflects only part of the MDD spectrum.
Neither sympathetic nor BP stress reactivity are exaggerated in young adults with MDD; however, greater symptom severity may amplify BP reactivity to stress, thereby increasing CVD risk.
交感神经和血压（BP）对压力的过度反应可能导致患有重度抑郁症（MDD）的成年人患心血管疾病（CVD）的风险增加；然而，在没有合并症的年轻 MDD 患者中是否存在这种情况尚不清楚。我们假设，与健康的非抑郁年轻成年人（HA）相比，年轻的 MDD 患者在急性应激时，肌肉交感神经活动（MSNA）和 BP 的增加会更加明显，并且在 MDD 患者中，症状严重程度与 MSNA 和 BP 反应性呈正相关。
在 28 名 HA（17 名女性）和 39 名轻度至中度严重程度的年轻 MDD 患者（未服药；31 名女性）中，在静息状态和冷加压试验（CPT）和 Stroop 颜色词测试（SCWT）期间测量 MSNA（微神经记录）和逐拍 BP（手指光容积描记法）。
静息状态下，两组间的 MSNA 无差异（p=0.24）。无论是 CPT 还是 SCWT 都不会引起 MSNA 或 BP 的反应性变化（MSNA：CPT：24±10 次/分 HA 与 21±11 次/分 MDD，p=0.67；平均动脉压（MAP）：CPT：22±7 HA 与 21±10mmHg MDD，p=0.46），亦或 SCWT（MSNA：-4±6 次/分 HA 与-5±8 次/分 MDD，p=0.99；MAP：-7±8 HA 与-9±5mmHg MDD，p=0.82）。在 MDD 患者中，症状严重程度预测 CPT 时的 MAP 反应性（β=0.78，SE=0.26，p=0.006），但不能预测 MSNA（p=0.42）。
轻度至中度的症状严重程度仅反映 MDD 谱的一部分。
年轻的 MDD 患者中，交感神经或 BP 对压力的反应均不明显；然而，更大的症状严重程度可能会放大 BP 对压力的反应，从而增加 CVD 风险。
