Goffi Federica, Maggioni Eleonora, Bianchi Anna Maria, Brambilla Paolo, Delvecchio Giuseppe
Department of Electronics Information and Bioengineering, Politecnico di Milano, Milan, Italy.
Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
Transl Psychiatry. 2025 Jul 1;15(1):217. doi: 10.1038/s41398-025-03430-3.
Major depressive disorder (MDD) is a heterogeneous psychiatric disorder that is a risk factor for cardiovascular diseases. Autonomic dysregulation, estimated as an important correlated pathophysiological cause, was investigated in many studies mainly through a quantitative evaluation of the heart rate variability (HRV).
The objective of this review was to provide any reproducible insights on autonomic regulation characteristics of MDD through the selection, revision, and joint interpretation of a restricted sample of studies based on systematic criteria.
The literature research resulted in thirty eligible articles that reported the comparison of short-term resting-state HRV measures between drug-free MDD patients and healthy controls, excluding subjects affected by cardiovascular diseases.
Most of the reviewed studies reported significant differences between MDD patients and controls in the investigated HRV measures, especially for those that mainly reflect vagal activity. Nonlinear measures, although computed by fewer studies, seem to be more sensitive in detecting autonomic changes in MDD.
Our findings can be considered as evidence that the intrinsic autonomic state of MDD is characterized by decreased parasympathetic tone, which, interpreted in the context of the polyvagal theory, might be associated with impaired emotion regulation and flexible adjustment in MDD.
重度抑郁症（MDD）是一种异质性精神障碍，是心血管疾病的危险因素。自主神经调节异常被认为是一个重要的相关病理生理原因，许多研究主要通过对心率变异性（HRV）的定量评估来进行调查。
本综述的目的是通过基于系统标准对有限的研究样本进行筛选、修订和联合解读，为MDD的自主神经调节特征提供任何可重复的见解。
文献研究得出30篇符合条件的文章，这些文章报告了未服用药物的MDD患者与健康对照之间短期静息状态下HRV测量值的比较，排除了受心血管疾病影响的受试者。
大多数综述研究报告，在研究的HRV测量值方面，MDD患者与对照组之间存在显著差异，尤其是那些主要反映迷走神经活动的测量值。非线性测量方法虽然研究较少，但在检测MDD中的自主神经变化方面似乎更敏感。
我们的研究结果可被视为证据，表明MDD的内在自主神经状态的特征是副交感神经张力降低，根据多元迷走神经理论来解释，这可能与MDD中情绪调节和灵活调整受损有关。
