Abstract
Reduced heart rate variability (HRV) and dysfunction of the autonomic nervous system (ANS) have been observed in schizophrenia patients. HRV parameters of schizophrenia patients in the resting state have been well-documented; however, these parameters of schizophrenia patients who experience continuous psychophysiological stress remain unclear. The objective of this study was to systematically explore the linear and nonlinear HRV parameters between schizophrenia patients and normal controls and to detect the adaptive capabilities of HRV of schizophrenia patients during the stimulation tests of autonomic nervous system. Forty-five schizophrenia patients and forty-five normal controls, matched for age, sex and body mass index, completed a 14 min ANS test. Thirteen linear and nonlinear HRV parameters of all subjects under the ANS test were computed and statistically analyzed between groups and between sessions. The STROBE checklist was adhered to in this study. All time-domain HRV features in the ANS test were significantly different between schizophrenia patients and normal controls (p < 0.01). The schizophrenia patients showed significantly low values in the Poincaré indices, which revealed significantly decreased heart rate fluctuation complexity compared with that of normal controls (p < 0.001). In addition, the normal controls, not schizophrenia patients, showed significant differences between the recovery and stress states in the parameters of low frequency, high frequency, and nonlinear dynamics. Schizophrenia patients showed autonomic dysfunction of the heart in a series of stimulation tests of the autonomic nervous system and could not regain normal physiological functions after stress cessation. Our findings revealed that the dynamic parameters of HRV in psychophysiological stress are sensitive and practical for a diagnosis of schizophrenia.
Highlights
Decreased variability in the heart rate of patients with schizophrenia in the resting state has been reported in previous studies [1,2,3,4]
The mean values of each RR interval (MEAN), standard deviation of normal-to-normal intervals (SDNN), root mean square successive differences (RMSSD), pNN50, and Poincaré (p < 0.001) of the schizophrenia patients were significantly lower than those of normal controls. These results indicated that most heart rate variability (HRV) parameters of schizophrenia patients were reduced compared with those of normal controls in the autonomic nervous system (ANS) test
We explored the difference in HRV parameters between schizophrenia patients and normal controls and, for the first time, assessed the autonomic nervous system of schizophrenia patients from the stress test to recovery by using linear and nonlinear dynamic analysis methods for HRV
Summary
Decreased variability in the heart rate of patients with schizophrenia in the resting state has been reported in previous studies [1,2,3,4]. Stress is a kind of physiological response to threatening environments and results in negative emotion and an increased heart rate [6]. It appears to play a major role in the pathophysiology of most psychiatric disorders [7]. The cardiac autonomic dysregulation of schizophrenia patients results in emotional and cognitive dysfunctions [12] and decreased HRV [13,14,15]
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