Abstract

In this study a Heart Rate Variability (HRV) analysis guided by respiration to evaluate different patterns of Autonomic Nervous System (ANS) in response to a cognitive stressor between Major Depressive Disorder (MDD) and control (CT) subjects is presented. Cardiorespiratory Time Frequency Coherence (TFC) reveals the local coupling of HRV and respiration signal which is essential and usually not included in estimation of ANS measures derived by HRV. Parasympathetic activity of ANS is measured as the power at the frequencies where TFC between HRV and respiration is significant, whereas sympathetic dominance is measured as the normalized power in the low frequency band [0.04,0.15] Hz of HRV excluding the power of those frequencies related to respiration. Results showed significantly lower (p < 0.05) sympathetic dominance in MDD with respect to CT subjects during stress, suggesting that ANS reactivity as response to stress stimuli is lower in MDD patients. The study of ANS reactivity to a stressor may serve as a biomarker useful for the early diagnosis and monitoring of MDD patients.

Highlights

  • Major Depressive Disorder (MDD) is the most prevalent psychiatric disease, which was ranked as the third leading cause of global disability in the world [1]

  • Beat occurrence time series were automatically detected on lead Y and Heart Rate Variability (HRV) signal was generated applying on those the integral pulse frequency modulation model, which accounts for the presence of ectopic beats [12], and subsequently was corrected by the mean heart rate [13]

  • Results of statistical analysis for Autonomic Nervous System (ANS) related indices derived by HRV in CT and MDD patients are shown in and CT group are observed during CS for the ratios RL/R, RRLLN//RR

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Summary

Introduction

Major Depressive Disorder (MDD) is the most prevalent psychiatric disease, which was ranked as the third leading cause of global disability in the world [1]. Comorbid anxiety disorder is one of the strongest predictors of MDD severity [5] Both depression and anxiety are associated with cognitive deficits and changes in brain function. ANS changes induced by depression may blur ANS changes induced by anxiety Another possible reason for the above inconsistencies, beyond the heterogeneity of the applied methods, is the estimation of HRV indices. To the best of our knowledge, respiratory information has seldom been taken into account by former HRV approaches in MDD [8, 9], which could lead to erroneous interpretation of HRV indices In this approach a time-frequency (TF) coherence analysis between HRV and respiration to define the TF regions where the signals are locally coupled is adopted [10, 11]. ANS response will be evaluated first in MDD patients and controls during a basal condition, during a cognitive stress task (cardiovascular reactivity) and during a recovery condition

Experimental Protocol
HRV analysis guided by respiration
Statistical Analysis
Results for ANS related indices
Discussion
Conclusion
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