Photoplethysmographic Waveform Analysis for Autonomic Reactivity Assessment in Depression.

Spyridon Kontaxis,Jordi Aguilo,Maria Luisa Bernal,Jesus Lazaro,Sara Siddi,Josep Maria Haro,Eduardo Gil,Pablo Laguna,Vaidotas Marozas,Concepcion De La Camara,Mar Posadas-De Miguel,Esther Garcia,Raquel Bailon

doi:10.1109/tbme.2020.3025908

Abstract

In the present study, a photoplethysmographic(PPG) waveform analysis for assessing differences in autonomic reactivity to mental stress between patients with Major Depressive Disorder(MDD) and healthy control(HC) subjects is presented. PPG recordings of 40MDD and 40HC subjects were acquired at basal conditions, during the execution of cognitive tasks, and at the post-task relaxation period. PPG pulses are decomposed into three waves (a main wave and two reflected waves) using a pulse decomposition analysis. Pulse waveform characteristics such as the time delay between the position of the main wave and reflected waves, the percentage of amplitude loss in the reflected waves, and the heart rate(HR) are calculated among others. The intra-subject difference of a feature value between two conditions is used as an index of autonomic reactivity. Statistically significant individual differences from stress to recovery were found for HR and the percentage of amplitude loss in the second reflected wave( A13) in both HC and MDD group. However, autonomic reactivity indices related to A13 reached higher values in HC than in MDD subjects(Cohen's[Formula: see text]), implying that the stress response in depressed patients is reduced. A statistically significant( ) negative correlation( r=-0.5) between depression severity scores and A13 was found. A decreased autonomic reactivity is associated with higher degree of depression. Stress response quantification by dynamic changes in PPG waveform morphology can be an aid for the diagnosis and monitoring of depression.

Highlights

D EPRESSION is a serious mental disorder causing the affected person to suffer from sadness, loss of interest, poor concentration, and feelings of tiredness [1]
Statistically significant (p < 0.001) individual differences were found in Major depressive disorder (MDD) patients mainly for heart rate (HR) and A13 indices, which were associated with changes from stress to recovery, i.e., ST vs R and stroop color task (SC) vs R
The present paper investigates the differences in autonomic reactivity to mental stress between MDD and healthy subjects by measuring changes in PPG morphology

Summary

Introduction

D EPRESSION is a serious mental disorder causing the affected person to suffer from sadness, loss of interest, poor concentration, and feelings of tiredness [1]. Prolonged stress is a crucial factor underlying MDD considering that more than 40% of all depressed patients suffer from cooccurring anxiety. Negative emotions, such as depressive mood, could have adverse effects on neurohormonal regulatory circuits in a similar way to prolonged stress [3]. The comorbidity of anxiety and depressive disorders has been associated with poorer trajectories of depressive symptoms [9]. These observations highlight the need of assessing the individual variation in stress susceptibility, resilience, and reactivity [4]

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