Heart rate time irreversibility is impaired in adolescent major depression

UNLABELLED We aimed to study heart rate time irreversibility--a nonlinear qualitative characteristics of heart rate variability indicating complexity of cardiac autonomic control at rest and in response to physiological stress (orthostasis) in never-treated major depressive disorder (MDD) adolescent female patients. METHODS We studied 20 MDD girls and 20 healthy age-matched girls at the age of 15 to 18 years. The ECG was recorded in supine position and in response to position change from lying to standing (orthostasis). Time irreversibility analysis was performed using Porta's (P%), Guzik's (G%) and Ehlers' (E) index. The depressive disorder severity was evaluated using Montgomery-Asberg Depression Rating Scale (MADRS) and Children's Depression Inventory (CDI). RESULTS Resting heart rate time irreversibility indices (logG%, logP%, Ehlers' index) were significantly reduced in MDD female patients without significant differences in response to orthostasis in MDD girls compared to controls. No significant correlations between time irreversibility and MDD severity were observed. CONCLUSION This study revealed the impaired heart rate asymmetry pattern indicating an altered complexity of cardiac autonomic regulation in adolescent female patients suffering from MDD.

[1]  I. Goldstein,et al.  Baroreflex mechanisms in major depression , 2007, Progress in Neuro-Psychopharmacology and Biological Psychiatry.

[2]  Jaroslaw Piskorski,et al.  Asymmetric properties of long-term and total heart rate variability , 2011, Medical & Biological Engineering & Computing.

[3]  Mathias Baumert,et al.  Short-term heart rate variability and cardiac norepinephrine spillover in patients with depression and panic disorder. , 2009, American journal of physiology. Heart and circulatory physiology.

[4]  J Theiler,et al.  Low Doses of Ethanol Reduce Evidence for Nonlinear Structure in Brain Activity , 1998, The Journal of Neuroscience.

[5]  Andreas Voss,et al.  Gender-dependent impact of major depression on autonomic cardiovascular modulation , 2011, Progress in Neuro-Psychopharmacology and Biological Psychiatry.

[6]  Julian F Thayer,et al.  On the Importance of Inhibition: Central and Peripheral Manifestations of Nonlinear Inhibitory Processes in Neural Systems , 2006, Dose-response : a publication of International Hormesis Society.

[7]  Bruce H. Friedman,et al.  An autonomic flexibility–neurovisceral integration model of anxiety and cardiac vagal tone , 2007, Biological Psychology.

[8]  Blanca de la Cruz Torres,et al.  Multiscale Time Irreversibility of Heartbeat at Rest and During Aerobic Exercise , 2010 .

[9]  M. Javorka,et al.  Respiratory sinus arrhythmia is reduced in adolescent major depressive disorder , 2009, European journal of medical research.

[10]  V. Vaccarino,et al.  Depressive Symptoms and Heart Rate Variability: Evidence for a Shared Genetic Substrate in a Study of Twins , 2008, Psychosomatic medicine.

[11]  Julian F Thayer,et al.  Age-related differences in prefrontal control of heart rate in humans: a pharmacological blockade study. , 2009, International journal of psychophysiology : official journal of the International Organization of Psychophysiology.

[12]  Alberto Porta,et al.  Assessment of cardiovascular regulation through irreversibility analysis of heart period variability: a 24 hours Holter study in healthy and chronic heart failure populations , 2009, Philosophical Transactions of the Royal Society A: Mathematical, Physical and Engineering Sciences.

[13]  D. Hoyer,et al.  Nonlinear broad band dynamics are less complex in major depression. , 2008, Bipolar disorders.

[14]  Chung-Kang Peng,et al.  Multiscale Analysis of Heart Rate Dynamics: Entropy and Time Irreversibility Measures , 2008, Cardiovascular engineering.

[15]  M. Åsberg,et al.  A New Depression Scale Designed to be Sensitive to Change , 1979, British Journal of Psychiatry.

[16]  E. Migliaro,et al.  Asymmetrical properties of heart rate variability in type 1 diabetes , 2010, Clinical Autonomic Research.

[17]  S. Porges.  The polyvagal theory: New insights into adaptive reactions of the autonomic nervous system , 2009, Cleveland Clinic Journal of Medicine.

[18]  S. Porges.  The polyvagal perspective , 2007, Biological Psychology.

[19]  Kewei Chen,et al.  Neural correlates of heart rate variability during emotion , 2009, NeuroImage.

[20]  Sandy Berger,et al.  Cardio-respiratory coupling in untreated patients with major depression. , 2012, Journal of affective disorders.

[21]  Mats Fredrikson,et al.  High-frequency heart rate variability and cortico-striatal activity in men and women with social phobia , 2009, NeuroImage.

[22]  G. Miller,et al.  Symptoms of depression and impaired endothelial function in healthy adolescent women , 2008, Journal of Behavioral Medicine.

[23]  M. Javorka,et al.  Short-term heart rate complexity is reduced in patients with type 1 diabetes mellitus , 2008, Clinical Neurophysiology.

[24]  Karl-Jürgen Bär,et al.  The influence of major depression and its treatment on heart rate variability and pupillary light reflex parameters. , 2004, Journal of affective disorders.

[25]  R. Lane,et al.  Claude Bernard and the heart–brain connection: Further elaboration of a model of neurovisceral integration , 2009, Neuroscience & Biobehavioral Reviews.

[26]  Pere Caminal,et al.  Methods derived from nonlinear dynamics for analysing heart rate variability , 2009, Philosophical Transactions of the Royal Society A: Mathematical, Physical and Engineering Sciences.

[27]  A. Malliani,et al.  Heart rate variability. Standards of measurement, physiological interpretation, and clinical use , 1996 .

[28]  J. Smyth,et al.  Rumination as a Mediator of Chronic Stress Effects on Hypertension: A Causal Model , 2012, International journal of hypertension.

[29]  C. Lamm,et al.  Hearts and minds: Coordination of neurocognitive and cardiovascular regulation in children and adolescents , 2010, Biological Psychology.

[30]  R. Lane,et al.  A model of neurovisceral integration in emotion regulation and dysregulation. , 2000, Journal of affective disorders.

[31]  Marek Malik,et al.  Heart rate deceleration runs for postinfarction risk prediction. , 2012, Journal of electrocardiology.

[32]  K. Tracey,et al.  The pulse of inflammation: heart rate variability, the cholinergic anti‐inflammatory pathway and implications for therapy , 2011, Journal of internal medicine.

[33]  Martin P. Paulus,et al.  Increased amygdala activation is related to heart rate during emotion processing in adolescent subjects , 2007, Neuroscience Letters.

[34]  E. Benarroch.  The central autonomic network: functional organization, dysfunction, and perspective. , 1993, Mayo Clinic proceedings.

[35]  G. Juckel,et al.  Gastric dysmotility in major depression , 2010, Progress in Neuro-Psychopharmacology and Biological Psychiatry.

[36]  S. Porges.  Orienting in a defensive world: mammalian modifications of our evolutionary heritage. A Polyvagal Theory. , 1995, Psychophysiology.

[37]  K. Bär,et al.  The altered complexity of cardiovascular regulation in depressed patients , 2010, Physiological measurement.

[38]  L. Donath,et al.  Inflammatory changes upon a single maximal exercise test in depressed patients and healthy controls , 2010, Progress in Neuro-Psychopharmacology and Biological Psychiatry.

[39]  K. Bär,et al.  Autonomic modulation in healthy first-degree relatives of patients with major depressive disorder , 2011, Progress in Neuro-Psychopharmacology and Biological Psychiatry.

[40]  R. Carney,et al.  Depression and heart rate variability in patients with coronary heart disease , 2009, Cleveland Clinic Journal of Medicine.

[41]  K. Bär,et al.  Non-linear complexity measures of heart rate variability in acute schizophrenia , 2007, Clinical Neurophysiology.

[42]  J. Ormel,et al.  Stressful life events and depressive symptoms in young adolescents: Modulation by respiratory sinus arrhythmia? The TRAILS study , 2009, Biological Psychology.

[43]  D Geue,et al.  Temporal asymmetries of short-term heart period variability are linked to autonomic regulation. , 2008, American journal of physiology. Regulatory, integrative and comparative physiology.

[44]  J. Thayer,et al.  Beyond Heart Rate Variability , 2006, Annals of the New York Academy of Sciences.

[45]  Michal Javorka,et al.  Time Irreversibility of Heart Rate Oscillations During Orthostasis , 2011 .

[46]  M. Javorka,et al.  Cardiac autonomic regulation is impaired in girls with major depression , 2010, Progress in Neuro-Psychopharmacology and Biological Psychiatry.

[47]  B. Leadbeater,et al.  Gender differences in and risk factors for depression in adolescence: A 4-year longitudinal study , 2004 .

[48]  G. Breithardt,et al.  Heart rate variability: standards of measurement, physiological interpretation and clinical use. Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology. , 1996 .

[49]  M. Javorka,et al.  Cardiovascular autonomic nervous system tests: reference values in young people (15–19 years) and influence of age and gender , 2002, Clinical physiology and functional imaging.

[50]  N. Allen,et al.  Autonomic cardiac control in depressed adolescents , 2010, Depression and anxiety.

[51]  Xiaojun Qiu,et al.  Analysis of heartbeat asymmetry based on multi-scale time irreversibility test , 2010 .