A blunted sympathetic and accentuated parasympathetic response to postural change in subjects with depressive disorders

作者:Jiang, Xiao-ling*; Zhang, Zheng-gang; Chen, Yuanyuan; Ye, Cui-Ping; Lei, Ying; Wu, Lei; Zhang, Ying; Xiao, Zhong-ju
来源:Journal of Affective Disorders, 2015, 175: 269-274.
DOI:10.1016/j.jad.2015.01.009

摘要

Background: In recent years, the bi-directional relationship between depression and ANS dysfunction has received considerable attention, but findings remain inconclusive. In this study, we aimed to examine the spectral HRV response to postural change in subjects with depressive disorders and in healthy controls, in order to gain insight into the characteristics of autonomic nervous system (ANS) response to postural change in subjects with depressive disorders. Methods: We compared HRV response to postural change between subjects with depressive disorders and healthy controls aged 20-37 years. Depression severity was assessed by the self-reported Beck Depression Inventory-II (BDI-II). Spectral HRV was analyzed at two moments: 10 min seated rest and 10 min at standing position, with spontaneous breathing. Results: No significant differences existed in the resting spectral HRV indices between subjects with depressive disorders and controls, however, following postural change, the increasing level of LE and LE/HE was lower and the decreasing level of HE power was higher, in the individuals with depression than that in healthy subjects. The differences in the LE power, HE power and the LE/HE ratio between seated rest before standing up and after postural change were found negatively correlated with depression severity. Conclusion: We found a blunted sympathetic and accentuated parasympathetic response to postural change in subjects with depressive disorder, suggesting that the autonomic impairment and early ANS dysfunction may exist among depressed individuals. These findings indicated that spectral analysis of HRV associated with postural change may be a more sensitive method than resting HRV analysis for detecting ANS dysfunction in depressive disorders. Limitations: Further studies are needed to expand the sample size and to clarify the mechanisms responsible for the autonomic dysfunction observed in individuals with depressive disorders.