Respiratory sinus arrhythmia reactivity in current and remitted major depressive disorder.
Respiratory sinus arrhythmia reactivity in current and remitted major depressive disorder.
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DOI：
10.1097/psy.0000000000000019
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发表时间：
2014-01
影响因子：
3.3
通讯作者：
Rottenberg J
中科院分区：
文献类型：
--
作者：
Bylsma LM;Salomon K;Taylor-Clift A;Morris BH;Rottenberg J
静息呼吸性窦性心律失常 (RSA) 水平较低和 RSA 反应性减弱被认为表明情绪调节能力受损。与健康对照组相比，重度抑郁症 (MDD) 与异常的 RSA 反应性和对言语应激任务的恢复有关。 RSA 功能受损是否反映了抑郁情绪状态的各个方面，或者是抑郁症的稳定脆弱性标志，目前尚不清楚。我们比较了 MDD (n=49)、缓解型抑郁症 (RMD, n=24) 和健康对照 (n=45) 个体之间的静息 RSA 和 RSA 反应性。心电图数据是在静息基线、定速呼吸基线和两项反应性任务（言语应激源、寒冷暴露）期间收集的。 RSA 在言语应激源的各个阶段（基线、指导、准备、言语、恢复）出现了按时间分组的二次效应（F=4.36(2,109)，p=.015）。后续分析显示，MDD 患者独特地表现出 RSA 反应性减弱，而 RMD 和对照组均表现出正常的任务相关迷走神经退缩和任务后恢复。在年龄、性别、腰围、体力活动和呼吸的协变后，按时间分组的交互作用仍然存在，但睡眠质量则不然。这些结果提供了新的证据，表明异常的 RSA 反应性标志着追踪抑郁状态的特征，例如睡眠不佳，而不是无症状人群中明显的稳定特征。
Low resting respiratory sinus arrhythmia (RSA) levels and blunted RSA reactivity are thought to index impaired emotion regulation capacity. Major Depressive Disorder (MDD) has been associated with abberant RSA reactivity and recovery to a speech stressor task relative to healthy controls. Whether impaired RSA functioning reflects aspects of the depressed mood state or a stable vulnerability marker for depression is unknown. We compared resting RSA and RSA reactivity between individuals with MDD (n=49), remitted depression (RMD, n=24), and healthy controls (n=45). ECG data were collected during a resting baseline, a paced-breathing baseline, and two reactivity tasks (speech stressor, cold exposure). A group by time quadratic effect emerged (F=4.36(2,109), p=.015) for RSA across phases of the speech stressor (baseline, instruction, preparation, speech, recovery). Follow-up analyses revealed that those with MDD uniquely exhibited blunted RSA reactivity, whereas RMD and controls both exhibited normal task-related vagal withdrawal and post-task recovery. The group by time interaction remained after covariation for age, sex, waist circumference, physical activity, and respiration, but not sleep quality. These results provide new evidence that abberant RSA reactivity marks features that track the depressed state, such as poor sleep, rather than a stable trait evident among asymtomatic persons.