Heart rate variability in patients with post-traumatic stress disorder or borderline personality disorder: relationship to early life maltreatment
Heart rate variability in patients with post-traumatic stress disorder or borderline personality disorder: relationship to early life maltreatment
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DOI：
10.1007/s00702-016-1584-8
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发表时间：
2016-09-01
影响因子：
3.3
通讯作者：
Bertsch, Katja
中科院分区：
文献类型：
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作者：
Meyer, Peter-Wolfgang;Mueller, Laura E.;Bertsch, Katja
创伤经历对自主神经系统有严重的影响。心率变异性（HRV）是自主神经系统功能的可靠心理生理指标。在创伤后应激障碍（PTSD）患者和一些边缘性人格障碍（BPD）患者中发现迷走神经介导的HRV降低。在这项研究中，我们比较了PTSD患者、当前BPD患者和缓解期BPD患者与健康志愿者在5分钟静息状态心电图记录中的HRV参数。91名未服药的女性参与者参加了这项研究（18名患有PTSD， 27名患有目前的BPD， 23名BPD缓解期，23名健康志愿者）。在时域和频域（总功率、低频和高频功率）HRV参数上，我们发现了显著的组间差异。连续差异均方根（RMSSD）在PTSD患者中最低（M = 48.6 ms, SD = 23.5 ms），其次是缓解期BPD患者（M = 57.7 ms, SD = 31.5 ms）和当前BPD患者（M = 71.1 ms, SD = 44.5 ms），而健康志愿者的RMSSD最高（M = 84.1 ms, SD = 41.7 ms）。BPD患者HRV的方差高于PTSD患者。此外，RMSSD与儿童创伤问卷评估的自我报告的早期生活虐待呈显著负相关。我们的发现指出了创伤经历、自主神经系统功能和精神病理之间复杂的相互作用。HRV的改变可能与早期生活虐待或相关的心理因素有关，而不是诊断实体。
Traumatic experiences have severe impact on the autonomous nervous system. Heart rate variability (HRV) is a reliable psychophysiological marker for the autonomous nervous system functioning. Reduced vagally mediated HRV has been found in patients with post-traumatic stress disorder (PTSD) and, in some studies, in patients with borderline personality disorder (BPD). In this study, we compared HRV parameters of patients with PTSD, current BPD, and BPD in remission with healthy volunteers in a 5 min resting-state electrocardiogram recording. 91 unmedicated female participants took part in the study (18 with PTSD, 27 with the current BPD, 23 with BPD in remission, and 23 healthy volunteers). We found significant group differences in both time-domain and frequency-domain (total power, low-frequency and high-frequency power) HRV parameters. Root mean square of the successive differences (RMSSD) was lowest in patients with PTSD (M = 48.6 ms, SD = 23.5 ms) followed by patients with BPD in remission (M = 57.7 ms, SD = 31.5 ms) and patients with the current BPD (M = 71.1 ms, SD = 44.5 ms), while the highest RMSSD was found in healthy volunteers (M = 84.1 ms, SD = 41.7 ms). Variance of HRV was higher in patients with BPD than in patients with PTSD. In addition, RMSSD was significantly negatively correlated with self-reported early life maltreatment assessed with the Childhood Trauma Questionnaire. Our findings point out a complex interaction between traumatic experiences, the functioning of the autonomic nervous system, and psychopathology. Alterations in HRV might be related to early life maltreatment or associated psychological factors rather than diagnostic entities.