Association of Predeployment Heart Rate Variability With Risk of Postdeployment Posttraumatic Stress Disorder in Active-Duty Marines
Association of Predeployment Heart Rate Variability With Risk of Postdeployment Posttraumatic Stress Disorder in Active-Duty Marines
复制标题
DOI：
10.1001/jamapsychiatry.2015.0922
复制
发表时间：
2015-10-01
期刊：
影响因子：
25.8
通讯作者：
Risbrough, Victoria B.
中科院分区：
文献类型：
--
作者：
Minassian, Arpi;Maihofer, Adam X.;Risbrough, Victoria B.
[英语泛读材料心率变异性（HRV）测量的自主神经系统功能紊乱与创伤后应激障碍（PTSD）有关。目前尚不清楚，然而，是否降低HRV前创伤暴露有助于发展PTSD.OBJECTIVE的风险，以检查是否HRV前的战斗部署是与增加风险的PTSD诊断后部署时，占部署相关的战斗暴露。设计，设置，和参与者之间的2008年7月14日，2012年5月24日，现役海军陆战队在战斗部署前1至2个月进行评估，并在返回后4至6个月再次进行评估。海军陆战队复原力研究（MRS-I）的第一阶段包括1415名男性海军陆战队员，其中59人在部署后发展为PTSD。海军陆战队复原力研究（MRS-II）第二阶段的参与者包括745名男性海军陆战队员，其中25人在部署后患上了创伤后应激障碍。分析时间为2013年11月25日至2015年4月16日。主要结果和指标在5分钟休息期间通过手指光电容积描记术测量展开前HRV。生成HRV的频域测量。PTSD的诊断采用临床医生管理PTSD量表。结果在考虑了与部署相关的战斗暴露后，部署前较低的HRV（通过HRV的低频（LF）与高频（HF）比率增加来测量）与部署后PTSD诊断的风险相关（合并MRS-I和MRS-II队列荟萃分析比值比，1.47; 95% CI，1.10-1.98; P = .01）。在部署前LF：HF比率高的参与者中，部署后PTSD的患病率较高（15.8% [38名参与者中的6名]）与LF不高的参与者相比：HF比率（3.7%[2122名参与者中的78名]）结论和相关性这项前瞻性纵向研究提供了初步和适度的证据，表明自主神经系统功能的改变有助于PTSD脆弱性，同时考虑到其他关键风险因素。如果这些发现被复制，改变自主神经系统功能的干预措施可能为预防和治疗PTSD开辟新的机会。
] IMPORTANCE Disrupted autonomic nervous system functioning as measured by heart rate variability (HRV) has been associated with posttraumatic stress disorder (PTSD). It is not clear, however, whether reduced HRV before trauma exposure contributes to the risk for development of PTSD.OBJECTIVE To examine whether HRV before combat deployment is associated with increased risk of a PTSD diagnosis after deployment when accounting for deployment-related combat exposure.DESIGN, SETTING, AND PARTICIPANTS Between July 14, 2008, and May 24, 2012, active-duty Marines were assessed 1 to 2 months before a combat deployment and again 4 to 6 months after their return. The first phase of the Marine Resiliency Study (MRS-I) included 1415 male Marines, 59 of whom developed PTSD after deployment. Participants in the second phase of the Marine Resiliency Study (MRS-II) included 745 male Marines, 25 of whom developed PTSD after deployment. Analysis was conducted from November 25, 2013, to April 16, 2015.MAIN OUTCOMES AND MEASURES Predeployment HRVwas measured via finger photoplethysmography during a 5-minute period of rest. Frequency-domain measures of HRV were generated. Diagnosis of PTSD was determined using the Clinician-Administered PTSD Scale.RESULTS After accounting for deployment-related combat exposure, lower HRV before deployment as measured by an increased low-frequency (LF) to high-frequency (HF) ratio of HRV was associated with risk of PTSD diagnosis after deployment (combined MRS-I and MRS-II cohortmeta-analysis odds ratio, 1.47; 95% CI, 1.10-1.98; P = .01). The prevalence of postdeployment PTSD was higher in participants with high predeployment LF: HF ratios (15.8% [6 of 38 participants]) compared with participants who did not have high LF: HF ratios (3.7%[78 of 2122 participants]).CONCLUSIONS AND RELEVANCE This prospective longitudinal study provides initial and modest evidence that an altered state of autonomic nervous system functioning contributes to PTSD vulnerability, taking into account other key risk factors. If these findings are replicated, interventions that change autonomic nervous system function may open novel opportunities for prevention and treatment of PTSD.