Vagal fluctuation as a predictor of current and future depression

迷走神经波动作为当前和未来抑郁症的预测因子

• 批准号: 7591767
• 负责人: Jonathan Adam Rottenberg
• 金额: $ 16.77万
• 依托单位: UNIVERSITY OF SOUTH FLORIDA
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-04-01 至 2010-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7591767
• 关键词: Accounting; American; Antidepressive Agents; Area; Attention; Behavioral; Biological; Cardiac; Clinical; Data; Diagnosis; Disease; Distress; Electrocardiogram; Exhibits; Foundations; Frequencies; Funding; Future; Goals; Grant; Heart; Heart Rate; Hospitalization; Impairment; Individual; Informal Social Control; Intervention; Laboratories; Link; Literature; Major Depressive Disorder; Measures; Mental Health; Mental disorders; Methods; Modality; Modification; Mood Disorders; Outcome; Outpatients; Participant; Pathway interactions; Patients; Persons; Population; Psychopathology; Psychophysiology; Public Health; Recovery; Recruitment Activity; Research; Research Personnel; Research Project Grants; Respiration; Rest; Risk; Unipolar Depression; Vagus nerve structure; Work; burden of illness; clinically significant; cost; depressed; depression; economic cost; environmental change; flexibility; follow-up; heart rate variability; metropolitan; prognostic; public health priorities; public health relevance; response; stressor

DESCRIPTION (provided by applicant): Depression is among the most prevalent of all psychiatric disorders, accounting for over 20% of economic costs for all mental illness. An important public health priority is the identification of factors that both increase individuals' vulnerability to depression and hinder recovery from this disorder. Abnormalities in cardiac vagal control may confer vulnerability to depression. More specifically, two distinct abnormalities in cardiac vagal control may confer vulnerability: low vagal level (VL) usually measured in a resting state, and low vagal fluctuation (VF), usually measured in response to environmental demands. VL and VF are increasingly understood as independent predictors of physical and mental health outcomes. To date, mood disorders research has focused almost exclusively on VL, with results largely inconclusive as to its etiological and prognostic value. Early data from our laboratory suggests that depression is characterized by low VF and that VF may predict the subsequent course of clinically significant depression. The broad objective of this R21 exploratory research project is to investigate VF as a liability marker for depression. We will use a battery of previously-validated laboratory tasks to elicit VF in 60 outpatients diagnosed with current unipolar depression, 30 participants with a past diagnosis of unipolar depression, and 30 healthy non-psychiatric participants. VL and VF will be assessed via high-frequency heart period variability derived from the electrocardiogram. Participants will be followed longitudinally and reassessed at six months. The specific aims of this project are to examine: (1) whether depression vulnerability is associated cross-sectionally with reduced VF during and after experimental stressors; and (2) whether those depressed individuals who preserve dynamic VF during and after experimental stressors are more likely to recover from their disorder six months later. The investigators intend to use these R21 data as the foundation for a larger R01 research grant project that will examine VF with respect to: (a) psychiatric disorders other than MDD; (b) predicting outcome over longer periods (~3 years); (c) predicting outcome in a controlled treatment modality; and (d) potential antidepressant effects of VF modification. From a public health perspective, the hypothesis that depression risk is related to low VF is exciting because it suggests that easily acquired and potentially manipulable measures of heart rate variability could be used to assist in the early assessment of depression risk, and perhaps to develop interventions that operate directly upon the vagal pathway itself. PUBLIC HEALTH RELEVANCE: An important public health priority is the identification of factors that both increase individuals' vulnerability to depression and hinder recovery from this disorder. Abnormalities in cardiac vagal control may confer vulnerability to depression. This project will examine the hypothesis that depression risk is related to a lack of dynamic cardiac vagal control, which is potentially important because it suggests that easily acquired and potentially manipulable measures of heart rate variability could be used to assist in the early assessment of depression risk, and perhaps to develop interventions that operate directly upon the vagal pathway itself.

描述（由申请人提供）：抑郁症是所有精神疾病中最普遍的，占所有精神疾病经济成本的20%以上。一个重要的公共卫生优先事项是确定既增加个人对抑郁症的脆弱性又阻碍从这种疾病中恢复的因素。心脏迷走神经控制功能障碍可能导致抑郁症。更具体地说，心脏迷走神经控制中的两种不同异常可能导致脆弱性：通常在静息状态下测量的低迷走神经水平（VL）和通常响应于环境需求测量的低迷走神经波动（VF）。VL和VF越来越多地被理解为身体和精神健康结果的独立预测因子。到目前为止，心境障碍的研究几乎完全集中在VL，其病因和预后价值的结果在很大程度上是不确定的。来自我们实验室的早期数据表明，抑郁症的特征是低VF，VF可以预测临床显著抑郁症的后续过程。这个R21探索性研究项目的广泛目标是调查VF作为抑郁症的易感性标志。我们将使用一组先前验证的实验室任务，在60名诊断为单相抑郁症的门诊患者、30名既往诊断为单相抑郁症的参与者和30名健康的非精神病参与者中引出VF。VL和VF将通过心电图得出的高频心动周期变异性进行评估。将对参与者进行纵向随访，并在6个月时重新评估。该项目的具体目的是研究：（1）抑郁症易感性是否与实验性压力源期间和之后的VF降低相关;以及（2）那些在实验性压力源期间和之后保持动态VF的抑郁个体是否更有可能在六个月后从他们的障碍中恢复。研究者打算使用这些R21数据作为一个更大的R 01研究资助项目的基础，该项目将检查VF的以下方面：（a）MDD以外的精神疾病;（B）预测更长时间（~3年）的结果;（c）预测受控治疗方式的结果;（d）VF改变的潜在抗抑郁作用。从公共卫生的角度来看，抑郁症风险与低VF相关的假设令人兴奋，因为它表明容易获得和潜在可操作的心率变异性测量可用于帮助早期评估抑郁症风险，并可能开发直接作用于迷走神经通路本身的干预措施。公共卫生关系：一个重要的公共卫生优先事项是确定既增加个人对抑郁症的脆弱性又阻碍从这种疾病中恢复的因素。心脏迷走神经控制功能障碍可能导致抑郁症。该项目将研究抑郁症风险与缺乏动态心脏迷走神经控制有关的假设，这可能很重要，因为它表明容易获得和潜在可操作的心率变异性测量可用于帮助早期评估抑郁症风险，并可能开发直接作用于迷走神经通路本身的干预措施。

项目成果

Respiratory sinus arrhythmia reactivity in current and remitted major depressive disorder.

• DOI: 10.1097/psy.0000000000000019
• 发表时间: 2014-01
• 期刊: Psychosomatic medicine
• 影响因子: 3.3
• 作者: Bylsma LM;Salomon K;Taylor-Clift A;Morris BH;Rottenberg J
• 通讯作者: Rottenberg J

Cardiovascular recovery from psychological and physiological challenge and risk for adverse cardiovascular outcomes and all-cause mortality.

从心理和生理挑战以及不良心血管结局和全因死亡率风险中恢复心血管。

• DOI: 10.1097/psy.0000000000000171
• 发表时间: 2015
• 期刊: Psychosomatic medicine
• 影响因子: 3.3
• 作者: Panaite,Vanessa;Salomon,Kristen;Jin,Alvin;Rottenberg,Jonathan
• 通讯作者: Rottenberg,Jonathan

Why might poor sleep quality lead to depression? A role for emotion regulation.

• DOI: 10.1080/02699931.2016.1247035
• 发表时间: 2017-12
• 期刊: Cognition & emotion
• 影响因子: 2.6
• 作者: O'Leary K;Bylsma LM;Rottenberg J
• 通讯作者: Rottenberg J

Major depressive disorder is associated with attenuated cardiovascular reactivity and impaired recovery among those free of cardiovascular disease.

• DOI: 10.1037/a0013001
• 发表时间: 2009-03
• 期刊: HEALTH PSYCHOLOGY
• 影响因子: 4.2
• 作者: Salomon, Kristen;Clift, April;Karlsdottir, Mardis;Rottenberg, Jonathan
• 通讯作者: Rottenberg, Jonathan

Respiratory sinus arrhythmia reactivity to a sad film predicts depression symptom improvement and symptomatic trajectory.

• DOI: 10.1016/j.ijpsycho.2015.12.002
• 发表时间: 2016-01
• 期刊: International journal of psychophysiology : official journal of the International Organization of Psychophysiology
• 作者: Panaite V;Hindash AC;Bylsma LM;Small BJ;Salomon K;Rottenberg J
• 通讯作者: Rottenberg J