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December 25, 2017Journal of Psychiatry and Brain ScienceOpen Access

Heart Rate Variability Predicts Treatment Outcome in Major Depression

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Key result

Higher baseline Respiratory Sinus Arrhythmia (RSA) significantly predicted positive clinical response to 12 weeks of antidepressant treatment in patients with Major Depressive Disorder.

Why the study?

Do baseline heart rate variability components (RSA and LF-HRV) predict treatment response to escitalopram or quetiapine in patients with Major Depressive Disorder?

Population

66 enrolled patients with Major Depressive Disorder, males and females 20-65 years of age meeting DSM-IV…

Comparison

Escitalopram or Quetiapine fumarate ER over 12… vs Healthy controls and treatment non-responders.

Design

Cohort

Follow-up

12 weeks

Authors

BHBrandon HageUniversity of Illinois ChicagoJSJames SinacoreUniversity of California, RiversideKHKeri J. HeilmanUniversity of North Carolina at Chapel Hill

Discussion

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Implication

Baseline RSA was associated with antidepressant response in MDD; leaves open its role as a treatment-selection biomarker pending randomized validation.

Study Design

Type

Cohort (n=77)

Multicenter

No

Structured PICO

Do baseline heart rate variability components (RSA and LF-HRV) predict treatment response to escitalopram or quetiapine in patients with Major Depressive Disorder?

P
Population
77 adults (41 with Major Depressive Disorder and 36 healthy controls) aged 20-65 years, followed for 12 weeks to evaluate baseline heart rate variability as a predictor of antidepressant treatment response.
E
Exposure
Escitalopram (10-30 mg/day) or Quetiapine fumarate ER (25-300 mg/day) over 12 weeks.
C
Comparator
Healthy controls (for baseline comparison) and treatment non-responders (for outcome comparison).
O
Outcome
Treatment response (reduction in HAM-D score) and its association with baseline HRV components (Respiratory Sinus Arrhythmia [RSA] and Low Frequency HRV [LF-HRV]).surrogate

Main Result

Standardized Mean Difference: 1.26

Absolute Event Rate: 6.18% vs 4.78%

p-value: p=<0.005

Baseline heart rate variability components (RSA and LF-HRV) may serve as predictive biomarkers for antidepressant treatment response in patients with Major Depressive Disorder.

Limitations

  • Small sample size
  • Heterogeneous sub-groups regarding age, ethnicity, and BMI
  • Potential influence of current mood state on self-assessment and rater-administered scales
  • Concomitant use of sedative-hypnotic medication in a small percentage of patients

Cite This Study

Hage et al. (2017) conducted a cohort in Major Depressive Disorder (n=77). Baseline Respiratory Sinus Arrhythmia (RSA) vs. Treatment non-responders was evaluated on Baseline Respiratory Sinus Arrhythmia (lnRSA) in treatment responders vs non-responders (Cohen's d 1.26, p=<0.005). Higher baseline Respiratory Sinus Arrhythmia (RSA) significantly predicted positive clinical response to 12 weeks of antidepressant treatment in patients with Major Depressive Disorder.

synapsesocial.com/papers/6a2273cdf1cd006d1cff7661https://doi.org/10.20900/jpbs.20170017
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Autonomic dysfunction and heart rate variability in depression2015 · 341 citations
  2. 2Distinguishing bipolar II depression from unipolar major depressive disorder: Differences in heart rate variability2015 · 66 citations
  3. 3The utility of low frequency heart rate variability as an index of sympathetic cardiac tone: A review with emphasis on a reanalysis of previous studies2013 · 969 citations
  4. 4Autonomic nervous system dysfunction in psychiatric disorders and the impact of psychotropic medications: a systematic review and meta-analysis2016 · 514 citations
  5. 5The Economic Burden of Adults With Major Depressive Disorder in the United States (2005 and 2010)2015 · 1,826 citations