Key result
Patients with major depressive disorder had significantly lower baseline heart rate variability and cardiac vagal control, and showed decreased reactivity and recovery after emotional provocations compared to healthy controls.
Why the study?
Heart rate variability and respiratory sinus arrhythmia reflect cardiac autonomic and vagal control as markers of emotional regulation and physical health, but differences during emotional memory tasks between patients with major depressive disorder and healthy controls warranted examination.
Do patients with major depressive disorder have altered cardiac autonomic and vagal control reactivity and recovery during emotional memory tasks compared to healthy controls?
Cross-Sectional (n=346)
Yes
Do patients with major depressive disorder have altered cardiac autonomic and vagal control reactivity and recovery during emotional memory tasks compared to healthy controls?
Absolute Event Rate: 32.95% vs 41.47%
p-value: p=<0.001
Patients with major depressive disorder exhibit cardiac autonomic dysregulation and blunted vagal reactivity and recovery during emotional provocations compared to healthy controls.
Cardiac autonomic assessment may aid MDD risk stratification; leaves open whether vagal modulation improves outcomes in controlled trials.
Background: Heart rate variability (HRV) and respiratory sinus arrhythmia (RSA) are indices of cardiac autonomic and cardiac vagal control (CVC), both of which are markers of emotional regulation and physical health. This study examined (1) the differences in cardiac autonomic regulation and CVC during baseline, depressive, and happiness autobiographical memory tasks between participants with major depressive disorder (MDD group) and healthy controls (HC group); (2) the associations between depressive symptoms and cardiac autonomic and CVC; and (3) the reactivity and recovery of cardiac autonomic and CVC between the MDD and HC groups. Methods: A total of 168 and 178 participants were included in the MDD and HC groups, respectively. Demographic data and the Beck Depression Inventory-II were collected before the experimental procedure. Lead II electrocardiograph (ECG) was measured during baseline, depressive, and happiness autobiographical memory tasks, and then interbeat intervals from ECG were converted to the time and frequency domains of HRV and RSA. Results: The participants in the MDD group showed lower HRV (including standard deviation of normal to normal intervals, low frequency, the natural logarithm of low frequency, and the natural logarithm of high frequency) and CVC (RSA and lnRSA) than those in the HC group. Depressive symptoms were positively correlated with heart rate and negatively correlated with the indices of cardiac autonomic and CVC. There was significantly increased reactivity and recovery of cardiac autonomic and CVC during and after depressive and happiness autobiographical memory tasks in the HC group, but not in the MDD group. Discussion: Participants with MDD had cardiac autonomic and CVC dysregulation, decreased reactivity, and did not recover to baseline after emotional provocations. These results can be the theoretical basis for clinical intervention by using HRV biofeedback to restore cardiac autonomic regulation and CVC during and after emotional events in the future.
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Lin et al. (2022) conducted a cross-sectional in Major Depressive Disorder (n=346). Major Depressive Disorder vs. Healthy controls was evaluated on Baseline standard deviation of normal to normal intervals (SDNN) (p=<0.001). Patients with major depressive disorder had significantly lower baseline heart rate variability and cardiac vagal control, and showed decreased reactivity and recovery after emotional provocations compared to healthy controls.
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