Key result
Patients with major depressive disorder exhibited reduced autonomic reactivity to mental stress compared to healthy controls, quantified by dynamic changes in photoplethysmographic waveform morphology (Cohen's d -0.81).
Why the study?
To evaluate photoplethysmographic waveform analysis for assessing differences in autonomic reactivity to mental stress between patients with major depressive disorder and healthy controls.
Does photoplethysmographic waveform analysis detect differences in autonomic reactivity to mental stress between patients with Major Depressive Disorder and healthy controls?
Case-Control (n=80)
Yes
Does photoplethysmographic waveform analysis detect differences in autonomic reactivity to mental stress between patients with Major Depressive Disorder and healthy controls?
Standardized Mean Difference: -0.81
p-value: p=<0.001
Stress response quantification by dynamic changes in PPG waveform morphology demonstrates decreased autonomic reactivity in MDD patients, which correlates with depression severity.
May support PPG-based autonomic phenotyping in MDD; hypothesis-generating and requires prospective validation before clinical use.
Objective:In the present study, a photoplethysmographic (PPG) waveform analysis for assessing differences in autonomic reactivity to mental stress between patients with Major Depressive Disorder (MDD) and healthy control (HC) subjects is presented.Methods:PPG recordings of 40 MDD and 40 HC subjects were acquired at basal conditions, during the execution of cognitive tasks, and at the post-task relaxation period. PPG pulses are decomposed into three waves (a main wave and two reflected waves) using a pulse decomposition analysis. Pulse waveform characteristics such as the time delay between the position of the main wave and reflected waves, the percentage of amplitude loss in the reflected waves, and the heart rate (HR) are calculated among others. The intra-subject difference of a feature value between two conditions is used as an index of autonomic reactivity.Results:Statistically significant individual differences from stress to recovery were found for HR and the percentage of amplitude loss in the second reflected wave (A₁₃) in both HC and MDD group. However, autonomic reactivity indices related toA₁₃reached higher values in HC than in MDD subjects (Cohen'sd=\!-0.81,\,AUC=0.74), implying that the stress response in depressed patients is reduced. A statistically significant ($p \,<\, 0.001$) negative correlation ($r=-0.5$) between depression severity scores andA₁₃was found.Conclusion:A decreased autonomic reactivity is associated with higher degree of depression.Significance:Stress response quantification by dynamic changes in PPG waveform morphology can be an aid for the diagnosis and monitoring of depression.
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Kontaxis et al. (2020) conducted a case-control in Major Depressive Disorder (n=80). Major Depressive Disorder vs. Healthy controls was evaluated on Autonomic reactivity to mental stress measured by percentage of amplitude loss in the second reflected wave (A13) from stress to recovery (Cohen's d -0.81, p=<0.001). Patients with major depressive disorder exhibited reduced autonomic reactivity to mental stress compared to healthy controls, quantified by dynamic changes in photoplethysmographic waveform morphology (Cohen's d -0.81).
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