Reduction of depressive symptoms during inpatient treatment is not associated with changes in heart rate variability

Vagally mediated heart rate variability (HRV) is a psychophysiological indicator of mental and physical health. Limited research suggests there is reduced vagal activity and resulting lower HRV in patients with Major Depressive Disorder (MDD); however little is actually known about the association between HRV and symptoms of depression and whether the association mirrors symptom improvement following psychotherapy. The aim of this study was to investigate the association between antidepressant therapy, symptom change and HRV in 50 inpatients (68% females; 17–68 years) with a diagnosis of MDD. Severity of depressive symptoms was assessed by self-report (Beck Depression Inventory II) and the Hamilton Rating Scale of Depression. Measures of vagally mediated HRV (root mean square of successive differences and high-frequency) were assessed at multiple measurement points before and after inpatient psychotherapeutic and psychiatric treatment. Results showed an expected negative correlation between HRV and depressive symptoms at intake. Depressive symptoms improved (d = 0.84) without corresponding change in HRV, demonstrating a de-coupling between this psychophysiological indicator and symptom severity. To our knowledge, this study is the first to examine an association between HRV and depressive symptoms before and after psychotherapy. The observed de-coupling of depression and HRV, and its methodological implications for future research are discussed.

Download Full-text

Improvement of Circadian Rhythm of Heart Rate Variability by Eurythmy Therapy Training

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2013/564340 ◽

2013 ◽

Vol 2013 ◽

pp. 1-9 ◽

Cited By ~ 12

Author(s):

Georg Seifert ◽

Jenny-Lena Kanitz ◽

Kim Pretzer ◽

Günter Henze ◽

Katharina Witt ◽

...

Keyword(s):

Heart Rate ◽

Heart Rate Variability ◽

Circadian Rhythm ◽

Negative Impact ◽

Vagal Activity ◽

Nonlinear Parameters ◽

Low Frequencies ◽

Before And After ◽

Time Domains

Background. Impairment of circadian rhythm is associated with various clinical problems. It not only has a negative impact on quality of life but can also be associated with a significantly poorer prognosis. Eurythmy therapy (EYT) is an anthroposophic movement therapy aimed at reducing fatigue symptoms and stress levels.Objective. This analysis of healthy subjects was conducted to examine whether the improvement in fatigue symptoms was accompanied by improvements in the circadian rhythm of heart rate variability (HRV).Design. Twenty-three women performed 10 hours of EYT over six weeks. Electrocardiograms (ECGs) were recorded before and after the EYT trial. HRV was quantified by parameters of the frequency and time domains and the nonlinear parameters of symbolic dynamics.Results. The day-night contrast with predominance of vagal activity at night becomes more pronounced after the EYT training, and with decreased Ultralow and very low frequencies, the HRV shows evidence of calmer sleep. During the night, the complexity of the HRV is significantly increased indicated by nonlinear parameters.Conclusion. The analysis of the circadian patterns of cardiophysiological parameters before and after EYT shows significant improvements in HRV in terms of greater day-night contrast caused by an increase of vagal activity and calmer and more complex HRV patterns during sleep.

Download Full-text

Evolution of Heart Rate Variability and Heart Rate Turbulence in Patients with Depressive Illness Treated with Selective Serotonin Reuptake Inhibitors

Medicina ◽

10.3390/medicina56110590 ◽

2020 ◽

Vol 56 (11) ◽

pp. 590

Author(s):

Catalina Giurgi-Oncu ◽

Cristina Tudoran ◽

Virgil Radu Enatescu ◽

Mariana Tudoran ◽

Gheorghe Nicusor Pop ◽

...

Keyword(s):

Heart Rate ◽

Heart Rate Variability ◽

Major Depressive Disorder ◽

Depressive Symptoms ◽

Depressive Disorder ◽

Serotonin Reuptake ◽

Selective Serotonin ◽

Major Depressive ◽

Heart Rate Turbulence ◽

Before And After

Background and objectives: Major depressive disorder (MDD) and cardiovascular diseases (CVDs) represent serious and prevalent medical conditions. Autonomic nervous system (ANS) dysfunctions, expressed by parameters of heart rate variability (HRV) and heart rate turbulence (HRT), have been repeatedly associated with depression. The aim of our study was to identify potential HRV and HRT alterations in patients with MDD, before and after selective serotonin reuptake inhibitor (SSRI) therapy, and to observe any correlations between these parameters and the severity of depressive symptoms. Another aim was to evidence if there was a normalization or improvement of HRV and HRT parameters that paralleled the reduction of the intensity of depressive symptoms. Materials and Methods: We studied heart rate variability (HRV) and heart rate turbulence (HRT) in a sample of 78 patients, aged under 51 years, who were referred to our outpatient clinic between June 2017 and December 2019, for complaints in the context of a new onset major depressive disorder (MDD), before and after therapy with SSRIs. Results: By using 24 h Holter ECG monitoring, we evidenced alterations of HRV and HRT parameters, significantly correlated with the severity of depressive symptoms (p < 0.001), as assessed by the Montgomery–Åsberg Depression Rating Scale (MADRS). Our results indicated that these parameters improved following one and six months of SSRI therapy, when a partial or total remission of depressive symptoms was achieved (p < 0.001). Changes in HRV parameters were correlated with the reduction of the severity of depression. Conclusions: In our study group, we highlighted, through 24 h ECG Holter monitoring, frequent and clear HRV and HRT abnormalities that were statistically correlated with the severity of depressive symptoms. Furthermore, we were able to document a progressive improvement of these parameters, which corresponded with the improvement of depressive symptoms under SSRI therapy, when compared to the values measured before the commencement of antidepressant pharmacotherapy.

Download Full-text

Variabilidade da Frequência Cardíaca em Universitários Saudáveis Após Ingesta de Bebida Energética / Heart Rate Variability in Healthy College Students After Energy Drink Intake

REVISTA CIÊNCIAS EM SAÚDE ◽

10.21876/rcsfmit.v6i4.609 ◽

2016 ◽

Vol 6 (4) ◽

pp. 28-41

Author(s):

Daniel Cesar Shirane ◽

Fernanda Pereira Maiolini ◽

Dalmo Antônio Ribeiro Moreira

Keyword(s):

College Students ◽

Heart Rate ◽

Heart Rate Variability ◽

Energy Drinks ◽

Energy Drink ◽

Vagal Activity ◽

Before And After ◽

Group A ◽

Group B ◽

Red Bull

Objetivo: O objetivo é analisar a variabilidade da frequência cardíaca em universitários saudáveis, após ingestão de bebida energética. Materiais e Métodos: Estudo prospectivo, uni-cego que incluiu indivíduos de coração normal. Todos submeteram-se à monitorização eletrocardiográfica por 5 minutos, antes da ingestão de 250 ml do energético Red Bull® (grupo A – GA) ou de placebo (grupo B – GB), numa relação 3:1, num período de 10 minutos. Após 45 minutos, um outro ECG foi realizado. Os indivíduos dos GA e GB permaneceram em repouso, sentados. Foi obtida a VFC antes e após a administração das substâncias, nos domínios do tempo (DT) e da frequência (DF). Foram excluídos consumidores de energéticos, aqueles que tivessem ingerido álcool ou cafeína nas 24 h antes da investigação. Resultados: Foram incluídos 30 indivíduos no grupo A (16H, 14M, média de idade 22±3a, variando entre 17 e 36 a) e 10 no grupo B (6H, 4M, média de idade 20±5a). Não se observou variação da frequência cardíaca antes e após nos GA e GB (70±10 vs 71±8 no GA [p=0,941] e, 69±8 vs. 70±9 no GB[p=0,881]). Houve incremento significativo da atividade vagal no GA, em comparação ao GB, tanto no DT (SDNN e RMSSD), como no DF (HF). O Red Bull® interferiu pouco no sistema simpático e na relação LF/HF nos GA e GB. Conclusões: O Red Bull® na dose empregada, aumentou a VFC por incremento do tônus parassimpáticos; não causou alteração no equilíbrio autonômico (relação LF/HF); esses achados confirmam os efeitos da cafeína sobre a VFC demonstrado em outros estudos.Palavras-chave: Variabilidade da Frequência Cardíaca; Bebida Energética; ArritmiasABSTRACTObjective: The objective is to analyze the heart rate variability in college students after energy drink intake. Materials and Methods. Prospective study, uni-blind which included normal individuals. All the students underwent electrocardiographic monitoring for 5 minutes before ingestion of 250 ml of Red Bull® (group A - GA) or placebo (Group B - GB) in a 3: 1 ratio, in a 10-minute period. After 45 minutes, another ECG was performed. Individuals at GA and GB remained at rest, sitting. HRV was obtained before and after administration of the substances in the time domain (TD) and frequency domain (FD). Those students categorized as frequent consumers of energy drinks and those who have been drinking alcohol or caffeine in the 24 hours prior to investigation were excluded from the study.Results: Thirty subjects were included in group A (16M, 14F, mean age 22 ± 3a, ranging between 17 and 36 a) and 10 in group B (6 H, 4M, mean age 20 ± 5a). There was no change in heart rate before and after ingestions in GA and GB (70 ± 10 vs 71 ± 8 in GA [p = 0.941] and 69 ± 8 vs. 70 ± 9 in GB [p = 0.881]). There was a significant increase in vagal activity in GA compared to GB, both in TD (SDNN and RMSSD) as well as in the FD (HF). The Red bull® little interfered with the sympathetic system and the LF / HF ratio in GA and GB. Conclusions: The Red Bull increased HRV by increase in parasympathetic tone; caused no change in autonomic balance (LF / HF ratio); these findings confirm the effects of caffeine on HRV shown in other studies.Keywords: Heart Rate Variability; Energy Drinks; Arrhythmias

Download Full-text

Burden and Heart Rate Variability in Bipolar Disorder Family Caregivers

Western Journal of Nursing Research ◽

10.1177/01939459211063660 ◽

2021 ◽

pp. 019394592110636

Author(s):

Elizabeth Williams ◽

Jaclene A. Zauszniewski

Keyword(s):

Bipolar Disorder ◽

Heart Rate ◽

Heart Rate Variability ◽

African American ◽

Family Caregivers ◽

Psychological Stress ◽

Self Report ◽

Future Research ◽

Race And Gender ◽

And Gender

Family caregivers of persons with bipolar disorder experience considerable stress. Yet, studies have not examined whether their stress differs by race and gender. This preliminary analysis of baseline data from 228 African American and White family caregivers of adults with bipolar disorder who were enrolled in a randomized controlled trial examined race and gender differences on two validated self-report measures of psychological stress (caregiver burden and caregiver reactions) and an electrocardiography device used to capture heart rate variability (HRV). No statistically significant differences were found by race or gender on either measure of psychological stress. African American caregivers had significantly lower scores on two indices of HRV compared to White caregivers. Women had significantly lower scores on one index of HRV compared to men. Low HRV indicates greater stress and mortality risk. Future research should include HRV to measure caregiver stress and implement relevant interventions.

Download Full-text

Virtual Reality–Assisted Heart Rate Variability Biofeedback as a Strategy to Improve Golf Performance: A Case Study

Biofeedback ◽

10.5298/1081-5937-39.1.11 ◽

2011 ◽

Vol 39 (1) ◽

pp. 15-20 ◽

Cited By ~ 18

Author(s):

Leah Lagos ◽

Evgeny Vaschillo ◽

Bronya Vaschillo ◽

Paul Lehrer ◽

Marsha Bates ◽

...

Keyword(s):

Heart Rate ◽

Heart Rate Variability ◽

Virtual Reality ◽

Sensation Seeking ◽

Low Frequency ◽

Sport Performance ◽

Self Report ◽

Lead Author ◽

Heart Rate Variability Biofeedback ◽

Before And After

Growing evidence suggests that Heart Rate Variability (HRV) biofeedback (BFB) may improve sport performance by helping athletes cope with the stress of competition. This study sought to identify whether HRV BFB procedure impacted psychological, physiological, and sport performance of a collegiate golfer. This individual volunteered to participate in 10 weeks of HRV BFB training according to the protocol developed by Leher, Vaschillo, and Vaschillo (2000). During the first, fourth, seventh, and tenth weeks of the study, the golfer and lead author met at a virtual reality golf center to practice skills for breathing at resonance frequency during golf performance. Golf performance and HR were recorded during nine holes of virtual reality golf before and after 10 weeks of HRV BFB training. Self-report questionnaires were administered also before and after HRV BFB training to measure symptoms of anxiety, stress, and sensation seeking. Physiological measures, including HRV and respiration rate, were recorded in the lab during the first, fourth, seventh, and tenth weeks of the study. Reduction in symptoms of anxiety, stress, and sensation seeking and increases in total HRV, low-frequency HRV, and amplitude of oscillation at .1 Hz and improved sport performance were observed. This effect became stronger across 10 weeks of HRV BFB training. A larger-scale study was conducted and is in the process of analysis to confirm these findings.

Download Full-text

The effects of six-week slow, controlled breathing exercises on heart rate variability in physically active, healthy individuals

Pedagogy of Physical Culture and Sports ◽

10.15561/26649837.2021.0101 ◽

2021 ◽

Vol 25 (1) ◽

pp. 4-9

Author(s):

Cihan Erdem Sürücü ◽

Sarp Güner ◽

Caner Cüce ◽

Dicle Aras ◽

Fırat Akça ◽

...

Keyword(s):

Heart Rate ◽

Heart Rate Variability ◽

Parasympathetic Activity ◽

Control Group ◽

Vagal Activity ◽

Physically Active ◽

Breathing Exercises ◽

Physical Exercises ◽

Before And After ◽

Controlled Breathing

Background and Study Aim: Heart rate variability (HRV) provides information about sympathetic-parasympathetic balance. The effects of different types of physical exercises on HRV have been investigated so far. The purpose of the current study was to evaluate the chronic effects of six-week slow and controlled breathing exercise on HRV in physically active, healthy adults. Material and Methods: A total of 22 individuals (11 female, 11 male) participated in the study voluntarily. The experimental group (EG) attended to the breathing exercises for 15 minutes per day, three days a week for six weeks. Neither the EG nor the control group (CG) did join in any regular physical activity program during the study. Both groups participated in the HRV measurements before and after the six-week of process. Results: Only the EG showed statistically significant changes in some HRV parameters. The alterations observed in LF:HF ratio, HFnu, and LFnu parameters were to reflect the increase in parasympathetic activity. Although the changes in the other parameters of HRV such as SDNN, SDSD, RMSSD, TP, HF, LF, and VLF were also related to increased vagal activity, these alterations were not significant. However, no significant change was found in the CG. Conclusions: These results show that only the slow, controlled breathing exercises for six weeks could be used to improve parasympathetic activity in physically active individuals. A study could be designed where the duration is kept over 8 weeks, and the effects of physical exercises only, breathing exercises only, and physical + breathing exercises together on HRV are examined.

Download Full-text

Heart rate variability in adolescent major depression

European Psychiatry ◽

10.1016/s0924-9338(11)72070-3 ◽

2011 ◽

Vol 26 (S2) ◽

pp. 361-361 ◽

Cited By ~ 2

Author(s):

I. Tonhajzerova ◽

I. Ondrejka ◽

Z. Turianikova ◽

L. Chladekova ◽

K. Javorka ◽

...

Keyword(s):

Heart Rate ◽

Heart Rate Variability ◽

Depressive Symptoms ◽

Major Depression ◽

Rating Scale ◽

Autonomic Regulation ◽

Cardiac Complications ◽

Nonlinear Methods ◽

Cardiac Autonomic Regulation ◽

Linear And Nonlinear

IntroductionImpaired cardiac autonomic regulation is likely important contributor to a potential cardiac complications in major depression. The knowledge regarding the depression effect on cardiac regulation in adolescent age is limited. Aim was to study short-term heart rate variability (HRV) as an index of cardiac autonomic control in never-treated major depressive disorder (MDD) adolescent patients using linear and nonlinear methods related to depressive symptoms severity.MethodsWe have examined 20 MDD girls and 20 healthy age-matched girls at the age from 15 to 18 years. The ECG was recorded in three positions: supine - orthostasis - supine. The HRV was analyzed using linear (time and frequency analysis) and novel nonlinear (symbolic dynamics, time assymetry) methods. The severity of depressive symptoms was evaluated using the scales Montgomery-Asberg Depression Rating Scale (MADRS) and Children’s Depression Inventory (CDI).ResultsSeveral HRV linear and nonlinear parameters were significantly reduced in MDD group compared to controls in supine rest and during orthostasis. The HRV nonlinear analysis indices significantly correlated with depressive symptoms severity.ConclusionsLinear and nonlinear analyses revealed reduced magnitude and complexity of the HRV indicating impaired neurocardiac regulation in adolescent major depression. In addition, new approach of HRV analysis using nonlinear methods provided important information about depressive symptoms severity and cardiac autonomic regulation relations.

Download Full-text

Effects of Posteroanterior Thoracic Mobilization on Heart Rate Variability and Pain in Women with Fibromyalgia

Rehabilitation Research and Practice ◽

10.1155/2014/898763 ◽

2014 ◽

Vol 2014 ◽

pp. 1-6 ◽

Cited By ~ 1

Author(s):

Michel Silva Reis ◽

João Luiz Quagliotti Durigan ◽

Ross Arena ◽

Bruno Rafael Orsini Rossi ◽

Renata Gonçalves Mendes ◽

...

Keyword(s):

Heart Rate ◽

Heart Rate Variability ◽

Controlled Trial ◽

Premenopausal Women ◽

Pain Scale ◽

Vagal Activity ◽

Autonomic Modulation ◽

Autonomic Tone ◽

Before And After ◽

Numeric Pain Scale

Fibromyalgia (FM) has been associated with cardiac autonomic abnormalities and pain. Heart rate variability (HRV) is reduced in FM with autonomic tone dominated by sympathetic activity. The purpose of this study was to evaluate the effects of one session of a posteroanterior glide technique on both autonomic modulation and pain in woman with FM. This was a controlled trial with immediate followup; twenty premenopausal women were allocated into 2 groups: (i) women diagnosed with FM(n=10)and (ii) healthy women(n=10). Both groups received one session of Maitland mobilization grade III posteroanterior central pressure glide, at 2 Hz for 60 s at each vertebral segment. Autonomic modulation was assessed by HRV and pain by a numeric pain scale before and after the intervention. For HRV analyses, heart rate and RR intervals were recorded for 10 minutes. FM subjects demonstrated reduced HRV compared to controls. Although the mobilization technique did not significantly reduce pain, it was able to improve HRV quantified by an increase in rMSSD and SD1 indices, reflecting an improved autonomic profile through increased vagal activity. In conclusion, women with FM presented with impaired cardiac autonomic modulation. One session of Maitland spine mobilization was able to acutely improve HRV.

Download Full-text

Vagally mediated heart rate variability in headache patients—a systematic review and meta-analysis

Cephalalgia ◽

10.1177/0333102415583989 ◽

2015 ◽

Vol 36 (3) ◽

pp. 265-278 ◽

Cited By ~ 25

Author(s):

Julian Koenig ◽

DeWayne P Williams ◽

Andrew H Kemp ◽

Julian F Thayer

Keyword(s):

Systematic Review ◽

Heart Rate ◽

Heart Rate Variability ◽

Effect Size ◽

Meta Analysis ◽

Medium Effect ◽

Future Research ◽

Vagal Activity ◽

Headache Disorders ◽

The Impact

Objective Vagal nerve activity—indexed by heart rate variability (HRV)—has been linked to altered pain processing and inflammation, both of which may underpin headache disorders and lead to cardiovascular disease (CVD). Here we examined the evidence for differences in parasympathetic (vagal) activity indexed by time- and frequency-domain measures of HRV in patients with headache disorders compared to healthy controls (HCs). Methods A systematic review and meta-analysis was conducted on studies investigating group differences in vagally mediated HRV (vmHRV) including time- (root-mean-square of successive R-R-interval differences (RMSSD)) and frequency- (high-frequency HRV) domain measures. Studies eligible for inclusion were identified by a systematic search of the literature, based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Results Seven studies reporting a total of 10 comparisons of patients with headache disorders (HF-HRV n = 67, RMSSD n = 122) and HCs (HF-HRV n = 64, RMSSD n = 125) were eligible for inclusion. Random-effects meta-analysis revealed a significant main effect on RMSSD ( Z = 2.03, p = 0.04; Hedges’ g = −0.63; 95% CI (−1.24, –0.02); k = 6) and similar pooled effect size estimates for HF-HRV when breathing was controlled ( g = −0.30; 95% CI (−0.69; 0.10)) but not when breathing was not controlled ( g = 0.02; 95% CI (−0.69; 0.74)). Controlling for breathing had no effect on RMSSD. Conclusion vmHRV is reduced in patients with headache disorders, findings associated with a medium effect size. Suggestions for future research in this area are provided, emphasizing a need to investigate the impact of headache disorders and commonly comorbid conditions—including mental disorders—as well as the investigation of the risk for CVD in migraine in particular. We further emphasize the need for large-scale studies to investigate HRV as a mechanism mediating the association of migraine and CVD.

Download Full-text