TY - JOUR
T1 - Low cardiac vagal tone index by heart rate variability differentiates bipolar from major depression
AU - Hage, Brandon
AU - Britton, Briana
AU - Daniels, David
AU - Heilman, Keri
AU - Porges, Stephen W.
AU - Halaris, Angelos
N1 - Funding Information:
The authors gratefully acknowledge the support of the Stanley Medical Research Institute that awarded a grant to Dr. A. Halaris for his studies in bipolar disorder.
Publisher Copyright:
© 2017, © 2017 Informa UK Limited, trading as Taylor & Francis Group.
PY - 2019/5/28
Y1 - 2019/5/28
N2 - Objectives: Major depressive disorder (MDD) and depression in bipolar disorder (BD) are often difficult to distinguish from each other. Autonomic nervous system (ANS) dysregulation is associated with various depressive symptoms and inflammatory response disinhibition. The beat-to-beat pattern of heart rate (heart rate variability, HRV) offers a non-invasive portal to ANS function and provides a reliable index of resting cardiac vagal tone. We quantified HRV and measured inflammatory biomarkers in MDD and BD patients in an effort to derive potential diagnostic criteria for MDD and BD. Methods: Sixty-four MDD and 37 BD patients were enrolled. HRV was assessed and blood was drawn at baseline after antidepressant washout and prior to study initiation. HRV was quantified and corrected for artefacts. Results: MDD subjects had significantly higher baseline respiratory sinus arrhythmia (P = 0.05) and LF-HRV (P < 0.01) in comparison to BD subjects. Compared to MDD subjects, BD subjects had significantly higher baseline levels of IL-10 (P < 0.01) and MCP-1 (P < 0.01). In the MDD group only, baseline LF-HRV was significantly positively correlated to baseline levels of IL-10 (r = 0.47, P < 0.01). Conclusions: Reduced vagal tone and higher levels of inflammatory biomarkers may distinguish BD from MDD and reveal an underlying pathophysiology of depression involving ANS dysfunction and chronic immune system dysregulation.
AB - Objectives: Major depressive disorder (MDD) and depression in bipolar disorder (BD) are often difficult to distinguish from each other. Autonomic nervous system (ANS) dysregulation is associated with various depressive symptoms and inflammatory response disinhibition. The beat-to-beat pattern of heart rate (heart rate variability, HRV) offers a non-invasive portal to ANS function and provides a reliable index of resting cardiac vagal tone. We quantified HRV and measured inflammatory biomarkers in MDD and BD patients in an effort to derive potential diagnostic criteria for MDD and BD. Methods: Sixty-four MDD and 37 BD patients were enrolled. HRV was assessed and blood was drawn at baseline after antidepressant washout and prior to study initiation. HRV was quantified and corrected for artefacts. Results: MDD subjects had significantly higher baseline respiratory sinus arrhythmia (P = 0.05) and LF-HRV (P < 0.01) in comparison to BD subjects. Compared to MDD subjects, BD subjects had significantly higher baseline levels of IL-10 (P < 0.01) and MCP-1 (P < 0.01). In the MDD group only, baseline LF-HRV was significantly positively correlated to baseline levels of IL-10 (r = 0.47, P < 0.01). Conclusions: Reduced vagal tone and higher levels of inflammatory biomarkers may distinguish BD from MDD and reveal an underlying pathophysiology of depression involving ANS dysfunction and chronic immune system dysregulation.
KW - biochemical markers
KW - Bipolar affective disorder
KW - heart rate variability
KW - major depressive disorder
KW - respiratory sinus arrhythmia
UR - http://www.scopus.com/inward/record.url?scp=85030665554&partnerID=8YFLogxK
U2 - 10.1080/15622975.2017.1376113
DO - 10.1080/15622975.2017.1376113
M3 - Article
C2 - 28895492
AN - SCOPUS:85030665554
VL - 20
SP - 359
EP - 367
JO - World Journal of Biological Psychiatry
JF - World Journal of Biological Psychiatry
SN - 1562-2975
IS - 5
ER -