Diminished vagal activity and blunted diurnal variation of heart rate dynamics in posttraumatic stress disorder
Standard
Diminished vagal activity and blunted diurnal variation of heart rate dynamics in posttraumatic stress disorder. / Agorastos, Agorastos; Boel, Judith A; Heppner, Pia S; Hager, Torben; Moeller-Bertram, Tobias; Haji, Uzair; Motazedi, Arame; Yanagi, Matthew A; Baker, Dewleen G; Stiedl, Oliver.
In: STRESS, Vol. 16, No. 3, 01.05.2013, p. 300-10.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
Harvard
APA
Vancouver
Bibtex
}
RIS
TY - JOUR
T1 - Diminished vagal activity and blunted diurnal variation of heart rate dynamics in posttraumatic stress disorder
AU - Agorastos, Agorastos
AU - Boel, Judith A
AU - Heppner, Pia S
AU - Hager, Torben
AU - Moeller-Bertram, Tobias
AU - Haji, Uzair
AU - Motazedi, Arame
AU - Yanagi, Matthew A
AU - Baker, Dewleen G
AU - Stiedl, Oliver
PY - 2013/5/1
Y1 - 2013/5/1
N2 - Affected autonomic heart regulation is implicated in the pathophysiology of cardiovascular diseases and is associated with posttraumatic stress disorder (PTSD). However, although sympathetic hyperactivation has been repeatedly shown in PTSD, research has neglected parasympathetic function. The objective of this study is the long-term assessment of heart rate (HR) dynamics and its diurnal changes as an index of autonomic imbalance in PTSD. Since tonic parasympathetic activity underlies long-range correlation of heartbeat interval fluctuations in the healthy state, we included nonlinear (unifractal) analysis as an important and sensitive readout to assess functional alterations. We conducted electrocardiogram recordings over a 24-h period in 15 deployed male subjects with moderate to high levels of combat exposure (PTSD: n = 7; combat controls: n = 8) in the supine position. HR dynamics were assessed in two 5-h sub-epochs in the time and frequency domains, and by nonlinear analysis based on detrended fluctuation analysis. Psychiatric symptoms were assessed using structured interviews, including the Clinician Administered PTSD Scale. Subjects with PTSD showed significantly higher baseline HR, higher LF/HF ratio in the frequency domain, blunted differences between day and night-time measures, as well as a higher scaling coefficient αfast during the day, indicating diminished tonic parasympathetic activity. Diminished diurnal differences and blunted tonic parasympathetic activity altering HR dynamics suggest central neuroautonomic dysregulation that could represent a possible link to increased cardiovascular disease in PTSD.
AB - Affected autonomic heart regulation is implicated in the pathophysiology of cardiovascular diseases and is associated with posttraumatic stress disorder (PTSD). However, although sympathetic hyperactivation has been repeatedly shown in PTSD, research has neglected parasympathetic function. The objective of this study is the long-term assessment of heart rate (HR) dynamics and its diurnal changes as an index of autonomic imbalance in PTSD. Since tonic parasympathetic activity underlies long-range correlation of heartbeat interval fluctuations in the healthy state, we included nonlinear (unifractal) analysis as an important and sensitive readout to assess functional alterations. We conducted electrocardiogram recordings over a 24-h period in 15 deployed male subjects with moderate to high levels of combat exposure (PTSD: n = 7; combat controls: n = 8) in the supine position. HR dynamics were assessed in two 5-h sub-epochs in the time and frequency domains, and by nonlinear analysis based on detrended fluctuation analysis. Psychiatric symptoms were assessed using structured interviews, including the Clinician Administered PTSD Scale. Subjects with PTSD showed significantly higher baseline HR, higher LF/HF ratio in the frequency domain, blunted differences between day and night-time measures, as well as a higher scaling coefficient αfast during the day, indicating diminished tonic parasympathetic activity. Diminished diurnal differences and blunted tonic parasympathetic activity altering HR dynamics suggest central neuroautonomic dysregulation that could represent a possible link to increased cardiovascular disease in PTSD.
KW - Adult
KW - Afghan Campaign 2001-
KW - Analysis of Variance
KW - Circadian Rhythm
KW - Combat Disorders
KW - Electrocardiography, Ambulatory
KW - Heart
KW - Heart Rate
KW - Humans
KW - Iraq War, 2003-2011
KW - Linear Models
KW - Male
KW - Military Personnel
KW - Nonlinear Dynamics
KW - Prospective Studies
KW - Stress Disorders, Post-Traumatic
KW - Time Factors
KW - Vagus Nerve
KW - Young Adult
U2 - 10.3109/10253890.2012.751369
DO - 10.3109/10253890.2012.751369
M3 - SCORING: Journal article
C2 - 23167763
VL - 16
SP - 300
EP - 310
JO - STRESS
JF - STRESS
SN - 1025-3890
IS - 3
ER -