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Inverse autonomic stress reactivity in depressed patients with and without prior history of depression
INTRODUCTION: There is a considerable association between major depressive disorder (MDD) and cardiovascular disease, most possibly relying on abnormalities in the autonomic nervous system (ANS)-related cardiac reactivity, although the exact underlying pathophysiological pathway is unclear. OBJECTIV...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Cambridge University Press
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9471622/ http://dx.doi.org/10.1192/j.eurpsy.2021.870 |
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author | Agorastos, A. Heinig, A. Wiedemann, K. Demiralay, C. |
author_facet | Agorastos, A. Heinig, A. Wiedemann, K. Demiralay, C. |
author_sort | Agorastos, A. |
collection | PubMed |
description | INTRODUCTION: There is a considerable association between major depressive disorder (MDD) and cardiovascular disease, most possibly relying on abnormalities in the autonomic nervous system (ANS)-related cardiac reactivity, although the exact underlying pathophysiological pathway is unclear. OBJECTIVES: This study tends to shed some additional light on this background by investigating ANS reactivity in MDD with respect to previous depression history through an objective stress challenge paradigm. METHODS: The study assessed the effects of an overnight hypothalamus-pituitary-adrenal (HPA) axis stimulation with metyrapone (MET) on baseline ANS activity through linear and non-linear heart rate variability (HRV) measures in the morning of two continuous days in a group of 14 physically healthy, antidepressant-free patients with clinical, non-psychotic MDD, to investigate differences in autonomic reactivity with respect to prior MDD history. RESULTS: The main findings of this study include statistically significant time x group interactions with respect to several HRV measures, suggesting substantial differences on autonomic reactivity between patients with and without depression history. Hereby, recurrent-episode MDD patients showed lower vagal activity, while first-episode MDD patients increased PNS activity after HPA axis stimulation. CONCLUSIONS: These findings indicate that HPA axis stimulation in MDD patients leads to inverse vagal response according to MDD history. We suggest that chronic stress system overactivation, as found in MDD, might lead to a progressive inversion of the original stress response through HPA axis and ANS divergence over the course of a recurrent illness. HRV could, thus, represent a significant biomarker in MDD with temporal sensitivity. |
format | Online Article Text |
id | pubmed-9471622 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Cambridge University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-94716222022-09-29 Inverse autonomic stress reactivity in depressed patients with and without prior history of depression Agorastos, A. Heinig, A. Wiedemann, K. Demiralay, C. Eur Psychiatry Abstract INTRODUCTION: There is a considerable association between major depressive disorder (MDD) and cardiovascular disease, most possibly relying on abnormalities in the autonomic nervous system (ANS)-related cardiac reactivity, although the exact underlying pathophysiological pathway is unclear. OBJECTIVES: This study tends to shed some additional light on this background by investigating ANS reactivity in MDD with respect to previous depression history through an objective stress challenge paradigm. METHODS: The study assessed the effects of an overnight hypothalamus-pituitary-adrenal (HPA) axis stimulation with metyrapone (MET) on baseline ANS activity through linear and non-linear heart rate variability (HRV) measures in the morning of two continuous days in a group of 14 physically healthy, antidepressant-free patients with clinical, non-psychotic MDD, to investigate differences in autonomic reactivity with respect to prior MDD history. RESULTS: The main findings of this study include statistically significant time x group interactions with respect to several HRV measures, suggesting substantial differences on autonomic reactivity between patients with and without depression history. Hereby, recurrent-episode MDD patients showed lower vagal activity, while first-episode MDD patients increased PNS activity after HPA axis stimulation. CONCLUSIONS: These findings indicate that HPA axis stimulation in MDD patients leads to inverse vagal response according to MDD history. We suggest that chronic stress system overactivation, as found in MDD, might lead to a progressive inversion of the original stress response through HPA axis and ANS divergence over the course of a recurrent illness. HRV could, thus, represent a significant biomarker in MDD with temporal sensitivity. Cambridge University Press 2021-08-13 /pmc/articles/PMC9471622/ http://dx.doi.org/10.1192/j.eurpsy.2021.870 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Abstract Agorastos, A. Heinig, A. Wiedemann, K. Demiralay, C. Inverse autonomic stress reactivity in depressed patients with and without prior history of depression |
title | Inverse autonomic stress reactivity in depressed patients with and without prior history of depression |
title_full | Inverse autonomic stress reactivity in depressed patients with and without prior history of depression |
title_fullStr | Inverse autonomic stress reactivity in depressed patients with and without prior history of depression |
title_full_unstemmed | Inverse autonomic stress reactivity in depressed patients with and without prior history of depression |
title_short | Inverse autonomic stress reactivity in depressed patients with and without prior history of depression |
title_sort | inverse autonomic stress reactivity in depressed patients with and without prior history of depression |
topic | Abstract |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9471622/ http://dx.doi.org/10.1192/j.eurpsy.2021.870 |
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