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Review
. 2020 Sep;50(12):1937-1948.
doi: 10.1017/S003329172000207X. Epub 2020 Aug 28.

Autonomic dysfunction in posttraumatic stress disorder indexed by heart rate variability: a meta-analysis

Martha Schneider  1 , Andreas Schwerdtfeger  1
Affiliations
Review

Autonomic dysfunction in posttraumatic stress disorder indexed by heart rate variability: a meta-analysis

Martha Schneider et al. Psychol Med. 2020 Sep.

Abstract

Background: Changes in autonomic nervous system (ANS) function have been observed in a variety of psychological disorders, including posttraumatic stress disorder (PTSD). Analysis of heart rate variability (HRV) provides insight into the functioning of the ANS. Previous research on PTSD found lower HRV in PTSD patients compared to controls, indicating altered sympathetic and parasympathetic activity, but findings are inconsistent. The purpose of this meta-analysis was to examine differences in HRV indices between individuals with PTSD and healthy controls at baseline and during stress.

Methods: The included primary studies present an aggregate of studies analyzing different HRV indices. Examined HRV indices were standard deviation of the normalized NN-intervals (SDNN), root mean square of successive differences (RMSSD), low-frequency (LF) and high-frequency (HF) spectral components, LF/HF ratio, and heart rate (HR). Moderating effects of study design, HRV and PTSD assessment, and sample characteristics were examined via subgroup-analyses and meta-regressions.

Results: Random-effects meta-analyses for HRV parameters at rest revealed significant group differences for RMSSD and HF-HRV, suggesting lower parasympathetic activity in PTSD. The aggregated effect size for SDNN was medium, suggesting diminished total variability in PTSD. A small effect was found for LF-HRV. A higher LF/HF ratio was found in the PTSD sample as compared to controls. Individuals with PTSD showed significantly higher HR. During stress, individuals with PTSD showed higher HR and lower HF-HRV, both indicated by small effect sizes.

Conclusions: Findings suggest that PTSD is associated with ANS dysfunction.

Keywords: Heart rate; heart rate variability; meta-analysis; posttraumatic stress disorder.

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References

    1. *Agorastos, A., Boel, J. A., Heppner, P. S., Hager, T., Moeller-Bertram, T., Haji, U., … Stiedl, O. (2013). Diminished vagal activity and blunted diurnal variation of heart rate dynamics in posttraumatic stress disorder. Stress (Amsterdam, Netherlands), 16(3), 300–310. doi:10.3109/10253890.2012.751369. - DOI - PubMed
    1. American Psychiatric Association (1994). Diagnostic and statistical manual of mental disorders (4th ed., Text Revision). Washington DC: Author.
    1. American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders (5th ed.) Arlington VA: Author.
    1. Asukai, N., Kato, H., Kawamura, N., Kim, Y., Yamamoto, K., Kishimoto, J., … Nishizono-Maher, A. (2002). Reliability and validity of the Japanese-language version of the impact of event scale-revised (Ies-RJ): Four studies of different traumatic events. The Journal of Nervous and Mental Disease, 190(3), 175–182. Retrieved from https://journals.lww.com/jonmd/Abstract/2002/03000/RELIABILIGY_AND_VALID.... - PubMed
    1. Benjamini, Y., & Hochberg, Y. (1996). Controlling the false discovery rate: A practical and powerful approach to multiple testing. Journal of the Royal Statistical Society B, 57, 289–300.

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