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. 2025 Aug;22(8):921-929.
doi: 10.30773/pi.2025.0043. Epub 2025 Aug 5.

Interactions Between Depression, Autonomic Dysfunction, Inhibitory Control and Reaction Time: Insights From Heart Rate Variability During Continuous Performance Test

Chung-Chih Hsu  1   2   3 , Tien-Yu Chen  1   2   4 , Hsun Ou  3   4 , Terry B J Kuo  1   2   5   6 , Cheryl C H Yang  1   2   5   7
Affiliations

Interactions Between Depression, Autonomic Dysfunction, Inhibitory Control and Reaction Time: Insights From Heart Rate Variability During Continuous Performance Test

Chung-Chih Hsu et al. Psychiatry Investig. 2025 Aug.

Abstract

Objective: This study investigates the relationship between depression, autonomic dysfunction, inhibitory control (IC), and reaction time by analyzing heart rate variability (HRV) during a cognitive task.

Methods: A total of 29 healthy males and 25 males diagnosed with depression (aged 20-35 years) participated. HRV data were recorded during the Conners Continuous Performance Test-II (CCPT-II) in each group. HRV parameters, including mean RR intervals, standard deviation of normal-to-normal heartbeats (SDNN), low-frequency power with logarithm (lnLF), and high-frequency power with logarithm (lnHF), were analyzed and correlated with IC (d') and reaction time.

Results: The depression group exhibited significantly lower lnHF values compared to the healthy group. SDNN and lnLF decreased in both groups during CCPT-II. In the healthy group, d' correlated significantly with SDNN, lnLF, and lnHF at t14 and across the test duration. However, in the depression group, only RR intervals correlated with d'. A significant correlation between reaction time and HRV was noted at t14 in the healthy group, suggesting autonomic nervous system (ANS) involvement in cognitive performance.

Conclusion: Reaction time in healthy individuals correlated with ANS function during later stages of CCPT-II, whereas depression disrupted this association. The lower d' in the depression group was not due to a speed-accuracy trade-off but rather a more pronounced neural network impairment. These findings suggest that depression impairs both IC and autonomic regulation.

Keywords: Detectability; Heart rate variation; Inhibitory control; Reaction time.

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Conflict of interest statement

Conflicts of Interest

The authors have no potential conflicts of interest to disclose.

Figures

Figure 1.
Figure 1.
Analysis of HRV parameters from t0 in each CCPT-II task using repeated measures analysis of variance, controlled for Beck Anxiety Inventory with Bonferroni correction. The data are represented as HRV values derived from each minute of the time window during CCPT-II. p<0.05 indicates significance. *denotes a significant difference at each time window in comparison with the t0 time window in the health group; †denotes a significant difference at each time window in comparison to the t0 time window in the depression group. RR, mean R-R intervals of ECG; SDNN, standard deviation of normal-to-normal heartbeats; lnLF, low-frequency power with logarithm; lnHF, high-frequency power with logarithm; CCPT-II, Conners Continuous Performance Test-II; HRV, heart rate variability.
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