The differences between patients with panic disorder and healthy controls in psychophysiological stress profile

Abstract

BackgroundAlarming somatic symptoms, in particular, cardiovascular symptoms, are the characteristic feature of panic attacks. Increased cardiac mortality and morbidity have been found in these patients. Power spectral analysis of electrocardiogram R–R intervals is known to be a particularly successful tool in the detection of autonomic instabilities in various clinical disorders. Our study aimed to compare patients with panic disorder and healthy controls in heart rate variation (HRV) parameters (very-low-frequency [VLF], low-frequency [LF], and high-frequency [HF] band components of R–R interval) in baseline and during the response to the mental task.Subjects and methodsWe assessed psychophysiological variables in 33 patients with panic disorder (10 men, 23 women; mean age 35.9±10.7 years) and 33 age- and gender-matched healthy controls (10 men, 23 women; mean age 35.8±12.1 years). Patients were treatment naïve. Heart rate, blood pressure, muscle tension, and HRV in basal conditions and after the psychological task were assessed. Power spectrum was computed for VLF (0.003–0.04 Hz), LF (0.04–0.15 Hz), and HF (0.15–0.40 Hz) bands using fast Fourier transformation.ResultsIn the baseline period, the VLF band was significantly lower in panic disorder group compared to controls (p<0.005). In the period of mental task, the LF/HF ratio was significantly higher in panic disorder patients compared to controls (p<0.05). No significant differences were found in the remaining parameters. There was a significant difference in ΔHF and ΔLF/HF ratio between patients and controls, with Δ increasing in patients and decreasing in controls.ConclusionThese findings revealed that patients suffering from panic disorder were characterized by relative sympathetic dominance (reactivity) in response to mental stress compared with healthy controls.

A critical period for experience-dependent development of the feelings of safety during early infancy: A polyvagal perspective on anger and psychometric tools to assess perceived safety

“…Therefore, in adulthood, after closure of the critical period, unsafety detection in the environment may preferentially promote the emergence of mobilizing sympathetic self-protective strategies related to anger to avoid the prevalence of immobilizing DVC self-protective strategies related to fear ( Figure 1 ). Interestingly, patients with panic disorder were characterized by relative reactive sympathetic dominance in response to mental stress compared to healthy controls (Kotianova et al, 2018 ).…”

Heart rate variability: Evaluating a potential biomarker of anxiety disorders

“…During a TSST experiment, patients with SAD had a greater LF/HF HRV ratio compared to healthy controls, implying that the SNS was more hyperactive than the PNS in patients when under social stress (García-Rubio et al, 2017). Similarly, studies using a mental arithmetic stress task have shown that patients with panic disorder have HRV indices reflective of a more hyperactive SNS than healthy controls (Choi et al, 2019;Kotianova et al, 2018). In youth with anxiety disorders, evidence has also been reported for a lowering of HRV PNS parameters compared to controls during a stressor with error feedback (Rozenman et al, 2017).…”

Automated detection of panic disorder based on multimodal physiological signals using machine learning

“…However, some studies have demonstrated mixed results, reporting lower HF power and LF/HF ratio in patients with PD [19][20][21][22]. Kotianova and others reported lower very low frequency (VLF) power during baseline measurement and higher LF/HF ratio during response to mental tasks in patients with PD compared with controls [23].…”