Vagally-mediated heart rate variability and depression in children and adolescents - A meta-analytic update

Baumeister-Lingens, Luise; Rothe, Roxana; Wolff, Lena; Gerlach, Alexander L.; Koenig, Julian; Sigrist, Christine

doi:10.1016/j.jad.2023.07.027

Cited by 4 publications

(3 citation statements)

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“…Kemp et al found a correlation between depressive symptomatology and HRV reduction in adult patients in their meta-analysis 15 . According to the latest meta-analysis in children and adolescents, there was no significant association in HRV parameters and depression symptoms, however, gender was a significant moderator for this relationship, revealing a more pronounced negative association among a group with the greater percentage of females 37 . This correlates with our results and percentage of girls in the present study.…”

Section: Discussionmentioning

confidence: 99%

Vortioxetine’s impact on the autonomic nervous system in depressed children and adolescents: analysis of the heart rate variability

Krivosova,

Hutka,

Ondrejka

et al. 2024

Sci Rep

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Relationship between depressive disorder and autonomic nervous system has been already discussed. Reduced emotional regulation is supposed to be associated with prefrontal hypofunction and subcortical hyperactivity. The aim of this study was to determine the effect of vortioxetine on heart rate variability (HRV), a parameter of cardiac autonomic regulation, in depressed hospitalized paediatric patients and assess the clinical effectiveness of the drug in this population. We performed repeated polysomnography analyses at admission and after a short treatment in hospital (15.2 days on average) and measured various HRV parameters (RRi, pNN50, RMSSD, LF-HRV, HF-HRV) during wakefulness, N3 and REM sleep stages. Out of 27 study subjects, 67% have improved depression symptoms as well as anxiety and subjective sleep quality after short vortioxetine treatment. We have found a significant decrease in parasympathetic parameters pNN50, RMSSD and HF-HRV during N3 sleep phase, though not exclusively among vortioxetine responders. The anticipated increase in cardiovagal regulation after vortioxetine treatment was not demonstrated in this pilot study, possibly due to the drug’s multimodal mechanism and impact on the nucleus tractus solitarii, particularly its antagonism on 5HT-3 receptors. Application of selective drugs could further explain the effect of vortioxetine on HRV in depressed patients.

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Section: Discussionmentioning

confidence: 99%

Vortioxetine’s impact on the autonomic nervous system in depressed children and adolescents: analysis of the heart rate variability

Krivosova,

Hutka,

Ondrejka

et al. 2024

Sci Rep

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“…Evidence has also accumulated on the association between vmHRV and depression, and meta-analyses suggest an association between major depressive disorder and reductions in vmHRV, in both adolescent (Baumeister-Lingens et al, 2023 ; Koenig et al, 2016 ) and adult samples (Kemp et al, 2010 ). The association between vmHRV and depressive symptoms has been examined in longitudinal studies, and both population-based (Jandackova et al, 2016 ) and twin studies (Huang et al, 2018 ) suggest that reductions in vmHRV may precede the onset of depressive symptoms.…”

Section: Introductionmentioning

confidence: 99%

A sex-specific pathway linking early life maltreatment, vagal activity, and depressive symptoms

Sigrist,

Ottaviani,

Baumeister-Lingens

et al. 2024

European Journal of Psychotraumatology

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Background: Experiences of early life maltreatment (ELM) are alarmingly common and represent a risk factor for the development of psychopathology, particularly depression. Research has focused on alterations in autonomic nervous system (ANS) functioning as a mediator of negative mental health outcomes associated with ELM. Early alterations in autonomic vagal activity (vmHRV) may moderate the relationship between ELM and depression, particularly when considering forms of emotional maltreatment. Recent evidence suggests that the relationships of both ELM and vmHRV with depression may be non-linear, particularly considering females. Objective: Building on and extending theoretical considerations and previous work, the present work aims to further the current understanding of the complex relationships between ELM exposure, vmHRV, and depression. Methods: This study uses an adaptive modelling approach, combining exploratory network-based analyses with linear and quadratic moderation analyses, drawing on a large sample of males and females across adolescence (total N = 213; outpatient at-risk sample and healthy controls) and adulthood (total N = 85; community-based convenience sample). Results: Exploratory network-based analyses reveal that exposure to emotional abuse is particularly central within a network of ELM subtypes, depressive symptoms, and concurrent vmHRV in both adolescents and adults. In adults, emotional neglect shows strong associations with both emotional abuse and vmHRV and is highly central as a network node, which is not observed in adolescents. Moderator analyses reveal significant interactions between emotional maltreatment and vmHRV predicting depressive symptoms in adult females. Significant quadratic relationships of emotional maltreatment and vmHRV with depression are observed in both adolescent and adult females. Conclusions: The present findings contribute to the understanding of the psychological and physiological mechanisms by which ELM acts as a risk factor for the development of depression. Ultimately, this will contribute to the development of targeted and effective intervention strategies to mitigate the detrimental effects of early adversity.

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“…What is more, it was proven that depression-induced autonomic dysfunction was more detectable and substantial in children as compared to adult patients [31]. New studies even suggest the use of HRV parameters as biomarkers for depression in children/adolescents [32]. Moreover, altered HRV profiles have been detected in children suffering from autism spectrum disorders [33], as well as attention-deficit/hyperactivity disorder [34].…”

Section: Introductionmentioning

confidence: 99%

Anthracycline’s Effects on Heart Rate Variability in Children with Acute Lymphoblastic Leukemia: Early Toxicity Signs—Pilot Study

Lazar,

Cainap,

Maniu

et al. 2023

JCM

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Anthracycline treatments are known to cause cardiotoxic long-term side effects in cancer survivors. Recently, a decrease in heart rate variability (HRV) has been identified in these patients, signaling autonomic dysfunction and altered cardiac fitness. This study aimed at evaluating changes in HRV in children treated with anthracyclines. A total of 35 pediatric patients with acute lymphoblastic leukemia were evaluated by means of a 24 h Holter ECG, at baseline and after reaching half the total cumulative dose of doxorubicin equivalent (120 mg/m2). Parameters of HRV were assessed, as well as any arrhythmic episodes, bradycardia and tachycardia percentages. The results showed a significant decrease in both time-domain and frequency-domain HRV parameters, following anthracycline treatment. The low-frequency (LF) to high-frequency (HF) parameters’ ratio also displayed a significant difference (p = 0.035), suggestive of early cardiac autonomic dysfunction. Of note, none of the patients presented symptoms of heart disease or elevated troponins, and only two patients presented echocardiographic signs of diastolic dysfunction. The present study showed that cardiac autonomic nervous system regulation is compromised in children treated with anthracyclines even before reaching the total cumulative dose. Therefore, HRV parameters could be the first indicators of subclinical cardiac toxicity, making Holter ECG monitoring of the oncological patient a necessity.

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Vagally-mediated heart rate variability and depression in children and adolescents - A meta-analytic update

Cited by 4 publications

References 113 publications

Vortioxetine’s impact on the autonomic nervous system in depressed children and adolescents: analysis of the heart rate variability

Vortioxetine’s impact on the autonomic nervous system in depressed children and adolescents: analysis of the heart rate variability

A sex-specific pathway linking early life maltreatment, vagal activity, and depressive symptoms

Anthracycline’s Effects on Heart Rate Variability in Children with Acute Lymphoblastic Leukemia: Early Toxicity Signs—Pilot Study

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