Motor activity and autonomic cardiac functioning in major depressive disorder.
BACKGROUND
The daily pattern of motor activity and the autonomic cardiovascular regulation were studied in major depression to quantify changes in psychomotor function and autonomic cardiac functioning. Additionally, relationships between motor activity parameters, cardiovascular measures and specific clinical features were examined.


METHODS
Wrist-actigraphy was used to monitor 24-h motor activity for 67 unmedicated (unipolar) depressed inpatients and 64 control subjects. During supine rest, spectral analysis was applied to assess HR and SBP variability, a baroreflex sensitivity (BRS) index and the respiratory frequency, in addition to mean heart rate (HR) and blood pressure (BP) levels for the patient group and a second control group (N=51).


RESULTS
The patients showed a lower motor activity level and a reduced fragmentation of motor activity during wake, and a higher motor activity level and a decreased immobility during sleep. The mean HR and DBP level and the respiratory frequency were higher in the patient group than in the control group, but no differences in HR and SBP variability or BRS were found. Furthermore, motor activity parameters and cardiovascular measures of the patients were related to agitation and retardation and overall, patients with lower motor activity levels demonstrated lower SBP levels.


CONCLUSIONS
This study confirms that the 24-h pattern of motor activity is altered in unmedicated depressed inpatients, but limited evidence was found for an autonomic cardiac dysfunction. Within the patient group there were relationships between motor activity parameters, cardiovascular measures, and clinical features, but the underlying neurobiological pathways need to be further explored.
Volkers
Anita C
AC
Department of Psychiatry, University Hospital Rotterdam-Dijkzigt and Erasmus University Rotterdam, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands. volkers@psy.fgg.eur.nl
Tulen
Joke H M
JH
van den Broek
Walter W
WW
Bruijn
Jan A
JA
Passchier
Jan
J
Pepplinkhuizen
Lolke
L
D000328:Adult; D000368:Aged; D001341:Autonomic Nervous System / Q000502:physiology; D001794:Blood Pressure; D002940:Circadian Rhythm; D003866:Depressive Disorder / Q000150:complications / Q000503:physiopathology*; D005260:Female; D006339:Heart Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D012890:Sleep; D014953:Wrist / Q000098:blood supply