Heart rate variability in bipolar mania and schizophrenia.
BACKGROUND
Autonomic nervous system (ANS) dysfunction and reduced heart rate variability (HRV) have been reported in a wide variety of psychiatric disorders, but have not been well characterized in bipolar mania. We recorded cardiac activity and assessed HRV in acutely hospitalized manic bipolar (BD) and schizophrenia (SCZ) patients compared to age- and gender-matched healthy comparison (HC) subjects.


METHODS
HRV was assessed using time domain, frequency domain, and nonlinear analyses in 23 manic BD, 14 SCZ, and 23 HC subjects during a 5min rest period. Psychiatric symptoms were assessed by administration of the Brief Psychiatric Rating Scale (BPRS) and the Young Mania Rating Scale (YMRS).


RESULTS
Manic BD patients demonstrated a significant reduction in HRV, parasympathetic activity, and cardiac entropy compared to HC subjects, while SCZ patients demonstrated a similar, but non-significant, trend towards lower HRV and entropy. Reduction in parasympathetic tone was significantly correlated with higher YMRS scores and the unusual thought content subscale on the BPRS. Decreased entropy was associated with increased aggression and diminished personal hygiene on the YMRS scale.


CONCLUSIONS
Cardiac function in manic BD individuals is characterized by decreased HRV, reduced vagal tone, and a decline in heart rate complexity as assessed by linear and nonlinear methods of analysis. Autonomic dysregulation is associated with more severe psychiatric symptoms, suggesting HRV dysfunction in this disorder may be dependent on the phase of the illness.
Henry
Brook L
BL
University of California San Diego, Department of Psychiatry, La Jolla, CA 92103-0851, United States. blhenry@ucsd.edu
Minassian
Arpi
A
Paulus
Martin P
MP
Geyer
Mark A
MA
Perry
William
W
D000328:Adult; D000374:Aggression; D001714:Bipolar Disorder / Q000503:physiopathology*; D010054:Brief Psychiatric Rating Scale; D016022:Case-Control Studies; D005260:Female; D006321:Heart / Q000503:physiopathology; D006339:Heart Rate; D006801:Humans; D006920:Hygiene; D008297:Male; D010275:Parasympathetic Nervous System / Q000503:physiopathology; D012559:Schizophrenia / Q000503:physiopathology*
Psychosom Med. 1997 May-Jun;59(3):231-5
9178333
Neuropsychobiology. 1998;38(1):19-24
9701718
J Clin Psychopharmacol. 2003 Oct;23(5):441-7
14520119
Harv Rev Psychiatry. 2005 Jan-Feb;13(1):28-42
15804932
Biol Psychol. 1998 Nov;49(3):303-23
9858059
Psychiatry Res. 1991 Apr;37(1):35-46
1862160
Respir Physiol Neurobiol. 2009 Jun 30;167(2):162-7
19505672
Neurosci Biobehav Rev. 2007;31(6):882-96
17706782
Am J Cardiol. 1991 Sep 1;68(6):626-30
1877480
Circulation. 2000 Jun 13;101(23):E215-20
10851218
Appl Psychophysiol Biofeedback. 2007 Mar;32(1):19-30
17333315
Psychiatry Res. 2002 Dec 15;113(1-2):139-49
12467953
Int J Cardiol. 2006 Apr 14;108(3):359-69
15979171
J Appl Physiol (1985). 1999 Aug;87(2):530-7
10444609
Schizophr Bull. 2010 Nov;36(6):1131-9
19429846
Auton Neurosci. 2005 Feb 7;117(2):127-31
15664566
Philos Trans A Math Phys Eng Sci. 2009 Apr 13;367(1892):1223-38
19324705
Eur Psychiatry. 2004 Feb;19(1):8-14
14969775
Schizophr Bull. 2000;26(4):847-54
11087017
Int J Psychophysiol. 2009 Feb;71(2):109-17
18708100
Am J Physiol Heart Circ Physiol. 2000 Jun;278(6):H2039-49
10843903
Methods Inf Med. 2004;43(2):202-6
15136870
Am J Cardiol. 1995 May 1;75(14):882-5
7732994
Biol Psychiatry. 1996 Feb 15;39(4):255-66
8645772
Psychosom Med. 2005 May-Jun;67 Suppl 1:S29-33
15953797
Psychophysiology. 1997 Nov;34(6):623-48
9401419
J Clin Psychiatry. 1990 Mar;51(3):97-101
2307666
Bipolar Disord. 2006 Oct;8(5 Pt 1):441-52
17042882
Biol Psychiatry. 2002 May 1;51(9):733-44
11983187
Proc Natl Acad Sci U S A. 1990 Jan;87(2):723-7
1967830
Ann Noninvasive Electrocardiol. 2002 Jan;7(1):60-3
11844293
J Anxiety Disord. 2003;17(1):75-87
12464290
Psychosom Med. 1995 Jul-Aug;57(4):331-5
7480562
Bipolar Disord. 2003 Apr;5(2):138-43
12680904
Neurosci Biobehav Rev. 2009 Feb;33(2):81-8
18771686
J Affect Disord. 1994 Dec;32(4):271-5
7897091
Psychiatr Q. 2008 Jun;79(2):139-50
18491230
J Psychiatr Res. 2005 Sep;39(5):519-27
15992561
Conf Proc IEEE Eng Med Biol Soc. 2004;2006:294-7
17271668
Epilepsia. 2001 Jul;42(7):912-21
11488892
Psychophysiology. 2002 Nov;39(6):861-4
12462513
Int J Psychophysiol. 2003 Jun;48(3):263-74
12798986
CNS Spectr. 2008 Feb;13(2 Suppl 1):1-10; quiz 11-2
18227747
Clin Neurophysiol. 2006 Dec;117(12):2715-22
17029956
Biol Psychiatry. 2003 Dec 15;54(12):1427-36
14675808
J Physiol Pharmacol. 2006 Nov;57 Suppl 11:5-29
17244936
Int J Psychophysiol. 1999 Jan;31(2):147-54
9987060
J Clin Psychiatry. 1990 Jul;51 Suppl:4-9; discussion 10-1
2195012
Biol Psychiatry. 1997 Mar 1;41(5):612-7
9046993
Psychopharmacol Bull. 1993;29(2):201-6
8290666
Chaos. 1996 Sep;6(3):414-427
12780271
J Psychosom Res. 1998 Jan;44(1):133-51
9483470
Card Electrophysiol Rev. 2002 Sep;6(3):250-5
12114847
Bipolar Disord. 2008 Mar;10(2):276-84
18271907
Am J Physiol Regul Integr Comp Physiol. 2002 Sep;283(3):R789-97
12185014
Auton Neurosci. 2009 Jan 28;145(1-2):99-103
19059813
Biol Psychol. 2007 Jul;75(3):300-5
17540493
Psychophysiology. 2003 Sep;40(5):716-26
14696725
Psychiatry Res. 1998 Mar 20;78(1-2):89-99
9579705
Arch Gen Psychiatry. 2009 Oct;66(10):1072-80
19805697
J Affect Disord. 2010 Jan;120(1-3):200-6
19435640
Biol Psychiatry. 2006 Sep 1;60(5):507-14
16603135
Eur J Appl Physiol. 2004 Dec;93(3):263-72
15338220
Ann Acad Med Singap. 2001 Nov;30(6):625-31
11817292
Circ Res. 1986 Aug;59(2):178-93
2874900
West J Nurs Res. 1995 Feb;17(1):32-48; discussion 101-11
7863645
Prog Neuropsychopharmacol Biol Psychiatry. 2004 Mar;28(2):371-8
14751435
Clin Neurophysiol. 2007 Sep;118(9):2009-15
17646130
Biol Psychol. 2007 Feb;74(2):224-42
17182165
Neuroimage. 2009 Jan 1;44(1):213-22
18778779
Biol Psychiatry. 2005 Sep 1;58(5):364-73
16139582
Clin Auton Res. 2005 Aug;15(4):292-8
16032384