title: Early dysautonomia detected by heart rate variability predicts late depression in female patients following mild traumatic brain injury.
abstract: Depression is one of the frequent complications following a mild traumatic brain injury (mTBI). Recent research indicated that abnormalities in the autonomic nervous system (ANS) can be evaluated by a noninvasive power spectral analysis of the heart rate variability (HRV). In this study, we investigated whether a frequency-domain analysis of HRV was correlated with late depression in mTBI patients. In total, 181 patients diagnosed with mTBI and 83 volunteers as healthy controls were recruited in 2010-2014. Beck Depression Inventory (BDI) scores were used to evaluate depression in the 1st week of assessment and at 1.5-, 3-, 6-, 12-, and 18-month follow-ups. Correlation and logistic regression analyses of the 1st week HRV parameters with BDI scores at 18 months were performed in individual female mTBI patients. Female mTBI patients were more vulnerable to depression accompanied by reduced HRV compared to healthy controls. Over time, depression was aggravated in female mTBI patients but was alleviated in male mTBI patients. A significantly lower parasympathetic proportion of the ANS was noted at 18 months with respect to the 1st week in female mTBI patients. In addition, depression in female mTBI patients at 18 months after injury was significantly correlated with a decrease in the parasympathetic proportion of the ANS in the 1st week (ρ = -0.411; p < .05). Dysautonomia resulted in higher risks of depression in female mTBI patients. We concluded that early dysautonomia following an mTBI contributes to late depression in female mTBI patients.
authors.affiliation: Graduate Institute of Medical Sciences, College of Medicine, Taipei Medical University, Taipei, Taiwan.|School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
authors.forename: Chih-Wei
authors.initials: CW
authors.lastname: Sung
authors.affiliation: Department of Psychiatry, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.
authors.forename: Hsin-Chien
authors.initials: HC
authors.lastname: Lee
authors.affiliation: Department of Neurosurgery, Taipei Medical University Hospital, Taipei Medical University, Taipei, Taiwan.|Graduate Program on Neuroregeneration, Taipei Medical University, Taipei, Taiwan.
authors.forename: Yung-Hsiao
authors.initials: YH
authors.lastname: Chiang
authors.affiliation: Graduate Institute of Injury and Prevention, College of Public Health, Taipei Medical University, Taipei, Taiwan.
authors.forename: Wen-Ta
authors.initials: WT
authors.lastname: Chiu
authors.affiliation: Graduate Institute of Injury and Prevention, College of Public Health, Taipei Medical University, Taipei, Taiwan.
authors.forename: Shu-Fen
authors.initials: SF
authors.lastname: Chu
authors.affiliation: Department of Emergency, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.
authors.forename: Ju-Chi
authors.initials: JC
authors.lastname: Ou
authors.affiliation: Graduate Institute of Injury and Prevention, College of Public Health, Taipei Medical University, Taipei, Taiwan.
authors.forename: Shin-Han
authors.initials: SH
authors.lastname: Tsai
authors.affiliation: Department of Neurosurgery, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.
authors.forename: Kuo-Hsing
authors.initials: KH
authors.lastname: Liao
authors.affiliation: Department of Neurosurgery, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.
authors.forename: Chien-Min
authors.initials: CM
authors.lastname: Lin
authors.affiliation: Department of Neurosurgery, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.
authors.forename: Jia-Wei
authors.initials: JW
authors.lastname: Lin
authors.affiliation: Graduate Institute of Medical Sciences, College of Medicine, Taipei Medical University, Taipei, Taiwan.|Division of Orthodontics & Dentofacial Orthopedics and Pedodontics, Department of Dentistry, Tri-Service General Hospital, Taipei, Taiwan.
authors.forename: Gunng-Shinng
authors.initials: GS
authors.lastname: Chen
authors.affiliation: School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
authors.forename: Wei-Jiun
authors.initials: WJ
authors.lastname: Li
authors.affiliation: Graduate Institute of Medical Sciences, College of Medicine, Taipei Medical University, Taipei, Taiwan.|Department of Physiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
authors.forename: Jia-Yi
authors.initials: JY
authors.lastname: Wang
mesh_terms: D000328:Adult; D001341:Autonomic Nervous System / Q000503:physiopathology*; D000070642:Brain Injuries, Traumatic / Q000150:complications* / Q000503:physiopathology; D003866:Depressive Disorder / Q000209:etiology* / Q000503:physiopathology; D005260:Female; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D054969:Primary Dysautonomias / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D012737:Sex Factors; D055815:Young Adult
keywords: Autonomic dysfunction; Depression; Dysautonomia; Heart rate variability; mTBI