title: A systematic review on heart rate variability in Bulimia Nervosa.
abstract: Eating disorders are associated with alterations of the autonomic nervous system (ANS). Among other indices, heart rate variability (HRV) provides a readily available index of ANS function. While ANS dysfunction indexed by HRV in Anorexia Nervosa has been addressed in previous reviews, here we aimed to review the current evidence on HRV in Bulimia Nervosa (BN). A systematic literature search in Web of Science, PsycInfo, Scopus, and PubMed identified 17 studies reporting HRV in patients with BN. Studies described (i) differences in resting state HRV in patients compared to controls, (ii) alterations in the stress response in BN indexed by HRV, and (iii) treatment effects on HRV in patients with BN. Despite a number of conflicting results, we conclude that BN is characterized by increased resting state vagally-mediated HRV and an impaired stress-response. Intervention-studies suggest that altered ANS-activity in BN is at least partially reversible. Future studies on the complex relation between BN and HRV should investigate the effect of comorbid disorders, subtypes of BN, and mechanisms affecting treatment outcome.
authors.affiliation: The Ohio State University, Department of Psychology, 1835 Neil Avenue, Columbus, OH 43210, United States. Electronic address: Peschel.4@osu.edu.
authors.forename: Stephanie K V
authors.initials: SK
authors.lastname: Peschel
authors.affiliation: The Ohio State University, Department of Psychology, 1835 Neil Avenue, Columbus, OH 43210, United States. Electronic address: feeling.2@osu.edu.
authors.forename: Nicole R
authors.initials: NR
authors.lastname: Feeling
authors.affiliation: Institute for Health and Behaviour, Research Unit INSIDE, University of Luxembourg, Belval Campus, 11 Porte des Sciences, L-4366 Esch-sur-Alzette, Luxembourg. Electronic address: claus.voegele@uni.lu.
authors.forename: Claus
authors.initials: C
authors.lastname: Vögele
authors.affiliation: Heidelberg University, Section for Translational Psychobiology in Child and Adolescent Psychiatry, Department of Child and Adolescent Psychiatry, Centre for Psychosocial Medicine, Blumenstraße 8, 69115 Heidelberg, Germany. Electronic address: Michael.Kaess@med.uni-heidelberg.de.
authors.forename: Michael
authors.initials: M
authors.lastname: Kaess
authors.affiliation: The Ohio State University, Department of Psychology, 1835 Neil Avenue, Columbus, OH 43210, United States. Electronic address: Thayer.39@osu.edu.
authors.forename: Julian F
authors.initials: JF
authors.lastname: Thayer
authors.affiliation: The Ohio State University, Department of Psychology, 1835 Neil Avenue, Columbus, OH 43210, United States; Heidelberg University, Section for Translational Psychobiology in Child and Adolescent Psychiatry, Department of Child and Adolescent Psychiatry, Centre for Psychosocial Medicine, Blumenstraße 8, 69115 Heidelberg, Germany. Electronic address: Julian.Koenig@med.uni-heidelberg.de.
authors.forename: Julian
authors.initials: J
authors.lastname: Koenig
mesh_terms: D000293:Adolescent; D000328:Adult; D001341:Autonomic Nervous System / Q000503:physiopathology*; D052018:Bulimia Nervosa / Q000503:physiopathology*; D005260:Female; D006339:Heart Rate; D006801:Humans; D055815:Young Adult
keywords: Autonomic nervous system; Bulimia Nervosa; Eating disorders; Heart rate variability; Vagal activity