title: Reduced power spectra of heart rate variability are correlated with anxiety in patients with mild traumatic brain injury.
abstract: Anxiety is one of the most frequently diagnosed emotional disorders after a mild traumatic brain injury (mTBI); however, predictors of anxiety after an mTBI remain uncertain. Recent research indicated that anxiety is associated with abnormalities in the autonomic nervous system (ANS) which can be evaluated by a power spectral analysis of heart rate variability (HRV). In this study, we investigated whether a frequency-domain analysis of HRV could correlate with the occurrence of anxiety in mTBI patients. We recruited 165 Taiwanese patients diagnosed with an mTBI and 82 volunteer healthy controls from three affiliated hospitals of Taipei Medical University during 2010-2014. The Beck Anxiety Inventory (BAI) was assessed at the 1st, 6th, and 12th weeks. We found that mTBI patients were more vulnerable to anxiety compared to healthy controls. The power spectral density of HRV was significantly lower in mTBI patients than in healthy controls. A correlation analysis indicated that anxiety was negatively significantly correlated with low- and high-frequency power at the 6th week. Our study suggests the clinical usefulness of HRV as a potential noninvasive tool for evaluating later anxiety in mTBI patients.
authors.affiliation: Division of Neurosurgery, Department of Surgery, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.
authors.forename: Kuo-Hsing
authors.initials: KH
authors.lastname: Liao
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: 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: 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: Division of Neurosurgery, Department of Surgery, Taipei Medical University Hospital, Taipei Medical University, Taipei, Taiwan; Graduate Program on Neuroregeneration, College of Medical Science and Technology, and Center for Neurotrauma and Neuroregeneration, Taipei Medical University, Taipei, Taiwan.
authors.forename: Yung-Hsiao
authors.initials: YH
authors.lastname: Chiang
authors.affiliation: Department of Emergency Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.
authors.forename: Barry
authors.initials: B
authors.lastname: Hoffer
authors.affiliation: Division of Neurosurgery, Department of Surgery, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.
authors.forename: Ju-Chi
authors.initials: JC
authors.lastname: Ou
authors.affiliation: Department of Emergency Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.
authors.forename: Kai-Yun
authors.initials: KY
authors.lastname: Chen
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: Division of Neurosurgery, Department of Surgery, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.
authors.forename: Chien-Min
authors.initials: CM
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. Electronic address: jywang2010@tmu.edu.tw.
authors.forename: Jia-Yi
authors.initials: JY
authors.lastname: Wang
mesh_terms: D000328:Adult; D001007:Anxiety / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology*; D001341:Autonomic Nervous System / Q000503:physiopathology; D001924:Brain Concussion / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology*; D005260:Female; D005500:Follow-Up Studies; D005583:Fourier Analysis; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged
keywords: Anxiety; Heart rate variability; Low-frequency (LF) power; mTBI