Heart Rate Variability in Psychiatric Disorders

心律變異分析已被廣泛應用於定量自主神經系統之活性及評估心血管疾病之預後。精神疾病已知會增加罹患心血管疾病的危險性，但自主神經系統在精神疾病的致病機轉中所扮演的角色仍不清楚。本綜說將介紹心律變異分析的觀念與原理，回顧過去應用心律變異分析於精神醫學之研究，並提出結合基因與心律變異分析之研究模式，及新發展之睡眠品質定量技術。過去的研究顯示，憂鬱、焦慮及精神分裂對於患者之自主神經功能有顯著影響。我們的研究也發現，脂蛋白E(apolipoprotein E)基因及腦源神經滋養因子(brain-derived neuron-trophic factor)基因之多形性會影響自主神經功能，顯示精神疾病和自律神經失調有一定之神經生理之關聯性。最後，我們並介紹一個新發展之睡眠品質定量技術並應用於憂鬱症之失眠研究。未來如何以心律變異分析來釐清精神疾病與自律神經失調之相關性，將是一個重要的研究課題。

關鍵字

自律神經失調；心律變異分析；精神疾病；基因

並列摘要

Objectives: The autonomic nervous system (ANS) dysregulation is a well known risk of adverse cardiovascular events. Analysis of heart rate variability (HRV) can give a valuable window into the ANS function being implicated in various medical diseases. But HRV analysis is not well established although psychiatric research findings have shown considerable association of psychopathology with cardiovascular comorbidity. In this review, we introduce the principle and technique of HRV analysis and illustrate how HRV analysis can shed light on neurobiology of psychiatric disorders. Methods: We present HRV methods and applications to quantify ANS dysregulation associated with psychiatric disorders. We will also highlight the novel approaches of HRV analysis to study mental illnesses in the context of genetic inferences and sleep physiology. Results: Symptoms of ANS disturbance are common in psychiatric disorders. HRV analysis has been used to quantify ANS dysregulation in depression, anxiety, and schizophrenia. Moreover, we reveal that some variations in genes, such as the genes encoding apolipoprotein-E and brain-derived neurotrophic factor, may have significant impact on cardiac dynamics which are implicated in psychopathology of psychiatric disorders. Finally, we introduce cardiopulmonary coupling analysis which is adopted from HRV analysis to show its application to quantify sleep stability. Conclusions: Investigating ANS functions may give insight into understanding neurobiology of psychiatric disorders. We need prospective studies of ANS dysregulation in various psychiatric disorders to evaluate their psychopathology connected with cardiovascular comorbidity.

並列關鍵字

autonomic dysregulation ； heart rate variability ； psychiatric disorder ； genetic inference

國際替代計量

Heart Rate Variability in Psychiatric Disorders

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