Characteristic Profiles of Heart Rate Variability in Depression and Anxiety

This chapter on heart rate variability (HRV) presents a view based on our published data that HRV profiles in depression and anxiety show differences and can be used for the differentiation of these two disorders in clinical practices. Characteristic HRV profiles in depression and anxiety are revealed by measurements incorporating task load. Analysis of two frequency-domain HRV parameters, low frequency (LF) and high frequency (HF), together with heart rate (HR) itself measured at rest (Rest), during the task load (Task), and at rest after the task (After) enables the evaluation of the autonomic regulation in response to behavioral changes with different stress levels. LF is the heart rate modulation related to blood pressure changes to stabilize circulation. HF is related to breathing rhythm and reflects parasympathetic activity. It has been indicated that LF, HF, their ratio LF/HF and HR in depression and anxiety show characteristic dysregulations during Rest, Task and After. These HRV profiles are useful for understanding the pathophysiology of the disorders

Spatiotemporal characteristics of hemodynamic changes in the human lateral prefrontal cortex during working memory tasks

Abstract The prefrontal cortex (PFC) is widely believed to subserve mental manipulation and monitoring processes ascribed to the central executive (CE) of working memory (WM). We attempted to examine and localize the CE by functional imaging of the frontal cortex during tasks designed to require the CE. Using near-infrared spectroscopy, we studied the spatiotemporal dynamics of oxygenated hemoglobin (oxy-Hb), an indicator of changes in regional cerebral blood flow, in both sides of lateral PFC during WM intensive tasks. In most participants, increases in oxy-Hb were localized within one subdivison during performance of the n-back task, whereas oxy-Hb increased more diffusely during the random number generation (RNG) task. Activation of the ventrolateral PFC (VLPFC) was prominent in the n-back task; both sustained and transient dynamics were observed. Transient dynamics means that oxy-Hb first increases but then decreases to less than 50% of the peak value or below the baseline level before the end of the task. For the RNG task sustained activity was also observed in the dorsolateral PFC (DLPFC), especially in the right hemisphere. However, details of patterns of activation varied across participants: subdivisions commonly activated during performance of the two tasks were the bilateral VLPFCs, either side of the VLPFC, and either side of the DLPFC in 4, 2, and 4 of the 12 participants, respectively. The remaining 2 of the 12 participants had no regions commonly activated by these tasks. These results suggest that although the PFC is implicated in the CE, there is no stereotyped anatomical PFC substrate for the CE

Impaired Prefrontal Hemodynamic Maturation in Autism and Unaffected Siblings

BACKGROUND: Dysfunctions of the prefrontal cortex have been previously reported in individuals with autism spectrum disorders (ASD). Previous studies reported that first-degree relatives of individuals with ASD show atypical brain activity during tasks associated with social function. However, developmental changes in prefrontal dysfunction in ASD and genetic influences on the phenomena remain unclear. In the present study, we investigated the change in hemoglobin concentration in the prefrontal cortex as measured with near-infrared spectroscopy, in children and adults with ASD during the letter fluency test. Moreover, to clarify the genetic influences on developmental changes in the prefrontal dysfunction in ASD, unaffected siblings of the ASD participants were also assessed. METHODOLOGY/PRINCIPAL FINDINGS: Study participants included 27 individuals with high-functioning ASD, age- and IQ-matched 24 healthy non-affected siblings, and 27 unrelated healthy controls aged 5 to 39 years. The relative concentration of hemoglobin ([Hb]) in the prefrontal cortex was measured during the letter fluency task. For children, neither the [oxy-Hb] change during the task nor task performances differed significantly among three groups. For adults, the [oxy-Hb] increases during the task were significantly smaller in the bilateral prefrontal cortex in ASD than those in control subjects, although task performances were similar. In the adult siblings the [oxy-Hb] change was intermediate between those in controls and ASDs. CONCLUSION/SIGNIFICANCE: Although indirectly due to a cross-sectional design, the results of this study indicate altered age-related change of prefrontal activity during executive processing in ASD. This is a first near-infrared spectroscopy study that implies alteration in the age-related changes of prefrontal activity in ASD and genetic influences on the phenomena

Return-to-Work Screening by Linear Discriminant Analysis of Heart Rate Variability Indices in Depressed Subjects

Using a linear discriminant analysis of heart rate variability (HRV) indices, the present study sought to verify the usefulness of autonomic measurement in major depressive disorder (MDD) patients by assessing the feasibility of their return to work after sick leave. When reinstatement was scheduled, patients’ HRV was measured using a wearable electrocardiogram device. The outcome of the reinstatement was evaluated at one month after returning to work. HRV indices including high- and low-frequency components were calculated in three conditions within a session: initial rest, mental task, and rest after task. A linear discriminant function was made using the HRV indices of 30 MDD patients from our previous study to effectively discriminate the successful reinstatement from the unsuccessful reinstatement; this was then tested on 52 patients who participated in the present study. The discriminant function showed that the sensitivity and specificity in discriminating successful from unsuccessful returns were 95.8% and 35.7%, respectively. Sensitivity is high, indicating that normal HRV is required for a successful return, and that the discriminant analysis of HRV indices is useful for return-to-work screening in MDD patients. On the other hand, specificity is low, suggesting that other factors may also affect the outcome of reinstatement

Heart Rate Variability Measurement Can Be a Point-of-Care Sensing Tool for Screening Postpartum Depression: Differentiation from Adjustment Disorder

Postpartum depression (PPD) is a serious mental health issue among women after childbirth, and screening systems that incorporate questionnaires have been utilized to screen for PPD. These questionnaires are sensitive but less specific, and the additional use of objective measures could be helpful. The present study aimed to verify the usefulness of a measure of autonomic function, heart rate variability (HRV), which has been reported to be dysregulated in people with depression. Among 935 women who had experienced childbirth and completed the Edinburgh Postnatal Depression Scale (EPDS), HRV was measured in EPDS-positive women (n = 45) 1 to 4 weeks after childbirth using a wearable device. The measurement was based on a three-behavioral-state paradigm with a 5 min duration, consisting of rest (Rest), task load (Task), and rest-after-task (After) states, and the low-frequency power (LF), the high-frequency power (HF), and their ratio (LF/HF) were calculated. Among the women included in this study, 12 were diagnosed with PPD and 33 were diagnosed with adjustment disorder (AJD). Women with PPD showed a lack of adequate HRV regulation in response to the task load, accompanying a high LF/HF score in the Rest state. On the other hand, women with AJD exhibited high HF and reduced LF/HF during the After state. A linear discriminant analysis using HRV indices and heart rate (HR) revealed that both the differentiation of PPD and AJD patients from the controls and that of PPD patients from AJD patients were possible. The sensitivity and specificity for PPD vs. AJD were 75.0% and 90.9%, respectively. Using this paradigm, an HRV measurement revealed the characteristic autonomic profiles of PPD and AJD, suggesting that it may serve as a point-of-care sensing tool in PPD screening systems

Stress-Reducing Effect of a 50 Hz Electric Field in Mice after Repeated Immobilizations, Electric Field Shields, and Polarization of the Electrodes

In BALB/c mice, immobilization-increased plasma glucocorticoid (GC) levels are suppressed by extremely low frequency (ELF) electric fields (EF). The aim of this study was to advance our understanding of the biological effects of ELF-EF, using its suppressive effect on the GC response. Mice were exposed to a 50 Hz EF of 10 kV/m via a parallel plate electrode and immobilized as needed. We examined the suppressive effect of ELF-EF on GC level change after repeated immobilizations, electrode polarization, and EF shielding of different portions of the mouse body parts. Additionally, bodyweight changes owing to stress and EF were examined. Immobilization-induced reduction in the plasma GC levels was reproduced in mice with stress and EF exposure, regardless of the stress episode numbers and electrode polarization. Furthermore, when the head of mice was shielded from the EF, the suppressive effect was possibly relatively lower than that when the abdomen was shielded. The bodyweight of the mice decreased for 3 days after immobilization before recovering; ELF-EF did not affect the bodyweight. Thus, to elicit the biological effects of the EF, not only the size of the area where the EF is distributed but also the area where the field is distributed should be important. The results also confirmed the stableness of the present experimental system, at least in terms of the stress-reducing effect. In addition, the restriction in this study caused weight loss, but ELF-EF was not considered to affect it. The results improve the understanding of the biological effect and medical applications of ELF-EF

Suppression of Glucocorticoid Response in Stressed Mice Using 50 Hz Electric Field According to Immobilization Degree and Posture

Various studies on immobilized BALB/c mice to evaluate changes in hormone levels associated with stress responses have advanced the characterization of multiple aspects of the biological actions of extremely low-frequency (ELF) electric fields (EFs). In this study, we aimed to investigate the effect of mouse posture on its stress responses and evaluate the importance of adjusting the stress degree in the model. Mice were immobilized inside centrifuge tubes and exposed to an ELF EF generated between parallel plate electrodes. Blood was collected under anesthesia immediately after EF exposure, and plasma glucocorticoids were assayed. The inhibitory effects of EFs on glucocorticoid elevation by immobilization were reproduced regardless whether mice were in the abdominal or lateral recumbent position, for the EF vector delivered to mice through the sagittal or frontal plane. The effect of ELF EF was reproduced in moderately and mildly stressed mice but not in severely immobilized mice. Hence, adjusting the stress degree is critical to the reproducibility of the results for this model. We characterized the effects of ELF EF on homeostasis, including the stress response, and provided valuable information for the scientific evaluation of the biological risks and medical applications of ELF EF

Near-Infrared Time-Resolved Spectroscopy Shows Anterior Prefrontal Blood Volume Reduction in Schizophrenia but Not in Major Depressive Disorder

Previous studies using various brain imaging methods have reported prefrontal blood flow disturbances in psychiatric disorders, including schizophrenia and major depressive disorder. In both disorders, alterations of the resting blood flow, in addition to that of the activation in response to task load, have been shown, but the results are not consistent. The present study aimed to examine the anterior prefrontal hemoglobin concentration at the resting state in schizophrenia and depression using near-infrared time-resolved spectroscopy (NIR-TRS), which estimates the optical absorption coefficients and calculates the absolute concentrations of oxygenated (oxy-Hb), deoxygenated (deoxy-Hb), and total (total-Hb; sum of oxy-Hb and deoxy-Hb) hemoglobin. Their ratios to systemic blood hemoglobin concentration (blood-Hb) were also assessed. In agreement with our previous data, total-Hb and total-Hb/blood-Hb in schizophrenia were significantly lower. The present study further revealed that both oxy-Hb/blood-Hb and deoxy-Hb/blood-Hb in schizophrenia were reduced. In depression, total-Hb, total-Hb/blood-Hb, oxy-Hb, and oxy-Hb/blood-Hb were higher than in schizophrenia and were not different from the control. The oxygen saturation (oxy-Hb/total-Hb), in addition to the optical pathlengths, did not show group differences. Lowered oxy-Hb/blood-Hb and deoxy-Hb/blood-Hb together with unchanged oxygen saturation may indicate that the prefrontal blood volume is reduced in schizophrenia. The present findings suggest that NIR-TRS is useful in analyzing the hemodynamic aspects of prefrontal dysfunction in schizophrenia and differentiating schizophrenia from depression