Cardiac Autonomic and Cardiac Vagal Control During and After Depressive and Happiness Autobiographical Memories in Patients With Major Depressive Disorder

I-Mei Lin; Yin-Chen Wu; Wen-So Su; Chiao-Li Khale Ke; Pei-Yun Lin; Mei-Feng Huang; Yi-Chun Yeh; Kuan-Ta Wu; Cheng-Fang Yen; Chih-Hung Ko; Sheng-Yu Fan

doi:10.3389/fpsyt.2022.878285

Cardiac Autonomic and Cardiac Vagal Control During and After Depressive and Happiness Autobiographical Memories in Patients With Major Depressive Disorder

Front Psychiatry. 2022 Jun 2:13:878285. doi: 10.3389/fpsyt.2022.878285. eCollection 2022.

Authors

I-Mei Lin^{1

2}, Yin-Chen Wu¹, Wen-So Su¹, Chiao-Li Khale Ke^{3

4}, Pei-Yun Lin^{3

4

5}, Mei-Feng Huang^{3

6

7}, Yi-Chun Yeh^{3

6}, Kuan-Ta Wu⁸, Cheng-Fang Yen^{3

6

7}, Chih-Hung Ko^{3

4}, Sheng-Yu Fan⁹

Affiliations

¹ Department of Psychology, College of Humanities and Social Sciences, Kaohsiung Medical University, Kaohsiung, Taiwan.
² Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
³ Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
⁴ Department of Psychiatry, Kaohsiung Municipal SiaoGang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
⁵ Department of Psychiatry, School of Medicine, College of Medicine, Graduate Institute of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
⁶ Department of Psychiatry, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
⁷ Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
⁸ Health Management Center, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
⁹ Institute of Gerontology, College of Medicine, National Cheng Kung University, Tainan, Taiwan.

Abstract

Background: Heart rate variability (HRV) and respiratory sinus arrhythmia (RSA) are indices of cardiac autonomic and cardiac vagal control (CVC), both of which are markers of emotional regulation and physical health. This study examined (1) the differences in cardiac autonomic regulation and CVC during baseline, depressive, and happiness autobiographical memory tasks between participants with major depressive disorder (MDD group) and healthy controls (HC group); (2) the associations between depressive symptoms and cardiac autonomic and CVC; and (3) the reactivity and recovery of cardiac autonomic and CVC between the MDD and HC groups.

Methods: A total of 168 and 178 participants were included in the MDD and HC groups, respectively. Demographic data and the Beck Depression Inventory-II were collected before the experimental procedure. Lead II electrocardiograph (ECG) was measured during baseline, depressive, and happiness autobiographical memory tasks, and then interbeat intervals from ECG were converted to the time and frequency domains of HRV and RSA.

Results: The participants in the MDD group showed lower HRV (including standard deviation of normal to normal intervals, low frequency, the natural logarithm of low frequency, and the natural logarithm of high frequency) and CVC (RSA and lnRSA) than those in the HC group. Depressive symptoms were positively correlated with heart rate and negatively correlated with the indices of cardiac autonomic and CVC. There was significantly increased reactivity and recovery of cardiac autonomic and CVC during and after depressive and happiness autobiographical memory tasks in the HC group, but not in the MDD group.

Discussion: Participants with MDD had cardiac autonomic and CVC dysregulation, decreased reactivity, and did not recover to baseline after emotional provocations. These results can be the theoretical basis for clinical intervention by using HRV biofeedback to restore cardiac autonomic regulation and CVC during and after emotional events in the future.

Keywords: cardiac autonomic; cardiac vagal control; depression; heart rate variability; respiratory sinus arrhythmia.