Abstract
Heart rate variability (HRV), determined by different methods from the fluctuation of heart rate (HR), has been used in many studies as a powerful index of autonomic function and indicator of cardiac risk. Here, we review how HRV measures in different domains such as time, frequency, and nonlinear domains have been successfully used to identify increased cardiac risk in PTSD patients. PTSD patients show high cardiac comorbidity that may have emerged for various reasons but is predominantly attributed to altered autonomic control. The deranged fear or “stress” system is implicated in affective and autonomic system dysfunctions. The underlying neurocircuitry and molecular key players of autonomic dysfunction in PTSD are still poorly understood. A malfunctioning cortical control of the downstream defense system is hypothesized to be causal for the blunted tonic vagal control and/or increased sympathetic activity that generally leads to increased HR, reduced HRV, and blunted diurnal/circadian changes compared to the healthy state. Altered serotonergic neurotransmission is likely involved in the reduced vagal function. Nonlinear approaches in combination with animal models are required to provide a better mechanistic understanding of the neural and molecular mechanisms underlying the healthy and the malfunctioning brain-heart interaction in PTSD.
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Abbreviations
- ANS:
-
Autonomic nervous system
- bpm:
-
Beats per minute
- DFA:
-
Detrended fluctuation analysis
- HR:
-
Heart rate
- HRV:
-
Heart rate variability
- PNS:
-
Parasympathetic nervous system
- PTSD:
-
Post-traumatic stress disorder
- RSA:
-
Respiratory sinus arrhythmia
- SNS:
-
Sympathetic nervous system
- SSRI:
-
Selective serotonin reuptake inhibitor
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Agorastos, A., Kellner, M., Baker, D.G., Stiedl, O. (2015). Diminished Vagal and/or Increased Sympathetic Activity in Post-Traumatic Stress Disorder. In: Martin, C., Preedy, V., Patel, V. (eds) Comprehensive Guide to Post-Traumatic Stress Disorder. Springer, Cham. https://doi.org/10.1007/978-3-319-08613-2_30-1
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