Heart rate variability is a trait marker of major depressive disorder: evidence from the sertraline vs. electric current therapy to treat depression clinical study

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Arquivos
art_BRUNONI_Heart_rate_variability_is_a_trait_marker_of_2013.PDF (214.92 KB)
Citações na Scopus
117
Tipo de produção
article
Data de publicação
2013
DOI
Scopus
Web of Science
PubMed
Título da Revista
ISSN da Revista
Título do Volume
Editora
CAMBRIDGE UNIV PRESS
Autores
KEMP, Andrew H.
DANTAS, Eduardo M.
NUNES, Maria Angelica
BOGGIO, Paulo S.
MILL, Jose Geraldo
FREGNI, Felipe
Citação
INTERNATIONAL JOURNAL OF NEUROPSYCHOPHARMACOLOGY, v.16, n.9, p.1937-1949, 2013
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
Decreased heart rate variability (HRV) is a cardiovascular predictor of mortality. Recent debate has focused on whether reductions in HRV in major depressive disorder (MDD) are a consequence of the disorder or a consequence of pharmacotherapy. Here we report on the impact of transcranial direct current stimulation (tDCS), a non-pharmacological intervention, vs. sertraline to further investigate this issue. The employed design was a double-blind, randomized, factorial, placebo-controlled trial. One hundred and eighteen moderate-to-severe, medication-free, low-cardiovascular risk depressed patients were recruited for this study and allocated to either active/sham tDCS (10 consecutive sessions plus two extra sessions every other week) or placebo/sertraline (50 mg/d) for 6 wk. Patients were age and gender-matched to healthy controls from a concurrent cohort study [the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)]. The impact of disorder, treatment and clinical response on HRV (root mean square of successive differences and high frequency) was examined. Our findings confirmed that patients displayed decreased HRV relative to controls. Furthermore, HRV scores did not change following treatment with either a non-pharmacological (tDCS) or pharmacological (sertraline) intervention, nor did HRV increase with clinical response to treatment. Based on these findings, we discuss whether reduced HRV is a trait-marker for MDD, which may predispose patients to a host of conditions and disease even after response to treatment. Our findings have important implications for our understanding of depression pathophysiology and the relationship between MDD, cardiovascular disorders and mortality.
Palavras-chave
Heart rate variability, major depressive disorder, randomized controlled trial, serotonin uptake inhibitors, sertraline, transcranial direct current stimulation
URI
https://observatorio.fm.usp.br/handle/OPI/3897
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Coleções
Artigos e Materiais de Revistas Científicas - FM/MCM
Artigos e Materiais de Revistas Científicas - HC/ICHC
Artigos e Materiais de Revistas Científicas - HC/IPq
Artigos e Materiais de Revistas Científicas - LIM/51