Hoyoung An1, Ji Won Han2, Hyun-Ghang Jeong3, Tae Hui Kim4, Jung Jae Lee5, Seok Bum Lee5, Joon Hyuk Park6, Ki Woong Kim7. 1. Department of Neuropsychiatry, St. Andrew's Hospital, Icheon, Republic of Korea. 2. Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea. 3. Department of Psychiatry, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea. 4. Department of Psychiatry, Yonsei University Wonju Severance Christian Hospital, Wonju, Republic of Korea. 5. Department of Psychiatry, Dankook University Hospital, Cheonan, Republic of Korea. 6. Department of Neuropsychiatry, Jeju National University Hospital, Jeju, Republic of Korea. 7. Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea; Department of Psychiatry, Seoul National University College of Medicine, Seoul, Korea; Department of Brain and Cognitive Science, Seoul National University College of Natural Sciences, Seoul, Korea. Electronic address: kwkimmd@snu.ac.kr.
Abstract
BACKGROUND: Changes in parasympathetic activity have been associated with depression; however, it is not well understood whether these changes are a result of depression, or represent a compensatory mechanism protecting against it. We examined the association of autonomic nervous system activity with the risk of depression in euthymic individuals and those with subsyndromal depression using heart rate variability (HRV) analysis. METHODS: From a community-based longitudinal cohort, 464 subjects from the baseline assessment and 253 who completed the 5-year follow-up visit were included in the cross-sectional and prospective analyses, respectively. Linear regression analysis was used to investigate the association of HRV measures with the current and future GDS scores. Logistic regression analysis examined the effect of HRV on future risk of SSD. RESULTS: Low-frequency power (LFN), high-frequency power (HFN), and the LFN/HFN ratio at the baseline assessment were associated with the GDS score at the 5-year follow-up assessment; however, they were not associated with the GDS score at the baseline assessment. High HFN indicated an increased risk of depression at the 5-year follow-up assessment in euthymic subjects (OR = 3.025, 95% CI = 1.184 - 7.726, p = 0.021). LIMITATIONS: HRV was not measured at the follow-up assessment and the interval between the assessments was comparatively long. Five-minute ECG recordings were used, and all participants were 65 years old or older. CONCLUSIONS: Parasympathetic predominance may precede the onset of depression in older adults.
BACKGROUND: Changes in parasympathetic activity have been associated with depression; however, it is not well understood whether these changes are a result of depression, or represent a compensatory mechanism protecting against it. We examined the association of autonomic nervous system activity with the risk of depression in euthymic individuals and those with subsyndromal depression using heart rate variability (HRV) analysis. METHODS: From a community-based longitudinal cohort, 464 subjects from the baseline assessment and 253 who completed the 5-year follow-up visit were included in the cross-sectional and prospective analyses, respectively. Linear regression analysis was used to investigate the association of HRV measures with the current and future GDS scores. Logistic regression analysis examined the effect of HRV on future risk of SSD. RESULTS: Low-frequency power (LFN), high-frequency power (HFN), and the LFN/HFN ratio at the baseline assessment were associated with the GDS score at the 5-year follow-up assessment; however, they were not associated with the GDS score at the baseline assessment. High HFN indicated an increased risk of depression at the 5-year follow-up assessment in euthymic subjects (OR = 3.025, 95% CI = 1.184 - 7.726, p = 0.021). LIMITATIONS: HRV was not measured at the follow-up assessment and the interval between the assessments was comparatively long. Five-minute ECG recordings were used, and all participants were 65 years old or older. CONCLUSIONS: Parasympathetic predominance may precede the onset of depression in older adults.