Non-linear analysis of the heart rate variability in characterization of manic and euthymic phases of bipolar disorder

•Recurrence plot and symbolic analysis provided evidence of the occurrence of physiological changes in BD, which justifies their use in the diagnostic and therapeutic for this disorder.•RP and SA simultaneous assessment in BD allowed correlations that showed pathophysiological associations in terms...

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Veröffentlicht in:Journal of affective disorders 2020-10, Vol.275, p.136-144
Hauptverfasser: Gregório, Michele Lima, Wazen, Guilherme Luiz Lopes, Kemp, Andrew Haddon, Milan-Mattos, Juliana Cristina, Porta, Alberto, Catai, Aparecida Maria, de Godoy, Moacir Fernandes
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Sprache:eng
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Zusammenfassung:•Recurrence plot and symbolic analysis provided evidence of the occurrence of physiological changes in BD, which justifies their use in the diagnostic and therapeutic for this disorder.•RP and SA simultaneous assessment in BD allowed correlations that showed pathophysiological associations in terms of sympathetic or parasympathetic functioning before and after treatment.•After treatment, it was possible to observe reduction of sympathetic modulation and increase of vagal (parasympathetic) modulation as well as increase of complexity, with no difference from controls, demonstrating improvement of the nonlinear HRV dynamics and treatment of the disease.•This noninvasive non-linear analyzes may be used as supplementary tools for understanding autonomic function in BD during mania and after drug treatment. – Bipolar Disorder (BD) has been associated with autonomic nervous system (ANS) dysregulation, with a consequent increase in mortality. Recent work highlights the non-linear analysis of ANS function. Our objective was to compare ANS modulation using recurrence plots (RP) and symbolic analysis (SA) in manic and euthymic phases of BD to controls. – Eighteen male patients (33.1 ± 12.0 years) were assessed during mania and at discharge in the euthymic phase compared and to a healthy group matched by age (33.9 ± 10.8 years). Electrocardiographic series (1000 RR intervals, at rest, in supine position) were captured using Polar Advantage RS800CX equipment and Heart Rate Variability (HRV) was analysed using RP and SA. Statistical analysis was performed using ANOVA with Tukey's post-test. The threshold for statistical significance was set at P < 0.05 and Cohen's d effect size was also quantified considering d > 0.8 as an important effect. The study was registered into the Clinical Trials Registration (ClinicalTrials.gov: NCT01272518). Manic group presented significantly higher linearity before treatment (P
ISSN:0165-0327
1573-2517
DOI:10.1016/j.jad.2020.07.012