|
|
|
| Characteristics of Autonomic Nervous Function in Patients with Anxiety and Depression Analyzed by Transcranial Doppler Upright Tilt Test |
| ZHANG Yawen, et al |
| The Third Hospital of Hebei Medical University, Hebei Shijiazhuang 050000, China |
|
|
|
|
Abstract Objective: To analyze the characteristics of autonomic nervous function in patients with anxiety and depression based on transcranial Doppler (TCD) upright tilt test.Methods: A total of 80 patients with anxiety and depression who were admitted to our hospital from March 2021 to February 2023 were selected as the case group, and another 80 healthy patients who underwent physical examination in our hospital during the same period were selected as the control group. Both groups underwent TCD, upright tilt test, and dynamic electrocardiogram (DCG) examinations. The occurrence rate of incomplete W wave rebound, hemodynamics during the upright tilt test, TCD cerebral blood flow, and heart rate variability (HRV) were compared between the two groups. Pearson correlation analysis was used to analyze the correlation between hemodynamics during the upright tilt test, TCD cerebral blood flow, and HRV. ROC curve analysis was performed to evaluate the predictive value of TCD combined with the upright tilt test for the occurrence of anxiety and depression. Results: Compared with the control group, the incidence of W wave callback insufficiency in the case group was significantly higher, with a statistically significant difference (11.25 % VS 0.00 %, χ2=5.378, P=0.020). In the case group, HR in the upright tilt position was higher than that in the control group, while DBP and SV were lower (t=6.532, 7.944, 6.152, P all=0.000). The absolute values of changes in DBP, HR, and SV from the supine position to the upright tilt position were higher in the case group than in the control group (t=12.015, 6.644, 5.635, P all=0.000). Vd, Vs, Vm in the upright tilt position were lower, and RI, PI were higher in the case group compared to the control group (t=10.488, 3.927, 11.256, 2.298, 5.918, P=0.000, 0.000, 0.000, 0.023, 0.000). The absolute values of changes in Vd, Vs, Vm, RI, and PI from the supine position to the upright tilt position were higher in the case group than in the control group (t=9.559, 10.943, 10.775, 10.738, 28.236, P all=0.000). LF, HF, PNN50, RMSSD, SDNN were lower in the case group compared to the control group (t=10.992, 12.098, 12.376, 6.078, 7.758, P all=0.000). Pearson correlation analysis showed negative correlations between the absolute values of changes in DBP, HR, SV, Vd, Vs, Vm, RI, PI, and LF, HF, PNN50, RMSSD, SDNN from the supine position to the upright tilt position (r<0, P<0.05). ROC curve analysis revealed that the AUCs for the absolute values of changes in DBP, HR, SV, Vd, Vs, Vm, RI, PI, and the combined prediction of anxiety and depression from the supine position to the upright tilt position were 0.603, 0.728, 0.802, 0.805, 0.756, 0.710, 0.783, 0.739, and 0.949, respectively. Conclusion: TCD combined with upright tilt test can effectively predict the occurrence of anxiety and depression, and both can reflect the characteristics of autonomic nervous function in patients.
|
|
|
|
|
|
[1] Werner-Seidler A,Perry Y,Calear AL,et al.School-based depression and anxiety prevention programs for young people:a systematic review and meta-analysis[J].Clin Psychol Rev,2017(51):30-47.
[2] 孙仙,张婷婷,王立群,等.宁夏回族自治区成人酒精使用障碍现况调查[J].中国心理卫生杂志,2023,37(12):1017-1022.
[3] Choi KW,Kim YK,Jeon HJ.Comorbid anxiety and depression:clinical and conceptual consideration and transdiagnostic treatment[J].Adv Exp Med Biol,2020(1191):219-235.
[4] Hu MX,Lamers F,de Geus EJ,et al.Differential autonomic nervous system reactivity in depression and anxiety during stress depending on type of stressor[J].Psychosom Med,2016,78(5):562-572.
[5] 苟显娜,赵丽莉,吴静悦,等.睡眠障碍伴发焦虑抑郁的脑血流自动调节功能的分析[J].河北医学,2021,27(1):37-41.
[6] Zhang W,Fu W,Yan,et al.Impaired dynamic cerebral autoregulation in young adults with mild depression[J].Psychophysiology,2022,59(1):e13949.
[7] 中华医学会精神病学分会.中国精神障碍分类与诊断标准第三版(精神障碍分类)[J].中华精神科杂志,2001,34(3):184-188.
[8] Zhang HL,Guo ZN,Yang G,et al.Compromised cerebrovascular modulation in chronic anxiety:evidence from cerebral blood flow velocity measured by transcranial Doppler sonography[J].Neurosci Bull,2012,28(6):723-728.
[9] Guo ZN,Feng L,Yan X,et al.Characteristics of cardio-Cerebrovascular modulation in patients with generalized anxiety disorder:an observational study[J].BMC Psychiatry,2017,17(1):259.
[10] Duschek S,Hoffmann A,Reyes Del Paso GA,et al.Short-term cerebral blood flow variability in major depressive disorder[J].Affect Disord,2021(282):1120-1124.
[11] Tobaldini E,Carandina A,Toschi-Dias E,et al.Depression and cardiovascular autonomic control:a matter of vagus and sex paradox[J].Neurosci Biobehav Rev,2020(116):154-161. |
|
|
|
2024, Vol. 30 
