Major Depressive Disorder and Chronic Fatigue Syndrome Show Characteristic Heart Rate Variability Profiles Reflecting Autonomic Dysregulations: Differentiation by Linear Discriminant Analysis

Abstract

Major depressive disorder (MDD) and chronic fatigue syndrome (CFS) have overlapping symptoms, and differentiation is important to administer the proper treatment. The present study aimed to assess the usefulness of heart rate variability (HRV) indices. Frequency-domain HRV indices, including high-frequency (HF) and low-frequency (LF) components, their sum (LF+HF), and their ratio (LF/HF), were measured in a three-behavioral-state paradigm composed of initial rest (Rest), task load (Task), and post-task rest (After) periods to examine autonomic regulation. It was found that HF was low at Rest in both disorders, but was lower in MDD than in CFS. LF and LF+HF at Rest were low only in MDD. Attenuated responses of LF, HF, LF+HF, and LF/HF to task load and an excessive increase in HF at After were found in both disorders. The results indicate that an overall HRV reduction at Rest may support a diagnosis of MDD. HF reduction was found in CFS, but with a lesser severity. Response disturbances of HRV to Task were observed in both disorders, and would suggest the presence of CFS when the baseline HRV has not been reduced. Linear discriminant analysis using HRV indices was able to differentiate MDD from CFS, with a sensitivity and specificity of 91.8% and 100%, respectively. HRV indices in MDD and CFS show both common and different profiles, and can be useful for the differential diagnosis.

Heart Rate Variability Measurement Can Be a Point-of-Care Sensing Tool for Screening Postpartum Depression: Differentiation from Adjustment Disorder

“…In comparison with the method obtaining only the Rest state [ 31 ], this paradigm is informative with respect to autonomic regulation. Further development of this three-behavioral-state paradigm is important to discriminate PPD from other disorders than AJD, including anxiety disorder and chronic fatigue syndrome, based on previous studies using the same paradigm [ 34 , 35 ].…”

“…To further establish the usefulness of the HRV and HR indices for differentiating the PPD, AJD, and control women, linear discriminant analysis was employed. The details can be found in our previous publication [ 35 ]. For linear discriminant analysis, a linear discriminant equation was made, which was composed of the HRV and HR indices multiplied by the coefficients and a constant (discriminant point) (Equation (1)).…”

“…HRV was originally used to assess cardiac function in coronary heart diseases, and at present, is extensively employed to examine autonomic function in psychiatric disorders in addition to various somatic disorders. Our previous studies have revealed that the use of a three-behavioral-state paradigm during frequency-domain HRV measurement is not only effective for detecting major depressive disorder but also for differentiating it from other disorders, including anxiety disorder and chronic fatigue syndrome [ 34 , 35 ]. The paradigm can be conducted at an outpatient office in 5 min and causes little distress to the patients.…”

Asymptomatic Autonomic Dysregulation after Recovery from Mild COVID-19 Infection Revealed by Analysis of Heart Rate Variability Responses to Task Load

“…HF component reflects parasympathetic activity [ 18 ], and LF is closely related to blood pressure Mayer wave, reflecting both sympathetic and parasympathetic activities in relation to baroreflex function [ 17 ]. HF, LF, and their ratio (LF/HF) are often utilized to analyze the sympathetic and parasympathetic activities of various somatic and mental disorders, including ischemic heart disease, depression, and anxiety [ 19 , 20 ].…”

“…Based on the above-stated issues, the present study aimed to control the behavioral state by measuring HRV in the well-controlled behavioral paradigm composed of three behavioral states [ 20 ]; initial resting (Rest), task performing (Task), and post-task resting (After) states as described below, and applied this paradigm to measure HRV in asymptomatic post-COVID-19 subjects. The three-behavioral-state paradigm has been used in our previous studies on depression, anxiety, and fatigue to reveal HRV disturbances [ 20 ]. In healthy subjects, HF reacts to the task load by decrement and LF/HF by increment.…”