Despair danger detected by measuring coronary heart fee modifications

Depression risk detected by measuring heart rate changes

A portable cardiac monitor of the type used in the study. Image credit: IMEC

For the first time, doctors have shown that measuring changes in 24-hour heart rate can reliably tell whether someone is depressed or not. In practice, this can give doctors an objective "early warning" of possible depression and a quick indication of whether or not the treatment is working, paving the way for faster, more responsive treatment. The lead researcher Dr. Carmen Schiweck (Goethe University, Frankfurt) presented the results of this pilot study at the virtual ECNP congress and said: "Put simply, our pilot study suggests that by measuring your heart rate for 24 hours with 90% accuracy, we can tell if a Person is currently depressed or not. "

Scientists knew that heart rate was related to depression, but so far they haven't been able to understand exactly how one relates to the other. This is in part because while your heart rate can fluctuate quickly, the depression goes on and off over a long period of time, with most treatments taking months to take effect. This makes it difficult to tell whether changes in depressed state are heart rate related or not.

"Two innovative elements in this study were the continuous recording of the heart rate over several days and nights and the use of the new antidepressant ketamine, which can relieve depression more or less immediately. As a result, we were able to find that the average resting heart rate can change suddenly, to reflect the change in mood, "said Schiweck.

Ketamine has a history as both an anesthetic and a recreational drug (a drug of abuse). However, in December last year, it was approved for the treatment of major depression in Europe after it had been introduced in the US a few months earlier. It can take weeks for traditional antidepressants to take effect. In contrast, ketamine acts quickly and results are often seen within minutes.

As Carmen Schiweck said, "We knew something would associate heart rate with psychiatric disorders, but we didn't know what it was and whether it would be clinically relevant. In the past, researchers had shown that depressed patients were consistently higher Heart rates and lower heart rate variability, but the time it takes to treat depression has made it difficult to track and correlate improvement in heart rate. However, when we discovered that ketamine resulted in rapid improvements in mood, Did we know that we might be able to use it to understand the relationship between depression and heart rate. "

Dr. Schiweck carried out this work in the Mind Body Research Group at KU Leuven, Belgium, with Dr. Stephan Claes as the main researcher. The team worked with a small sample of 16 major depressive disorder patients, none of whom had responded to normal treatment, and 16 healthy control subjects. They measured their heart rate for 4 days and 3 nights, and then the volunteers with depression were given either ketamine treatment or placebo.

"We found that patients with depression had both a higher base heart rate and less heart rate fluctuation, as expected. On average, we found that depressed patients had a heart rate that was about 10 to 15 beats per minute higher than post-treatment controls We measured the heart rate again and found that both the frequency and the heart rate fluctuation of the previously depressed patients had changed to be closer to those found in the controls. "

The most striking result was that the scientists were able to use the 24-hour heart rate as a "biomarker" for depression. The heart rates were measured with a portable mini-EKG. The data was fed into an artificial intelligence program, with which almost all controls and patients could be correctly classified as depressed or healthy.

"Usually heart rates are higher during the day and lower at night. Interestingly, the drop in heart rate during the night seems to be impaired in depression. This seems to be a way of identifying patients at risk of developing depression or relapse," said Schiweck.

The team also found that patients with a higher resting heart rate responded better to treatment with ketamine, which can help determine which patients are likely to respond to which treatment.

Schiweck noted, "We need to remember that this is a small proof-of-concept study: 6 of our 16 first-time patients responded to treatment with at least a 30% reduction in the Hamiltonian depression rating scale, so we'll need to repeat They're working with a larger, antidepressant-free sample. Our next step is to monitor depressed and remission patients to confirm that the changes we see can be used as an early warning system. "

Professor Brenda Penninx from the Department of Psychiatry at University Hospital Amsterdam said: "This is an innovative proof-of-concept study. My own group had previously examined the short-term variability of heart rate in over a thousand depressed patients and controls and we couldn't find a consistent one Find differentiation and found that antidepressants have more influence than the depression status itself. However, this study monitored the variability of heart rate in the ambulatory setting for several days and nights, which provides clear information about autonomy during the day and night nervous system. It needs to be investigated will determine whether these interesting results apply in larger, more diverse treatment settings. "

Professor Penninx was not involved in this work, this is an independent comment.

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More information:
Conference summary: heart rate and heart rate variability as characteristics or status markers for depression? Findings from a ketamine treatment paradigm

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European College of Neuropsychopharmacology

Depression risk determined by measuring heart rate changes (2020, September 11)
accessed on September 11, 2020

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