A Bayesian analysis of heart rate variability changes over acute episodes of bipolar disorder.


Journal

Npj mental health research
ISSN: 2731-4251
Titre abrégé: Npj Ment Health Res
Pays: England
ID NLM: 9918592488906676

Informations de publication

Date de publication:
03 Oct 2024
Historique:
received: 19 03 2024
accepted: 22 09 2024
medline: 4 10 2024
pubmed: 4 10 2024
entrez: 3 10 2024
Statut: epublish

Résumé

Bipolar disorder (BD) involves autonomic nervous system dysfunction, detectable through heart rate variability (HRV). HRV is a promising biomarker, but its dynamics during acute mania or depression episodes are poorly understood. Using a Bayesian approach, we developed a probabilistic model of HRV changes in BD, measured by the natural logarithm of the Root Mean Square of Successive RR interval Differences (lnRMSSD). Patients were assessed three to four times from episode onset to euthymia. Unlike previous studies, which used only two assessments, our model allowed for more accurate tracking of changes. Results showed strong evidence for a positive lnRMSSD change during symptom resolution (95.175% probability of positive direction), though the sample size limited the precision of this effect (95% Highest Density Interval [-0.0366, 0.4706], with a Region of Practical Equivalence: [-0.05; 0.05]). Episode polarity did not significantly influence lnRMSSD changes.

Identifiants

pubmed: 39363115
doi: 10.1038/s44184-024-00090-x
pii: 10.1038/s44184-024-00090-x
doi:

Types de publication

Journal Article

Langues

eng

Pagination

44

Subventions

Organisme : UKRI
ID : EP/S02431X/1
Organisme : UKRI
ID : EP/S02431X/1
Organisme : European Research Council
ID : P/Y023838/1
Pays : International

Informations de copyright

© 2024. The Author(s).

Références

Merikangas, K. R. et al. Prevalence and correlates of bipolar spectrum disorder in the world mental health survey initiative. Arch. Gen. Psychiatry 68, 241–251 (2011).
doi: 10.1001/archgenpsychiatry.2011.12 pubmed: 21383262 pmcid: 3486639
Simon, J. et al. The costs of bipolar disorder in the united kingdom. Brain Behav. 11, e2351 (2021).
doi: 10.1002/brb3.2351 pubmed: 34523820 pmcid: 8553306
Hayes, J. F., Marston, L., Walters, K., King, M. B. & Osborn, D. P. Mortality gap for people with bipolar disorder and schizophrenia: Uk-based cohort study 2000–2014. Br. J. Psychiatry 211, 175–181 (2017).
doi: 10.1192/bjp.bp.117.202606 pubmed: 28684403 pmcid: 5579328
Ramesh, A., Nayak, T., Beestrum, M., Quer, G. & Pandit, J. A. Heart rate variability in psychiatric disorders: A systematic review. Neuropsychiat. Disease Treat. 2217–2239 (2023).
Ronca, V. et al. Wearable technologies for electrodermal and cardiac activity measurements: A comparison between fitbit sense, empatica e4 and shimmer gsr3+. Sensors 23, 5847 (2023).
doi: 10.3390/s23135847 pubmed: 37447697 pmcid: 10346781
Shaffer, F. & Ginsberg, J. P. An overview of heart rate variability metrics and norms. Front. Public Health 258 (2017).
Stone, J. D. et al. Assessing the accuracy of popular commercial technologies that measure resting heart rate and heart rate variability. Front. Sports Active Living 37 (2021).
Empatica EmbracePlus. Embrace plus user manual https://www.empatica.com/en-eu/embraceplus/ (2021). Accessed December 18 2023.
Plews, D. J., Laursen, P. B., Stanley, J., Kilding, A. E. & Buchheit, M. Training adaptation and heart rate variability in elite endurance athletes: opening the door to effective monitoring. Sports Med. 43, 773–781 (2013).
doi: 10.1007/s40279-013-0071-8 pubmed: 23852425
Plews, D. J. et al. Monitoring training with heart-rate variability: How much compliance is needed for valid assessment? Int. J. sports Physiol. Perform. 9, 783–790 (2014).
doi: 10.1123/ijspp.2013-0455 pubmed: 24334285
Tarvainen, M., Lipponen, J., Niskanen, J. & Ranta-Aho, P. Kubios hrv version 3–user’s guide. Kuopio: University of Eastern Finland (2017).
Nuuttila, O.-P., Nummela, A., Korhonen, E., Häkkinen, K. & Kyröläinen, H. Individualized endurance training based on recovery and training status in recreational runners. Med. Sci. Sports Exercise. 54 (2022).
Alvares, G. A., Quintana, D. S., Hickie, I. B. & Guastella, A. J. Autonomic nervous system dysfunction in psychiatric disorders and the impact of psychotropic medications: a systematic review and meta-analysis. J. Psychiatry Neurosci. 41, 89–104 (2016).
doi: 10.1503/jpn.140217 pubmed: 26447819
Chalmers, J. A., Quintana, D. S., Abbott, M. J.-A. & Kemp, A. H. Anxiety disorders are associated with reduced heart rate variability: a meta-analysis. Front. psychiatry 5, 80 (2014).
doi: 10.3389/fpsyt.2014.00080 pubmed: 25071612 pmcid: 4092363
Koch, C., Wilhelm, M., Salzmann, S., Rief, W. & Euteneuer, F. A meta-analysis of heart rate variability in major depression. Psychol. Med. 49, 1948–1957 (2019).
doi: 10.1017/S0033291719001351 pubmed: 31239003
Faurholt-Jepsen, M., Kessing, L. V. & Munkholm, K. Heart rate variability in bipolar disorder: a systematic review and meta-analysis. Neurosci. Biobehav. Rev. 73, 68–80 (2017).
doi: 10.1016/j.neubiorev.2016.12.007 pubmed: 27986468
Hillebrand, S. et al. Heart rate variability and first cardiovascular event in populations without known cardiovascular disease: meta-analysis and dose–response meta-regression. Europace 15, 742–749 (2013).
doi: 10.1093/europace/eus341 pubmed: 23370966
Sessa, F. et al. Heart rate variability as predictive factor for sudden cardiac death. Aging (Albany NY) 10, 166 (2018).
doi: 10.18632/aging.101386 pubmed: 29476045
Anmella, G. et al. Exploring digital biomarkers of illness activity in mood episodes: hypotheses generating and model development study. JMIR Mhealth Uhealth (2023).
Stautland, A. et al. Reduced heart rate variability during mania in a repeated naturalistic observational study. Front. Psychiat. 14 (2023).
Wazen, G. L. L., Gregório, M. L., Kemp, A. H. & de Godoy, M. F. Heart rate variability in patients with bipolar disorder: from mania to euthymia. J. Psychiatr. Res. 99, 33–38 (2018).
doi: 10.1016/j.jpsychires.2018.01.008 pubmed: 29407285
Hage, B. et al. Diminution of heart rate variability in bipolar depression. Front. Public health 5, 312 (2017).
doi: 10.3389/fpubh.2017.00312 pubmed: 29270399 pmcid: 5723669
Faurholt-Jepsen, M., Brage, S., Kessing, L. V. & Munkholm, K. State-related differences in heart rate variability in bipolar disorder. J. Psychiatr. Res. 84, 169–173 (2017).
doi: 10.1016/j.jpsychires.2016.10.005 pubmed: 27743529
Singer, J. D. & Willett, J. B.Applied longitudinal data analysis: Modeling change and event occurrence (Oxford university press, 2003).
Parsons, S. & McCormick, E. M. Two timepoints poorly capture trajectories of change: A warning for longitudinal neuroscience. Available at SSRN 4415029 (2023).
Quintana, D. S. & Williams, D. R. Bayesian alternatives for common null-hypothesis significance tests in psychiatry: a non-technical guide using jasp. BMC Psychiatry 18, 1–8 (2018).
doi: 10.1186/s12888-018-1761-4
Colling, L. J. & Szűcs, D. Statistical inference and the replication crisis. Rev. Philos. Psychol. 12, 121–147 (2021).
doi: 10.1007/s13164-018-0421-4
Wagenmakers, E.-J. et al. Bayesian inference for psychology. part i: Theoretical advantages and practical ramifications. Psychonomic Bull. Rev. 25, 35–57 (2018).
doi: 10.3758/s13423-017-1343-3
Rognli, E. W., Zahl-Olsen, R., Rekdal, S. S., Hoffart, A. & Bertelsen, T. B. Editorial perspective: Bayesian statistical methods are useful for researchers in child and adolescent mental health (2023).
Young, R. C., Biggs, J. T., Ziegler, V. E. & Meyer, D. A. A rating scale for mania: reliability, validity and sensitivity. Br. J. psychiatry 133, 429–435 (1978).
doi: 10.1192/bjp.133.5.429 pubmed: 728692
Hamilton, M. A rating scale for depression. J. Neurol. Neurosurg. psychiatry 23, 56 (1960).
doi: 10.1136/jnnp.23.1.56 pubmed: 14399272 pmcid: 495331
Tohen, M. et al. The international society for bipolar disorders (isbd) task force report on the nomenclature of course and outcome in bipolar disorders. Bipolar Disord. 11, 453–473 (2009).
doi: 10.1111/j.1399-5618.2009.00726.x pubmed: 19624385
Empatica. E4 wristband technical specifications - empatica support https://support.empatica.com/hc/en-us/articles/202581999-E4-wristband-technical-specifications (2020).
Li, K., Cardoso, C., Moctezuma-Ramirez, A., Elgalad, A. & Perin, E. Heart rate variability measurement through a smart wearable device: Another breakthrough for personal health monitoring? Int. J. Environ. Res. Public Health 20, 7146 (2023).
doi: 10.3390/ijerph20247146 pubmed: 38131698 pmcid: 10742885
Vieluf, S. et al. Twenty-four-hour patterns in electrodermal activity recordings of patients with and without epileptic seizures. Epilepsia 62, 960–972 (2021).
doi: 10.1111/epi.16843 pubmed: 33619751
Nasseri, M. et al. Signal quality and patient experience with wearable devices for epilepsy management. Epilepsia 61, S25–S35 (2020).
doi: 10.1111/epi.16527 pubmed: 32497269
Van Hees, V. T. et al. A novel, open access method to assess sleep duration using a wrist-worn accelerometer. PloS one 10, e0142533 (2015).
doi: 10.1371/journal.pone.0142533 pubmed: 26569414 pmcid: 4646630
Patterson, M. R. et al. 40 years of actigraphy in sleep medicine and current state of the art algorithms. NPJ Dig. Med. 6, 51 (2023).
doi: 10.1038/s41746-023-00802-1
Föll, S. et al. Flirt: A feature generation toolkit for wearable data. Comput. Methods Prog. Biomed. 212, 106461 (2021).
doi: 10.1016/j.cmpb.2021.106461
Cao, R. et al. Accuracy assessment of oura ring nocturnal heart rate and heart rate variability in comparison with electrocardiography in time and frequency domains: comprehensive analysis. J. Med. Internet Res. 24, e27487 (2022).
doi: 10.2196/27487 pubmed: 35040799 pmcid: 8808342
de Vries, H., Kamphuis, W., van der Schans, C., Sanderman, R. & Oldenhuis, H. Trends in daily heart rate variability fluctuations are associated with longitudinal changes in stress and somatisation in police officers. In Healthcare, 10, 144 (MDPI, 2022).
Boudreau, P., Yeh, W.-H., Dumont, G. A. & Boivin, D. B. Circadian variation of heart rate variability across sleep stages. Sleep 36, 1919–1928 (2013).
doi: 10.5665/sleep.3230 pubmed: 24293767 pmcid: 3825442
Ortiz, A. et al. Reduced heart rate variability is associated with higher illness burden in bipolar disorder. J. Psychosom. Res. 145, 110478 (2021).
doi: 10.1016/j.jpsychores.2021.110478 pubmed: 33820643
O’Regan, C., Kenny, R., Cronin, H., Finucane, C. & Kearney, P. Antidepressants strongly influence the relationship between depression and heart rate variability: findings from the irish longitudinal study on ageing (tilda). Psychol. Med. 45, 623–636 (2015).
doi: 10.1017/S0033291714001767 pubmed: 25075912
Sammito, S. & Böckelmann, I. New reference values of heart rate variability during ordinary daily activity. Heart Rhythm 14, 304–307 (2017).
doi: 10.1016/j.hrthm.2016.12.016 pubmed: 27986556
Hoffman, M. D. et al. The no-u-turn sampler: adaptively setting path lengths in hamiltonian monte carlo. J. Mach. Learn. Res. 15, 1593–1623 (2014).
Phan, D., Pradhan, N. & Jankowiak, M. Composable effects for flexible and accelerated probabilistic programming in numpyro. arXiv preprint arXiv:1912.11554 (2019).
Abril-Pla, O. et al. Pymc: a modern, and comprehensive probabilistic programming framework in python. PeerJ Computer Sci. 9, e1516 (2023).
doi: 10.7717/peerj-cs.1516
Watanabe, S. A widely applicable bayesian information criterion. J. Mach. Learn. Res. 14, 867–897 (2013).
Gelman, A., Carlin, J. B., Stern, H. S. & Rubin, D. B.Bayesian data analysis (Chapman and Hall/CRC, 1995).
Makowski, D., Ben-Shachar, M. S., Chen, S. A. & Lüdecke, D. Indices of effect existence and significance in the bayesian framework. Front. Psychol. 10, 2767 (2019).
doi: 10.3389/fpsyg.2019.02767 pubmed: 31920819 pmcid: 6914840
Kruschke, J. K. Bayesian data analysis. Wiley Interdiscip. Rev.: Cogn. Sci. 1, 658–676 (2010).
doi: 10.1002/wcs.72 pubmed: 26271651
De Prisco, M. & Vieta, E. The never-ending problem: Sample size matters. Eur. Neuropsychopharmacol.: J. Eur. Coll. Neuropsychopharmacol. 79, 17–18 (2023).
doi: 10.1016/j.euroneuro.2023.10.002
Bassett, D. A literature review of heart rate variability in depressive and bipolar disorders. Aust. N.Z. J. Psychiatry 50, 511–519 (2016).
doi: 10.1177/0004867415622689 pubmed: 26698824
Bassett, D. et al. Reduced heart rate variability in remitted bipolar disorder and recurrent depression. Aust. N.Z. J. Psychiatry 50, 793–804 (2016).
doi: 10.1177/0004867416652734 pubmed: 27307288
Kumar, R., Carroll, C., Hartikainen, A. & Martín, O. A. Arviz a unified library for exploratory analysis of bayesian models in python (2019).

Auteurs

Filippo Corponi (F)

School of Informatics, University of Edinburgh, Edinburgh, UK. filippo.corponi@ed.ac.uk.

Bryan M Li (BM)

School of Informatics, University of Edinburgh, Edinburgh, UK.

Gerard Anmella (G)

Bipolar and Depressive Disorders Unit, Hospìtal Clinic de Barcelona, Barcelona, Spain.
Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.
Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.
Departament de Medicina, Universitat de Barcelona, Barcelona, Spain.

Clàudia Valenzuela-Pascual (C)

Bipolar and Depressive Disorders Unit, Hospìtal Clinic de Barcelona, Barcelona, Spain.

Isabella Pacchiarotti (I)

Bipolar and Depressive Disorders Unit, Hospìtal Clinic de Barcelona, Barcelona, Spain.

Marc Valentí (M)

Bipolar and Depressive Disorders Unit, Hospìtal Clinic de Barcelona, Barcelona, Spain.

Iria Grande (I)

Bipolar and Depressive Disorders Unit, Hospìtal Clinic de Barcelona, Barcelona, Spain.

Antonio Benabarre (A)

Bipolar and Depressive Disorders Unit, Hospìtal Clinic de Barcelona, Barcelona, Spain.

Marina Garriga (M)

Bipolar and Depressive Disorders Unit, Hospìtal Clinic de Barcelona, Barcelona, Spain.

Eduard Vieta (E)

Bipolar and Depressive Disorders Unit, Hospìtal Clinic de Barcelona, Barcelona, Spain.

Stephen M Lawrie (SM)

Division of Psychiatry, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK.

Heather C Whalley (HC)

Division of Psychiatry, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK.
Generation Scotland, Institute for Genetics and Cancer, University of Edinburgh, Edinburgh, UK.

Diego Hidalgo-Mazzei (D)

Bipolar and Depressive Disorders Unit, Hospìtal Clinic de Barcelona, Barcelona, Spain.

Antonio Vergari (A)

School of Informatics, University of Edinburgh, Edinburgh, UK.

Classifications MeSH