Low HRV is a risk factor for pathophysiology and psychopathology

http://www.ncbi.nlm.nih.gov/pubmed/18771686

lower HRV and elevated norepinephrine have been associated with a number of adverse health outcomes

	Fagundes, Christopher P.1 Murray, David M.2 Hwang, Beom Seuk1,3 Gouin, Jean-Philippe1,4 Thayer, Julian F.4,5 Sollers, John J.6 Shapiro, Charles L.7 Malarkey, William B.1,7,8,9 Kiecolt-Glaser, Janice K.1,9,10 kiecolt-glaser.1@osu.edu
	Psychoneuroendocrinology. Sep2011, Vol. 36 Issue 8, p1137-1147. 11p.

HRV and mood disorders

Int J Psychophysiol. 2013 Sep;89(3):288-96. doi: 10.1016/j.ijpsycho.2013.06.018. Epub 2013 Jun 22.

The relationship between mental and physical health: insights from the study of heart rate variability.

Kemp AH1, Quintana DS.

Author information

• 1SCAN Research & Teaching Unit, School of Psychology, University of Sydney, Australia; Discipline of Psychiatry, University of Sydney, Australia; Hospital Universitário, University of São Paulo, São Paulo, Brazil. Electronic address: andrew.kemp@sydney.edu.au.

Abstract

Here we review our recent body of work on the impact of mood and comorbid anxiety disorders, alcohol dependence, and their treatments on heart rate variability (HRV), a psychophysiological marker of mental and physical wellbeing. We have shown that otherwise healthy, unmedicated patients with these disorders display reduced resting-state HRV, and that pharmacological treatments do not ameliorate these reductions. Other studies highlight that tricyclic medications and the serotonin and noradrenaline reuptake inhibitors in particular may have adverse cardiovascular consequences. Reduced HRV has important functional significance for motivation to engage social situations, social approach behaviours, self-regulation and psychological flexibility in the face of stressors. Over the longer-term, reduced HRV leads to immune dysfunction and inflammation, cardiovascular disease and mortality, attributable to the downstream effects of a poorly functioning cholinergic anti-inflammatory reflex. We place our research in the context of the broader literature base and propose a working model for the effects of mood disorders, comorbid conditions, and their treatments to help guide future research activities. Further research is urgently needed on the long-term effects of autonomic dysregulation in otherwise healthy psychiatric patients, and appropriate interventions to halt the progression of a host of conditions associated with morbidity and mortality.

noradrenaline loss in the sympathetic nervous system of the heart

Symptoms or signs of abnormal autonomic nervous system function occur commonly in several neurological disorders.
Clinical evaluations have depended on physiological, pharmacological, and neurochemical approaches. Recently, imaging of sympathetic noradrenergic innervation has been introduced and applied especially in the heart. Most studies have used the radiolabeled sympathomimetic amine, (123)I-metaiodobenzylguanidine. Decreased uptake or increased "washout" of (123)I-metaiodobenzylguanidine-derived radioactivity is associated with worse prognosis or more severe disease in hypertension, congestive heart failure, arrhythmias, and diabetes mellitus. This pattern may reflect a high rate of postganglionic sympathetic nerve traffic to the heart. Many recent studies have agreed on the remarkable finding that all patients with Parkinson's disease and orthostatic hypotension have a loss of cardiac sympathetic innervation, whereas all patients with multiple system atrophy, often difficult to distinguish clinically from Parkinson's disease, have intact cardiac sympathetic innervation. Because Parkinson's disease entails a postganglionic sympathetic noradrenergic lesion, the disease appears to be not only a movement disorder, with dopamine loss in the nigrostriatal system of the brain, but also a dysautonomia, with noradrenaline loss in the sympathetic nervous system of the heart. As new ligands are developed, one may predict further discoveries of involvement of components of the autonomic nervous system in neurological diseases.
Semin Neurol. 2003 Dec;23(4):423-33.