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Diminished Vagal and/or Increased Sympathetic Activity in Post-Traumatic Stress Disorder

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Comprehensive Guide to Post-Traumatic Stress Disorder

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Abstract

Heart rate variability (HRV), determined by different methods from the fluctuation of heart rate (HR), has been used in many studies as a powerful index of autonomic function and indicator of cardiac risk. Here, we review how HRV measures in different domains such as time, frequency, and nonlinear domains have been successfully used to identify increased cardiac risk in PTSD patients. PTSD patients show high cardiac comorbidity that may have emerged for various reasons but is predominantly attributed to altered autonomic control. The deranged fear or “stress” system is implicated in affective and autonomic system dysfunctions. The underlying neurocircuitry and molecular key players of autonomic dysfunction in PTSD are still poorly understood. A malfunctioning cortical control of the downstream defense system is hypothesized to be causal for the blunted tonic vagal control and/or increased sympathetic activity that generally leads to increased HR, reduced HRV, and blunted diurnal/circadian changes compared to the healthy state. Altered serotonergic neurotransmission is likely involved in the reduced vagal function. Nonlinear approaches in combination with animal models are required to provide a better mechanistic understanding of the neural and molecular mechanisms underlying the healthy and the malfunctioning brain-heart interaction in PTSD.

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Abbreviations

ANS:

Autonomic nervous system

bpm:

Beats per minute

DFA:

Detrended fluctuation analysis

HR:

Heart rate

HRV:

Heart rate variability

PNS:

Parasympathetic nervous system

PTSD:

Post-traumatic stress disorder

RSA:

Respiratory sinus arrhythmia

SNS:

Sympathetic nervous system

SSRI:

Selective serotonin reuptake inhibitor

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Authors and Affiliations

  1. Department of Functional Genomics and Department of Molecular and Cellular Neurobiology, Center for Neurogenomics and Cognitive Research, Neuroscience Campus, VU University, De Boelelaan 1085, NL-1081 HV, Amsterdam, The Netherlands

    Oliver Stiedl

  2. Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martini Str. 52, D-20246, Hamburg, Germany

    Agorastos Agorastos & Michael Kellner

  3. Department of Psychiatry, University of California San Diego and Veterans Affairs Center of Excellence for Stress and Mental Health (116A), VA San Diego Healthcare System, 3350 La Jolla Village Dr., San Diego, CA, 92161, USA

    Dewleen G. Baker

Authors
  1. Agorastos Agorastos
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  2. Michael Kellner
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  3. Dewleen G. Baker
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  4. Oliver Stiedl
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Correspondence to Oliver Stiedl .

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Editors and Affiliations

  1. Buckinghamshire New University, Uxbridge, Middlesex, United Kingdom

    Colin R. Martin

  2. Kings College, London, United Kingdom

    Victor R. Preedy

  3. University of Westminster, London, United Kingdom

    Vinood B. Patel

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Agorastos, A., Kellner, M., Baker, D.G., Stiedl, O. (2015). Diminished Vagal and/or Increased Sympathetic Activity in Post-Traumatic Stress Disorder. In: Martin, C., Preedy, V., Patel, V. (eds) Comprehensive Guide to Post-Traumatic Stress Disorder. Springer, Cham. https://doi.org/10.1007/978-3-319-08613-2_30-1

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