Autonomic dysfunction in posttraumatic stress disorder indexed by heart rate variability: a meta-analysis

Area of Science:

• Psychophysiology
• Neuroscience
• Clinical Psychology

Background:

• Autonomic nervous system (ANS) dysfunction is implicated in various psychological disorders, including posttraumatic stress disorder (PTSD).
• Heart rate variability (HRV) analysis offers insights into ANS function, with prior PTSD research showing inconsistent HRV differences between patients and controls.
• Previous studies suggest altered sympathetic and parasympathetic activity in PTSD patients.

Purpose of the Study:

• To systematically review and synthesize existing research on heart rate variability (HRV) differences in individuals with posttraumatic stress disorder (PTSD) compared to healthy controls.
• To examine HRV indices at both baseline and during stress conditions in PTSD populations.
• To clarify inconsistencies in previous findings regarding ANS function in PTSD.

Main Methods:

• A meta-analysis was conducted on primary studies examining various heart rate variability (HRV) indices.
• Key HRV metrics analyzed included SDNN, RMSSD, LF, HF, LF/HF ratio, and heart rate (HR).
• Subgroup analyses and meta-regressions were employed to explore moderating effects of study design, assessment methods, and sample characteristics.

Main Results:

• Meta-analyses revealed significantly lower parasympathetic activity (RMSSD, HF-HRV) in individuals with PTSD at rest.
• Diminished total HRV (SDNN) and altered sympathetic-parasympathetic balance (higher LF/HF ratio) were observed in the PTSD group.
• Individuals with PTSD exhibited higher resting heart rate and exacerbated HR and reduced HF-HRV responses during stress.

Conclusions:

• Posttraumatic stress disorder (PTSD) is consistently associated with autonomic nervous system (ANS) dysfunction.
• Findings highlight reduced parasympathetic modulation and altered sympathetic-parasympathetic balance as key features of PTSD.
• HRV alterations provide objective markers for ANS dysfunction in PTSD.