Heart Rate Variability Features as Predictors of Intermittent Theta-Burst Stimulation Response in Posttraumatic...

Area of Science:

• Neuroscience
• Psychiatry
• Autonomic Nervous System Research

Background:

• Posttraumatic stress disorder (PTSD) is linked to autonomic dysfunction, affecting sympathetic and parasympathetic systems.
• This dysfunction manifests as elevated heart rate and reduced heart rate variability (HRV).
• Intermittent theta-burst stimulation (iTBS) shows promise for PTSD treatment, but its impact on autonomic activity and HRV as a biomarker is unclear.

Purpose of the Study:

• To investigate heart rate variability (HRV) as a predictive biomarker for clinical response to intermittent theta-burst stimulation (iTBS) in veterans with PTSD.
• To assess the effects of iTBS on autonomic activity in PTSD patients.

Main Methods:

• Fifty veterans with PTSD underwent a randomized controlled trial with sham-controlled iTBS (right dorsolateral prefrontal cortex).
• Heart rate variability (HRV) parameters, including total power (TP) and root mean square of successive differences (RMSSD), were analyzed.
• iTBS effects on autonomic response were evaluated using an ultra-short HRV approach.

Main Results:

• Total power (TP) and RMSSD were significant predictors of acute clinical response to iTBS.
• Higher TP and RMSSD were associated with improved PTSD symptoms and functionality.
• No other significant changes in HRV metrics were observed post-stimulation.

Conclusions:

• Autonomic activity, measured by HRV, shows potential as a cost-effective biomarker for predicting iTBS response in PTSD.
• Reduced autonomic dysfunction correlates with superior clinical improvements following iTBS.
• Future research should explore HRV during iTBS and in hyperaroused PTSD patients.