Analysis of HAM-D Scores on Cognitive Functions and Heart Rate Variability in Patients with Major Depressive Disorder
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Keywords
Autonomic, cognitive, depressive diorder, regression analysis
Abstract
Background: Previous research has shown that Major Depressive Disorder (MDD) is accompanied by severe impairments in cognitive and autonomic processes, which may linger even when mood symptoms recover. This study aimed to analyse the relationship between depression severity, as measured by the Hamilton Depression Rating Scale (HAM-D), and how it affects heart rate variability (HRV) and cognitive function in patients with Major Depressive Disorder (MDD).
Methodology: The cross-sectional study was conducted at RUHS College of Medical Sciences and Associated Hospitals, Jaipur, from July 2022 to January 2023 on 90 subjects having major depressive disorder (MDD) of either sex in the 20-40 age group using the Hamilton score for depression (HAM D), Heart Rate Variability (HRV) measurements, and a battery of cognitive tests. Regression analyses were conducted to examine the associations between HAM-D scores with both HRV parameters and cognitive functions.
Results: Results indicated a significant negative correlation between HAM-D scores and HRV measures with p<0.001, suggesting that
increased depression severity is associated with reduced HRV. Additionally, higher HAM-D scores predicted poorer performance on cognitive tasks, particularly in the domains of executive function and working memory. The coefficient of determination r2=0.724 suggests that approximately 72.4% of the variance in the dependent variable (Hamilton rating score for depression) could be explained by the combined cognitive function and heart rate variability parameters.
Conclusion: These findings highlight the potential utility of, emphasizing the importance of comprehensive assessment and treatment approaches that address both the affective and cognitive aspects of depression.
References
2. Vahia VN. Diagnostic and statistical manual of mental disorders 5: A quick glance. Indian J Psychiatry. 2013;55(3):220-3. doi: 10.4103/0019-5545.117131.
3. McIntyre RS, Lee Y. Cognition in major depressive disorder: A "systemically important functional index" (SIFI). J Clin Psychiatry. 2016;77(6):813-9. doi: 10.4088/JCP.15com10385.
4. Arvind BA, Gururaj G, Loganathan S, Amudhan S, Varghese M, Benegal V, et al. Prevalence and socioeconomic impact of depressive disorders in India: multisite population-based cross-sectional study. BMJ Open 2019; 9(6): e027250.doi:10.1136/bmjopen-2018-027250.
5. Hamilton M. A rating scale for depression. J NeurolNeurosurgPsychiatry. 1960;23(1):56-62. doi: 10.1136/jnnp.23.1.56.
6. Thayer JF, Ahs F, Fredrikson M, Sollers JJ 3rd, Wager TD. A meta-analysis of heart rate variability and neuroimaging studies: implications for heart rate variability as a marker of stress and health. NeurosciBiobehav Rev. 2012;36(2):747-56. doi: 10.1016/j.neubiorev.2011.11.009.
7. Kemp AH, Quintana DS, Gray MA, Felmingham KL, Brown K, Gatt JM. Impact of depression and antidepressant treatment on heart rate variability: A review and meta-analysis. Biol Psychiatry. 2010;67(11):1067-74. doi: 10.1016/j.biopsych.2009.12.012.
8. Rock PL, Roiser JP, Riedel WJ, Blackwell AD. Cognitive impairment in depression: a systematic review and meta-analysis. Psychol Med.2014;44(10):2029-40. doi: 10.1017/S0033291713002535.
9. Bora E, Harrison BJ, Yücel M, Pantelis C. Cognitive impairment in euthymic major depressive disorder: a meta-analysis. Psychol Med.2013;43(10):2017-26. doi: 10.1017/S0033291712002085.
10. The ICD-10 classification of mental and behavioural disorders: Diagnostic criteria for research. Geneva: World Health Organization, 1993.
11. Majumder S. Socioeconomic status scales: Revised Kuppuswamy, BG Prasad, and Udai Pareekh's scale updated for 2021. J Family Med Prim Care.2021;10(11):3964-3967. doi: 10.4103/jfmpc.jfmpc_600_21.
12. Heart rate variability: Standards of measurement, physiological interpretation, and clinical use. Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology. Circulation.1996;93(5):1043-65.
13. Folstein MF, Folstein SE, McHugh PR. "Mini-mental state". A practical method for grading the cognitive state of patients for the
clinician. J Psychiatr Res.1975;12(3):189-98. doi: 10.1016/0022-3956(75)90026-6.
14. Nasreddine ZS, Phillips NA, Bédirian V, Charbonneau S, Whitehead V, Collin I, et al. The Montreal Cognitive Assessment, MoCA: A brief screening tool for mild cognitive impairment. J Am Geriatr Soc. 2005;53(4):695-9. doi: 10.1111/j.1532-5415.2005.53221. x.
15. Misra UK, Kalita J. Clinical neurophysiology: nerve conduction, electromyography, evoked potentials. 4th ed. New York, NY: Elsevier Health Sciences; 2019.377-380.
16. Hack LM, Tozzi L, Zenteno S, et al. A Cognitive Biotype of Depression Linking Symptoms, Behavior Measures, Neural Circuits, and Differential Treatment Outcomes: A Prespecified Secondary Analysis of a Randomized Clinical Trial. JAMA Netw Open. 2023;6(6): e2318411. doi:10.1001/jamanetworkopen.2023.18411
17. Koenig AM, DeLozier IJ, Zmuda MD, Marron MM, Begley AE, Anderson SJ, et al. Neuropsychological functioning in the acute and remitted States of late-life depression. J Alzheimers Dis. 2015;45(1):175-85. doi: 10.3233/JAD-148006.
18. Delardas O, Giannos P. Cognitive Performance Deficits Are Associated with Clinically Significant Depression Symptoms in Older US Adults. Int J Environ Res Public Health. 2023 Mar 28;20(7):5290. doi: 10.3390/ijerph20075290.
19. Blair M, Coleman K, Jesso S, Desbeaumes Jodoin V, Smolewska K, Warriner E, et al. Depressive Symptoms Negatively Impact Montreal Cognitive Assessment Performance: A Memory Clinic Experience. Can J Neurol Sci. 2016;43(4):513-7. doi: 10.1017/cjn.2015.399.
20. Bruder GE, Kayser J, Tenke CE, Leite P, Schneier FR, Stewart JW, et al. Cognitive ERPs in depressive and anxiety disorders during tonal and phonetic oddball tasks. Clin Electroencephalogr. 2002;33(3):119-24. doi: 10.1177/155005940203300308.
21. MacQueen GM, Campbell S, McEwen BS, et al. Course of illness, hippocampal function, and hippocampal volume in major depression. Proc Natl Acad Sci U S A.2003;100(3): 1387–1392. 26.
22. Aimaier G, Qian K, Zheng Z, Peng W, Zhang Z, Ding J, et al. Interictal Heart Rate Variability as a Biomarker for Comorbid Depressive Disorders among People with Epilepsy. Brain Sci. 2022 May 20;12(5):671. doi: 10.3390/brainsci12050671.
23. Oncu GC, Tudoran C, Enatescu VR, Tudoran M, Pop GN, Bredicean C. Evolution of Heart Rate Variability and Heart Rate Turbulence in Patients with Depressive Illness Treated with Selective Serotonin Reuptake Inhibitors. Medicina (Kaunas) 2020;56(11): 590.doi:10.3390/medicina56110590.
24. Carney RM, Blumenthal JA, Stein PK, Watkins L, Catellier D, Berkman LF, et al. Depression, heart rate variability, and acute myocardial infarction. Circulation. 2001;104(17):2024-8. doi: 10.1161/hc4201.097834.
25. Schmaal L, Veltman DJ, van ETG, Sämann PG, Frodl T, Jahanshad N, et al. Subcortical brain alterations in major depressive disorder: findings from the ENIGMA Major Depressive Disorder working group. Mol Psychiatry. 2016;21(6):806-12. doi: 10.1038/mp.2015.69.
26. Riemann D, Krone LB, Wulff K, Nissen C. Sleep, insomnia, and depression. Neuropsychopharmacology. 2020;45(1):74-89. doi: 10.1038/s41386-019-0411-y.
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