Heart rate variability response to mental arithmetic stress in patients with schizophrenia Autonomic response to stress in schizophrenia

MARIANA N. CASTRO; DANIEL E. VIGO; HYLKE WEIDEMA; RODOLFO D. FAHRER; ELVINA M CHU; DELFINA DE ACHÁVAL; MARTÍN NOGUÉS; RAMÓN C. LEIGUARDA; DANIEL P. CARDINALI; SALVADOR M. GUINJOAN

SCHIZOPHRENIA RESEARCH

ELSEVIER SCIENCE BV

Lugar: Amsterdam; Año: 2008 vol. 99 p. 294 - 303

0920-9964

Background: The vulnerability-stress hypothesis is an established model of schizophrenia symptom formation. We sought to characterise the pattern of the cardiac autonomic response to mental arithmetic stress in patients with stable schizophrenia. Methods: We performed heart rate variability (HRV) analysis on recordings obtained before, during, and after a standard test ofautonomic function involving mental stress in 25 patients with DSM-IV schizophrenia (S) and 25 healthy individuals (C). Results: Patients with schizophrenia had a normal response to the mental arithmetic stress test. Relative contributions of lowfrequency (LF) HRVand high-frequency (HF) HRV influences on heart rate in patients were similar to controls both at rest (LF 64± 19% (S) vs. 56±16% (C); HF 36±19% (S) vs. 44±16% (C), t=1.52, p=0.136) and during mental stress, with increased LF (S: 76± 12%, C: 74±11%) and decreased HF (S: 24±12%, C: 26±11%) in the latter study condition. Whilst healthy persons recovered the resting pattern of HRV immediately after stress termination (LF 60±15%, HF 40±15%, F=18.5, pb0.001), in patients HRV remained unchanged throughout the observed recovery period, with larger LF (71±17%) and lower HF (29±17%) compared with baseline (F=7.3, p=0.013). Conclusions: Patients with schizophrenia exhibit a normal response to the mental arithmetic stress test as a standard test ofautonomic function but in contrast with healthy individuals, they maintain stress-related changes of cardiac autonomic function beyond stimulus cessation.