Heart Rate Variability May Predict Therapeutic Response in Major Depressive Disorder, Panic Disorder

Heart rate variability factors may predict therapeutic response in patients with major depressive disorder and panic disorder.

In patients with major depressive disorder (MDD) and panic disorder (PD), heart rate variability (HRV) factors may predict therapeutic response, according to results published in the Journal of Affective Disorders.

Researchers studied HRV indexes of patients with both PD (n=29) and MDD (n=28), in addition to healthy control patients (n=39), over a duration of 12 weeks. They adapted and administered the mental arithmetic task and then examined changes in HRV factors, including pNN50 measures and low-frequency (LF) to high-frequency (HF) ratios, during rest, stress, and recovery intervals. Subsequently, changes in these parameters were correlated with clinical indicators of therapeutic response.

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After statistical analysis, the investigators found that during periods of stress and recovery, participants with PD and MDD showed lower values of pNN50 (pNN50 value, 7.49 [P =.001] and 9.43 [P =.0001], respectively) when compared with healthy control patients. In addition, they reported that individuals from the MDD and PD groups exhibited an increased LF/HF ratio vs healthy control patients during the stress interval (frequency ratio, 6.15; P =.002).

The primary limitation of the study was the absence of data on antidepressant use and cognitive behavioral therapy.

“The HRV parameters of LF/HF ratio and pNN50 might be used as clinical markers to differentiate between MDD and PD as well as to predict treatment response in MDD and PD,” the researchers wrote. “Future research will be needed to find out more appropriate treatment options for MDD and PD patients.”


Choi KW, Jang EH, Kim AY, et al. Heart rate variability for treatment response between patients with major depressive disorder versus panic disorder: a 12-week follow-up study. J Affect Disord. 2019;246:157-165.