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      Guidelines for Reporting Articles on Psychiatry and Heart rate variability (GRAPH): recommendations to advance research communication

      review-article
      Author(s): 1 , * , 2 , 3 , 4 , 5
      Publication date (Electronic):
      Journal: Translational Psychiatry
      Publisher: Nature Publishing Group

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          Abstract

          The number of publications investigating heart rate variability (HRV) in psychiatry and the behavioral sciences has increased markedly in the last decade. In addition to the significant debates surrounding ideal methods to collect and interpret measures of HRV, standardized reporting of methodology in this field is lacking. Commonly cited recommendations were designed well before recent calls to improve research communication and reproducibility across disciplines. In an effort to standardize reporting, we propose the Guidelines for Reporting Articles on Psychiatry and Heart rate variability (GRAPH), a checklist with four domains: participant selection, interbeat interval collection, data preparation and HRV calculation. This paper provides an overview of these four domains and why their standardized reporting is necessary to suitably evaluate HRV research in psychiatry and related disciplines. Adherence to these communication guidelines will help expedite the translation of HRV research into a potential psychiatric biomarker by improving interpretation, reproducibility and future meta-analyses.

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          Impact of Reduced Heart Rate Variability on Risk for Cardiac Events: The Framingham Heart Study

          Hisako Tsuji, Martin Larson, Ferdinand J Venditti … (1996)
          Although heart rate variability (HRV) is altered in a variety of pathological conditions, the association of reduced HRV with risk for new cardiac events has not been studied in a large community-based population. The first 2 hours of ambulatory ECG recordings obtained on subjects of the Framingham Heart Study who were free of clinically apparent coronary heart disease or congestive heart failure were reprocessed to assess HRV. Five frequency-domain measures and three time-domain measures were obtained. The associations between HRV measures and the incidence of new cardiac events (angina pectroris, myocardial infarction, coronary heart disease death, or congestive heart failure) were assessed with proportional hazards regression analyses. There were 2501 eligible subjects with a mean age of 53 years. During a mean follow-up of 3.5 years, cardiac events occurred in 58 subjects. After adjustment for age, sex, cigarette smoking, diabetes, left ventricular hypertrophy, and other relevant risk factors, all HRV measures except the ratio of low-frequency to high-frequency power were significantly associated with risk for a cardiac event (P = .0016 to .0496). A one-standard deviation decrement in the standard deviation of total normal RR intervals (natural log transformed) was associated with a hazard ratio of 1.47 for new cardiac events (95% confidence interval of 1.16 to 1.86). The estimation of HRV by ambulatory monitoring offers prognostic information beyond that provided by the evaluation of traditional cardiovascular disease risk factors.
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            Orienting in a defensive world: mammalian modifications of our evolutionary heritage. A Polyvagal Theory.

            STEPHEN PORGES (1995)
            The vagus, the 10th cranial nerve, contains pathways that contribute to the regulation of the internal viscera, including the heart. Vagal efferent fibers do not originate in a common brainstem structure. The Polyvagal Theory is introduced to explain the different functions of the two primary medullary source nuclei of the vagus: the nucleus ambiguus (NA) and the dorsal motor nucleus (DMNX). Although vagal pathways from both nuclei terminate on the sinoatrial node, it is argued that the fibers originating in NA are uniquely responsible for respiratory sinus arrhythmia (RSA). Divergent shifts in RSA and heart rate are explained by independent actions of DMNX and NA. The theory emphasizes a phylogenetic perspective and speculates that mammalian, but not reptilian, brainstem organization is characterized by a ventral vagal complex (including NA) related to processes associated with attention, motion, emotion, and communication. Various clinical disorders, such as sudden infant death syndrome and asthma, may be related to the competition between DMNX and NA.
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              Advances in heart rate variability signal analysis: joint position statement by the e-Cardiology ESC Working Group and the European Heart Rhythm Association co-endorsed by the Asia Pacific Heart Rhythm Society.

              Roberto Sassi, Sergio Cerutti, Federico Lombardi … (2015)
              Following the publication of the Task Force document on heart rate variability (HRV) in 1996, a number of articles have been published to describe new HRV methodologies and their application in different physiological and clinical studies. This document presents a critical review of the new methods. A particular attention has been paid to methodologies that have not been reported in the 1996 standardization document but have been more recently tested in sufficiently sized populations. The following methods were considered: Long-range correlation and fractal analysis; Short-term complexity; Entropy and regularity; and Nonlinear dynamical systems and chaotic behaviour. For each of these methods, technical aspects, clinical achievements, and suggestions for clinical application were reviewed. While the novel approaches have contributed in the technical understanding of the signal character of HRV, their success in developing new clinical tools, such as those for the identification of high-risk patients, has been rather limited. Available results obtained in selected populations of patients by specialized laboratories are nevertheless of interest but new prospective studies are needed. The investigation of new parameters, descriptive of the complex regulation mechanisms of heart rate, has to be encouraged because not all information in the HRV signal is captured by traditional methods. The new technologies thus could provide after proper validation, additional physiological, and clinical meaning. Multidisciplinary dialogue and specialized courses in the combination of clinical cardiology and complex signal processing methods seem warranted for further advances in studies of cardiac oscillations and in the understanding normal and abnormal cardiac control processes.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Transl Psychiatry
                Journal ID (iso-abbrev): Transl Psychiatry
                Title: Translational Psychiatry
                Publisher: Nature Publishing Group
                ISSN (Electronic): 2158-3188
                Publication date (Print): May 2016
                Publication date (Electronic): 10 May 2016
                Publication date PMC-release: 1 May 2016
                Volume: 6
                Issue: 5
                Page: e803
                Affiliations
                [1 ]Division of Mental Health and Addiction, NORMENT, KG Jebsen Centre for Psychosis Research, University of Oslo, Oslo University Hospital , Oslo, Norway
                [2 ]Telethon Kids Institute, University of Western Australia , Perth, WA, Australia
                [3 ]Cooperative Research Centre for Living with Autism (Autism CRC) , Brisbane, QLD, Australia
                [4 ]School of Psychology, University of Sydney , Sydney, NSW, Australia
                [5 ]Department of Cardiology and Intensive Therapy, Poznań University of Medical Sciences , Poznań, Poland
                Author notes
                [* ]Division of Mental Health and Addiction, NORMENT, KG Jebsen Centre for Psychosis Research, University of Oslo, Oslo University Hospital , Building 49, Oslo University Hospital, Ullevål, Kirkeveien 166, PO Box 4956, Nydalen, Oslo N-0424, Norway. E-mail: daniel.quintana@ 123456medisin.uio.no
                Article
                Publisher Item ID: tp201673
                DOI: 10.1038/tp.2016.73
                PMC ID: 5070064
                PubMed ID: 27163204
                SO-VID: 34098a5d-5969-4717-9ba0-0aa712df76ac
                Copyright © Copyright © 2016 Macmillan Publishers Limited
                License:

                This work is licensed under a Creative Commons Attribution 4.0 International License. The images or other third party material in this article are included in the article's Creative Commons license, unless indicated otherwise in the credit line; if the material is not included under the Creative Commons license, users will need to obtain permission from the license holder to reproduce the material. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

                History
                Date received : 19 November 2015
                Date revision received : 18 March 2016
                Date accepted : 23 March 2016
                Categories
                Subject: Review

                ScienceOpen disciplines: Clinical Psychology & Psychiatry
                Data availability:
                ScienceOpen disciplines: Clinical Psychology & Psychiatry

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