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Relation between heart rate variability and non-verbal behavior in depression based on Polyvagal theory

Grant number: 14/20799-6
Support type:Scholarships in Brazil - Scientific Initiation
Effective date (Start): February 01, 2015
Effective date (End): January 31, 2016
Field of knowledge:Health Sciences - Medicine - Psychiatry
Principal researcher:Andre Russowsky Brunoni
Grantee:Raquel Albano Fernandes
Home Institution: Hospital Universitário (HU). Universidade de São Paulo (USP). São Paulo , SP, Brazil
Associated research grant:12/20911-5 - Escitalopram and transcranial direct current stimulation in major depressive disorder: a double blind, placebo-controlled, randomized, non-inferiority trial, AP.JP


Major depressive disorder (MDD) is a psychiatric disorder marked by depressed mood and anhedonia. Other symptoms may include changes in sleep, appetite and libido, negative ideation and suicidal thoughts. Besides, it is a high recurrence, morbidity and mortality disorder. Although in the past few decades there has been an increase on the number of studies about depression, its pathophysiological mechanism is still uncertain, which corroborates the need for these investigations fosuced on the mechanisms involved in MDD and on diagnoses and treatment tactics to continue. One possible branch of investigation involves the analysis of depression markers, which are parameters that indicate presence or severity of an ilness or disorder. Among these parameters there are heart rate variability (HRV) and non-verbal behavior, both of them modified in patients with MDD: they show a decreased HRV and also decreased non-verbal behavioral coding capacity (decreased emotional expressivity). These alterations, according to the Polyvagal Theory, may be correlated and associated to the disfunction of vagal activity. This theory emphasizes the bidirectional conduction (afferent-efferent) aspect of the vagus nerve as well as its part on both the visceral states regulation and emotion. In this sense, this research aims to verify if there is a correlation between HRV and expressive non-verbal behavior in depressed patients, based on the Polyvagal Theory. We will recruit 40 patients among 18 to 75 years old who suffer from unipolar depression and that are not using antidepressants or other psychotropics. HRV will be measured with the subject lying down resting for 15 minutes. We will use the WindowsECG® software for electrocardiogram registration and the Kubios® software for HRV analysis, wich will be measured through both spectral and temporal analysis of the heart rate. Non-verbal behavior will be measured through filmed semi-structured interviews, which are later evaluated by trained judges, who use a padronyzed ethogram developed for evaluation of filmed behavior during interviews. This ethogram takes into account aspects of positive feelings/social interaction and negative feelings/isolation. During the statistic analysis, we will use correlations to analyze the correlation between HRV and non-verbal communication, as well as partial correlations to evaluate the depression severity on this possible association. This project involves the same researchers team and patients population of two other researches which FAPESP supports: a "Jovem Pesquisadores" (2012-20911/5, beneficiary: Prof. Dr. André Russowsky Brunoni) and a post doctoral research (11/51732-6, beneficiary: Prof. Dr. Juliana Teixeira Fiquer / Supervisor: Prof. Dr. Clarice Gorenstein). (AU)

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(References retrieved automatically from Web of Science and SciELO through information on FAPESP grants and their corresponding numbers as mentioned in the publications by the authors)
FERNANDES, RAQUEL A.; FIQUER, JULIANA T.; GORENSTEIN, CLARICE; RAZZA, LAIS BORALLI; FRAGUAS, JR., RENERIO; BORRIONE, LUCAS; BENSENOR, ISABELA M.; LOTUFO, PAULO A.; DANTAS, EDUARDO MIRANDA; CARVALHO, ANDRE F.; et al. Nonverbal behaviors are associated with increased vagal activity in major depressive disorder: Implications for the polyvagal theory. Journal of Affective Disorders, v. 209, p. 18-22, . (12/50879-6, 14/20799-6, 11/51732-6)

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