Einfluss einer posttraumatischen Belastungsstörung auf die Herzfrequenzvariabilität als Marker des autonomen Nervensystems – eine systematische Literaturübersicht

Zusammenfassung

Einleitung: Im Rahmen einer PTBS ist eine umfassende Störung verschiedener neurobiologischer Regulationsmechanismen, u. a. eine damit assoziierte gestörte parasympathische-sympathische Balance, beschrieben, die potenziell mit den Parametern der Herzfrequenzvariabilität (HRV) erfasst werden kann.

Methoden: Es wurde ein systematisches Review in PubMed mit den Suchwörtern „hrv“ oder „heart rate variability“ und „PTSD“ oder „posttraumatic stress disorder“ durchgeführt.

Ergebnisse: Insgesamt konnten 15 Originalarbeiten identifiziert werden, die größtenteils einen signifikanten (9 Studien) bzw. einen tendenziellen Zusammenhang (3 Studien) einer PTBS mit einer Erniedrigung der HRV zeigten. Limitationen der Studien werden beschrieben.

Diskussion: Trotz der Limitationen demonstrierte ein Großteil der Studien einen Zusammenhang einer PTBS mit einer Reduzierung der HRV. Eine Beurteilung dieses potenziellen Markers als Ergänzung für die klinische Diagnostik und Therapieverlaufskontrolle bei Patienten mit einer PTBS erscheint aber auf der Basis der bisher gewonnenen Daten verfrüht. Weitere Studien sind erforderlich.

Abstract

Introduction: PTSD is associated with comprehensive disruption of several neurobiological regulation mechanisms and with a disruption in the parasympathetic-sympathetic balance. This can be measured with the heart rate variability (HRV).

Methods: A systematic review in PubMed using the keywords “hrv” or “heart rate variability” and “PTSD” or “posttraumatic stress disorder” was performed.

Results: Overall 15 original studies were identified. In most cases a significant relationship of PTSD for reduction of HRV was demonstrated (9 studies) or, respectively, a reduction by trends was shown in 3 studies. Limitations were discussed.

Discussion: In spite of the limitations, most of the studies have shown a relationship between PTSD and HRV. However, an assessment of this potential marker as a supplement for clinical diagnosis and therapy follow-up in patients with PTSD seems to be premature on the basis of the data obtained so far. Further research is required.

Schlüsselwörter

PTBS - Sympathikus - Parasympathikus - Stress - Autonomes Nervensystem - Herzfrequenzvariabilität

Key words

PTSD - sympathetic nervous system - parasympathetic nervous system - stress - autonomic nervous system - heart rate variability

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