ANALYSIS OF HEART-RATE-VARIABILITY IN POSTTRAUMATIC-STRESS-DISORDER PATIENTS IN RESPONSE TO A TRAUMA-RELATED REMINDER

Background: Spectral analysis of heart rate variability has recently b een shown to be a reliable noninvasive rest for quantitative assessmen t of cardiovascular autonomic regulatory responses. providing a dynami c map of sympathetic and parasympathetic interaction. In a prior study exploring the state of hyperarousal characterizing the posttraumatic stress disorder (PTSD) syndrome, the authors described standardized he art rate analysis carried out in 9 PTSD patients at rest. which demons trated clear-cut evidence of a baseline autonomic hyperarousal state. Methods: To examine the dynamics of this hyperarousal state, standardi zed heart rate analysis was carried out in 9 PTSD patients compared to a matched control group Of 9 healthy volunteers. Twenty-minute record ings of electrocardiogram in response to a trauma-related cue as oppos ed to a resting state were performed and analyzed. The PTSD patients w ere asked to recount the presumed triggering traumatic event, and the control subjects recounted a significant stressful negative life event . Results: Our results show that whereas the control subjects demonstr ated significant autonomic responses to the stressogenic stimulus supp lied by the recounting of a major stressful experience, the PTSD patie nts demonstrated almost no autonomic response to the recounting of the triggering stressful event, The PTSD patients demonstrated a degree o f autonomic dysregulation at rest which was comparable to that seen in the control subjects' reaction to the stress model. Conclusions: The lack of response to the stress model applied in the study appears to i mply that PTSD patients experience so great a degree of autonomic hype ractivation at rest, that they are unable to marshal a further stress response to the recounting of the triggering trauma, as compared to co ntrol subjects. (C) 1998 Society of Biological Psychiatry.