Central Autonomic Network Association With Cardiac Autonomic Sleep-Wake Rhythm in Major Depression and Borderline Personality Disorder

Abstract

Background Resting heart rate variability (HRV), a measure of ANS activity, adaptability and health, has been shown to be altered in patients with Major Depressive Disorder (MDD) and Borderline Personality disorder (BPD). The Central Autonomic Network (CAN) comprises brain regions involved in both physiological and behavioral regulation. Evidence linking cortical thickness of CAN components and HRV circadian patterns is scarce. We explored this relationship in patients with BPD, MDD and healthy controls (CS).

Methods Forty-two participants (15 BPD, 14 MDD, 13HC) underwent 24hr-HRV recordings following structural MRI. Cortical thickness analysis was performed (FreeSurfer). Sleep-wake HRV measures (i.e, HF and RMSSD) were calculated. Cortical thickness of CAN regions were tested as HRV predictors.

Results Cortical thickness of right anterior cingulate and lateral orbitofrontal cortex predicted 50% of RMSSD (p=.023) and 58% of HF (p=.008) nocturnal variation respectively in BPD patients where greater cortical thickness was associated with increased HRV. HC exhibited this association between left inferior frontal gyrus (IFG) and middle frontal gyrus areas and sleep-HRV(p<.05). Left triangular segment of IFG explained 86% variability of nocturnal RMSSD in this group (p=.001). MDD group did not show significant correlations.

Conclusions Greater cortical thickness of CAN regions may be associated with increased sleep-HRV in BPD patients and HC. Nocturnal HRV patterns could serve as a biomarker of preserved neural architecture and functioning. Neural correlates of HRV may provide important insights into mechanisms involved in self-regulation that might be related to emotional well-being or psychopathology.