Platelet Serotonin Transporter Function and Heart Rate Variability in Patients with Panic Disorder

다국어 초록 (Multilingual Abstract)

Many studies showed abnormal serotonin transporter (5-HTT) function and heart rate variability (HRV) in panic disorder patients. The present study investigated the relationship between HRV power spectral analysis findings and platelet serotonin uptake in panic disorder patients. Short-term HRV over 5 min and platelet serotonin transporter uptake parameters (Vmax and Km) were measured both in 45 patients with panic disorder and in 30 age-matched normal healthy control subjects. Low frequency power (LF) normalized unit (nu) and LF/high frequency power (HF) were significantly higher, whereas HF and HF nu were lower in the patient group than in the control group. Vmax and Km were all significantly lower (i.e., reflects decreased 5-HTT function) in patients with panic disorder than in normal controls. In the patient group,Km was negatively correlated with LF/HF and LF nu whereas no such correlations between them were found in the control group. By multivariate analysis based on multiple hierarchical linear regression, a low Km independently predicted an increased LF nu even after controlling for age, sex, and body mass index in the patient group.
These results suggest that impaired 5-HTT function is closely related to dysregulation of autonomic nervous system in panic disorder.

참고문헌 (Reference)

1 김세주, "세로토닌 수송체와 약물치료" 대한정신약물학회 17 (17): 263-272, 2006

2 손상준, "강박장애와 공황장애 환자의 삶의 질" 대한신경정신의학회 45 (45): 438-443, 2006

3 Hamilton M, "The assessment of anxiety states by rating" 32 : 50-55, 1959

4 Murphy DL, "Targeting the murine serotonin transporter: insights into human neurobiology" 9 : 85-96, 2008

5 Iny LJ, "Studies of a neurochemical link between depression, anxiety, and stress from [3H]imipramine and [3H]paroxetine binding on human platelets" 36 : 281-291, 1994

6 First MB, "Structured clinical interview for DSM-IV axis I disorders"

7 Maron E, "Serotonin function in panic disorder: important, but why?" 31 : 1-11, 2006

8 Ballenger JC, "Remission rates in patients with anxiety disorders treated with paroxetine" 65 : 1696-1707, 2004

9 Alvarenga ME, "Psychophysiological mechanisms in panic disorder: a correlative analysis of noradrenaline spillover, neuronal noradrenaline reuptake, power spectral analysis of heart rate variability, and psychological variables" 68 : 8-16, 2006

10 Kawachi I, "Prospective study of phobic anxiety and risk of coronary heart disease in men" 89 : 1992-1997, 1994

11 Akselrod S, "Power spectrum analysis of heart rate fluctuation: a quantitative probe of beat-to-beat cardiovascular control" 213 : 220-222, 1981

12 Camacho A, "Platelets and psychiatry: lessons learned from old and new studies" 62 : 326-336, 2000

13 Norman TR, "Platelet serotonin uptake in panic disorder" 11 : 69-72, 1986

14 Kang EH, "Platelet serotonin transporter function after short-term paroxetine treatment in patients with panic disorder"

15 Smoller JW, "Panic attacks and risk of incident cardiovascular events among postmenopausal women in the Women’s Health Initiative Observational Study" 64 : 1153-1160, 2007

16 Fox MA, "Neurochemical, behavioral, and physiological effects of pharmacologically enhanced serotonin levels in serotonin transporter (SERT)-deficient mice" 201 : 203-218, 2008

17 Lin PY, "Meta-analysis of the association of serotonin transporter gene polymorphism with obsessive-compulsive disorder" 31 : 683-689, 2007

18 Lim YJ, "Korean panic disorder severity scale: construct validity by confirmatory factor analysis" 24 : 95-102, 2007

19 Esler M, "Increased brain serotonin turnover in panic disorder patients in the absence of a panic attack: reduction by a selective serotonin reuptake inhibitor" 10 : 295-304, 2007

20 Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology, "Heart rate variability: standards of measurement, physiological interpretation and clinical use" 93 : 1043-1065, 1996

21 Lavoie KL, "Heart rate variability in coronary artery disease patients with and without panic disorder" 128 : 289-299, 2004

22 Ramaekers D, "Heart rate variability and heart rate in healthy volunteers. Is the female autonomic nervous system cardioprotective?" 19 : 1334-1341, 1998

23 Yeragani VK, "Heart rate and QT interval variability: abnormal alpha-2 adrenergic function in patients with panic disorder" 121 : 185-196, 2003

24 Tjurmina OA, "Exaggerated adrenomedullary response to immobilization in mice with targeted disruption of the serotonin transporter gene" 143 : 4520-4526, 2002

25 Yeragani VK, "Effects of isoproterenol infusions on heart rate variability in patients with panic disorder" 56 : 289-293, 1995

26 Kuo TB, "Effect of aging on gender differences in neural control of heart rate" 277 : 2233-2239, 1999

27 Yeragani VK, "Decreased heart rate variability in panic disorder patients: a study of power-spectral analysis of heart rate" 46 : 89-103, 1993

28 Lesch KP, "Association of anxiety- related traits with a polymorphism in the serotonin transporter gene regulatory region" 274 : 1527-1531, 1996

29 Klein E, "Altered heart rate variability in panic disorder patients" 37 : 18-24, 1995

30 Hamilton M, "A rating scale for depression" 23 : 56-62, 1960