Major depressive disorder was associated with elevated heart rate, reduced vagal HRV, and attenuated heartbeat-evoked potential amplitude (Cohen's d -0.35; 95% CI -0.51 to -0.20).
Cross-Sectional (n=833)
Are there reproducible central cardiac interoception deficits and peripheral autonomic dysfunctions in patients with Major Depressive Disorder?
Patients with major depressive disorder exhibit reproducible central-peripheral brain-heart interaction impairments, including elevated heart rate, reduced vagal HRV, and attenuated heartbeat-evoked potentials.
Standardized Mean Difference: -0.35 (95% CI -0.51–-0.2)
p-value: p=4.3x10
INTRODUCTION: Brain-heart interaction (BHI) offers a systems-level framework for understanding major depressive disorder (MDD), yet reproducible cross-system markers remain unclear. We aimed to identify reproducible BHI impairments in MDD and clarify their physiological and clinical correlates. METHODS: In this cross-sectional EEG-ECG study, we analyzed three independent resting-state datasets (total N=693) and an acute stress dataset (N=140) under strict medication control. BHI was assessed across cardiac (HR, RR intervals), autonomic (HRV: RMSSD, pNN50, SD1, LF/HF, etc.), and cortical (heartbeat-evoked potential, HEP) domains. RESULTS: MDD cases consistently showed elevated HR, reduced vagal HRV, and attenuated HEP amplitude at the left centroparietal region (pooled Cohen's d (95%CI) for HEP = -0.35(-0.51 to -0.20); p = 4.3×10 CONCLUSION: We identified a reproducible central-peripheral BHI impairment model in MDD, suggesting partially distinct pathophysiological contributions of central and peripheral features. This model challenges the view that BHI abnormalities in MDD reflect a unitary hierarchical mechanism and provides a stratified framework that supports conceptualizing MDD as a brain-body disorder.
H et al. (2026) conducted a cross-sectional in Major Depressive Disorder (MDD) (n=833). Major Depressive Disorder vs. Controls was evaluated on Heartbeat-evoked potential (HEP) amplitude at the left centroparietal region (Cohen's d -0.35, 95% CI -0.51 to -0.20, p=4.3x10). Major depressive disorder was associated with elevated heart rate, reduced vagal HRV, and attenuated heartbeat-evoked potential amplitude (Cohen's d -0.35; 95% CI -0.51 to -0.20).