Introduction: Given the growing evidence of reduced heart rate variability in psychiatric diseases associated with emotional instability, we investigated cardiovascular autonomic modulation in patients with borderline personality disorder (BPD) during resting state, parasympathetic stimulation (metronomic breathing), and sympathetic stimulation (mental arithmetic stress test). Methods: In 29 BPD outpatients and 30 controls, we recorded RR-intervals (RRI), blood pressure, skin conductance levels, and respiratory frequency during resting state, metronomic breathing, stress anticipation, stress exposure, and stress recovery. We calculated baroreflex sensitivity (BRS) and parameters of heart rate variability, including the root mean square of successive differences (RMSSD), an index of cardiovagal modulation. Results: During resting state, BPD patients showed higher blood pressure and shorter RRI, as well as lower RMSSD and BRS than controls. Metronomic breathing increased RMSSD and BRS in BPD patients. During the stress exposure, BRS significantly decreased in controls, but not in BPD patients. Furthermore, BPD patients showed less cardioacceleration in response to stress exposure than controls. During stress recovery, we found increases in RMSSD and BRS in controls, but not in BPD patients. Conclusion: Our data show reduced cardiovascular autonomic modulation in BPD patients during resting state, psychophysiological relaxation, and stress exposure. The results indicate a vagal modulation deficit in this cohort. Breathing techniques, such as metronomic breathing, might be helpful to reduce stress and to increase vagal tone in BPD patients.
Neuropsychobiology

中文翻译：

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边缘性人格障碍患者节拍呼吸和压力暴露期间的心血管自主神经调节

简介：鉴于越来越多的证据表明与情绪不稳定相关的精神疾病的心率变异性降低，我们调查了边缘型人格障碍 (BPD) 患者在静息状态、副交感神经刺激（节拍呼吸）和交感神经刺激（心算）期间的心血管自主神经调节。压力测试）。方法：在 29 名 BPD 门诊患者和 30 名对照组中，我们记录了静息状态、节拍呼吸、压力预期、压力暴露和压力恢复期间的 RR 间期 (RRI)、血压、皮肤电导水平和呼吸频率。我们计算了压力反射灵敏度 (BRS) 和心率变异性参数，包括连续差的均方根 (RMSSD)，这是一种心血管调节的指数。结果：在静息状态下，与对照组相比，BPD 患者的血压更高，RRI 更短，RMSSD 和 BRS 更低。节拍呼吸增加 BPD 患者的 RMSSD 和 BRS。在压力暴露期间，BRS 在对照组中显着降低，但在 BPD 患者中没有。此外，与对照组相比，BPD 患者对压力暴露的反应表现出更少的心脏加速。在压力恢复期间，我们发现对照组的 RMSSD 和 BRS 增加，但 BPD 患者没有。结论：我们的数据显示 BPD 患者在静息状态、心理生理放松和压力暴露期间心血管自主神经调节降低。结果表明该队列存在迷走神经调节缺陷。呼吸技术，例如节拍呼吸，可能有助于减轻压力并增加 BPD 患者的迷走神经张力。
神经心理生物学