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Cardiac stability at differing levels of temporal analysis in panic disorder, post-traumatic stress disorder, and healthy controls


  • This research was funded by Grant number MH64724 from the National Institute of Mental Health to Javaid I. Sheikh. We are grateful for the administrative support provided by the Research Service of the Veterans Affairs Palo Alto Health Care System and the Sponsored Projects Office, Stanford University. We are likewise grateful for the technical support provided by Ned J. Arsenault, Karin Voelker, Tram Nguyen, Janel Lynch, Karyn Skultety, Erika Mozer, Lorraine P. Leskin and Gregory A. Leskin.


The panic disorder (PD) literature provides evidence for both physiologic rigidity and instability as pathognomonic features of this disorder. This ambiguity may be a result of viewing PD at differential levels of temporal analysis. We assessed cardiac variability across three levels of temporal scale in PD patients, post-traumatic stress disorder (PTSD) patients, and healthy controls. Sixteen healthy controls, 14 PD patients, 23 PTSD patients, and 16 PTSD + PD patients presented for a polysomnogram. Differences were assessed in respiratory sinus arrhythmia (RSA), autoregressive stability of heart rate (HR), and the number of nonspecific accelerations in HR over the night. No differences in RSA were found between groups; however, PD patients exhibited significantly lower autoregressive HR stability, and all patients had significantly more HR accelerations than controls. These data reinforce prior findings demonstrating physiologic instability in PD and indicate that prior equivocalities regarding physiologic variability in PD may be due to limited temporal scaling of measurements.