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Resting vagal activity in schizophrenia: Meta-analysis of heart rate variability as a potential endophenotype
Open accessAbstract
Background: Cardiac vagal tone, indexed by heart rate variability (HRV), is a proxy for the functional integrity of feedback mechanisms integrating central and peripheral physiology. Aims: To quantify differences in HRV in individuals with schizophrenia compared with healthy controls. Method: Databases were systematically searched for studies eligible for inclusion. Random effect meta-analyses of standardised mean differences were calculated for vagal activity indicated by high-frequency HRV and the root mean square of successive R–R interval differences (RMSSD). Results: Thirty-four studies were included. Significant main effects were found for high-frequency HRV (P = 0.0008; Hedges' g =–0.98, 95% CI −1.56 to −0.41, k = 29) and RMSSD (P<0.0001; g =–0.91, 95% CI −1.19 to −0.62, k = 24), indicating lower vagal activity in individuals with schizophrenia than in healthy controls. Considerable heterogeneity was evident but effects were robust in subsequent sensitivity analyses. Conclusions: Given the association between low HRV, threat processing, emotion regulation and executive functioning, reduced vagal tone may be an endophenotype for the development of psychotic symptoms.
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“As mentioned earlier, the meta-analysis did not find any difference in HRV markers of parasympathetic functioning between AP-naïve and medicated patients with SCZ.”
From Autonomic nervous system dysfunction in schizophrenia: impact on cognitive and metabolic health (2021) · cites this paper as [27]
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“Similarly, subgroup analyses did not reveal any differences in HRV outcomes between inpatients and outpatients.”
From Autonomic nervous system dysfunction in schizophrenia: impact on cognitive and metabolic health (2021) · cites this paper as [27]
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“In comparison to non-psychiatric HCs, patients with SCZ exhibit reduced HRV and vagal cardiac control26.”
From Autonomic nervous system dysfunction in schizophrenia: impact on cognitive and metabolic health (2021) · cites this paper as [27]
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“Subsequent meta-regressions did not show any significant effects as a function of age, illness duration, or medication status (medicated vs. unmedicated).”
From Autonomic nervous system dysfunction in schizophrenia: impact on cognitive and metabolic health (2021) · cites this paper as [27]
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Metadata
- Authors
- Clamor, A., Lincoln, T. M., Thayer, J. F., & Koenig, J.
- Affiliations
- Universität Hamburg (DE)
- Corresponding author
- Clamor, Annika
- Venue
- British Journal of Psychiatry
- Publisher
- Royal College of Psychiatrists
- Published
- 2016-01
- Volume
- 208
- Issue
- 1
- Pages
- 9-16
- ISSN
- 0007-1250 (ISSN-L)
- 1472-1465
- OpenAlex
- W2236535974
- Cited by
- 167
- References
- 65
- Citations by year
- 2026: 10 · 2025: 13 · 2024: 22 · 2023: 18 · 2022: 16 · 2021: 17 · 2020: 20 · 2019: 11 · 2018: 16 · 2017: 9 · 2016: 11
- FWCI
- 2.77
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The British Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Ohio State University
- Deutscher Akademischer Austauschdienst
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Life Sciences › Neuroscience › Neurology › Vagus Nerve Stimulation Research
- Keywords
- schizophrenia, heart rate variability, vagal tone, endophenotypes, high-frequency HRV, RMSSD, cardiac autonomic function, threat processing, emotion regulation, executive function, psychotic symptoms
- MeSH terms
- Brain, Emotions, Heart Rate, Humans, Schizophrenia, Vagus Nerve, Executive Function, Endophenotypes
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