自律神經系統相關參數與焦慮及憂鬱量表所得分數之關聯性研究

Abstract

焦慮與憂鬱症狀與自律神經系統失調之間的關聯受到廣泛關注，而心律變異度 (Heart Rate Variability, HRV) 被視為評估自律神經調節的重要非侵入性生理指標。然而，過去多數研究主要著重於靜態檢測，較少探討生理挑戰條件下的動態自律神經反應。因此，本研究使用氣泵式行動心律變異血壓檢測儀，探討不同姿勢條件下自律神經指標與焦慮及憂鬱量表分數之間的關聯性，並評估姿勢挑戰是否能提供較靜態測量更具生理意義之資訊。本研究共納入 90 位受試者，使用 GAD-7、ASI-3、PHQ-4 與 BDI-II 評估焦及憂鬱症狀，並於坐姿與站姿條件下量測 HRV、低頻功率 (LF)、高頻功率 (HF) 及 LF/HF ratio。研究結果顯示，整體 HRV 由坐姿條件下的 40.41 ± 4.34 顯著下降至站姿條件下的 38.82 ± 6.33 (p = 0.014)，顯示姿勢轉換成功誘發可測量之自律神經調節反應。雖然 HRV 與心理量表之相關性整體偏弱，但站姿條件下所呈現之反應模式與焦慮及憂鬱相關之自律神經失調理論較為一致。較高之心理症狀分數傾向與較低之 HRV 與 HF，以及較高之 LF 指標有關，反映副交感神經調節下降與交感神經活性增加之趨勢。本研究認為，姿勢挑戰的價值未必在於提升統計相關強度，而在於使低負荷狀態下不易觀察之自律神經反應模式更具生理可解釋性。探索性分析顯示，姿勢挑戰後出現 HRV 下降者較可能呈現與焦慮症狀相關之自律神經反應特徵，而較高焦慮症狀程度者亦傾向出現較明顯之 HRV 下降，顯示姿勢誘發之 HRV 變化可能作為反映焦慮症狀的早期生理訊號。氣泵式行動檢測儀亦展現於動態條件下穩定取得 HRV 訊號之潛力，支持未來於真實情境中進行行動式自律神經檢測與焦慮風險篩檢之可行性。

Heart rate variability (HRV) is a widely used non-invasive indicator of autonomic regulation. However, previous studies have primarily focused on resting-state measurements, with limited investigation of autonomic responses under physiological challenge conditions. Therefore, this study employed a pressure-based mobile cardiovascular monitoring device to investigate the associations between autonomic nervous system (ANS)-related parameters and anxiety and depression measures under different postural conditions, and to evaluate whether postural challenge provides additional physiologically meaningful information beyond conventional resting-state assessment. The final dataset consisted of 90 participants. Levels of anxiety and depressive symptoms were evaluated using the GAD-7, ASI-3, PHQ-4, and BDI-II questionnaires. HRV indices, including HRV, low-frequency (LF) power, high-frequency (HF) power, and the LF/HF ratio, were measured under sitting and standing conditions. The results demonstrated that overall HRV significantly decreased from 40.41 ± 4.34 in the sitting condition to 38.82 ± 6.33 in the standing condition (p = 0.014), indicating that postural transition successfully elicited measurable autonomic adjustments. Although associations between HRV and psychological measures were generally weak, autonomic response patterns observed during standing appeared to align more closely with previous findings regarding anxiety- and depression-related autonomic dysregulation. Higher psychological symptom scores tended to exhibited lower HRV and HF measures and relatively higher LF-related indices, suggesting reduced parasympathetic modulation and increased sympathetic dominance. These findings suggest that the value of postural challenge may lie not in strengthening statistical associations, but in revealing autonomic response patterns that are more physiologically interpretable. Furthermore, exploratory analyses suggested that posture-induced HRV reduction may represent an early physiological signal associated with elevated anxiety symptoms. Individuals demonstrating reduced HRV during postural challenge appeared more likely to exhibit anxiety-related autonomic characteristics, highlighting the potential value of pressure-based mobile HRV monitoring in future anxiety screening applications.