Heart rate variability in individuals with autism spectrum disorders: A meta-analysis

• Published in: Neuroscience and biobehavioral reviews Vol. 118; pp. 463 - 471
• Main Authors: Cheng, Ying-Chih, Huang, Yu-Chen, Huang, Wei-Lieh
• Format: Journal Article
• Language: English
• Published: United States Elsevier Ltd 01.11.2020
• Subjects: Autism Spectrum Disorder; Autism spectrum disorders; Autonomic nervous system; Biomarkers; Heart Rate; Heart rate variability; Humans; Respiratory sinus arrhythmia; Social stress; Stress, Psychological; RSA; SDANN; pNN50; HRV; RMSSD; Autism spectrum disorders; SD; VLF; ASD; NOS; Autonomic nervous system; SDNN; LF; Social stress; LF/HF; Heart rate variability; Respiratory sinus arrhythmia; HF
• ISSN: 0149-7634; 1873-7528; 1873-7528
• DOI: 10.1016/j.neubiorev.2020.08.007

•Subjects with autism spectrum disorders (ASD) show significantly lower baseline RSA than healthy subjects.•RSA reactivity during social and cognitive tasks in subjects with ASD was also significantly lower than in healthy subjects.•Among the above several reactivity conditions, the effect size of RSA reactivity during social stress is highest.•Our findings support reduced HRV values (especially low RSA under social stress) to be a candidate biomarker of ASD. Heart rate variability (HRV) in individuals with autism spectrum disorders (ASD) has been investigated in some studies but the procedures and results vary. We conducted a systematic review and meta-analysis to compare HRV in individuals with and without ASD; the influence of different conditions and HRV indices is considered. Baseline HRV and HRV reactivity were analyzed in several ways: parasympathetic indices in hierarchical order (main analysis), total variability, specific parasympathetic indices and respiratory sinus arrhythmia (RSA), etc. The review covered 34 studies for quantitative analysis. Individuals with ASD had a significantly lower baseline HRV for parasympathetic indices in hierarchical order (Hedges’g=-0.5168, p < 0.0001) and RSA (g=-0.5860, p=0.0010). The reactivity of HRV in situations of social stress (g=-0.4647, p = 0.0033) and social debriefing (g=-0.5001, p = 0.0007) was also significantly lower in subjects with ASD. RSA reactivity was significantly lower in ASD group for all situations, with the largest effect size for social stress (g=-0.7246, p < 0.0001). The results support low HRV to be a potential biomarker of ASD, especially RSA reactivity under social stress.