The heartbeat evoked potential is a questionable biomarker in nightmare disorder: A replication study.
NeuroImage. Clinical January 1, 2022 Tamás Bogdány, Pandelis Perakakis, Róbert Bódizs et al.
Frequent nightmares are common and linked to mental health problems, but their biological basis is poorly understood. A small 2019 study reported that the heartbeat evoked potential (HEP) measured during REM sleep differed markedly between 11 nightmare sufferers and 11 controls, and correlated with depression in the nightmare group, suggesting HEP could be a biomarker. This replication attempt analyzed HEPs in two larger databases (39 and 41 participants each) using the same methods. No significant HEP differences between groups were found in either database, nor any association with depression scores. These results cast doubt on HEP as a reliable biomarker for nightmare disorder and indicate that interpreting HEP as a marker of impaired arousal and emotional processing during REM sleep is premature.