Heart rate variability, the vagus and calm.
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476 to 500 of 1,007Sources of Inaccuracy in Photoplethysmography for Continuous Cardiovascular Monitoring.
Photoplethysmography (PPG) is a low-cost, noninvasive optical technique that uses change in light transmission with changes in blood volume within tissue to provide information for cardiovascular health and fitness. As remote health and wearable medical devices become more prevalent, PPG devices are being developed as part of wearable systems to monitor parameters such as heart rate (HR) that do not require complex analysis of the PPG waveform. However, complex analyses of the PPG waveform yield valuable clinical information, such as: blood pressure, respiratory information, sympathetic nervous system activity, and heart rate variability. Systems aiming to derive such complex parameters do not always account for realistic sources of noise, as testing is performed within controlled parameter spaces. A wearable monitoring tool to be used beyond fitness and heart rate must account for noise…
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Heart rate variability: Can it serve as a marker of mental health resilience?: Special Section on "Translational and Neuroscience Studies in Affective Disorders" Section Editor, Maria Nobile MD, PhD.
Background: Stress resilience influences mental well-being and vulnerability to psychiatric disorders. Usually, measurement of resilience is based on subjective reports, susceptible to biases. It justifies the need for objective biological/physiological biomarkers of resilience. One promising candidate as biomarker of mental health resilience (MHR) is heart rate variability (HRV). The evidence for its use was reviewed in this study.
Methods: We focused on the relationship between HRV (as measured through decomposition of RR intervals from electrocardiogram) and responses to laboratory stressors in individuals without medical and psychiatric diseases. We conducted a bibliographic search of publications in the PubMed for January 2010-September 2018.
Results: Eight studies were included. High vagally mediated HRV before and/or during stressful laboratory tasks was associated with enhanced c…
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Reneau M (2020)reviewMEDLINE-indexed journal, not yet read by usPain management nursing : official journal of the American Society of Pain Management Nurses25 citations Heart Rate Variability Biofeedback to Treat Fibromyalgia: An Integrative Literature Review.
Objectives: Fibromyalgia (FM) is associated with debilitating pain and a reduced heart rate variability (HRV), reflecting decreased emotional adaptability and resistance to stress. Common pharmacological treatments are ineffective, and opioids are highly addictive and cause an estimated 15,000 overdose deaths per year. Effective recommendations include patient-centered interventions like physical activity, cognitive behavioral therapy, and biofeedback. Heart rate variability biofeedback (HRVB) may be effective in improving HRV, thus increasing stress resistance and emotional adaptability and reducing pain.
Design: This integrative literature review was conducted to examine the relationship between HRVB and FM-related chronic pain using the Theory of Symptom Self-Management and to identify available HRVB technology.
Data sources: We searched PubMed, EBSCOhost, and Google Scholar electroni…
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The social brain and heart rate variability: Implications for psychotherapy.
Purpose: Humans evolved within the mammalian line as a highly social species. Indeed, sociality has been a major driver of human social intelligence. From birth, social relationships have emotional and self-regulating properties and operate through different body systems. This paper will explore how heart rate variability (HRV), an index of the vagal regulation of the heart and a central element of the physiological underpinnings of sociality, is related to mental health problems, with important implications for psychotherapy.
Methods: We conducted a narrative review of the literature on the bi-directional links between prosocial motivations, HRV, and psychophysiological functioning.
Results: HRV is associated not only with the ability to downregulate physiological arousal, but also with a variety of psychological and behavioural variables which are usually the target of psychotherapeuti…
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Theoretical implications and clinical support for heart rate variability biofeedback for substance use disorders.
Heart rate variability (HRV) biofeedback is an accessible, cost-effective intervention that has demonstrated clinical value for numerous physical and mental health conditions; however, research on HRV biofeedback in substance use disorders (SUD) is in its nascence. We argue that HRV biofeedback may be particularly beneficial as an adjunct treatment for SUD by targeting bodily systems that are known to be disrupted by chronic substance use and are not historically the focus of psychosocial or pharmacological SUD treatment approaches. In addition to advocating for HRV biofeedback applications in SUD, we identify several gaps within the existing experimental literature, and propose new studies that could accelerate understanding of how and for whom HRV biofeedback is most likely to promote positive behavior change.
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Current Evidence on Heart Rate Variability Biofeedback as a Complementary Anticraving Intervention.
Background: The limited success of conventional anticraving interventions encourages research into new treatment strategies. Heart rate variability biofeedback (HRVB), which is based on slowed breathing, was shown to improve symptom severity in various disorders. HRVB, and certain rates of controlled breathing (CB), may offer therapeutic potential as a complementary drug-free treatment option to help control substance craving.
Methods: This review evaluated current evidence on the effectiveness of HRVB and CB training as a complementary anticraving intervention, based on guidelines from the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols. Studies that assessed a cardiorespiratory feedback or CB intervention with substance craving as an outcome were selected. Effect sizes were calculated for each study. The Scale for Assessing Scientific Quality of Investigatio…
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Heart-rate variability: a biomarker to study the influence of nutrition on physiological and psychological health?
As the influence of diet on health may take place over a period of decades, there is a need for biomarkers that help to identify those aspects of nutrition that have either a positive or a negative influence. The evidence is considered that heart-rate variability (HRV) (the time differences between one beat and the next) can be used to indicate the potential health benefits of food items. Reduced HRV is associated with the development of numerous conditions for example, diabetes, cardiovascular disease, inflammation, obesity and psychiatric disorders. Although more systematic research is required, various aspects of diet have been shown to benefit HRV acutely and in the longer term. Examples include a Mediterranean diet, omega-3 fatty acids, B-vitamins, probiotics, polyphenols and weight loss. Aspects of diet that are viewed as undesirable, for example high intakes of saturated or trans-…
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Lehrer PM (2018)reviewMEDLINE-indexed journal, not yet read by usInternational journal of psychophysiology : official journal of the International Organization of Psychophysiology43 citations Heart rate variability biofeedback and other psychophysiological procedures as important elements in psychotherapy.
Lang's distinction of psychophysiological, behavioral, and cognitive domains in psychological problems and therapies provides a useful heuristic for guiding psychotherapy. Much psychotherapy practice emphasizes the cognitive domain, but behavioral and psychophysiological interventions show at least equivalent effectiveness for some kinds of problems. Most descriptions of cognitive behavior therapy emphasize cognitive procedures, although most CBT approaches also incorporate behavioral interventions such as social skills training, exposure, and behavior activation. The contribution of psychophysiological methods is often underemphasized. Muscle relaxation and breathing interventions, particularly heart rate variability biofeedback, have been shown to have clinically significant therapeutic effects for a variety of problems. Although used more sporadically in the West, similar methods are …
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In the search for integrative biomarker of resilience to psychological stress.
Psychological resilience can be defined as individual's ability to withstand and adapt to adverse and traumatic events. Resilience is traditionally assessed by subjective reports, a method that is susceptible to self-report bias. An ideal solution to this challenge is the introduction of standardised and validated physiological and/or biological predictors of resilience. We provide a summary of the major concepts in the field of resilience followed by a detailed critical review of the literature around physiological, neurochemical and immune markers of resilience. We conclude that in future experimental protocols, biological markers of resilience should be assesses both during baseline and during laboratory stressors. In the former case the most promising candidates are represented by heart rate variability and by in vitro immune cells assay; in the latter case-by startle responses (espe…
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Guidelines for Reporting Articles on Psychiatry and Heart rate variability (GRAPH): recommendations to advance research communication.
The number of publications investigating heart rate variability (HRV) in psychiatry and the behavioral sciences has increased markedly in the last decade. In addition to the significant debates surrounding ideal methods to collect and interpret measures of HRV, standardized reporting of methodology in this field is lacking. Commonly cited recommendations were designed well before recent calls to improve research communication and reproducibility across disciplines. In an effort to standardize reporting, we propose the Guidelines for Reporting Articles on Psychiatry and Heart rate variability (GRAPH), a checklist with four domains: participant selection, interbeat interval collection, data preparation and HRV calculation. This paper provides an overview of these four domains and why their standardized reporting is necessary to suitably evaluate HRV research in psychiatry and related disci…
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Beauchaine TP, Thayer JF (2015)reviewMEDLINE-indexed journal, not yet read by usInternational journal of psychophysiology : official journal of the International Organization of Psychophysiology598 citations Heart rate variability as a transdiagnostic biomarker of psychopathology.
The Research Domain Criteria (RDoC), developed by the National Institute of Mental Health as a neuroscience-informed alternative to traditional psychiatric nosology, is an explicitly dimensional system in which classification of psychopathology is derived inductively (i.e., from basic science), across multiple levels of analysis (e.g., genetic, neural, psychophysiological, and behavioral). Although RDoC is often presented as paradigmatically revolutionary, a review of the history of psychophysiology suggests that roots of RDoC thinking extend at least as far back as the mid-20th Century. In this paper, we briefly and selectively review the historical emergence of neurobiologically-informed dimensional trait models of psychopathology, and we summarize our thinking regarding high frequency heart rate variability (HF-HRV) as a transdiagnostic biomarker of self-regulation and cognitive contr…
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Training adaptation and heart rate variability in elite endurance athletes: opening the door to effective monitoring.
The measurement of heart rate variability (HRV) is often considered a convenient non-invasive assessment tool for monitoring individual adaptation to training. Decreases and increases in vagal-derived indices of HRV have been suggested to indicate negative and positive adaptations, respectively, to endurance training regimens. However, much of the research in this area has involved recreational and well-trained athletes, with the small number of studies conducted in elite athletes revealing equivocal outcomes. For example, in elite athletes, studies have revealed both increases and decreases in HRV to be associated with negative adaptation. Additionally, signs of positive adaptation, such as increases in cardiorespiratory fitness, have been observed with atypical concomitant decreases in HRV. As such, practical ways by which HRV can be used to monitor training status in elites are yet to…
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Kemp AH, Quintana DS (2013)reviewMEDLINE-indexed journal, not yet read by usInternational journal of psychophysiology : official journal of the International Organization of Psychophysiology353 citations The relationship between mental and physical health: insights from the study of heart rate variability.
Here we review our recent body of work on the impact of mood and comorbid anxiety disorders, alcohol dependence, and their treatments on heart rate variability (HRV), a psychophysiological marker of mental and physical wellbeing. We have shown that otherwise healthy, unmedicated patients with these disorders display reduced resting-state HRV, and that pharmacological treatments do not ameliorate these reductions. Other studies highlight that tricyclic medications and the serotonin and noradrenaline reuptake inhibitors in particular may have adverse cardiovascular consequences. Reduced HRV has important functional significance for motivation to engage social situations, social approach behaviours, self-regulation and psychological flexibility in the face of stressors. Over the longer-term, reduced HRV leads to immune dysfunction and inflammation, cardiovascular disease and mortality, attr…
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A review of the affects of worry and generalized anxiety disorder upon cardiovascular health and coronary heart disease.
Objective: The aims of this review article are to present psychophysiological and behavioral pathways for the involvement of worry and generalized anxiety disorder (GAD) upon cardiovascular function. The review will focus on persons with and without coronary heart disease (CHD), and encompass etiological and prognostic studies.
Methods: Articles (1975-2011) reporting on GAD or worry affecting CHD prognosis or cardiovascular function were found using MEDLINE, EMBASE, SCOPUS and PsychINFO database searches, and extracted to form a narrative review.
Results: Available evidence in experimental and observational studies in CHD free samples consistently showed that worry was associated with diminished heart rate variability (HRV) and elevated heart rate. Worry and GAD were commonly associated with blood pressure and diagnosed hypertension or medication use in both disease-free and established …
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Biofeedback of heart rate variability and related physiology: a critical review.
Low heart rate variability (HRV) characterizes several medical and psychological diseases. HRV biofeedback is a newly developed approach that may have some use for treating the array of disorders in which HRV is relatively low. This review critically appraises evidence for the effectiveness of HRV and related biofeedback across 14 studies in improving (1) HRV and baroreflex outcomes and (2) clinical outcomes. Results revealed that HRV biofeedback consistently effectuates acute improvements during biofeedback practice, whereas the presence of short-term and long-term carry-over effects is less clear. Some evidence suggests HRV biofeedback may result in long-term carry-over effects on baroreflex gain, which is an area most promising for future investigations. On the other hand, concerning clinical outcomes, there is ample evidence attesting to efficacy of HRV biofeedback. However, because …
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The relationship between heart rate variability and inflammatory markers in cardiovascular diseases.
Introduction: Recent evidence implicates a cholinergic anti-inflammatory pathway. Because vagus nerve activity mediates some heart rate variability (HRV), this qualitative review examines the literature concerning circulating cytokines and HRV in cardiovascular function in humans. This qualitative review examines the literature concerning circulating cytokines and HRV in cardiovascular function in humans.
Methods: Thirteen studies on HRV, inflammation, and cardiovascular function were located by electronic library search and descriptively reviewed.
Results: The relationship between HRV and inflammation was studied in healthy controls, patients with acute or stable coronary heart disease (CHD), patients with metabolic syndrome or impaired glucose tolerance and patients with kidney failure. Investigations focused mainly on Interleukin-6 (IL-6) and C-reactive peptide (CRP). The majority of …
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Burr RL (2007)reviewMEDLINE-indexed journal, not yet read by usSleep249 citations Interpretation of normalized spectral heart rate variability indices in sleep research: a critical review.
The normalized spectral heart rate variability (HRV) measures low-frequency (LF)nu and high-frequency (HF)nu are frequently used in contemporary sleep research studies to quantify modulation of the sympathetic and parasympathetic branches of the autonomic nervous system. The purpose of this tutorial and methodologic critique is to concisely demonstrate the structural algebraic redundancy inherent in the normalized spectral HRV measures with respect to each other, and also with respect to the well-known HRV index of sympathovagal balance, LF:HF ratio. The statistical problems and interpretational paradoxes related to the mathematical definitions of LFnu and HFnu are briefly outlined. Examples of use of normalized spectral HRV measures in recent articles from the sleep-relevant research literature are critically reviewed. LFnu, HFnu, and LF:HF ratio should be considered equivalent carriers…
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Dysregulated physiological stress systems and accelerated cellular aging.
Exposure to chronic stressors is associated with accelerated biological aging as indicated by reduced leukocyte telomere length (LTL). This impact could be because of chronic overactivation of the body's physiological stress systems. This study examined the associations between LTL and the immune system, hypothalamic-pituitary-adrenal axis and autonomic nervous system. LTL was assessed in 2936 adults from the Netherlands Study of Depression and Anxiety. Inflammation markers (interleukin-6, c-reactive protein, tumor necrosis factor-alpha), hypothalamic-pituitary-adrenal-axis indicators (salivary cortisol awakening curve [area under the curve indicators, with respect to the ground and increase], evening levels, 0.5 mg dexamethasone cortisol suppression ratio), and autonomic nervous system measures (heart rate, respiratory sinus arrhythmia, pre-ejection period) were determined. Linear regre…
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Neuromodulation Applied to Diseases: The Case of HRV Biofeedback.
The vagus or "wandering" nerve is the main branch of the parasympathetic nervous system (PNS), innervating most internal organs crucial for health. Activity of the vagus nerve can be non-invasively indexed by heart-rate variability parameters (HRV). Specific HRV parameters predict less all-cause mortality, lower risk of and better prognosis after myocardial infarctions, and better survival in cancer. A non-invasive manner for self-activating the vagus is achieved by performing a slow-paced breathing technique while receiving visual feedback of one's HRV, called HRV-biofeedback (HRV-B). This article narratively reviews the biological mechanisms underlying the role of vagal activity and vagally mediated HRV in hypertension, diabetes, coronary heart disease (CHD), cancer, pain, and dementia. After searching the literature for HRV-B intervention studies in each condition, we report the effec…
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Psychophysiological Reactivity in Couples During a Marital Interaction Task.
The ability to regulate our own physiological arousal when dealing with the emotional expression of our partner is crucial for satisfactory and stable intimate relationships. In previous physiological studies of marital interactions, researchers have found greater levels of psychophysiological arousal for members of the couple in conflictual interactions in comparison with positive interactions. Past researchers have established that intense and prolonged autonomic and neuroendocrine arousal during marital conflict can have negative consequences for mental and physical health. In this study we examined the physiological reactivity, as measured by skin conductance level, heart rate and cortisol levels, from both partners during a couple's interaction task consisting of a structured conversation about positive and negative aspects of their relationship. Participants were thirty-two heteros…
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Therapeutic Potential of Vagus Nerve Stimulation for Inflammatory Bowel Diseases.
The vagus nerve is a mixed nerve, comprising 80% afferent fibers and 20% efferent fibers. It allows a bidirectional communication between the central nervous system and the digestive tract. It has a dual anti-inflammatory properties via activation of the hypothalamic pituitary adrenal axis, by its afferents, but also through a vago-vagal inflammatory reflex involving an afferent (vagal) and an efferent (vagal) arm, called the cholinergic anti-inflammatory pathway. Indeed, the release of acetylcholine at the end of its efferent fibers is able to inhibit the release of tumor necrosis factor (TNF) alpha by macrophages via an interneuron of the enteric nervous system synapsing between the efferent vagal endings and the macrophages and releasing acetylcholine. The vagus nerve also synapses with the splenic sympathetic nerve to inhibit the release of TNF-alpha by splenic macrophages. It can al…
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Critical Review of Transcutaneous Vagus Nerve Stimulation: Challenges for Translation to Clinical Practice.
Several studies have illustrated that transcutaneous vagus nerve stimulation (tVNS) can elicit therapeutic effects that are similar to those produced by its invasive counterpart, vagus nerve stimulation (VNS). VNS is an FDA-approved therapy for the treatment of both depression and epilepsy, but it is limited to the management of more severe, intervention-resistant cases as a second or third-line treatment option due to perioperative risks involved with device implantation. In contrast, tVNS is a non-invasive technique that involves the application of electrical currents through surface electrodes at select locations, most commonly targeting the auricular branch of the vagus nerve (ABVN) and the cervical branch of the vagus nerve in the neck. Although it has been shown that tVNS elicits hypo- and hyperactivation in various regions of the brain associated with anxiety and mood regulation, …
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Ernst G (2017)reviewMEDLINE-indexed journal, not yet read by usFrontiers in public health246 citations Heart-Rate Variability-More than Heart Beats?
Heart-rate variability (HRV) is frequently introduced as mirroring imbalances within the autonomous nerve system. Many investigations are based on the paradigm that increased sympathetic tone is associated with decreased parasympathetic tone and vice versa. But HRV is probably more than an indicator for probable disturbances in the autonomous system. Some perturbations trigger not reciprocal, but parallel changes of vagal and sympathetic nerve activity. HRV has also been considered as a surrogate parameter of the complex interaction between brain and cardiovascular system. Systems biology is an inter-disciplinary field of study focusing on complex interactions within biological systems like the cardiovascular system, with the help of computational models and time series analysis, beyond others. Time series are considered surrogates of the particular system, reflecting robustness or fragi…
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From the heart to the mind: cardiac vagal tone modulates top-down and bottom-up visual perception and attention to emotional stimuli.
The neurovisceral integration model (Thayer and Lane, 2000) posits that cardiac vagal tone, indexed by heart rate variability (HRV), can indicate the functional integrity of the neural networks implicated in emotion-cognition interactions. Our recent findings begin to disentangle how HRV is associated with both top-down and bottom-up cognitive processing of emotional stimuli. Higher resting HRV is associated with more adaptive and functional top-down and bottom-up cognitive modulation of emotional stimuli, which may facilitate effective emotion regulation. Conversely, lower resting HRV is associated with hyper-vigilant and maladaptive cognitive responses to emotional stimuli, which may impede emotion regulation. In the present paper, we recapitulate the neurovisceral integration model and review recent findings that shed light on the relationship between HRV and top-down and bottom-up vi…
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Vagal influence during worry and cognitive challenge.
The primary foci of the study were exploration of the linkage between cognitive and autonomic inflexibility of worry and generalized anxiety disorder (GAD) and examination of the effects of an analog cognitive restructuring task on this relationship. Cardiac responses of GAD and non-GAD participants were measured to examine the sympathetic and parasympathetic effects of worry and cognitive challenge. Diagnostic groups of undergraduate students were determined via administration of a structured interview, yielding a GAD group (n=16) and a control group (n=19) of individuals without GAD, depression, or panic disorder diagnoses. Cardiac autonomic responses were acquired via electrocardiogram during rest, worry, and cognitive challenge conditions by an experimenter blind to diagnosis. Metrics were compared between the two groups and across the three conditions. Individuals diagnosed with GAD…
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