Autonomy of autonomic dysfunction in major depression.: Objective: To investigate cardiac autonomic dysfunction in patients with major depressive disorder (MDD). Research in this area has faced several limitations because of the heterogeneity of the disease, the influence of medication, and methodological shortcomings. Methods: Participants were 75 patients suffering from an acute recurrent episode of MDD and 75 matched controls. All participants were assessed at baseline for linear and nonlinear parameters of heart rate variability, QT variability a
Autonomic regulation and vagal tone
Heart rate variability, the vagus and calm.
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المكتبة البحثية1,007 works heldPeer-reviewed work held with its DOI and abstract, labelled with the study design its publication types report. None of it has been read or assessed, so nothing here may be cited as showing anything. Retracted work is held for the record but never listed; a review that a later version replaced is listed under its replacement and marked.
Non-invasive vagus nerve stimulation acutely improves spontaneous cardiac baroreflex sensitivity in healthy young men: A randomized placebo-controlled trial.: Background: Despite positive outcomes of transcutaneous vagus nerve stimulation (tVNS) via the auricular branch of the vagus nerve (ABVN), the mechanisms underlying these outcomes remain unclear. Additionally, previous studies have not been controlled the possible placebo effects of tVNS. Objective: To test the hypothesis that tVNS acutely improves spontaneous cardiac baroreflex sensitivity (cBRS) and autonomic modulation, and that these effects are specific to stimulation of ABVN. Methods: Thir
Non-invasive vagus nerve stimulation in healthy humans reduces sympathetic nerve activity.: Background: Vagus nerve stimulation (VNS) is currently used to treat refractory epilepsy and is being investigated as a potential therapy for a range of conditions, including heart failure, tinnitus, obesity and Alzheimer's disease. However, the invasive nature and expense limits the use of VNS in patient populations and hinders the exploration of the mechanisms involved. Objective: We investigated a non-invasive method of VNS through electrical stimulation of the auricular branch of the vagus n
Effects of transcutaneous vagus nerve stimulation in individuals aged 55 years or above: potential benefits of daily stimulation.: Ageing is associated with attenuated autonomic function. Transcutaneous vagal nerve stimulation (tVNS) improved autonomic function in healthy young participants. We therefore investigated the effects of a single session of tVNS (studies 1 and 2) and tVNS administered daily for two weeks (study 3) in volunteers aged ≥ 55 years. tVNS was performed using modified surface electrodes on the tragus and connected to a transcutaneous electrical nerve stimulation (TENS) machine. Study 1: participants (n=
Modulation of vagal tone enhances gastroduodenal motility and reduces somatic pain sensitivity.: Background: The parasympathetic nervous system, whose main neural substrate is the vagus nerve, exerts a fundamental antinociceptive role and influences gastrointestinal sensori-motor function. Our research question was to whether combined electrical and physiological modulation of vagal tone, using transcutaneous electrical vagal nerve stimulation (t-VNS) and deep slow breathing (DSB) respectively, could increase musculoskeletal pain thresholds and enhance gastroduodenal motility in healthy sub
Sex differences in healthy human heart rate variability: A meta-analysis.: The present meta-analysis aimed to quantify current evidence on sex differences in the autonomic control of the heart, indexed by measures of heart rate variability (HRV) in healthy human subjects. An extensive search of the literature yielded 2020 titles and abstracts, of which 172 provided sufficient reporting of sex difference in HRV. Data from 63,612 participants (31,970 females) were available for analysis. Meta-analysis yielded a total of 1154 effect size estimates (k) across 50 different
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176 to 200 of 1,007The effects of Baduanjin exercise on the psychological condition and heart rate variability of sports-disadvantaged college students: A randomised trial.
Objective: To investigate the effects of a 16-week Baduanjin exercise programme on the psychological status and heart rate variability (HRV) of college students in a sports-disadvantaged group, offering a theoretical basis for the potential of Baduanjin exercise to improve mental health. Trial design: This prospective study enrolled 93 college students from Wuyi University, exempt from the National Standards for Students' Physical Health due to illness or disability. The participants were divided into a control group (n = 47) and an experimental group (n = 46). Over 16 weeks, the experimental group engaged in the Baduanjin exercise, whereas the control group did not participate in regular physical training. Methods: We assessed the Symptom Checklist-90-Revised (SCL-90-R, the primary outcome) scores and HRV (time domain and frequency domain indices, the secondary outcomes) of all particip…
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Effects of a Randomised Trial of 5-Week Heart Rate Variability Biofeedback Intervention on Cognitive Function: Possible Benefits for Inhibitory Control.
Previous research suggests that higher heart rate variability (HRV) is associated with better cognitive function. However, since most previous findings on the relationship between HRV and cognitive function were correlational in nature, it is unclear whether individual differences in HRV play a causal role in cognitive performance. To investigate whether there are causal relationships, we used a simple breathing manipulation that increases HRV through a 5-week HRV biofeedback intervention and examined whether this manipulation improves cognitive performance in younger and older adults (N = 165). The 5-week HRV biofeedback intervention did not significantly improve inhibitory control, working memory and processing speed across age groups. However, improvement in the Flanker score (a measure of inhibition) was associated with the amplitude of heart rate oscillations during practice session…
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A Pilot Study of a Three-Session Heart Rate Variability Biofeedback Intervention for Veterans with Posttraumatic Stress Disorder.
Many veterans do not complete traditional trauma treatments; others may continue to struggle with posttraumatic stress disorder (PTSD) even after completing a full course of therapy (Blasé et al., in Int J Environ Res Public Health 18(7):Article 3329, https://doi.org/10.3390/ijerph18073329 , 2016). Heart rate variability (HRV) biofeedback (HRVB) is a non-invasive, non-pharmacological, breathing-based cardiorespiratory training technique that can reduce trauma symptoms and improve HRV parameters. Prior studies have demonstrated HRVB is well-tolerated by veterans with PTSD symptoms (Tan et al., in Appl Psychophysiol Biofeedback 36(1):27-35, 10.1007/s10484-010-9141-y, 2011; Schuman and Killian, in Appl Psychophysiol Biofeedback 44(1):9-20, https://doi.org/10.1007/s10484-018-9415-3 , 2019). This randomized wait-list controlled pilot study tested a short mobile app-adapted HRVB intervention i…
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Increasing coordination and responsivity of emotion-related brain regions with a heart rate variability biofeedback randomized trial.
Heart rate variability is a robust biomarker of emotional well-being, consistent with the shared brain networks regulating emotion regulation and heart rate. While high heart rate oscillatory activity clearly indicates healthy regulatory brain systems, can increasing this oscillatory activity also enhance brain function? To test this possibility, we randomly assigned 106 young adult participants to one of two 5-week interventions involving daily biofeedback that either increased heart rate oscillations (Osc+ condition) or had little effect on heart rate oscillations (Osc- condition) and examined effects on brain activity during rest and during regulating emotion. While there were no significant changes in the right amygdala-medial prefrontal cortex (MPFC) functional connectivity (our primary outcome), the Osc+ intervention increased left amygdala-MPFC functional connectivity and function…
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Changes in Medial Prefrontal Cortex Mediate Effects of Heart Rate Variability Biofeedback on Positive Emotional Memory Biases.
Previous research suggests that implicit automatic emotion regulation relies on the medial prefrontal cortex (mPFC). However, most of the human studies supporting this hypothesis have been correlational in nature. In the current study, we examine how changes in mPFC-left amygdala functional connectivity relate to emotional memory biases. In a randomized clinical trial examining the effects of heart rate variability (HRV) biofeedback on brain mechanisms of emotion regulation, we randomly assigned participants to increase or decrease heart rate oscillations while receiving biofeedback. After several weeks of daily biofeedback sessions, younger and older participants completed an emotional picture memory task involving encoding, recall, and recognition phases as an additional measure in this clinical trial. Participants assigned to increase HRV (Osc+) (n = 84) showed a relatively higher rat…
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Mobile Heart Rate Variability Biofeedback as a Complementary Intervention After Myocardial Infarction: a Randomized Controlled Study.
Background: To enhance effective prevention programs after myocardial infarction (MI), the study examined the effects and feasibility of mobile biofeedback training on heart rate variability (HRV-BF). Methods: Forty-six outpatients aged 41 to 79 years with a documented MI were randomized to HRV-BF versus usual care. Generalized estimating equation (GEE) analyses were performed to test improvements in measures of short- and long-time HRV, namely, the standard deviation of the normal-to-normal intervals (SDNN) and well-being after 12 weeks of HRV-BF. Results: There were intervention effects for short-time HRV (d > 0.4, p < 0.04), which were partly replicated in the GEE models that accounted for control variables: In the HRV-BF group, the high-frequency HRV (group × time interaction: β = 0.59, p = 0.04) compensated for significantly lower baseline levels than the group with usual care. In a…
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Effect of napping on a bean bag chair on sleep stage, muscle activity, and heart rate variability.
Background: Although ample evidence has demonstrated that daytime napping is beneficial for health and cognitive performance, bedding for napping has not yet been scientifically investigated. Objectives: To explore the effect of a bean bag chair on daytime napping and physiological parameters related to sleep. Methods: Fourteen healthy participants were enrolled within the context of a randomized, single-blind, crossover study to evaluate the effects of a bean bag chair in comparison with those of a urethane chair manufactured to have a similar shape. Electroencephalogram, electromyogram, and heart rate variability were recorded and compared between wakefulness and napping. Results: Electroencephalogram analyses revealed no significant differences in sleep architecture or frequency components; however, a significant decrease was found in electromyogram recordings in the trapezius muscle,…
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Heart rate variability (HRV) changes and cortical volume changes in a randomized trial of five weeks of daily HRV biofeedback in younger and older adults.
Previous studies indicate that the structure and function of medial prefrontal cortex (PFC) and lateral orbitofrontal cortex (OFC) are associated with heart rate variability (HRV). Typically, this association is assumed to reflect the PFC's role in controlling HRV and emotion regulation, with better prefrontal structural integrity supporting greater HRV and better emotion regulation. However, as a control system, the PFC must monitor and respond to heart rate oscillatory activity. Thus, engaging in regulatory feedback during heart rate oscillatory activity may over time help shape PFC structure, as relevant circuits and connections are modified. In the current study with younger and older adults, we tested whether 5 weeks of daily sessions of biofeedback to increase heart rate oscillations (Osc+ condition) vs. to decrease heart rate oscillations (Osc- condition) affected cortical volume …
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Heart Rate Variability biofeedback therapy for children and adolescents with chronic pain: A pilot study.
Purpose: As a brief, noninvasive, cost-effective, and technology-driven therapy, biofeedback is a promising and welcomed clinical intervention for children and adolescents with pediatric chronic pain conditions. The aim of this pilot study was to explore the application of a brief Heart Rate Variability (HRV) biofeedback intervention supplemented by at-home breathing practice as a tool for reducing symptomatology associated with chronic pain in a pediatric urban hospital setting. Design and methods: Twenty-one participants aged 10-17 years (M = 14.05, SD = 1.91; 76% female) and their caregivers completed the study. Participants were randomized to either 1) receive immediate biofeedback treatment including at-home breathing practice or 2) to be placed on a 4-week waitlist and then enrolled in the biofeedback treatment. Study outcomes included self-reported pain intensity, health-related q…
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Regulating emotion following severe traumatic brain injury: a randomized controlled trial of heart-rate variability biofeedback training.
Background: While difficulties regulating emotions are almost ubiquitous after traumatic brain injury (TBI), remediation techniques are limited. Heart-rate variability (HRV) is a physiological measure of emotion regulation and can be modified using biofeedback training. The aim of the current study was to evaluate the efficacy of repeated biofeedback training for improving emotion regulation difficulties following TBI. Design: Fifty adults with severe TBI were allocated to either biofeedback or waitlist conditions. Treatment consisted of six biofeedback sessions whereby participants were taught to breathe at their resonant frequency. Outcomes included changes in physiological and subjective reactivity to anger-induction, emotional well-being, and physiology at rest, together with symptoms of psychological distress and sleep disturbances (ACTRN12618002031246). Results: While biofeedback l…
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Exploring the Effects of a Brief Biofeedback Breathing Session Delivered Through the BioBase App in Facilitating Employee Stress Recovery: Randomized Experimental Study.
Background: Recovery from stress is a predictive factor for cardiovascular health, and heart rate variability (HRV) is suggested to be an index of how well people physiologically recover from stress. Biofeedback and mindfulness interventions that include guided breathing have been shown to be effective in increasing HRV and facilitating stress recovery. Objective: This study aims to assess the effectiveness of a brief app-based breathing intervention (BioBase) in enhancing physiological recovery among employees who were induced to cognitive and emotional stress. Methods: In total, we recruited 75 full-time employees. Interbeat (RR) intervals were recorded continuously for 5 min at baseline and during cognitive and emotional stress induction. The session ended with a 5-min recovery period during which participants were randomly allocated into 3 conditions: app-based breathing (BioBase), m…
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Reducing bedtime physiological arousal levels using immersive audio-visual respiratory bio-feedback: a pilot study in women with insomnia symptoms.
Hyperarousal is a critical component of insomnia, particularly at bedtime when individuals are trying to fall asleep. The current study evaluated the effect of a novel, acute behavioral experimental manipulation (combined immersive audio-visual relaxation and biofeedback) in reducing bedtime physiological hyperarousal in women with insomnia symptoms. After a clinical/adaptation polysomnographic (PSG) night, sixteen women with insomnia symptoms had two random-order PSG nights: immersive audio-visual respiratory bio-feedback across the falling asleep period (manipulation night), and no pre-sleep arousal manipulation (control night). While using immersive audio-visual respiratory bio-feedback, overall heart rate variability was increased and heart rate (HR) was reduced (by ~ 5 bpm; p < 0.01), reflecting downregulation of autonomic pre-sleep arousal, relative to no-manipulation. HR continued…
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Efficacy of rhythmical massage in comparison to heart rate variability biofeedback in patients with dysmenorrhea-A randomized, controlled trial.
Background: 20-90% of all women suffer from dysmenorrhea. Standard therapy of primary dysmenorrhea (PD) are NSAIDs and oral contraceptives, effective but not without possible side effects. Objective: To examine the efficacy of rhythmical massage (Anthroposophic Medicine) and heart rate variability biofeedback compared to usual care (control group) on pain intensity in women with primary dysmenorrhea. Methods: This was a three-arm randomized controlled study. Both interventions (rhythmical massage once a week or HRV biofeedback 15 min daily) were carried out over a period of three months. The third group (control) applied usual care. The primary outcome were between-group differences in mean pain intensity (detected by a Numeric Rating Scale, NRS) during menstruation after three months (post-assessment, t2). Secondary outcomes were the use of analgesics, quality of life (SF-12) and heart …
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Heart Rate Variability and Cognitive Bias Feedback Interventions to Prevent Post-deployment PTSD: Results from a Randomized Controlled Trial.
Introduction: There is a long history of pre-deployment PTSD prevention efforts in the military and effective pre-deployment strategies to prevent post-deployment PTSD are still needed. Materials and methods: This randomized controlled trial included three arms: heart rate variability biofeedback (HRVB), cognitive bias modification for interpretation (CBM-I), and control. The hypothesis was that pre-deployment resilience training would result in lower post-deployment PTSD symptoms compared with control. Army National Guard soldiers (n = 342) were enrolled in the Warriors Achieving Resilience (WAR) study and analyzed. The outcome was PTSD symptom severity using the PTSD Checklist - Military version (PCL) measured at pre-deployment, 3- and 12-month post-deployment. Due to the repeated measures for each participant and cluster randomization at the company level, generalized linear mixed mod…
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The Effect of Heart Rate Variability Biofeedback Training on Mental Health of Pregnant and Non-Pregnant Women: A Randomized Controlled Trial.
In this study, we examined the efficacy of heart rate variability (HRV)-biofeedback on stress and stress-related mental health problems in women. Furthermore, we examined whether the efficacy differed between pregnant and non-pregnant women. Fifty women (20 pregnant, 30 non-pregnant; mean age 31.6, SD = 5.9) were randomized into an intervention (n = 29) or a waitlist condition (n = 21). All participants completed questionnaires on stress, anxiety, depressive symptoms, sleep, and psychological well-being on three occasions with 6-week intervals. Women in the intervention condition received HRV-biofeedback training between assessment 1 and 2, and women in the waitlist condition received the intervention between assessment 2 and 3. The intervention consisted of a 5-week HRV-biofeedback training program with weekly 60⁻90 min. sessions and daily exercises at home. Results indicated a statisti…
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Psychological treatment of comorbid asthma and panic disorder in Latino adults: Results from a randomized controlled trial.
Confusion between panic and asthma symptoms can result in serious self-management errors. A cognitive behavior psychophysiological therapy (CBPT) intervention was culturally adapted for Latinos consisting of CBT for panic disorder (PD), asthma education, differentiation between panic and asthma symptoms, and heart rate variability biofeedback. An RCT compared CBPT to music and relaxation therapy (MRT), which included listening to relaxing music and paced breathing at resting respiration rates. Fifty-three Latino (primarily Puerto Rican) adults with asthma and PD were randomly assigned to CBPT or MRT for 8 weekly sessions. Both groups showed improvements in PD severity, asthma control, and several other anxiety and asthma outcome measures from baseline to post-treatment and 3-month follow-up. CBPT showed an advantage over MRT for improvement in adherence to inhaled corticosteroids. Improv…
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Circadian misalignment increases cardiovascular disease risk factors in humans.
Shift work is a risk factor for hypertension, inflammation, and cardiovascular disease. This increased risk cannot be fully explained by classic risk factors. One of the key features of shift workers is that their behavioral and environmental cycles are typically misaligned relative to their endogenous circadian system. However, there is little information on the impact of acute circadian misalignment on cardiovascular disease risk in humans. Here we show-by using two 8-d laboratory protocols-that short-term circadian misalignment (12-h inverted behavioral and environmental cycles for three days) adversely affects cardiovascular risk factors in healthy adults. Circadian misalignment increased 24-h systolic blood pressure (SBP) and diastolic blood pressure (DBP) by 3.0 mmHg and 1.5 mmHg, respectively. These results were primarily explained by an increase in blood pressure during sleep opp…
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Effects of Heart Rate Variability Biofeedback on EEG Alpha Asymmetry and Anxiety Symptoms in Male Athletes: A Pilot Study.
Heart rate variability biofeedback (HRV-BFB) has been shown as useful tool to manage stress in various populations. The present study was designed to investigate whether the biofeedback-based stress management tool consisting of rhythmic breathing, actively self-generated positive emotions and a portable biofeedback device induce changes in athletes' HRV, EEG patterns, and self-reported anxiety and self-esteem. The study involved 41 healthy male athletes, aged 16-21 (mean 18.34 ± 1.36) years. Participants were randomly divided into two groups: biofeedback and control. Athletes in the biofeedback group received HRV biofeedback training, athletes in the control group didn't receive any intervention. During the randomized controlled trial (days 0-21), the mean anxiety score declined significantly for the intervention group (change-4 p < 0.001) but not for the control group (p = 0.817). In a…
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Pilot Randomized Study of a Gratitude Journaling Intervention on Heart Rate Variability and Inflammatory Biomarkers in Patients With Stage B Heart Failure.
Objective: Stage B, asymptomatic heart failure (HF) presents a therapeutic window for attenuating disease progression and development of HF symptoms, and improving quality of life. Gratitude, the practice of appreciating positive life features, is highly related to quality of life, leading to development of promising clinical interventions. However, few gratitude studies have investigated objective measures of physical health; most relied on self-report measures. We conducted a pilot study in Stage B HF patients to examine whether gratitude journaling improved biomarkers related to HF prognosis. Methods: Patients (n = 70; mean [standard deviation] age = 66.2 [7.6] years) were randomized to an 8-week gratitude journaling intervention or treatment as usual. Baseline (T1) assessments included the six-item Gratitude Questionnaire, resting heart rate variability (HRV), and an inflammatory bio…
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A randomized-controlled trial of heart rate variability biofeedback for psychotic symptoms.
Arousal and the way it is coped with are relevant to the emergence of psychotic symptoms. Heart rate variability (HRV) stems from autonomic responses to environmental demands such as stress and is an index of physiological arousal, adaptability, and homeostatic reflexes forming autonomic balance. A randomized-controlled between-subjects trial that compared HRV-biofeedback (BF) to an active relaxation and to a waiting control condition was conducted in a sample with attenuated subclinical psychotic symptoms (N = 84). A 20-min intervention was preceded and followed by repeated assessments of stress responses. Change scores of the post-stress periods were analyzed using ANOVAs for HRV, subjective stress, perceived control, and state paranoia. As expected, BF participants showed greater improvements in perceived control than waiting controls (p = 0.006). However, no group differences occurre…
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Physical activity, mindfulness meditation, or heart rate variability biofeedback for stress reduction: a randomized controlled trial.
In contemporary western societies stress is highly prevalent, therefore the need for stress-reducing methods is great. This randomized controlled trial compared the efficacy of self-help physical activity (PA), mindfulness meditation (MM), and heart rate variability biofeedback (HRV-BF) in reducing stress and its related symptoms. We randomly allocated 126 participants to PA, MM, or HRV-BF upon enrollment, of whom 76 agreed to participate. The interventions consisted of psycho-education and an introduction to the specific intervention techniques and 5 weeks of daily exercises at home. The PA exercises consisted of a vigorous-intensity activity of free choice. The MM exercises consisted of guided mindfulness meditation. The HRV-BF exercises consisted of slow breathing with a heart rate variability biofeedback device. Participants received daily reminders for their exercises and were conta…
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Mental distress and effort to engage an image-guided navigation system in the surgical training of endoscopic sinus surgery: a prospective, randomised clinical trial.
The use of image-guided navigation systems in the training of FESS is discussed controversy. Many experienced sinus surgeons report a better spatial orientation and an improved situational awareness intraoperatively. But many fear that the navigation system could be a disadvantage in the surgical training because of a higher mental demand and a possible loss of surgical skills. This clinical field study investigates mental and physical demands during transnasal surgery with and without the aid of a navigation system at an early stage in FESS training. Thirty-two endonasal sinus surgeries done by eight different trainee surgeons were included. After randomization, one side of each patient was operated by use of a navigation system, the other side without. During the whole surgery, the surgeons were connected to a biofeedback device measuring the heart rate, the heart rate variability, the…
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The effects of a stress management intervention in elementary school children.
Objective: This preliminary study tests the effectiveness of an elementary school-based stress management technique on anxiety symptoms and heart rate variability (HRV) in children. Methods: In this controlled prospective longitudinal study, children in third-grade classroom participated in a teacher-led daily 10-minute stress management intervention for 4 months. The control class teacher read from a children's book for 10 minutes daily. A standardized anxiety scale and HRV (using computer biofeedback program) were measured before the 4-month intervention, immediately after, and 1 year later. Results: The intervention class showed significant improvement from baseline to the immediate postintervention period in total anxiety (N = 14, F = 12.95, p = .002), with 1-year follow-up scores maintaining improvement (N = 13, F = 5.88, p = .025). The intervention class had small improvement in HR…
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The effects of heart rate variability biofeedback in patients with preterm labour.
Preterm birth is a highly prevalent phenomenon that was shown to be associated with mental stress during pregnancy (Rich-Edwards and Grizzard in Am J Obstet Gynecol 192(5 Suppl):S30-S35, 2005). We aimed to assess the effects of heart rate variability (HRV)-biofeedback in patients with preterm labour. Therefore, we conducted a controlled randomized parallel group study in 48 female patients aged 19-38 years (median = 29) with preterm labour at gestational week 24th-32nd (median = 29th). In this study, one group (n = 24) attended six sessions of HRV-biofeedback over 2 weeks whereas patients of the other group (n = 24) were assigned to control sessions. In the HRV-biofeedback treated group, perception of chronic stress was decreased 4 weeks after completion of training compared to baseline (p < 0.05) but there was no change in the control group. In the HRV-biofeedback group, preterm birth w…
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Randomised controlled trial of a 12 week yoga intervention on negative affective states, cardiovascular and cognitive function in post-cardiac rehabilitation patients.
Background: Negative affective states such as anxiety, depression and stress are significant risk factors for cardiovascular disease, particularly in cardiac and post-cardiac rehabilitation populations. Yoga is a balanced practice of physical exercise, breathing control and meditation that can reduce psychosocial symptoms as well as improve cardiovascular and cognitive function. It has the potential to positively affect multiple disease pathways and may prove to be a practical adjunct to cardiac rehabilitation in further reducing cardiac risk factors as well as improving self-efficacy and post-cardiac rehabilitation adherence to healthy lifestyle behaviours. Method and design: This is a parallel arm, multi-centre, randomised controlled trial that will assess the outcomes of post- phase 2 cardiac rehabilitation patients assigned to a yoga intervention in comparison to a no-treatment wait-…
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