Effects of heart rate variability biofeedback training on psychological state and cardiac autonomic regulation in stressed people

Background: Fingolimod modulates sphingosine-1-phosphate receptors that are also found in cardiovascular tissue. Objective: To investigate the effects of fingolimod on cardiac autonomic regulation prospectively. Methods: Twenty-seven relapsing–remitting multiple sclerosis patients underwent 24-hour electrocardiogram recording before, at the first day of fingolimod treatment (1d) and after three months of continuous dosing (3mo). The time interval between two consecutive R-peaks (RR-interval) was measured. Cardiac autonomic regulation was assessed by the various parameters of heart rate variability. Parasympathetic stimulation prolongs the RR-interval and increases heart rate variability while the effects of sympathetic stimulation are mainly the opposite. The low frequency/high frequency ratio reflects sympathovagal balance. Results: From baseline to 1d, a prolongation of the RR-interval ( P<0.001), an increase in the values of various heart rate variability parameters ( P<0.05 to P<0.001) and a decrease in the low frequency/high frequency ratio ( P<0.05) were demonstrated. At 3mo, although the RR-interval remained longer ( P<0.01), the values of various heart rate variability parameters were lower ( P<0.01 to P<0.001) as compared to baseline. At 3mo, the low frequency/high frequency ratio ( P<0.05) was higher in men than in women although no such difference was found at baseline or at 1d. Conclusions: After an initial increase in parasympathetic regulation, continuous fingolimod dosing shifts cardiac autonomic regulation towards sympathetic predominance, especially in men. Careful follow-up of fingolimod-treated relapsing–remitting multiple sclerosis patients is warranted as sympathetic predominance associates generally with impaired outcome. ClinicalTrials.cov: NCT01704183

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Binary symbolic dynamics analysis to detect stress-associated changes of nonstationary heart rate variability

Scientific Reports ◽

10.1038/s41598-020-72034-2 ◽

2020 ◽

Vol 10 (1) ◽

Author(s):

Conrad Spellenberg ◽

Peter Heusser ◽

Arndt Büssing ◽

Andreas Savelsbergh ◽

Dirk Cysarz

Keyword(s):

Heart Rate ◽

Heart Rate Variability ◽

Psychological Stress ◽

Symbolic Dynamics ◽

Acute Stress ◽

Stress Test ◽

Autonomic Regulation ◽

Rr Interval ◽

Cardiac Autonomic Regulation ◽

Acute Psychological Stress

Abstract Psychological stress may have harmful physiological effects and result in deteriorating health. Acute psychological stress acts also on cardiac autonomic regulation and may lead to nonstationarities in the interbeat interval series. We address the requirement of stationary RR interval series to calculate frequency domain parameters of heart rate variability (HRV) and use binary symbolic dynamics derived from RR interval differences to overcome this obstacle. 24 healthy subjects (12 female, 20–35 years) completed the following procedure: waiting period, Trier Social Stress Test to induce acute psychological stress, recovery period. An electrocardiogram was recorded throughout the procedure and HRV parameters were calculated for nine 5-min periods. Nonstationarities in RR interval series were present in all periods. During acute stress the average RR interval and SDNN decreased compared to rest before and after the stress test. Neither low frequency oscillations (LF), high frequency oscillations (HF) nor LF/HF could unambiguously reflect changes during acute stress in comparison to rest. Pattern categories derived from binary symbolic dynamics clearly identified acute stress and accompanying alterations of cardiac autonomic regulation. Methods based on RR interval differences like binary symbolic dynamics should be preferred to overcome issues related to nonstationarities.

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Distinguishing Mild Traumatic Brain Injury and Stress Responses: Implications for Heart Rate Variability Biofeedback Training

Biofeedback ◽

10.5298/1081-5937-43.1.04 ◽

2015 ◽

Vol 43 (1) ◽

pp. 4-5

Author(s):

Leah Lagos

Keyword(s):

Traumatic Brain Injury ◽

Heart Rate ◽

Heart Rate Variability ◽

Stress Responses ◽

Stress Disorder ◽

Biofeedback Training ◽

Postconcussion Syndrome ◽

Heart Rate Variability Biofeedback ◽

Specialized Form ◽

Biofeedback Research

Recent research has noted a significant overlap between symptoms of posttraumatic stress disorder (PTSD) and postconcussion syndrome (PCS). In this article, an argument is made for providing a specialized form of heart rate variability biofeedback that allows for the physiological discharge of trauma among patients who present with comorbid symptoms of PTSD and PCS. Recommendations for clinicians who encounter the manifestation of trauma during their work with PCS patients are provided. Future areas of heart rate variability biofeedback research among PCS and PTSD populations are further delineated.

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The effect of heart rate variability biofeedback training on stress and anxiety: a meta-analysis

Psychological Medicine ◽

10.1017/s0033291717001003 ◽

2017 ◽

Vol 47 (15) ◽

pp. 2578-2586 ◽

Cited By ~ 88

Author(s):

V. C. Goessl ◽

J. E. Curtiss ◽

S. G. Hofmann

Keyword(s):

Heart Rate ◽

Heart Rate Variability ◽

Meta Analysis ◽

Wearable Devices ◽

Biofeedback Training ◽

Cochrane Library ◽

Heart Rate Variability Biofeedback ◽

Stress Symptoms ◽

The Cochrane Library ◽

Study Bias

BackgroundSome evidence suggests that heart rate variability (HRV) biofeedback might be an effective way to treat anxiety and stress symptoms. To examine the effect of HRV biofeedback on symptoms of anxiety and stress, we conducted a meta-analysis of studies extracted from PubMed, PsycINFO and the Cochrane Library.MethodsThe search identified 24 studies totaling 484 participants who received HRV biofeedback training for stress and anxiety. We conducted a random-effects meta-analysis.ResultsThe pre-post within-group effect size (Hedges' g) was 0.81. The between-groups analysis comparing biofeedback to a control condition yielded Hedges' g = 0.83. Moderator analyses revealed that treatment efficacy was not moderated by study year, risk of study bias, percentage of females, number of sessions, or presence of an anxiety disorder.ConclusionsHRV biofeedback training is associated with a large reduction in self-reported stress and anxiety. Although more well-controlled studies are needed, this intervention offers a promising approach for treating stress and anxiety with wearable devices.

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Linking an Anxiety-Related Personality Trait to Cardiac Autonomic Regulation in Well-Defined Healthy Adults: Harm Avoidance and Resting Heart Rate Variability

Psychiatry Investigation ◽

10.4306/pi.2016.13.4.397 ◽

2016 ◽

Vol 13 (4) ◽

pp. 397 ◽

Cited By ~ 1

Author(s):

Lien-Cheng Kao ◽

Yu-Wen Liu ◽

Nian-Sheng Tzeng ◽

Terry B. J. Kuo ◽

San-Yuan Huang ◽

...

Keyword(s):

Heart Rate ◽

Heart Rate Variability ◽

Personality Trait ◽

Healthy Adults ◽

Autonomic Regulation ◽

Harm Avoidance ◽

Resting Heart Rate ◽

Cardiac Autonomic Regulation ◽

Resting Heart Rate Variability ◽

Related Personality

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Biofeedback as an intervention for persistent post-concussive symptoms: A randomized feasibility trial

Journal of Concussion ◽

10.1177/20597002211046459 ◽

2021 ◽

Vol 5 ◽

pp. 205970022110464

Author(s):

Marquise M Bonn ◽

Liliana Alvarez ◽

Laura Graham ◽

James W Thompson ◽

James P Dickey

Keyword(s):

Heart Rate ◽

Heart Rate Variability ◽

Biofeedback Training ◽

Feasibility Trial ◽

Control Group ◽

Low Resolution ◽

Heart Rate Variability Biofeedback ◽

Electromagnetic Tomography ◽

Healthy Control ◽

Study Intervention

Background Case reports indicate that low-resolution electromagnetic tomography neurofeedback and heart rate variability biofeedback may improve physiological functioning in individuals with persistent post-concussive symptoms. However, it is unclear whether larger-scale studies are feasible. Purpose To evaluate the feasibility of a combined low-resolution electromagnetic tomography neurofeedback and heart rate variability biofeedback intervention for individuals with persistent post-concussive symptoms. Methods Individuals with persistent post-concussive symptoms were randomized into intervention and control groups, and their baseline and post-test assessments were compared to a healthy control group. Outcomes included self-report questionnaires, resting electroencephalograph and electrocardiograph recordings, and a driving simulation task. Participants in the intervention group completed three 20 min low-resolution electromagnetic tomography neurofeedback sessions per week and at-home heart rate variability biofeedback training every morning and night for 8 weeks. Feasibility was evaluated according to recruitment capability and sample characteristics, data collection procedures, suitability of the intervention and study procedures, management and implementation of the study intervention, and preliminary participant responses to the intervention. Results Thirty-three individuals were recruited and 24 completed this study (seven intervention participants, nine persistent post-concussive symptoms control participants, and eight healthy control participants). One-quarter of participants (four intervention participants and three persistent post-concussive symptoms control participants) experienced simulator sickness during the driving simulator task and had to withdraw from the study. Intervention participants had an 88% and 86% compliance rate for the low-resolution electromagnetic tomography neurofeedback and heart rate variability biofeedback sessions, respectively. Low-resolution electromagnetic tomography neurofeedback sessions took approximately 1 h to complete per participant. Preliminary analysis indicated that the intervention reduced electroencephalograph z-score deviation with a very large effect size ( d = 1.36) compared to the other study groups. Conclusions Pilot studies evaluating the efficacy of low-resolution electromagnetic tomography neurofeedback and heart rate variability biofeedback should be performed to confirm these preliminary findings. However, the protocol should be modified to reduce participant fatigue and withdrawal. This trial was registered with Clinicialtrials.gov (NCT03338036; https://clinicaltrials.gov/ct2/show/NCT03338036?term=03338036&draw=2&rank=1 ).

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Effects of heart rate variability biofeedback training in athletes exposed to stress of university examinations

PLoS ONE ◽

10.1371/journal.pone.0201388 ◽

2018 ◽

Vol 13 (7) ◽

pp. e0201388 ◽

Cited By ~ 8

Author(s):

Veronique Deschodt-Arsac ◽

Romain Lalanne ◽

Beatrice Spiluttini ◽

Claire Bertin ◽

Laurent M. Arsac

Keyword(s):

Heart Rate ◽

Heart Rate Variability ◽

Biofeedback Training ◽

Heart Rate Variability Biofeedback

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A Guide to Cleaner Skin Temperature Recordings and More Versatile Use of Your Thermistor

Biofeedback ◽

10.5298/1081-5937-44.3.06 ◽

2016 ◽

Vol 44 (3) ◽

pp. 168-176 ◽

Cited By ~ 2

Author(s):

Fredric Shaffer ◽

Didier Combatalade ◽

Erik Peper

Keyword(s):

Heart Rate ◽

Heart Rate Variability ◽

Skin Temperature ◽

Temperature Measurements ◽

Biofeedback Training ◽

Heart Rate Variability Biofeedback ◽

Temperature Biofeedback ◽

Peripheral Temperature ◽

Client Assessment

Valid peripheral temperature measurements ensure the integrity of client assessment and biofeedback training. Accurate measurements require understanding of the signal and potential influences on measurement fidelity, and developing bulletproof monitoring procedures. In addition to their use in temperature biofeedback, thermistors can assist heart rate variability biofeedback practice and monitor breathing when a respirometer is not available.

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